Cem Kopuz

A further morphological study of the persistent median artery in neonatal cadavers

Persistent median artery was studied in 60 upper limbs of 30 neonatal cadavers. It was found in 12 (20%) specimens while partial atrophy in the distal part of the median artery was detected in 9 (15%) specimens. These findings correlated well with those of other series including the authors’ previous study which covered both adults and neonates. There was no significant difference statistically between the authors’ current and previous studies (p>0,05). Therefore both studies were combined. The incidence of persistent median artery in this enlarged series (100 specimens) was 17%. This rate of persistent median artery was higher than those of most other published series. We believe this may be due to evolutionary and racial trends; the neonatal origin of our specimens would be another differing factor. Partial atrophy of the median artery, and the different incidences in neonates and adults raised the possibility that the median artery regresses at a later age, possibly during perinatal and early infancy period.

Anatomic variations of the coracoacromial ligament in neonatal cadavers: a neonatal cadaver study.

One of the most common causes of pain and disability in the upper limb is inflammation of the rotator cuff tendons. When no significant bony abnormality exists in the surrounding structures, the coracoacromial ligament has been implicated as a possible cause of impingement on the cuff tendons and various morphological variants of the ligament have so far been claimed to be either the cause or the result of impingement. In this study, 110 shoulders from 60 neonatal cadavers that were preserved in a preparation of formaldehyde were dissected. Anatomic variations of coracoacromial ligaments were investigated with metric and histologic analysis. Three main ligament types were identified: quadrangular, broad band and U-shaped. The multiple banded ligament was not found. Histologic analysis showed that in U-shaped ligaments a thin tissue existed in the central part of the ligament close to the coracoid. Comparing our data with the adult measurements of a previous study we suggest that the primordial ligament is broad shaped, but assumes a quadrangular shape due to the different growth rates of the coracoid and acromial ends. We also suggest that broad and U-shaped ligaments account for the primordial and quadrangular and Y-shaped ligaments account for the adult types of the single or double banded anatomic variants respectively. Our results show that various types of the coracoacromial ligament are present at the neonatal period and that the final shape of the ligament should be defined by developmental factors, rather than degenerative changes.

Morphometry of the fibrous ring of the mitral valve

In standard textbooks of anatomy it is generally accepted that the fibrous ring of the mitral valve lies in a single plane throughout its entire circumference. Some authors have stated otherwise, but there are no morphometric studies. 30 formalin-fixed hearts were sectioned to reveal the shape of the fibrous ring of the mitral valve and studied by morphometric, radiographic and histological methods. It was noted that the fibrous ring adopted a horizontal S shape around the two commissures and the average distance between the highest and lowest parts of the fibrous ring was found to be 7.1 mm (range 6.2-12.5 mm). Radiographic evaluation revealed that the fibrous ring lies approximately in two planes rather than in one. Histological study showed that the fibrous tissue of the mitral valve is continuous with the aortic fibrous ring, and that a slight but significant thickening marks the insertion of the mitral valve. The mitral valve thus lies in two planes, and it is hoped that this information will contribute to cardiac and valvuloplastic surgery.

A further morphological study of the persistent median artery in neonatal cadavers@@@Une étude morphologique complémentaire sur l'artère médiane persistante sur des enfants morts-nés

SummaryPersistent median artery was studied in 60 upper limbs of 30 neonatal cadavers. It was found in 12 (20%) specimens while partial atrophy in the distal part of the median artery was detected in 9 (15%) specimens. These findings correlated well with those of other series including the authors previous study which covered both adults and neonates. There was no significant difference statistically between the authors current and previous studies (p>0,05). Therefore both studies were combined. The incidence of persistent median artery in this enlarged series (100 specimens) was 17%. This rate of persistent median artery was higher than those of most other published series. We believe this may be due to evolutionary and racial trends; the neonatal origin of our specimens would be another differing factor. Partial atrophy of the median artery, and the different incidences in neonates and adults raised the possibility that the median artery regresses at a later age, possibly during perinatal and early infancy period.RésuméLa persistance de la. médiane a été recherchée sur 60 membres supérieurs provenant de 30 cadavres de nouveau-nés. Elle a été trouvée sur 12 pièces (20 % des cas) tandis quune atrophie localisée de la partie distale de la. médiane était détectée sur 9 pièces (15 %). Ces constatations ont une bonne corrélation avec celles dautres séries, y compris létude antérieure des auteurs portant à la fois sur des adultes et des nouveau-nés. Il ny avait pas de différence statistiquement significative entre létude rapportée ici et la précédente (p>0,05). Cest pourquoi les deux études ont été rassemblées. La fréquence de la persistance dune a. médiane dans cette étude élargie (100 cas) a été de 17 %. Ce taux da. médiane persistante est plus élevé que celui de la plupart des autres séries publiées. Nous pensons quil peut être lié à des facteurs évolutifs et ethniques ; lorigine néonatale de nos observations a pu être un autre facteur différentiel. Latrophie partielle de la. médiane et la différence de fréquence chez le nouveau-né par rapport à ladulte proviennent de la possibilité qua la. médiane de régresser à un stade plus tardif, peut-être durant la période périnatale ou dans la première enfance.

A study of variable origins of arteries in arm

A series of anomalous arterial supply of the arm and shoulder is presented. In these cases, the deep brachial artery arose from a common trunk with posterior circumflex humeral artery. In one case, the superior ulnar collateral artery and deep brachial artery originated from the posterior circumflex humeral artery. The common trunk or posterior circumflex humeral artery arose from the brachial artery at the level of the lower border of the teres major (at the origin of the brachial artery). A possible ontogenetic explanation is provided for this situation. Awareness of the variations of arteries of the arm or shoulder is important for angiographers and the surgeon who operates in this region.