BACKGROUND: Many surgical strategies aim to treat the symptomatic neuroma of the superficial branch of the radial nerve (SBRN). It is still difficult to treat despite many attempts to reveal a reason for surgical treatment failure. The lateral antebrachial cutaneous nerve (LACN) is known to overlap and communicate with SBRN. Our study aims to determine the frequency of spreading of LACN fibers into SBRN branches through a microscopic dissection to predict where and how often LACN fibers may be involved in SBRN neuroma. METHODS: Eighty-seven cadaveric forearms were thoroughly dissected. The path of LACN fibers through the SBRN branching was ascertained using microscopic dissection. Distances between the interstyloid line and entry of LACN fibers into the SBRN and emerging and bifurcation points of the SBRN were measured. RESULTS: The LACN fibers joined the SBRN at a mean distance of 1.7 ± 2.5 cm proximal to the interstyloid line. The SBRN contained fibers from the LACN in 62% of cases. Most commonly, there were LACN fibers within the SBRN's third branch (59%), but they were also observed within the first branch, the second branch, and their common trunk (21%, 9.2%, and 22%, respectively). The lowest rate of the LACN fibers was found within the SBRN trunk (6.9%). CONCLUSION: The SBRN contains LACN fibers in almost 2/3 of the cases, therefore, the denervation of both nerves might be required to treat the neuroma. However, the method must be considered based on the particular clinical situation.

• MeSH
• Dissection methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Cadaver * MeSH
• Peripheral Nervous System Neoplasms surgery   MeSH
• Nerve Fibers MeSH
• Radial Nerve * anatomy & histology   surgery   MeSH
• Neuroma * surgery   MeSH
• Forearm innervation   surgery   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

White matter bundle segmentation using diffusion MRI fiber tractography has become the method of choice to identify white matter fiber pathways in vivo in human brains. However, like other analyses of complex data, there is considerable variability in segmentation protocols and techniques. This can result in different reconstructions of the same intended white matter pathways, which directly affects tractography results, quantification, and interpretation. In this study, we aim to evaluate and quantify the variability that arises from different protocols for bundle segmentation. Through an open call to users of fiber tractography, including anatomists, clinicians, and algorithm developers, 42 independent teams were given processed sets of human whole-brain streamlines and asked to segment 14 white matter fascicles on six subjects. In total, we received 57 different bundle segmentation protocols, which enabled detailed volume-based and streamline-based analyses of agreement and disagreement among protocols for each fiber pathway. Results show that even when given the exact same sets of underlying streamlines, the variability across protocols for bundle segmentation is greater than all other sources of variability in the virtual dissection process, including variability within protocols and variability across subjects. In order to foster the use of tractography bundle dissection in routine clinical settings, and as a fundamental analytical tool, future endeavors must aim to resolve and reduce this heterogeneity. Although external validation is needed to verify the anatomical accuracy of bundle dissections, reducing heterogeneity is a step towards reproducible research and may be achieved through the use of standard nomenclature and definitions of white matter bundles and well-chosen constraints and decisions in the dissection process.

• MeSH
• Algorithms MeSH
• White Matter diagnostic imaging   MeSH
• Dissection methods   MeSH
• Humans MeSH
• Neural Pathways diagnostic imaging   MeSH
• Image Processing, Computer-Assisted methods   MeSH
• Diffusion Tensor Imaging methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH
• Research Support, N.I.H., Extramural MeSH
• Research Support, U.S. Gov't, Non-P.H.S. MeSH

Cíl: Cílem této studie je poskytnout obrazové podklady i slovní popis k umožnění představy anatomického průběhu fasciculus fronto-occipitalis inferior (inferior fronto-occipital fascicle; IFOF) při pohledu na mozek z laterální strany a také poukázat na klinickou důležitost této asociační dráhy bílé hmoty. Metoda: Ve třech hemisférách mozků zemřelých dárců byl Klinglerovou metodou vypreparován IFOF, a to se snahou ponechat co možná nejvíce původních kortikálních struktur. Ponechané kortikální struktury mozku umožňují udržení orientace na povrchu mozkové hemisféry. Jako další metoda ke studiu anatomického průběhu IFOF bylo provedeno zobrazení tenzorů difuze (diffusion tensor imaging; DTI) traktografie z dat získaných vyšetřením MR zdravého dobrovolníka. Výsledky: IFOF se ve všech třech hemisférách podařilo vypreparovat. Průběh IFOF byl zdokumentován na fotografiích preparátů. Podobně je průběh IFOF znázorněn pomocí traktografických rekonstrukcí a na projekcích výsledků traktografií do MR obrazu mozku. Obě metody poskytují, pokud jde o anatomii IFOF, velmi podobné výsledky. Závěr: Dostupnost neuronavigace a případně jiných technologických vymožeností nijak nesnížila potřebu znalosti anatomie. Autoři doufají, že výsledky předkládané v práci mohou posloužit k rozšíření znalostí nebo alespoň probudit zájem o anatomii.

