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Heart diseases caused by congenital malformations are an unwanted and sometimes relentless diagnostic that most patients should be aware of. Coarctation of the aorta (CoA) is a relatively common defect that represents 4-6% of the congenital heart defects and whose exact underlying mechanism is not completely known. It is defined as a narrowing of the aorta, usually just distal to the origin of the left subclavian artery, close to the ductus arteriosus, resulting in hypertension in the upper body and hypoperfusion of the lower body. A severe coarctation should be diagnosed shortly after birth and repaired by surgery immediately. To properly diagnose the aortic coarcation, chest X-ray, echocardiography, computed tomography (CT)/magnetic resonance imaging (MRI) or angiography is needed. In adults with untreated coarctation, blood often reaches the lower body through collaterals which can be easily identified on CT, as well as focal area of narrowing and constriction with dilatation of the aorta proximal and distal to the affected segment. Also on a standard radiography the post-stenotic dilatation of the aorta results in a classic "figure 3 sign". Unfortunately, coarctations are a long-life disease that cannot be prevented because their etiology is mostly congenital. The best solution for these patients is an early detection. That's why CT imaging can provide accurate information of the coarcation anatomy as well as other associated cardiac abnormalities. [ABSTRACT FROM AUTHOR]

The MCA (middle cerebral artery) aneurysms represent 20-25% of all intracranial aneurysms. Because of their complex anatomy including broad necks, and the high risk to occlude small branches whose origin cannot be seen on angiography when detaching the coils, these aneurysms are considered unfavorable for endovascular treatment. Because they are easy to reach in the Sylvian fissure and in that region the fissure is large enough to allow complex reconstruction and bypass techniques if necessary, the best treatment for these lesions is surgical clipping. Several studies showed the surgical results to be superior to endovascular results. This article aims to bring to the attention the importance of the surgical anatomy of these kinds of aneurysms, in order to adopt the best treatment option for these cerebral vascular dilations. [ABSTRACT FROM AUTHOR]

The hip joint is one of the most intensively studied joints in human, it is very complex, its development involvs three bones in acetabular development and other three osification centers in proximal femural epiphisis development. It is the first of inferior limb joints with distinct morphological catacteristics, and it follows after the uper limb with one week. The first steps of joint development, occurs by not yet known mecanisms, involving cartilage morphogenesis, grows factors, cartilage derived morphogenic proteins (CDMP), bone morphogenic proteins (BMP), hyaluronan. An important described factor is early muscular contraction and movement of the limbs. Morphometric data on the hip joint is used in fetal age calculation and congenital hip disease diagnostic. Available date are from anatomy disection studys, ultrasonography and compared anatomy studys (on cicks). Many indicators like depth and diameter of the acetabulum, the diameter of the femoral head, the ligament of the head dimensions, the neck-shaft aspect, differences between males and females fetuses or between the right and left sides, the femoral angles. [ABSTRACT FROM AUTHOR]

The hip joint is one of the most complex of all the joints in human body. It is very important in locomotion physiology. The acetabulofemoral joint starts to develop in the early 4th week of gestation and its component bones are recognizable structures at the age of 6 weeks in utero. Skeletal development is based cartilage morphogenesis, witch is controled by grows factors, described as BMP (bone morphogenic proteins) and CDMP (cartilage derived morphogenic proteins). The first step of joint development, the induction of joint occurs by not yet known mecanisms, at ulterior joint location within cartilage condensations. The first incriminated factor is hyaluronan, end early muscular contraction and movement of the limbs are also very important [ABSTRACT FROM AUTHOR]

Idiopathic infantile arterial calcification is a rare cause of calcification of the arteries that can lead to prenatal or postnatal death (within the first 6 months of life). IAC exact etiology is unknown. Recently it has been postulated autosomal recessive genetic etiology. It is characterized by calcification of arterial internal elastic lamina general, leading to rupture and modifications of the occlusive intimal stenosis and low elasticity of the vessel wall. Most children die of vaso-occlusive disease, especially coronary arteries or refractory hypertension and heart failure. Our case belongs to a term infant, weighing 3200 g, height 45 cm, died at birth in salvation. The task has not been followed and no historical data. Macroscopic examination reveals marked visceral stasis, skin with autolysis appearance and maceration. Microscopic examination reveals calcification in the arterial wall and lumen stenosis. Vaso-occlusive disorders caused fetal death at birth, highlighting the importance of prenatal diagnosis. [ABSTRACT FROM AUTHOR]

