Association of retroesophageal right subclavian arteries with thoracic ducts terminating in the right venous angle.
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Humans↗
Biomedical subjects
H Nathan
Publications and source records attributed to H Nathan.
Mental foramen and mental nerve: changes with age.
In a study of 525 dry mandibles and dissections in 50 cadavers, the mental foramen (MF) was found: single in 94.67% of the cases and multiple in 5.33%. Its shape was round in 34.48% with an average diameter of 1.68 mm and oval in 65.52% with an average long diameter of 2.37 mm. In 43.66% the MF was located in front of the apex of the root of the second premolar. In children before tooth eruption, the MF is somewhat closer to the alveolar margin; during the eruption period, the MF descends to half way between the margins, and in adults with the teeth preserved, the MF is somewhat closer to the inferior border. With loss of teeth and bone resorption the MF moves upwards closer to the alveolar border. In extreme cases of resorption the MF and the adjacent part of the mandibular canal are open at the alveolar margin. In the dissections the findings were similar. The mental nerve emerged from the MF closer to or at the alveolar border, according to the degree of resorption. In extreme degrees of resorption, the mental nerve and the final part of the inferior alveolar nerve were found directly under the gums. In these cases, the vestibular grooves became very shallow, and the mucosa passed directly from the cheeks over the alveolar ridge. Practical implications of the changes of the MF and mental nerve are discussed.
Adolescent↗
Some observations on the posterior and lateral bridge of the atlas.
Six hundred and seventy-two atlas vertebrae of 6 population groups were examined for the presence of a posterior and/or lateral bridge. Of these, 174 (25.9%) presented with partial posterior bridge formation and 53 (7.9%) with a complete bridge. Twenty-six (3.8%) showed some form of lateral bridging. Although controversy exists as to the origin of atlas bridging, the findings of the present study show that aging could be a factor predisposing to complete bridge formation. The clinical significance of bridge formation is discussed with reference to their possible effect on normal vertebral artery function, particularly in rotation.
Cervical Atlas↗
Nerve root compression in spondylolysis and spondylolisthesis.
Thirty-four bony specimens of isthmic spondylolysis were examined and, in a significant number (32%), stenosis of the intervertebral foramen was noted. Although not emphasised in previous reports, this finding may be an important factor in the aetiology of nerve root compression when this is associated with spondylolysis and spondylolisthesis. Anatomical guidelines for adequate surgical decompression are suggested.
Humans↗
Rotation and forward displacement of the right kidney in hepatomegaly.
In a dissecting room cadaver, with an enormously enlarged liver, the right kidney was found rotated and displaced forward and downward. The anterior (inferior) pole of this kidney appeared bulging under the inferior border of the liver, reaching the anterior abdominal wall. An explanation for the changes which occurred during the development of the hepatomegaly and resulted in the displacement of the kidney are analyzed. The practical clinical implications that such a variation may have, either diagnostic or surgical, are stressed. The findings in the left kidney or an aberrant inferior polar artery, arching around and compressing the renal vein, are also described and analyzed.
Cadaver↗
Sublingual gland herniation through the mylohyoid muscle.
A deficiency in the mylohyoid muscle, usually with a herniation of part of the sublingual gland and fat tissue through it, was present in 82 (27.3%) of 300 half-heads dissected. In 17 (11.3%) of the cadavers the condition was bilateral. The hiatus appeared as a transverse fissure between the fibers or as a broader round or oval opening. In some cases the herniation was found constricted at its base; in others the base was broad. The importance of these herniations for diagnostic and surgical purposes is stressed, and the possible factors in their development are analyzed.
Adult↗
Assessment of splenic function in dogs following arterial ligation and autotransplantation.
Two methods for the preservation of splenic function following trauma to the spleen were studied and compared in dogs and puppies. One method was splenectomy and autotransplantation of small pieces of splenic tissue, and the other--ligation of the main branches of the splenic artery after partial splenectomy. Dogs subjected to splenectomy alone or laparotomy alone served as controls. Splenic function was assessed on the basis of resistance to sepsis by virulent pneumococci. Cultures were obtained from the blood, peritoneal fluid and intraabdominal organs 3 days after i.v. injection of the pneumococci; none of the adult dogs in any of the groups had positive cultures. Among splenectomized puppies, 55.5% had positive cultures for pneumococci, whereas those which underwent ligation of the splenic artery and partial splenectomy had negative cultures. Microscopic examination of the autotransplants revealed loss of the characteristic structure of splenic tissue, whereas in the dogs in which the splenic artery had been ligated, the spleen showed numerous islands of tissue with well-preserved follicular structure. We suggest that in children with severe splenic trauma, ligation of the splenic artery may provide a promising alternative to splenectomy.
Animals↗
Medical students' stress reactions to dissections.
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Adaptation, Psychological↗
Hallux sesamoid bones. Anatomical observations with special reference to osteoarthritis and hallux valgus.
The normal characteristics of the hallux sesamoid bones were studied in 200 toes (100 dissections and 100 radiographs from patients with hallux valgus), and pathological changes were recorded. Normally each sesamoid articulated with a separate groove on the plantar surface of the first metatarsal head. A bony ridge on the head separated these grooves. Bipartite sesamoids were found in 4% of the toes. Osteoarthritic changes manifested by deformity, irregularity, lipping, cysts in the sesamoids and in the heads of the first metatarsal, and erosions in the articular surfaces were present in 32% of the dissected toes. Fusion of the sesamoids was found in 6%. Ankylosis between the sesamoids and the head of the metatarsal was observed in 4%. In the toes affected by hallux valgus the sesamoids, together with the plantar pad and the tendon of the flexor hallucis brevis, were displaced laterally to a variable degree. In severe deformities the lateral sesamoid was dislocated lateral to the first metatarsal head and the medial sesamoid occupied the groove originally corresponding to the lateral sesamoid, while the metatarsal ridge separating the two sesamoids tended to disappear. Osteoarthritis of the metatarsophalangeal joint frequently accompanied hallux valgus.
Hallux↗
Varicocele and left renal vein compression.
Several current theories concerning the possible etiology of varicocele are critically reviewed. The possibility of arterial compression of the left renal vein, probably by the superior mesenteric artery is elaborated upon. Since direct experimentation is impossible because of the exclusively human character of this disease, a "triple indirect approach" is adopted. Three differently directed studies are conducted: intraoperative antegrade spermatic phlebography visualizing the left renal vein, anatomic dissection of the left renal vascular pedicle, and intraoperative marking of the superior mesenteric artery and the left renal vein for in vivo studies of their relationships. Because the outcomes of these three pathways converge and focus on the superior mesenteric artery compression of the left renal vein, it is concluded that this is a probable contributing mechanism in the etiology of varicocele.
Humans↗
Right and left accessory renal arteries arising from a common trunk associated with unrotated kidneys.
We describe a rare anomaly of the kidneys and its vessels, which was found in a white adult male cadaver. The anomaly consisted of unrotated kidneys with partially extrarenal calices and pelves. In addition to the normal vessels, each kidney received a branch from a common trunk, originating from the inferior end of the aorta.
Adult↗
The proximal tibio fibular joint. An anatomical study with clinical and pathological considerations.
The proximal tibiofibular joint (TFJ) was studied in 489 dry bones and 50 specimens of dissected knees. A marked variability in morphological characteristics was found with frequent osteoarthritic changes. The most common types of joint found were the trochoid and the double trochoid, followed by the plane type. No articular facet could be recognised in 10 dry fibulae and 12 dry tibiae. The inclination of the joint ranged between 5 degrees and 80 degrees. Osteoarthritis of some degree was present in the TFJ joint in 83 fibulae (27%) and 80 tibiae (38%). It was associated with osteoarthritis of the knee joint, especially affecting the medial compartment, in 30% of cases. Osteoarthritis of the TFJ was also found in a case of multiple exostoses and in a specimen with Bejel disease. No correlation could be established between the presence of the 'squating facets' in the distal end of the tibia and the morphological characteristics or pathology of the TFJ. A clinical case of osteoarthritis of the TFJ in a women of 57 is presented, and the differential diagnosis of pain over the lateral aspect of the knee is discussed.
Female↗
The association of a retroesophageal right subclavian artery, a right-sided terminating thoracic duct, and a left vertebral artery of aortic origin: anatomical and clinical considerations.
The findings in a cadaver demonstrated: (a) an aberrant retroesophageal right subclavian artery (RRSA); (b) a thoracic duct (Th.d.) terminating at the junction of the right internal jugular and subclavian veins ('venous angle'), and (c) a left vertebral artery (LVA) of aortic origin. The origin of the RRSA from the aortic arch was distal and medial to the left subclavian artery and it reached the upper extremity by crossing posterior to the esophagus. The Th.d. ran a normal retroesophageal course in the mediastinum, until it was intercepted by the anomalous subclavian artery. At this level the Th.d. was deflected towards the right and, accompanied by the anomalous artery, reached the right venous angle. The LVA arose from the aortic arch between the left common carotid and the left subclavian arteries, and ascended to the transverse foramen of C6. The practical importance of associations in general is discussed, and the special diagnostic and surgical significance of the RRSA and Th.d. is stressed.
Aorta, Thoracic↗
The reciprocal influence of the different finger pattern types on their ridge count values.
The mutual influence of fingertip pattern types, whorls (W), ulnar loops (Lu), radial loops (Lr) and arches (A), on the pattern ridge count (RC) values is evident from the dermatoglyphics of a sample of 606 Israeli Jewish males. The presence of W is associated with an increase in the RC of Lu and Lr of the same individual, and conversely, the presence of Lu, Lr or A coincides with a decrease in the RC of W. The presence of A decreases also the RC of Lu and Lr, but the reciprocal influence does not occur because the RC of A is, by definition, always equal to zero. When two different pattern types concomitantly affect a third type, the net results is an intermediate one. The modifying influence of a pattern on the RC of others is proportional to the number of fingers carrying that pattern. When the total RC of an individual is used for genetic or medical purposes, the reciprocal influences of fingertip patterns on pattern RC values must be considered.
Dermatoglyphics↗
The lumbosacral ligament (LSL), with special emphasis on the "lumbosacral tunnel" and the entrapment of the 5th lumbar nerve.
The lumbo-sacral ligament (LSL) was studied in 42 specimens. It extends from the L5 vertebra to the ala of the sacrum and forms, with the structures to which it is attached, an osteofibrotic tunnel as an extension of the intervertebral foramen. The 5th lumbar nerve root passes through the tunnel over the ala of the sacrum and behind the LSL. A branch of the 4th lumbar nerve root passes in front of the LSL to join the 5th below the ligament to form the lumbo-sacral trunk. The sympathetic ramus communicans to the L5 root always penetrates the LSL at its superior border and reaches the nerve inside the tunnel. Branches of the ilio-lumbar vessels accompany the L5 root. Large osteophytes on the inferior border of L5 and tightness of the LSL were often found to cause entrapment and compression of the L5 nerve root against the ala of the sacrum.
Adult↗
The lateral wall of the cavernous sinus. With special reference to the nerves related to it.
In a study of the cavernous sinus in 70 specimens, the lateral wall of the sinus was found to be formed by two layers: a superficial, dural layer and a deep layer. The latter was formed by the sheaths of nerves III, IV, and V 1,2 plus a reticular membrane extending between the sheaths. This membrane was often incomplete, particularly between the sheaths of nerves III and IV above, and V1 below. These findings do not conform with the descriptions of a single dural layer of the lateral wall, with nerves III, IV, and V 1,2 embedded in it, nor to other descriptions showing the cavity of the sinus divided into two compartments by a septum close to the lateral wall, with nerves III, IV, and V1 located within the septum. In the present study, the superficial and the deep layers of the lateral wall were found to be loosely attached to each other and easy to separate. In no case was a superficial compartment of the sinus found to be present between the two layers, and the nerves were never found to be running embedded in the superficial layer.
Adult↗
ABO, MNSs and rhesus blood group systems in some Jewish populations of Israel.
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ABO Blood-Group System↗
Fentanyl infusion anesthesia for aortocoronary bypass surgery: plasma levels and hemodynamic response.
Plasma fentanyl concentrations were measured by radioimmunoassay in patients during aortocoronary bypass surgery and correlated with hemodynamic responses to surgical stimulation. Thirty patients scheduled for aortocoronary bypass surgery were divided into three groups of 10. Patients in group 1 received fentanyl, 30 micrograms/kg, as a loading dose followed by an infusion of 0.3 microgram/kg/min; those in group 2 received 40 micrograms/kg as a loading dose followed by an infusion of 0.4 microgram/kg/min; and those in group 3 received 50 micrograms/kg as the loading dose followed by an infusion of 0.5 microgram/kg/min. The total dose of fentanyl administered to each group up to the time of rewarming on cardiopulmonary bypass was 60 micrograms/kg, 90 micrograms/kg, respectively. Each of the dose regimens produced stable plasma concentrations starting approximately 20 minutes after induction and continuing until the infusion was discontinued. Patients in group 1 had a mean plasma concentration of 10 to 12 ng/ml in the stable period compared with 12 to 14 ng/ml in group 2 and 15 to 18 ng/ml in group 3. Fewer patients in group 3 responded to intubation and surgical stimulation than in the other groups, although the differences between groups were not statistically significant. Response to stimulation was treated by the administration of droperidol or volatile anesthetic agents. At a plasma concentration of 15 ng/ml, 50% of patients had an increase in systolic blood pressure which required treatment. This minimal intra-arterial concentration, analogous to MAC, can be achieved by the administration of fentanyl as a loading dose of 50 micrograms/kg followed by an infusion of 0.5 microgram/kg/min.
Anesthesia, Intravenous↗