Aim: The aim of this study is to provide both image sources and a verbal description to allow the mental visualization of the course of the inferior fronto-occipital fascicle (IFOF) when looking at the brain from the lateral side, and to highlight the clinical importance of this associative white matter tract. Methods: In the three hemispheres of the brains of deceased donors, the IFOF was dissected using the Klingler method, with the aim to preserve as many intact cortical structures as possible. The spared cortical structures of the brain are good reference points for orientation on the brain surface. Diffusion tensor imaging (DTI) tractography was performed as another method to study the anatomical course of the IFOF. The data for the tractography were obtained using MRI examination in a healthy volunteer. Results: It was possible to dissect the IFOF in all three hemispheres. The course of the IFOF was documented in photographs of the dissections. Similarly, the course of the IFOF is depicted through the use of tractographic reconstructions and projections of these reconstructions in the MRI image of the brain. Both methods provide very similar results when it comes to IFOF anatomy. Conclusion: The availability of neuronavigation or other technological instruments did not reduce the need for knowledge of anatomy. The authors hope that the results presented in this project can serve to expand one s knowledge or at least to awaken an interest in anatomy.

• Keywords
• fasciculus fronto, occipitalis inferior, sémantický systém,
• MeSH
• White Matter MeSH
• Dissection * methods   MeSH
• Humans MeSH
• Brain * anatomy & histology   MeSH
• Neural Pathways anatomy & histology   MeSH
• Diffusion Tensor Imaging methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

INTRODUCTION: Numerous variations are characteristic for hand anatomy. Although a lot of work has been done in the field, a detailed description of the branches of the radial artery is still missing. The aim of this study is to determine the incidence and diameter of the accessory artery, which can be found running on the dorsal surface of the interosseus dorsalis primus muscle, to deliver the detailed description of this arterial variation and based on that to suggest a systematic name of the artery which would be in line with Terminologia Anatomica. METHODS: We used 133 complete donor bodies and 237 cadaverous hands in our study, giving us a total sample size of 503 samples. When possible, we determined the age of the donors which was between 62 and 90 years. We performed detailed anatomical dissection to determine the individual branching. We also measured the diameter of selected arteries. When relevant we performed statistical comparisons. To do that we first applied Shapiro-Wilk test to determine the normality of distribution and after that we used Mann-Whitney U test and One-way ANOVA. RESULTS: The variation of interest was found in 11.93% of cases. Based on the anatomical differences we determined four types of branching, type 1-3 forming the anastomosis with superficial palmar arch (being considered as positive findings) and type 4 which did not form this anastomosis (thus considered to be a negative finding). DISCUSSION: We successfully determined the incidence of this arterial variation on a sufficient sample size. We also described the anatomy of this branching in detail and were able to determine four types of this branching. After careful consideration of these findings we proposed the new name for this artery and suggest to use the name superficial dorsal branch of radial artery. This could contribute to a better understanding of this branching and potential use in clinical practice.

• MeSH
• Radial Artery anatomy & histology   MeSH
• Dissection methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Cadaver MeSH
• Sex Characteristics MeSH
• Hand anatomy & histology   blood supply   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Léčba maligního melanomu se v posledním desetiletí výrazně změnila. Biologická léčba dokáže nabídnou velmi dobrou kontrolu onemocnění a kompletní odpovědi již nejsou výjimkou. Nic-méně chirurgie zůstává metodou první volby a především u časných melanomů může vést ke komplet-nímu vyléčení. Již téměř samozřejmou součástí stagingu časného melanomu je sentinelová biopsie. U lokoregionálně pokročilých nádorů zůstává stále zásadní role lymfadenektomií. Jisté pochybnosti se mohou vyskytnout u izolované hypertermické perfuze. Již menší roli má chirurgie v terapii vzdálených metastáz, ovšem u solitárních metastáz může vést i k vyléčení.