The main objective of the study is highlighting the lumbosacral central core and its limits, a controversial issue in the speciality literature, as well as the appearance of the histological modificationsregistered at this leveldue to the interruption of the flow channels corresponding to the kinetic reflex. For this study we have collected samples of lumbosacral central core from the corpse of a woman who suffered from IIIrd degree pelvi-perineal prolapse. In accordance to the exit place of the spinal nerve anterior roots, there have been performed four cross sections at a distance of 1-1.5 cm and parasagittal sections at the levels L2, L4, S2 and S4. They have been determined and stained by means of specific techniques. Microscopic examination of the resulting samples have confirmed the fact that the lumbosacral core existed and extended between the spinal cord segments L2-S4 but it also confirmed the morpho-histological changes registered by the neurons present at this level: degeneration of the constituent neurons, the enlargement of the perineuronal space, an intense glial reaction which marked the lesion site. The damage registered by the component of the postural proprioceptive reflexes due to the streching and rupture of the pudendal nerve during the postpartum periodprobably induced the degeneration and reduction of the number of neurons at the level of the lumbosacral central core. [ABSTRACT FROM AUTHOR]

The evolution of paranasal sinuses extends over a long period of time, pre- and postnatal, at birth only the maxillary and some of the ethmoidal cells are developed. The goal of this study was to analyze and demonstrate which structures play a promoter role in the evolution and configuration of the paranasal sinuses, and if evolution is determined genetically or by local factors which modify their influence in different moments of prenatal development. Our study was performed on fetal skulls and cephalic extremities (with soft parts) from fetuses of different ages, ranging from 14 to 33 weeks, which were examined by CT and through anatomic, macroscopic and mezoscopic dissection techniques. Pieces were photographed and the images underwent digital processing. The analysis of CT images combined with their corresponding anatomic sections, digitally processed revealed that the soft tissues, especially the epithelial mucosa of the nasal fossae expand and they determine a certain rhythm and amplitude to the process of chondrification and ossification of the surrounding structures, structures which are more dense and take the shape and size of the soft parts surrounding them, in the rhythm these grow and develop. This process is later completed by partial resorbtion of mucosa through a genetic mechanism, often met in organogenesis, called apoptosis. In conclusion, the morphogenesis of the paransal sinuses is genetically determined, but it is also follows the .environmental theory.; the development of the sinuses is related to fetal cranial growth, through all three of its components (basal, capsular and bone resolution), the volume of pneumatic spaces being defined through a process of mucosal resorption, phenomenon which takes place in different moments of pre- and postnatal development (apoptosis). [ABSTRACT FROM AUTHOR]

Face has a major social role, as an interface between individual and enviroment. It's appearance varies with age, due to inherent biological changes. Superficial facial structures can prolab with age or in pathological conditions (traumatic, infectuos, tumors). Superficial fascia, muscles of facial expression and the skin are anchored to the deep layers by different mechanisms. At the cheeks these mechanisms are represented by jugal fat pad and attachments of superficial layers to the nearby support structures. The study was conducted on 12 hemicraniums and mesoscopic images have been captured with an operator microscope. Tissue samples have been prelevated by sectioning the tissues perpendicular on the skin. The latter have been special stained for highlightning conjunctive and muscular fibres. Final results show the presence at this level of a truely superficial musculoaponeurotical system, with private provision. [ABSTRACT FROM AUTHOR]

In recent years has grown the need to address the management of colorectal cancer from a multidisciplinary perspective, and this is mainly due to fast advancement of medical imaging technology. Objectives of this research will be to evaluate the role of paraclinical and imagistic examination in early diagnosis and prognosis of colorectal tumors. We will focus on vascular colorectal arrangement and neoangiogenesis processes in middle rectal carcinoma, in order to identify some aspects that can represent the basis of treatments which can stop this process, and also tumor development. Study was performed on a group of 10 patients diagnosed with middle rectal cancer at the Military Hospital "Iacob Czihac" Iasi. Patients were imagistic investigated and then we compared the results with intraoperative exploration, with the study of the resection specimens and pathologic examination results. In the studied cases was observed how tumor vascular involvement proportionally increases with the degree of local invasion, so in advanced stage it can be seen dilatated stasis veins, inside the mezorectum and also the infiltration of mesorectal limph nodes. Anterior location of these middle rectal tumors gives them the possibility to early invade the vagina in women or the bladder, prostate and seminal vesicles in men. On the other side, laterorectal situation is the most aggresive one, because here there are major blood vessels. Rectal cancer prognosis depends mainly on tumor stage and the quality of circumferential resection margins, involving here mesorectal state. Malignant pathology significantly alter colorectal vascular arhitecture, neoangiogeneseis having response in distance. [ABSTRACT FROM AUTHOR]

Tibial pilon fractures usually result from high energy trauma. Management of these fractures is challenging because of the complexity of the injury pattern and the risk of significant complications. Various treatment methods are available, depending not only on the fracture type but mostly on the extent of the soft tissue injury. In tibial pilon fractures we can tempt orthopaedic reduction and minimally invasive fixation with plates used internal abord. This protects the soft tissues, an important factor in postoperative care of these fractures. Material and methods: We present 2 cases treated with closed reduction and internal fixation with plates. Conclusions: By minimally invasive fixation we avoided possible complications of extensive skin wound and skin-plate conflict. The recovery was much easier, avoiding joint stiffness and therefore osteoporosis at this level. [ABSTRACT FROM AUTHOR]

In diabetc foot, vascular damage is the one that most often dictates therapy and particularly prognosis of lesions. Changes in large and small vessels are very important factors for the development of ulceration and failure of conservative treatment, which often require surgery. Material and Method: We studied 30 patients with diabetes (13 patiens with type I diabetes mellitus . 8 men and 5 women, 17 patients with type 2 diabetes mellitus . 10 men and 7 women), with a duration of disease between 15 and 20 years, admitted in the Department of Diabetes, Nutrition and Methabolic Diseases with several neuropathic lesions clinically demonstrated that required a surgery (minor amputation, surgical debridement, drainage, excision of necrotic tissues etc.). During the surgery were taken bioptic fragments from the areas of tissue with apparently no microscopic changes. These were specifically coloured, using current coloration (Hemalaun Eosin, van Gieson stain) and special stains (trichromic C. Szekely stain, Gordon-Sweet stain, PAS stain). Results: In all cases studied, in optic microscopy were noticed arteriolar lesions that interested the intima, but also the tunica media. They consist in obvious endothelial changes, but also a diminution of arteriolar lumens. Therefore, abnormalities of arteriolar intima were highlighted, characterized by swelling of endothelium, thickening of the subendothelial layer and appearance of lipid deposits in subendothelium. There were also aspects of organized thrombosis, with redrainage of different sizes. In ulcerate lesions, in areas with inflammatory multiform cellular infiltrate, chronic type, there were also noticed areas with a high density of lumens, especially arteriolar and metaarteriolar, suggesting angiogenesis processes. In cases of deep plantary ulcerations, were highlighted aspects of mineralization in the media or at the limit of intima and tunica media. Conclusions: Vascular lesions interested the intima, but also the tunica media, causing endothelial hyperplasia, hialinosis and sometimes mediocalcinosis in tunica media. The arteriolar lesions described were present in all studied cases even if peripheral vascular disease did not have a clinical expression. [ABSTRACT FROM AUTHOR]

A general affectation of small muscles appears during the progress of diabetes, producing modifications of pressure points that, associated with neuropathy, lead to foot ulcerations. The aim of the study is to identify the changes in striate muscles of diabetic foot. Material and method. The study group consisted of 25 patients ( type 1 diabetes . 9 patients, 5 males and 4 females, type 2 diabetes . 16 patients, 10 males and 6 females), with a history of diabetes between 10 and 30 years. All patients had peripheral diabetic neuropathy and different stages of lesions in feet that needed surgical treatment (amputations limited to the inferior extremity of limbs). Fragments of tissue were processed and examined in usual stains (Haemalaun-Eosine, trichromic Szekely and van Gieson staining). The CD34 marker was used to highlight the vascular endothelium. Results. In van Gieson stain, the edematous aspect of endomysium could be seen. Degenerated muscular tissue was replaced with adipose tissue. By argentic impregnation techniques was proven that endomysium is preserved in case of degenerative changes of striate muscles. In endomysium and perimysium, vascular lumens were noted with CD34 marker in fragments coming from deep ulcers. Conclusions. Diabetic foot associates all modifications produced in nerves, vessels, soft tissues and skeleton, causing biomechanical changes of foot, severe infections, dysfunction and amputations. Muscular modifications are progressive, from distancing fibers, destruction, disorganization, to replacement with adipose tissue. Myositis is present in cases of inflammation. [ABSTRACT FROM AUTHOR]

The anatomical variations in the vascular areas emerge more often on the venous system, especially on the small or superficial veins, as the anatomical variations within the large venous vessels are much rarer. We present an anatomical variation discovered accidentally during a CT with contrast substance, done on a male patient aged 45; in his case, the left innominate vein participates to the formation of the superior vena cava by passing under the transverse aorta. [ABSTRACT FROM AUTHOR]