The treatment of melanoma has changed substantially in the last decade. Biologic therapy offers very good disease control and even complete responses are quite common. Nevertheless surgery is still the treatment of first choice and mostly in early melanomas can lead to complete cure. The surgery has major role in diagnostics, removal of the primary tumor. Nearly certain part of staging in early mela-nomas is the sentinel node biopsy. In locoregionally advanced melanomas still remains the crucial role of lymphadenectomies. Some doubts can appear concerning isolated hyperthermic perfusions. Lesser role has surgery in treatment of distant metastases, but in solitary metastases can have curative potential.

• Keywords
• ilioinguinální disekce, mnohočetný končetinový relaps,
• MeSH
• Axilla surgery   MeSH
• Sentinel Lymph Node Biopsy methods   MeSH
• Cytodiagnosis methods   MeSH
• Dissection classification   methods   MeSH
• Extremities pathology   MeSH
• Hip surgery   MeSH
• Humans MeSH
• Lymph Node Excision classification   methods   MeSH
• Melanoma * surgery   diagnosis   pathology   MeSH
• Neoplasm Metastasis pathology   therapy   MeSH
• Perfusion methods   MeSH
• Recurrence MeSH
• Neoplasm Staging classification   MeSH
• Groin surgery   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Craniovertebral junction surgery usually requires the exposure of the third segment of the vertebral artery (V3). However, the complexity of musculature, a relatively high incidence of anomalies in the course of the vertebral artery (VA), and the presence of a rich venous plexus in this region make the V3 exposure challenging with a high risk of serious complications while taking down the suboccipital muscles in a single layer. A muscle dissection in interfascial layers, however, overcomes the drawbacks inherent in a blind dissection of the V3 as each of the muscles represents substantial landmark aiding subsequent step of the procedure and thus helping identify underlying anatomical structure early and safely. Moreover, along with a bloodless VA dissection off its surrounding venous plexus, it permits a safe and comfortable V3 exposure during the surgically demanding procedures.

• MeSH
• Vertebral Artery surgery   MeSH
• Dissection methods   MeSH
• Humans MeSH
• Neurosurgical Procedures methods   MeSH
• Check Tag
• Humans MeSH
• Publication type
• Journal Article MeSH

INTRODUCTION: Impacted mesiodentes in the inverted position may interfere with the base of the nasal cavity or the nasal septum. They can rarely erupt into the nose as well. Traditionally they are extracted via intraoral approaches (transpalatal or vestibular). Also, an endoscopically assisted transnasal approach can be used. In this paper, the authors are the first to present a group of patients suffering from impacted mesiodentes who have been surgically treated using a modified maxillary vestibular approach with subperiostal intranasal dissection. MATERIAL AND METHOD: The prospective study was completed in the time period 12/2013-6/2017. The inclusion criteria were: 1. Mesiodens impacted in the inverted position extending to the base of the nasal cavity or into the nasal septum without concomitant pathological lesion and without eruption into the nasal cavity. 2. Localization of the mesiodens at the level of or dorsally to the roots of the upper middle incisors in the sagittal plane or ventrally to the roots of these teeth, but with the crown extending significantly posteriorly to the base of the nasal cavity.3. Indication for extraction because of clinical or orthodontic reasons. RESULTS: In total, 9 patients were enrolled into the group. In these patients, surgical extractions of 9 mesiodentes were performed using the alternative approach described above. All extractions were done according to a uniform surgical protocol. The mean age of the patients was 11.7 ± 3.1 years (age range 7-17 years). The crown's most cranial point exceeded the bone of the nasal cavity on average by2.0 ± 1.4 mm (in the range 0-5 mm). 8 mesiodentes were conical, 1 was tuberculate. Surgical procedure and postoperative healing were always without any complications. CONCLUSION: For the removal of midline supernumerary teeth, the modified maxillary vestibular approach with subperiostal intranasal dissection in comparison to the intraoral palatal approach provides less postoperative morbidity and a lower risk of complications (smaller surgical wound, minimal exposure of maxilla, minimal bone loss, reduced risk of damage to the roots of the upper incisors, lower risk of damage to the nasopalatine neurovascular bundle, good visibility in the surgical field, easier surgery, and finally no need of postoperative palatal splint). For oral and maxillofacial surgeons the presented technique represents a more traditional way of surgical tooth extraction than the endoscopically assisted transnasal approach.

• MeSH
• Dissection methods   MeSH
• Child MeSH
• Tooth Extraction methods   MeSH
• Humans MeSH
• Malocclusion etiology   therapy   MeSH
• Maxilla surgery   MeSH
• Adolescent MeSH
• Nasal Cavity pathology   surgery   MeSH
• Orthodontics, Corrective methods   MeSH
• Prospective Studies MeSH
• Incisor abnormalities   diagnostic imaging   surgery   MeSH
• Tooth, Impacted diagnostic imaging   surgery   therapy   MeSH
• Tooth, Supernumerary complications   diagnostic imaging   pathology   surgery   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

PURPOSE: To determine the frequency of formation of various types of bubbles and the potential impact of donor and lamella parameters on this frequency, and to identify possible risk factors of unsuccessful "big-bubble" creation in preparation of pre-Descemet endothelial keratoplasty and Descemet membrane endothelial keratoplasty with peripheral stromal support. METHODS: Donor age and sex, death to preservation time (DPT), storage time, presence of corneal scars (mainly a condition after cataract surgery), and endothelial cell density of 256 donor corneas were assessed before Descemet membrane endothelial keratoplasty with peripheral stromal support or pre-Descemet endothelial keratoplasty lamella preparation using the big-bubble technique. RESULTS: Mean donor age was 62.3 ± 8.5 years (28.3% women and 71.7% men). Mean endothelial cell density of the donor graft was 2866 ± 255 cells/mm. Mean DPT was 10.12 ± 4.88 hours, and mean storage time of the transplant before surgery was 6.5 ± 4.8 days. Corneal scars were present in 17 donor grafts (6.6%) after cataract surgery. Eleven corneas were devalued because of Descemet membrane rupture during preparation (4.3%). In 182 corneas, standard bubble type I was created (71.7%); in 27 corneas, bubble type II was created; eventually, both types of bubbles formed simultaneously (10.5%); in 47 corneas, no bubble was created (18.4%). CONCLUSIONS: We identified higher endothelial cell density, shorter DPT, and the presence of corneal scars after cataract surgery as risk factors threatening successful bubble formation. The only risk factor for creating type II bubbles was higher donor age in our study.

• MeSH
• Time Factors MeSH
• Descemet Membrane surgery   MeSH
• Dissection methods   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Corneal Diseases surgery   MeSH
• Intraoperative Complications MeSH
• Prospective Studies MeSH
• Risk Factors MeSH
• Endothelium, Corneal cytology   MeSH
• Aged MeSH
• Tissue Preservation statistics & numerical data   MeSH
• Descemet Stripping Endothelial Keratoplasty methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Laryngocele (LC) is an uncommon clinical entity, occasionally associated with fatal complications. If its neck becomes obstructed, mucous accumulates and then a laryngeal mucocele (LMC) is formed. Reports of LMCs are rare in the literature. A fluid-filled combined LMC in a 48 year-old Greek construction worker with presenting symptoms of cervical swelling and dysphonia is described. The male patient was surgically treated via an external approach. A LC rarely becomes symptomatic and infection unusually occurs. Magnetic resonance imaging depicts in detail the size, extension and structure of the neck mass and remains the diagnostic gold standard, providing superior soft-tissue discrimination, in cases of a concurrent laryngeal tumor. Histopathological examination confirms diagnosis, since there is always a high index of suspicion for malignancy. Established guidelines regarding surgical treatment of a LC do not exist. Although during the last two decades micro laryngoscopy with CO2 laser has gained popularity for the treatment of an internal LC, the external approach still remains the method of choice in cases of a combined LMC.

• MeSH
• Dissection methods   MeSH
• Laryngoscopy methods   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging methods   MeSH
• Mucocele * complications   diagnosis   physiopathology   surgery   MeSH
• Laryngeal Neoplasms * complications   diagnosis   physiopathology   surgery   MeSH
• Airway Obstruction diagnosis   etiology   surgery   MeSH
• Otorhinolaryngologic Surgical Procedures methods   MeSH
• Tomography, X-Ray Computed methods   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

The ureter is a derivate of the Wolffian mesonephric duct and undergoes complex changes during development. The most common developmental anomaly is complete duplication of the ureter. Duplication of the ureter may be complete or incomplete. Incomplete duplication of ureter is well known as bifid ureter. Presence of various anomalies of the ureter is associated with increased risk of urinary tract infections and many other clinical complications.

• MeSH
• Dissection methods   MeSH
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Urinary Tract anatomy & histology   pathology   MeSH
• Cadaver MeSH
• Aged MeSH
• Ureter abnormalities   pathology   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH