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Cerebral white matter consists mainly of axons surrounded by myelin sheaths, which are grouped to form association, commissural, and projection fasciculi. The aim of our work was to quantify and compare under the microscope the axons of the white matter association fasciculi in the cerebral hemispheres of cow (Bos taurus), pig (Sus scrofa domesticus) and rabbit (Oryctolagus cuniculus) indirectly by identification of their myelin sheaths. The samples were taken from 30 cerebral hemispheres: 10 cow, 10 pig and 10 rabbit (15 right and 15 left). They were obtained following a protocol based on the Talairach-Tournoux coordinate system for human and primate brains. The slides were stained with Luxol Fast Blue, observed by optical microscopy, and photographed at 600x. Samples were also prepared for observation in scanning transmission electron microscopy (STEM) with osmium tetroxide. The myelin sheaths/axons were counted with the ImageJ software. Statistically significant differences in the number of myelin sheaths per 410 µm² were found in the inferior and superior longitudinal fasciculi between the left and right hemispheres of cows, with predominance of the right hemisphere; and in the inferior occipitofrontal fasciculus of the rabbit with predominance of the left hemisphere. The use of animal models for experiments in the cerebral fasciculi, especially pig, could give us a greater understanding of the behavior of demyelinating and neurodegenerative diseases in humans.

Ischaemic stroke (CVA) is one of the leading causes of morbidity and mortality at a global and national level. We studied 35 patients, determined the arteries that presented a higher frequency of occlusion in acute ischemic stroke and identified the middle cerebral artery and the poste- rior cerebral artery. We consider it necessary that specialists can locate anatomically strokes in order to apply neuroprotective therapies to improve treatment options and preventing secondary obstructions.

This study aimed to describe the condylar layer and cartilage island in subjects with unilateral condylar hyperplasia (UCH). Five individuals (15-18 years old) with a diagnosis of UCH, treated in a university hospital in Temuco, Chile, were included. The analysis examined the presence, extension, and thickness of the layers on the condylar surface, the number, depth, and area of the cartilage islands, and the argyrophilic proteins of the nucleolar organizer region (AgNOR) score. Statistical significance was set at P

Arthrocentesis has been used in the temporomandibular joint (TMJ) to analyze components of the synovial fluid or as a therapeutic procedure associated or not with the administration of a drug. The rabbit is one of the most commonly used animal species as a model for pathologies that affect the TMJ. The aim of this study was to propose a specific technique to perform arthrocentesis on the rabbit TMJ, emphasizing descriptions of reference points and measurements for a successful puncture without complications.Fourteen adult rabbits (Oryctolagus cuniculus) were used. The project was approved by the Scientific Ethics Committee of the Universidad de La Frontera (File Nº083/2016).The description of the technique was divided into three steps: 1) Location of the rabbit TMJ, 2) Positioning of the needles in the TMJ, and 3) Passage of fluid through the TMJ.This arthrocentesis technique could help to simplify the procedure and give the investigator a guide for joint washing and extraction of synovial fluid in the rabbit TMJ.

Background: Nuclear bodies (NB) are membrane-less subnuclear organelles that perform important functions in the cell, such as transcription, RNA splicing, processing and transport of ribosomal pre-RNA, epigenetic regulation, and others. The aim of the work was to analyse the classification of NB in the Terminologia Histologica (TH) and biological and bibliographical databases. Materials and methods: The semantic structure of the Nucleoplasm section in the TH was analysed and unsystematic bibliographical search was made in the PubMed, SciELO, EMBASE databases and European Bioinformatics Institute (EMBL-EBI) biology database to identify which structures are classified as NB. Results: It was found that the terms Corpusculum convolutum, Macula interchromatinea and Corpusculum PML are not correctly classified in the TH, since they are subordinated under the term Chromatinum and not under Corpusculum nucleare. The bibliography consulted showed that 100%, 92.6% and 81.5% of articles mentioned Corpusculum convolutum, Macula interchromatinea and Corpusculum PML, respectively as nuclear bodies. Conclusions: It is suggested to relocate the terms Corpusculum convolutum, Macula interchromatinea and Corpusculum PML with the name of Corpusculum nucleare and the incorporation of two new entities to the Histological Terminology according to the information collected: paraspeckles and histone locus body.

The identification of factors that influence attention deficit/hyperactivity disorder (ADHD) will help to develop intervention strategies for the personal and social adjustment of these individuals. The goal of the study is to assess the perception of anxiety in a group of children and adolescents with ADHD and the anxiety that their parents believe their children have, through the Screen for Child Anxiety Related Emotional Disorder (SCARED). Participants were 76 children and 76 of their parents who attended a program for educational attention to students with ADHD. The SCARED was applied at the end of one of the sessions in separate spaces for children and parents. Concerning gender, 49.2% of the boys were above the SCARED cutoff point (≥25) compared with 57.1% of the girls. In the case of the parents’ perception of their children's anxiety, 50% of the fathers scored above the cutoff point versus 72.5% of the mothers. The main findings of the study indicate that there is no significant difference between boys and girls. In the comparison of fathers and mothers, significant differences were only found in the factor of generalized anxiety, favoring the mothers. Lastly, significant differences between girls/boys and parents were found in the total anxiety score of the generalized anxiety factor in favor of the parents. Key words: Attention deficit with hyperactivity disorder, anxiety in parents, anxiety in children, self-report.

espanolIntroduccion: la obesidad y el cancer de mama (CM) son dos enfermedades con sintomatologia conocida, sin embargo, la asociacion de ambas y su repercusion en el sistema respiratorio estan escasamente investigadas. Objetivo: describir los efectos del sobrepeso y la obesidad sobre los volumenes pulmonares de pacientes con cancer de mama de la ciudad de Talca. Metodo: cuarenta y una mujeres con diagnostico de CM se dividieron en nueve pacientes con cancer de mama y normopeso (CM + NP), 18 con cancer de mama y sobrepeso (CM + SP) y 14 con cancer de mama y obesidad (CM + O). Se midieron la capacidad vital forzada y los volumenes pulmonares. Para el analisis estadistico se utilizo ANOVA o Kruskal-Wallis y para las correlaciones, Pearson o Spearman. Se considero un nivel de significancia de p Resultados: las pacientes con CM + NP tuvieron un mayor volumen residual que las pacientes con CM + SP y CM + O (ambos p Conclusiones: la disminucion en los volumenes pulmonares se ve exacerbada cuando las pacientes con CM presentan malnutricion por exceso; ademas, se correlaciona negativamente con el IMC en pacientes con CM + O. EnglishIntroduction: obesity and breast cancer (BC) are two diseases with known symptoms; however, the association of both and its impact on the respiratory system is poorly investigated. Objective: to describe the effects of overweight and obesity on the pulmonary volumes of patients with breast cancer from the city of Talca. Method: forty-one women diagnosed with BC were divided into three groups: nine patients with breast cancer and normal weight (BC + NW), 18 with breast cancer and overweight (BC + OW) and 14 with breast cancer and obesity (BC + O). Forced vital capacity and lung volumes were measured, ANOVA or Kruskal-Wallis was used for the statistical analysis, and for the Pearson or Spearman correlations, a level of significance of p Results: patients with BC + NW had a greater residual volume than those with BC + OW and BC + O (both p Conclusions: the decrease in pulmonary volumes is exacerbated when patients with BC present malnutrition by excess. In addition, it is negatively correlated with the BMI in patients with BC + O.

Los apendices testiculares y epididimarios son remanescentes embriologicos del conducto paramesonefrico y del conducto mesonefrico, respectivamente. Estos apendices pueden sufrir torsion causando un cuadro conocido como escroto agudo. El presente trabajo tuvo como objetivo determinar las variaciones de los apendices testicular y epididimario, registrando su forma y tamano. Se utilizaron 30 cadaveres de individuos adultos, Brasilenos, con edades comprendidas entre 18 y 70 anos, fijados en formaldehido 40%, facilitados por el Laboratorio de Anatomia Descriptiva y Topografica de la Universidad Federal de Alagoas (UFAL), Maceio, Brasil. A traves de diseccion se identifico la presencia de los respectivos apendices, los que fueron medidos con un caliper manual (MetricaR), registrando su longitud y anchura. Los apendices testiculares fueron observados en 41 testiculos (68,3%) y los apendices epididimarios en 15 casos (25%). El promedio de la longitud fue de 4,9 mm (DE=1,7) para el apendice testicular y de 5,2 mm (DE=2,4) para el epididimario. Con respecto a la anchura de los apendices, el promedio registrado fue de 3,2 mm (DE=1,7) para el testicular y de 2,6 mm (DE=0,9) para el epididimario. Los datos obtenidos puede ser utlizados como soporte morfologico a la clinica urologica y cirugia testicular.

Los aneurismas de la arteria poplitea son los mas frecuentes entre los aneurismas perifericos, pudiendo ser tratados con stents a traves de cirugia endovascular. Sin embargo, tales stents poseen el mismo diametro en la parte proximal y distal, no siendo compatible con la anatomia vascular de ese segmento. El objetivo del presente estudio fue determinar la diferencia entre el diametro del tercio distal de la arteria femoral y el diametro de la arteria tibial posterior, ademas de obtener el diametro de otras arterias del miembro inferior. Se utilizaron 28 cadaveres formolizados de individuos adultos, de ambos sexos, los que fueron disecados en la region correspondiente. Los diametros registrados fueron los siguientes: en el tercio distal de la arteria femoral (inicio de la arteria poplitea), parte final de la arteria poplitea antes de su bifurcacion en arterias tibial anterior y posterior, arterias tibial anterior y posterior (tronco tibiofibular). En el sexo masculino, desde el tercio distal de la arteria femoral hasta la arteria tibial posterior hubo una reduccion del diametro de 27,92% (p

This article describes the effects of MPA use on the canine uterus using stereological methods. Entire reproductive tracts were removed from normal healthy canine bitches ( Canis lupus familiaris ) and grouped as: nulliparous (n = 11), multiparous (n = 11) and MPA-treated (n = 11; nulliparous; two treatments; 5 mg/kg). 1 cm samples were cut from the corpus, horn and uterine tube and fixed in 10% formaldehyde. Sections of each were mounted on slides and stained with hematoxylin-eosin. We assessed the fraction area for components of endometrium and myometrium and V V (volume density) and S V (surface density) of the gland and stroma using the M 36 test system provided by the STEPanizer Stereological Tool. No gross histological differences were observed between study groups in the uterine tube, uterine corpus and horn. The wall of the uterine corpus and horn in MPA-treated bitches was characterized as being thicker than in the other groups. A cross-section of the uterine corpus revealed no differences between components of uterine wall in the corpus and horn; however, differences were observed in the volume density [V V ; %] in variables such as: V V[str.vasc/uterus] (nulliparous vs . multiparous; p = 0.0019) and V V[str.supravasc/uterus] (multiparous vs . nulliparous and MPA; p = 0.0035). In the endometrial gland, differences were detected in S V[gland/endom] (multiparous vs . MPA, p = 0.0442). In the uterine horn, differences were only observed in the variable V V[lumen.gland/endom] (multiparous vs . MPA; p = 0.0019). This study shows quantitative changes in the architecture of the endometrium and myometrium in all the uterine segments, mainly morphological endometrial gland changes of the uterine corpus, increasing the surface area per unit of volume; however, these changes usually do not differ quantitatively from those observed in the uterus of multiparous bitches.

Kiefererkrankungen wie Osteomyelitis, kondylare Hyperaktivitat und Kiefertumoren benotigen eine exakte bildgebende Abklarung, um die Therapie adaquat planen zu konnen. Die klassische planare Skelettszintigraphie, Orthopantomographie, CT und MRT konnen zur Abklarung von Kiefererkrankungen eingesetzt werden. Die „single photon emission computed tomography“/CT (SPECT/CT) bietet metabolische und morphologische Informationen in einem Untersuchungsgang und ist zunehmend in groseren Kliniken verfugbar. Die SPECT/CT ist zur Beurteilung der Ausbreitung und Aktivitat einer Osteomyelitis und von Kiefertumoren der planaren Szintigraphie alleine, der CT und der Orthopantomographie uberlegen. In unserer Klinik hat die SPECT/CT die bisherigen Verfahren zur Beurteilung der Kieferosteomyelitis und kondylaren Hyperaktivitat abgelost. Sofern verfugbar, sollte zur Abklarung einer Kieferosteomyelitis die SPECT/CT eingesetzt werden.

The aim of this study was to perform a histological analysis of the conditions in patients undergoing surgery for unilateral condylar hyperplasia (UCH) using different histopathological analytical techniques and to describe the complications and existing controversy in order to better define the disease. A partial condylectomy was performed in five patients who had been diagnosed with UCH using clinical and imaging methods. The samples obtained were analyzed using routine histological techniques including haematoxylin-eosin, Van Gieson, picrosirius, alcian blue/haematoxylin-eosin, and AgNOR staining. The analyses were performed by an observer who was blinded to the clinical parameters of the disease. The cellularity, tissue layers, size of the anatomical structures, and the relationships between them were assessed. The analysis of these patients was complemented by a review of the scientific literature. Variability was observed in the analysis of the cases. The presence of connective tissue was detected at the bone level, with cartilage formation at different levels. Each island presented levels of involvement that could indicate various degrees of aggressiveness. Type I collagen was observed in most cases, although type III was also identified. The development of histological diagnostic methods to determine the aggressiveness or level of involvement in UCH is not currently possible. Further studies are needed to establish new histological classifications.

The origin, relationships and innervation of the abductor digiti minimi muscle were determined in 145 human feet, from formaldehyde-fixed cadavers. The muscle arises from both processes of the calcaneal tuberosity, from the plantar aponeurosis and from the septum which separates it from the flexor digitorum brevis muscle. The nerve to the abductor digiti minimi muscle arises next to the origin of the lateral plantar nerve, close to the abductor hallucis muscle, and descends becoming closely related to the medial face of the calcaneus and the deep face of the abductor hallucis muscle. Then, it passes inferiorly through the origin of the quadratus plantae muscle and later divides into two branches for the two heads of the muscle.

Las ventajas de los adhesivos en base a cianoacrilatos para uso en cierre de heridas cutaneas ha sido demostrada, pero escasos estudios reportan el uso del etil-cianoacrilato a nivel nacional. El objetivo fue comparar aspectos morfologicos de cicatrizacion en piel de conejo entre etil-cianoacrilato y sutura. Utilizamos 10 conejos machos adultos, divididos en 2 grupos de 5 animales, del Centro de Cirugia Experimental de la Universidad de La Frontera, Chile. Al grupo experimental se le realizaron dos incisiones, una en cada lado del dorso del torax, 4 cm de largo, atravesando epidermis y dermis. La incision derecha fue cerrada con etil-cianoacrilato, la izquierda con punto intradermico de acido poliglicolico. Se tomaron biopsias a los dias 7, 14 y 21 dias postoperatorio. Al dia 7, la incision tratada con etil-cianoacrilato presento una reaccion inflamatoria moderada, con infiltracion moderada de PMN. Las biopsias de sutura presentaban una etapa de regeneracion mas avanzada, sin presentar desarrollo epidermico. Al dia 14, las incisiones tratadas con etil-cianoacrilato se encontraban en la fase final de la etapa inflamatoria, mientras que las biopsias de sutura se encontraban ya en etapa proliferativa. Al dia 21, ambos tipos de cierre se encontraban en etapa de remodelacion, con epidermis gruesa y lamina basal formada. La dermis presento tejido conectivo denso irregular, escasos foliculos pilosos y glandulas sebaceas. El etil-cianoacrilato, como adherente cutaneo, es una buena alternativa de uso, mostrando una adecuada biocompatibilidad. Presentando una reaccion inflamatoria moderada, limitada y de corta duracion a nivel dermico. La cicatriz logra mejores resultados esteticos con respecto a las incisiones cerradas con sutura. Se debe considerar su uso limitado a sitios no expuestos a movimientos y de baja tension.

Diseases of the jaw, such as osteomyelitis, condylar hyperactivity and tumors need adequate imaging to evaluate the extension and activity for therapy planning.Conventional planar scintigraphy, orthopantomography, computed tomography (CT) and magnetic resonance imaging (MRI) can be used for the evaluation of jaw diseases.Single photon emission computed tomography/computed tomography (SPECT/CT) provides metabolic and morphologic information in one imaging step and is becoming increasingly more available in larger hospitals.The SPECT/CT is superior to planar scintigraphy alone, CT and orthopantomography in the evaluation of the extension and activity of osteomyelitis and jaw tumors.In our hospital SPECT/CT has replaced the other imaging modalities in the evaluation of osteomyelitis and condylar hyperactivity.If available SPECT/CT should be performed for the evaluation of osteomyelitis of the jaw.

Introducción: Existen pocos estudios sobre el pronóstico individual del paciente añoso que inicia hemodiálisis (HD) crónica, pese a que frecuentemente se plantea el dilema entre el posible beneficio y la carga que supone el propio tratamiento. Objetivos: Evaluar la utilidad del índice pronóstico del Registro REIN (REIN) y del modelo predictivo de mortalidad precoz del Registre de Malalts Renals de Catalunya (RMRC) en pacientes añosos incidentes en HD al compararlos con la supervivencia observada. Métodos: Se estudiaron los pacientes mayores de 75 años que iniciaron y siguieron HD en nuestro Servicio entre 2004-2009. Se recogieron variables sociodemográficas, clínicas, comorbilidad, mortalidad y si el inicio de HD fue planificado o no. Se calculó el índice REIN y la probabilidad de mortalidad precoz del RMRC. Resultados: Se analizaron 63 pacientes de una edad media de 80,4 ± 3,9 años, con un número de enfermedades añadidas de 3,4 ± 1,8. Un 59% iniciaron HD por un catéter, un 57,1% tenían enfermedad cardiovascular, el 15,9% neoplasia, el 31,2% enfermedad pulmonar obstructiva crónica y el 19% nefropatía diabética. La supervivencia observada a los 6 y a los 12 meses fue de 79,4 y 73%, respectivamente. Los pacientes que no se valían por sí mismos (21%) presentaban una mayor mortalidad a los 6 meses. El análisis de las curvas ROC (Receiver Operating Characteristic) mostró una escasa concordancia entre la mortalidad observada y los índices REIN (área 0,681, p = 0,046) y RMRC (área 0,594, p = 0,255). Conclusiones: El índice de probabilidad de mortalidad al año del RMRC es poco útil en la práctica clínica para el pronóstico individual. El índice REIN es sólo ligeramente concordante con la mortalidad observada en los primeros 6 meses de HD. Una pobre autonomía funcional fue el principal factor de riesgo de mortalidad precoz en los pacientes añosos que inician HD. Introduction: Few studies address the individual prognosis of an elderly patient beginning chronic haemodialysis (HD), despite the fact that doctors must frequently weigh the possible benefits and disadvantages of prescribing this treatment. Objectives: Evaluate the usefulness of the REIN Registry's prognosis score and the predictive index for early mortality proposed by the Catalan Registry of Renal Patients (RMRC, Registre de Malalts Renals de Catalunya) in elderly patients beginning HD by comparing indices with observed survival rates. Methods: We studied patients aged 75 years and older who started and continued HD treatment in our Department between 2004 and 2009. Socio-demographic, clinical, co-morbidity and mortality data were recorded, in addition to whether or not initiating HD was planned. We calculated the REIN score and the RMRC probability of early mortality. Results: We analysed 63 patients with a mean age of 80.4±3.9 years and a mean of 3.4±1.8 additional illnesses. Of these patients, 59% began HD with a catheter; 57.1% had cardiovascular disease, 15.9% neoplasia, 31.2% chronic obstructive pulmonary disease and 19% diabetic nephropathy. Survival rates observed at 6 and at 12 months were 79.4% and 73%, respectively. Patients who began HD on an emergency basis (47.7%) or who were unable to care for themselves (21%) had higher 6-month mortality rates. Analysis of ROC curves (Receiver Operating Characteristic) showed slight concordance between the observed mortality rates and both the REIN score (area 0.681, P=.046) and the RMRC index (area 0.594, P=.255). Conclusions: The RMRC 1-year mortality probability model is not well adapted for individual prognoses in clinical practice. The REIN score only shows slight concordance with the mortality rates observed in the first 6 months of HD. Poor functional independence was the main risk factor for early mortality in elderly patients beginning HD treatment.

Indexación: Scielo La clínica neuroquirúrgica tiene la necesidad de un acabado conocimiento anatómico de las arterias comunicantes como integrantes del círculo arterial del cerebro, por su variabilidad morfológica, su relación compleja con las estructuras adyacentes y por la alta frecuencia observada en la conformación de aneurismas. Debido a la importancia de estos vasos, efectuamos un estudio biométrico de los mismas, relacionando datos de calibre y longitud con índice cefálico. En el sexo masculino, el calibre promedio de la ACoP fue de 1,07 mm en el lado derecho y de 1,06 mm en el izquierdo; en el sexo femenino fue de 1,12 mm en el lado derecho y de 1,14 mm en el izquierdo. En el grupo de individuos con índice braquicéfalo, el calibre de la ACoP fue de 1,15 mm y en el grupo dolicomesocéfalo fue de 1,05 mm. Su longitud fue de 18,65 mm en los braquicéfalos y de 16,44 mm en los dolicomesocéfalos.El calibre de la ACoA fue de 1,53 mm en el sexo masculino y de 1,05 mm en el femenino, mientras que su longitud fue de 2,81 mm en el sexo masculino y de 2,33 mm en el femenino.La descripción biométrica y bioantropológica muestra parámetros importantes a considerar en la clínica quirúrgica. PALABRAS CLAVE : Anatomía; Biometría; Círculo arterial cerebral; Arterias comunicantes; Indice cefálico. -------------------------------------------------------------------------------- RESUMEN: The neurosurgical clinic needs extensive and thorough anatomical knowledge of the communicating arteries as part of the cerebral arterial circle for their morphological variability, their complex relation as adjacent structures, and for the frequency observed in the formation of aneurisms. Considering the importance of these vessels, we conducted a biometric study of these, relating caliber and longitude information to the cephalic index. In the male, the mean caliber of the PCoA

The structures in the carpal tunnel are the flexor muscle tendons and their sheaths and the median n. Due to the inflexibility of its walls, any swelling of its contents that produces decrease of its volume, may compress the median n. There are many possible causes of nerve compression, such as the presence of arteries in this tunnel [3, 13]. The carpal tunnels of 70 hands of 35 adult cadavers of both sexes, whose age ranged from 23 to 77 years, were studied by dissection. An abnormal course of the superficial palmar branch of the radial a. was found in 2 hands (2.85%). This vascular branch passed through the carpal tunnel. This unusual course of the superficial palmar branch of the radial a. is described with details correlating its presence in the carpal tunnel with the median n.

De acuerdo a la literatura anátomo-clínica, se hace necesario disponer de mayor información respecto a las arterias que componen el sistema vértebro-basilar como elementos de la fosa posterior del cráneo, dada su importancia en cirugía. El objetivo de este estudio es complementar los datos obtenidos en trabajos previos, estudiando la relación biométrica entre el índice cefálico, la fosa cerebelar, el clivus y la arteria basilar de los especímenes observados. El trabajo se efectuó en el sistema arterial de 70 cerebros formolizados. Los cálculos estadísticos fueron realizados usando el programa computacional Prisma 2.3, análisis de varianza, chi cuadrado y test de Student. En el grupo dólico-mesocéfalo, la arteria basilar presentó una longitud promedio de 33.3mm, para una longituddelclivus de 55,7 mm, con una fosa cerebelar de 106.1 mm de ancho y de 44.0 mm de alto. En el grupo braquicéfalo, la arteria basilar presentó una longitudpromedio de 36.9 mm, para una longitud del clivus de 54.4 mm y un ancho 108.0 mm y un alto de 46.0 mm de la fosa cerebelar. Los autores enfatizan la variabilidad que se observa en la arteria basilar, al considerar, además del lado y sexo, componentesbio-antropológicos, como el índice cefálico According to clinical anatomy literature, always it is made necessary to have greater information with respect to the arteries that compose the vertebro - basilar system as elements of the posterior cranial fossa, in attention to its importance in surgical proceedings. The objective of this study is to complement the data collected in previous researchs being studied the possible biometrical relation between the cephalic index, the cerebellar fossa, clivus and the basilar artery in the studied specimens. This research was made in the available brains in the anatomy laboratories and data base of our department and that corresponds to our field. The statistics calculus were made using the computational Program Prism 2.3, square analysis of variance, chi and test of Student. In the dolicho- mesocephalic group (DM) the basilar artery (AB) presents-displays a length average of 33.3 mm for a length of clivus of 55.7, wide of the cerebellar fossa of 106.1 mm and height of 44.0 mm. In the brachicephalic group(BH),the AB presents an average length of 36.9 mm for a length of clivus of 54.4 mm, wide of the cerebellar fossa of 108.0 mm and height of 46.0 mm. The authors emphasize in the variability that is observed when considering besides of the side and sex, an bio-anthropological component, as it is the case of the cephalic index

El conducto deferente de conejo (Oryctolagus cuniculus), cumple un rol preponderante en el transporte de los espermatozoides hacia la uretra. Con el objetivo de profundizar su estudio morfológico, analizamos las características histológicas e histoquímicas. Utilizamos 5 conejos (Oryctolagus cuniculus) obtenidos del Bioterio de la Facultad de Medicina de la Universidad de La Frontera, Temuco, Chile. Una vez sacrificados los conejos, se disecó macro y mesoscópicamente la región pélvica. Se extrajo en bloque el sistema urogenital y posteriormente, disecaron los conductos deferentes, seccionándose para el estudio histológico parte de las regiones epididimaria, funicular, pélvica y ampular. Se procesaron las muestras histológicamente y se realizaron las tinciones histológicas de Hematoxilina-Eosina, Van Giesson, Van Giesson Elástica, Tricrómico de Masson, y Reticulina de Gomori e histoquímicas de PAS, Pas diastasa, Azul Alcian pH 2,5 y pH 0,4. Se observó en el conducto deferente una túnica adventicia de tejido conjuntivo denso con vasos y nervios. Presenta una gruesa pared muscular con un estrato externo de fibras longitudinales, un estrato medio con fibras espiraladas y un estrato circular interno. El segmento epididimario presentó un epitelio pseudoestratificado cilíndrico, pero al llegar al segmento ampular el epitelio varió a cuboídeo simple. La mucosa formaba pliegues longitudinales a lo largo del conducto deferente, desde la región epididimaria hasta la pélvica, determinando un lumen irregular, vista en corte transversal. Los tres primeros segmentos el conducto deferente presentaba estereocilios, no así en la zona ampular. La presencia de material de secreción se comprobó a lo largo del conducto aumentando considerablemente en la ámpula. El estudio histoquímico reveló una reacción PAS positiva, específicamente en la zona apical de las células epiteliales, a lo largo de todo el conducto. En la ámpula, la mucosa se plegaba en varios compartimentos, como mallas angulosas, formando cámaras. En el tejido conjuntivo que rodeaba la mucosa de las cámaras se observaron abundantes fibras reticulares. El tejido conjuntivo que rodeaba cada ámpula por separado era rico en fibras elásticas, las que se encontraron distribuidas en forma irregular, formando verdaderas redes. The deferens rabbit`s ductus plays a preponderant role in the transportation of sperm towards the urethra. In order to deepen its morphological study we analized its histological and histochemical characteristics. We used 5 rabbits, obtained in the Bioterio of the Faculty of Medicine of the Universidad de La Frontera, Temuco, Chile. Once the rabbit were slaughtered, the pelvic region was dissected macro and mesoscopically. The urogenital system was extracted and later the ductus deferens were dissected, sectioning part of the epididimary, funicular, pelvic and ampullar regions for the hitological study. The samples were processed for histological study and histochemical tinctins of Hematoxilina- Eosina, Van Giesson, Elastic van Giesson, Masson Trichromic and Gomori Reticulina, and histochemical PAS, Alcian Blue pH 2.5 and pH0,4 were made. An adventicia of dense conjunctive tissue with vessels and nerves was observed. Present the muscular layer, which constitutes the greater part of the wall at the level of the first anatomic segments. It consists of an outer layer of longitudinal mainly oblique fibers and outer circular layer. The epididimary segment presented a pseudostratified cylindrical epithelium, but when reaching the ampular segment the epithelium varied to a simple cuboideo one. The mucous membrane formed longitudinal folds along the deferent duct, from the epididimary region as far as (to) the pelvic one, determining an irregular lumen, seen in the cross cut. The three first segments of the deferent duct there were stereocilios, but there were none in the ampular zone. The histochemical study revealed the presence of polysaccharides in this last part. At the level of ampulla the mucous folded in various compartments, as angular nets in whose walls elastic fibers were observed.

RESUMEN: Los puntos motores son el lugar de penetración de las fibras motoras en el músculo a través del epimisio por lo que su conocimiento es de importancia, sobretodo cuando se quiere electroestimular un músculo atrofiado. En relación a este tema, estudiamos la inervación del músculo braquial, describiendo con detalles los ramos que proceden del nervio musculocutáneo, considerando el nivel en que se originan, su distribución terminal y nivel de penetración en el tejido muscular. Para ello, estudiamos 46 miembros superiores de 23 cadáveres formolizados de individuos adultos, brasileños, de ambos sexos. Para determinar el punto de origen y el punto de penetración de los ramos musculares mencionados se consideró como referencia a la línea biepicondilar (LBE). El músculo braquial recibió ramos procedentes del nervio musculocutáneo en todos los casos (100%); un ramo fue encontrado en 15 casos (65,2%) en el lado derecho y en 18 casos (78,3%) en el izquierdo; con dos ramos se observaron 6 casos (26,1%) en el lado derecho y 2 casos (8,7%) en el izquierdo. También se presentaron 3 y 4 ramos. Cuando se presentó 1 ramo, su nivel de origen en el lado derecho fue en promedio de 130,1 ± 13,3 mm respecto de LBE y de 127,8 ± 12,0 mm en el izquierdo. Cuando se presentaron dos ramos, el nivel de origen de éstos, en el lado derecho fue en promedio de 126,2 ± 14,5 mm para el proximal y de100,2 ± 37,1 mm para el distal, siempre respecto de LBE. En el lado izquierdo, por tratarse de solo dos casos, no se calculó el promedio. Con respecto al punto de ingreso en el vientre muscular, la mayor parte de ellos lo hicieron por la parte medial del músculo, encontrando que cuando fue ramo único, 13 de ellos tuvieron esta característica en el lado derecho y 15 en el izquierdo. La casi totalidad de estos nervios se subdividieron en ramos menores (secundarios), encontrando 2, 3, 4 y 5 de ellos, los que penetraron en el tejido muscular a distintos niveles. Estos datos pueden servir de referencia a las cirugías de reinervación, bloqueo selectivo de puntos motores y tratamientos fisioterapéuticos en el brazo SUMMARY: The motor points are the penetration place of the motor fibers in the muscle through the epimisio, that is why its knowledge is of great importance, mainly when an atrophied muscle require to be electro-stimulated. In relation to this subject, we studied the innervation of the brachial muscle, describing in detail the branches coming from the musculocutaneous nerve, taking into account the levels where they originate, their final distribution and the penetration level in the muscular tissue. For this purpose, we have studied 46 upper limbs of 23 formolized corpses of Brazilian adult individuals of both sexes.In order to determine the origin and the penetration points of the mentioned muscular branches the biepicondilar line (LBE) was considered as reference. The brachial muscle received branches coming from the musculocutaneous nerve in all cases (100%); 1 branch was found in 15 cases (65.2%) at the right side and in 18 cases (78.3%) at the left side. With 2 branches, 6 cases (26.1%) were observed at the right side and 2 cases (8.7%) at the left side. There were also 3 and 4 branches. When there was only 1 branch, its origin level at the right side was of 130.1 ± 13.3 mm on average in respect to LBE and of 127.88 ± 12.0 mm at the left side. When there were 2 branches, their origin level was 126.2 ± 14.5 mm on average for the proximal and of 100.2 ± 37.1 mm for the distal, always in respect to LBE. At the left side, as there were only 2 cases, the average was not calculated. In relation to the entrance point in the muscular vientre, most of then did it through the medial portion of the muscle, finding that, when there was a single branch, 13 of then had this characteristic at the right side and 15 at the left side. Almost all these nerves subdivided in smaller branches (secondary) finding 2, 3, 4 and 5 of them, which penetrated in the muscular tissue at different levels. These data may serve as reference for reinnervation surgeries, selective blocking on motor points and physiotherapeutic treatments in the arm

La arteria ulnar se origina normalmente de la arteria braquial a nivel de la fosa cubital. Algunas veces tiene un origen más alto pero su trayecto y relaciones a nivel del antebrazo son normales. En otras ocasiones, un origen alto de la arteria ulnar va acompañado de un trayecto distinto, anterior a la musculatura antebraquial, pasando a denominarse arteria ulnar superficial. Sin embargo, raramente ha sido descrita superficial a la fascia profunda,de tal modo que su trayecto es próximo a la superficie pero subfascial. Describimos un caso de arteria ulnar superficial, unilateral, encontrada en la disección de un cadáver de un individuo adulto de sexo masculino, en la Disciplina de Anatomía Humana, Facultad de Medicina de la Universidad de La Frontera, Temuco, Chile. La arteria ulnar superficial se originaba de la arteria braquial en la parte distal del brazo. Acompañada de sus dos venas satélites era cruzada anteriormente por la vena intermedia basílica. Descendía anteriormente a los músculos pronador redondo, flexor radial del carpo y palmar largo, colocándose en el tercio medio del antebrazo, anteromedialmente al músculo flexor ulnar del carpo, aproximándose a la vena basílica del antebrazo. Las variaciones anatómicas arteriales adquieren importancia en los procedimientos de rutina que se efectúan tanto a nivel de la fosa cubital como de la región antebraquial anterior, en especial para los cirujanos plásticos y vasculares, radiólogos y otros profesionales que deben intervenir las venas superficiales de la región

El nervio musculocutáneo es responsable de la inervación motora de los músculos anteriores del brazo, pudiendo transportar por una determinada distancia fibras del nervio mediano. Esas fibras componen un ramo comunicante entre ambos, el que puede o no estar presente. Con el propósito de determinar su frecuencia y nivel de localización en el brazo, disecamos 32 miembros superiores de 16 cadáveres formolizados de individuos adultos, brasileiros, de ambos sexos. El ramo comunicante fue encontrado en 10 casos (31,3%), 9 de ellos en el sexo masculino, 4 en el lado derecho y 6 en el lado izquierdo, siendo bilateral en dos individuos. Se constató macroscópicamente que el ramo comunicante se dispuso desde el nervio musculocutáneo hacia el nervio mediano en 9 casos (90% de los casos encontrados), observándose una disposición contraria en el caso restante. En un caso se presentó doble. El ramo se localizó totalmente dentro del tercio proximal del brazo en 2 casos (20%), dentro del tercio medio en 4 (40%) y entre el tercio proximal y medio en los 4 restantes (40%). El caso que presentó una disposición contraria se encontró totalmente en el tercio medio. La presencia de este ramo tiene una explicación embriológica y en lesiones del nervio musculocutáneo pueden ser afectadas estructuras inervadas por el nervio mediano. The musculocutaneous nerve is responsible for the motor innervation of the anterior arm muscles and sometimes it carryes by a short distance fibers of the median nerve. This fibers are part of a communicating branch between both, which may be ocurrent or not. With the object to detect their frequence of ocurrence and their localization level in the arm, 32 upper limbs from 16 formolized cadavers of brazilian individuals, from both sexes were dissected. The communicating branch was found in 10 cases (31.3 %), 9 of them on males with 4 cases in the right and 6 in the left side; in two individues it was bilateral. This investigation confirmed the macroscopical disposition of the communicating branch from the musculocutaneous nerve to the median nerve in 9 cases (90% of the total cases found) and at the contrary disposition in only one case. One of them was a double disposition. The branch was totally localized at the proximal third of the arm in two cases (20 %), inside the median third in 4 cases (40%) and between the proximal third an the median in the remaining 4 (40% of cases). The case with a contrary disposition was only found in the median third. The presence of this branch has an embriologic explanation and in cases of musculocutaneous nerve lessions can be to affected structures innervated by the median nerve

El músculo cuadrado plantar puede presentar, ocasionalmente, un fascículo supernumerario, el cual puede producir, dependiendo de su desarrollo, alteraciones en la mecánica articular del pie. Disecamos 150 miembros inferiores de cadáveres de individuos adultos, de ambos sexos y diferentes grupos étnicos. Observamos tres casos de músculos supernumerarios en relación al músculo cuadrado plantar, siendo bilateral en uno de ellos. En el caso 1, el músculo se originaba por medio de dos cabezas, una tibial y otra fibular. En el caso 2, el músculo presentaba dos cabezas, una originada en la cara anterior del músculo sóleo y la otra en la fíbula. En el caso 3, el músculo tenía su origen en la tibia y en la fascia que recubre los músculos tibial posterior y flexor largo de los dedos. En los tres casos, estos músculos se continuaban por medio de un tendón, relacionado con la cara medial del calcáneo y envueltos por una vaina sinovial propia, encontrándose cubiertos por el retináculo de los músculos flexores y acompañando al nervio plantar lateral. Finalmente, se relacionan con el margen medial del músculo cuadrado plantar, cuyas fibras musculares se insertan en la parte lateral del tendón del músculo en estudio. La presencia de este músculo puede producir un síndrome de compresión nerviosa o síndrome del túnel tarsiano.

The clinical physicians insist in the necessity of an anatomical precise knowledge, for the success in neurochirurgical interventions during the approaching to the posterior cranial fossa. Based in previous reports, we have made an anatomical revision of the anterior inferior cerebellar artery focused to its anterior pontine and lateral pontine segments with data that may contribute to their better knowledge. This research was done by the study of 70 human brains from both sexes, collected at Sâo Paulo Medical School/ UNIFESP, Brazil, and to which them , we registred some anthropological data. The brains were inyected in its vascular system with red collored neopren latex and fixed using established anatomical techniques. The range of 1.0-1.5 mm for the external diameter of the AICA is more frecuently at right side in both sexes; in 47.4% of the Brachycephalics (BH) and in 53.1% of the Dolicho-mesocephalics (DM). At the left side and masculine sex, was observed in 45.3% and in 64.3% of feminine sex ; in 52.7% of the BH and in 53.1% of the DM. The course of the AICA at right side is ventral to abducent nerve (AN) in 68.0% in DM groups and in 69.0% in BH groups; at the left side this course was observed in 74.0% in DM and 77.0% in BH groups. The authors insist in the variability observed in the arterial patterns, when taking in consideration besides side and sex, other parameters like the cephalic index

The irrigation of the perifoveolar region in the femoral head, has been the aim of some anatomo-clinic studies in the belief that it would suffer aseptic necrosis by the section of the ligament from the femoral head and from its relating vessels. In order to clarify the above hypothesis an anatomo-histological study was performed on a 3 months old, 30 kg pig specimen (Sus scrofa). This consisted in a surgical sectioning of the femur head ligament and its enclosing arteries, which were also ligated in order to observe nutrition at the perifoveolar head level. After 92 days, with the specimen weigthing 83 kg, it was sacrificed and samples from the ligament and femur head closer to the fovea were taken. It was not possible to observe histopatological alterations or necrosis in the insert area of the ligament of the femoral head and adjacent areas, in the compact bone or in the spongy substances. Histological alterations in the articular cartilage were not observed either. Instead, a moderate fibrosis at the distal extremity of the ligament in the femoral head was noticed. Signs of active mineralization were shown in the bony counterfoil. The side control did not present histopatologic alterations. Through this study the irrigation of the femoral head in a pig specimen was proved to be minimal and perhaps non existent., La irrigación de la cabeza del fémur ha sido motivo de algunos estudios anatomoclínicos, al mencionarse que ella sufriría necrosis aséptica, por la sección del ligamento de la cabeza del fémur y de sus vasos acompañantes (Moore, 1996). De acuerdo a la hipótesis en que la sección del ligamento de la cabeza del fémur junto a sus vasos podría afectar la nutrición perifoveolar de la cabeza, se efectuó un estudio anatomohistológico en un cerdo(Sus scrofa),de 3 meses de edad y 30 kg de peso, al que se seccionó quirúrgicamente el ligamento mencionado y las arterias que lo acompañan, las cuales también fueron ligadas. Después de 92 días y teniendo el cerdo un peso de 83 kg, fue sacrificado y se obtuvieron muestras para microscopia óptica del ligamento y de la cabeza del fémur, próxima a la fóvea. No fue posible observar alteraciones histopatológicas o necrosis aséptica en la zona de inserción del ligamento de la cabeza femoral y zonas adyacentes, tanto en la sustancias ósea compacta como esponjosa. Tampoco se observó alteración histopatológica en el cartílago articular. Fue observada sólo una moderada fibrosis en el extremo distal del ligamento de la cabeza femoral. La matriz ósea mostraba signos de mineralización activa. El lado control tampoco presentaba alteraciones histopatológicas. Este estudio mostró la escasa participación que tienen las arterias acompañantes del ligamento de la cabeza femoral en la irrigación perifoveolar de la cabeza del fémur en el cerdo. &nbsp

Numerous studies on the hand arterial supply have contributed important data for the reconstructive surgery of it. With the aim of contribute to the knowledge of their arteries, we performed a biometric study of the deep palmar branch of the ulnar artery (DPB) in 60 hands from 30 cadavers of brazilian adult individuals of both sexs. The arteries were injected with latex neoprene. The DPB arose from a common branch with the hipothenar muscles branch in 46.7% of the cases; independently from the ulnar artey in 11.7%; from the ulnar proper palmar digital artery of the little finger in 15 % and from the common palmar digital artery of the fourth interosseous space in 6.7 %. In the first disposition, the common branch arose 10.6 ± 4.7 mm distal to the distal wrist crease (DWC) in female and 12.2 ± 4.1 mm in male; in second disposition the DPB origin was 33.6 ± 4.1 mm distal to the DWC in male; in third disposition it originated 35.8 ± 2.88 mm distal to the DWC in male and in last, it originated 41.0 ± 3.54 mm distal to the DWC. In 18.3% of the all cases we observed two DPB and in 1.7% it was no present. The caliber of these vessels were registrated. The DPB is important in hand arterial supply due to form a part of the deep palmar arch and sometimes, in presence of the thrombosis of the radial artery, it can carry the necessary blood to the deep palmar and dorsal regions

RESUMEN: Los nervios mediano y ulnar son responsables de la inervación motora de la mano, además de otorgar ramos para la inervación sensitiva de ella, principalmente de su región palmar. En la región palmar y en estrecha relación con el retináculo de los músculos flexores (RF), el ramo comunicante (RC) une los nervios digitales palmares comunes de los III y IV espacios interóseos (NDPC3 y NDPC4). Lesiones de este ramo pueden ocurrir durante la liberación quirúrgica del canal del carpo ( MAY & ROSEN, 1981). Debido a su importancia anátomo-clínica y con el propósito de contribuir con datos anatómicos y biométricos sobre su disposición, disecamos 50 manos de cadáveres de individuos formolizados, brasileños, de ambos sexos, correspondientes al Departamento de Morfologia de la Universidad Federal de São Paulo, Brasil. Registramos su posición, su relación con el arco palmar superficial (APS) y con el RF. Además, las distancias entre el margen distal del RF y el ramo mencionado, como también entre éste y el pliegue distal de la muñeca (PDM). El ramo comunicante fue encontrado en 48 casos (96,0 %); su posición fue totalmente proximal al APS o a la arteria ulnar (cuando no se presentó el referido arco) en 20 casos (41,7 %), distal en 5 (10,4 %) y dorsal al mismo en 4 (8,3 %). El RC emergió desde el NDPC4 (n. ulnar) y se dirigió distalmente para unirse al NDPC3 (n. mediano) en 39 casos (81,3 %) y emergió desde el segundo dirigiéndose distalmente hasta el primero en 8 (16,7 %). Cuando el RC emergió del NDPC4 la distancia entre este punto y el PDM fue en promedio de 33,4 mm (DS: 5,3) en el lado derecho y de 30,7 mm (DS: 4,0) en el izquierdo. La distancia entre el PDM y el punto donde se unió al NDPC3 fue de 43,5 mm (DS: 5,7) en el lado derecho y de 39,3 mm (DS:5,8) en el izquierdo. La distancia entre el margen distal del RF y el RC a nivel del IV hueso metacarpiano fue de 6,1 mm (DS: 3,6) en el lado derecho y de 4,9 mm (DS: 2,5) en el izquierdo. A nivel del III espacio interóseo esta distancia fue de 9,7 mm (DS: 4,3) y de 8,6 mm (DS: 4,7) en el izquierdo. Estos datos biométricos pueden servir de referencia para determinar la posición del RC durante los procedimientos quirúrgicos efectuados en la región. SUMMARY: The ulnar and median nerves are responsible for motor innervation of the hand and also send other branches involved in the sensitive innervation of the palmar region mainly. In the palmar region and in close relationship to the flexor retinaculum (FR), the communicating branch (CB) join to common palmar digital nerves of the 4th from the ulnar nerve and 3rd interosseous spaces from the median nerve (CPDN4 and CPDN3, respectively). Reports showing lessions on this branch during endoscopic carpal tunnel release (May & Rosen, 1981). Because of its anatomical-clinical importance the purpose of this article was contribute with anatomical and biometric knowledge of such branch disposition. We dissected 50 formalized hands of brazilian individuals from both sexs in the Morphology Department of the Universidad Federal de São Paulo, Brazil. The position of the communicating branch respect to the superficial palmar arch (SPA) and the flexor retinaculum was determined. Furthermore, the distances between the distal margin of the FR and the above mentioned branch were also registrated, as well as between this one and the distal wrist crease (DWC). The CB was found in 48 cases (96.0 %). In 20 cases (41.7 %) the CB was totally proximal to the SPA or ulnar artery (when the SPA was not present). It was found distal to the SPA in 5 cases (10.4 %) and dorsal to it in 4 (8.3 %). In 39 cases (81.3 %) the CB emerged from the CPDN4 and distally it connects with the CPDN3 and in other 8 cases (16.7 %) emerged from the last nerve to distally connect to the CPDN4. The distance between the place of the CB emerged from the CPDN4 and the DWC was in average 33.4 mm (SD: 5.3) in the right side and 30.7 (SD: 4.0) in the left side. The distance between the DWC and the point where it connected to the CPDN3 was 43.5 mm (SD: 5.7) in the right side and 39.3 (SD: 5.8) in the left side. The distance of the distal margin between the FR and CB at the axis ofthe IV metacarpal bone level was 6.1 mm (SD: 3.6) in the right side and 4.9 mm (SD: 2.5) in the left side. At level of the III interosseous space, this distance was 9.7 mm (SD: 4.3 ) in the right side and 8.6 mm (SD: 4.7) in the left side. These biometric data may help to characterize the CB position and be used as reference for the surgical procedures on this region.

Existe aun poca informacion cuantitativa y cualitativa disponible, de las arterias que componen el sistema vertebro-basilar, entre las cuales tenemos las cerebelares, de gran importancia en la cirugia que se realiza en la fosa posterior del craneo. Los objetivos de nuestro estudio son analizar y suplementar la informacion anatomica relacionada con la arteria cerebelar superior, considerando ademas el lado, sexo, grupo etnico e indice cefalico de los especimenes observados. La investigacion se efectuo en 70 encefalos de individuos brasilenos adultos, de ambos sexos, con registros antropologicos, colectados para investigacion, inyectados con latex neopreno y fijados en formaldehido al 10%, en el Laboratorio de Anatomia de la Escola Paulista de Medicina/UNIFESP, Sao Paulo, Brasil. La mediciones cefalicas y calculo del indice cefalico, se efectuaron de acuerdo a normas de MARTIN SALLER (1957). Los datos estadisticos fueron procesados usando los programas computacionales EPISTAT y EPI-INFO. La rama medial derecha, se origino en el segmento pontino-anterior de la arteria cerebelar superior en el 85.7 % en el sexo masculino y en el 67.9 % en el femenino; 73.3% en blancos y en el 88.0% en mestizos; en el 78.1% en dolico-mesocefalos y en el 78.9% en braquicefalos. La rama lateral derecha, se origino en el segmento ambiens en el 85.7% en ambos sexos; en el 84.5 % en blancos y en el 88.0% en mestizos; en el 87.5% en los dolico-mesocefalos y en 84.2% en los braquicefalos. La variabilidad de los patrones arteriales es evidente cuando se usan distintos parametros y se consideran caracteristicas antropologicas de los individuos en estudio

The relationship between the deep palmar arch (DPA) and the deep branch of the ulnar nerve (dbUN) was analysed in 60 hands from 30 formaldehyde treated cadavers of adult individuals, of both sexes, with age ranging from 21 to 70 years, in the Division of Descriptive and Topographic Anatomy of the Federal University of São Paulo (UNIFESP). The arteries were injected with neoprene latex and dissections were performed under a magnifying glass. DPA was ventral to dbUN in 50% of the cases (type I) and dorsal in 45% (type). In type I dbUN crossed the arterial arch at the following levels: in the 4th interosseous space in 17.9% of the cases, in the 3rd interosseous space in 21.4% and in the 3rd metacarpal bone in 39.3%. In type II dbUN crossed the arterial arch in the 4th metacarpal bone in 25.9% and in the 3rd intersseous space in 37%. The relationship between the nerve and the palmar metacarpal arteries was also studied. The data obtained may be of practical use in the surgery of the palmar region.

The accessory soleus muscle is infrequently found; no reports of it are available in South American literature. It is found between the tibia and the soleus muscle in the distal leg. It may be misdiagnosed as a hemangioma, lipoma or sarcoma. It may be the cause of functional disorder such as varus or equino-varus. Among 254 dissections performed in young adults of both sexes and different ethnic origin we found only 2 accessory soleus muscles, both in males. One originated from the soleus muscle and was inserted in the superior aspect of the "calcaneo", in front of the "tendon calcaneo". The other originated from the anterior fascia of the soleus muscle and was inserted on the medial aspect of the "calcaneo". The clinical significance of the accessory soleus muscle is related to the presence of pain or functional disorders.

The authors studied 400 dry skulls of adult Brazilian individual (135 females and 265 males) beloging to the collections of the laboratories of Descriptive and Topographic Anatomy of the São Paulo School of Medicine and the Medical School of the University of São Paulo. Metopism was observed in 11 skulls (2.75%, 4 females and 7 males). Incomplete metopic suture was present in 115 skulls (28.75%, 27 females and 88 males). The form of metopic suture was mainly linear (64.35%). The presence of metopism must be remembered, for instance, in skull fractures.

The mixed micelles C12E4 (tetraethylene glycol mono-n-dodecyl ether)/CTAB (hexadecyltrimethylammonium bromide) were studied. The surface tension results were analyzed on the basis of a treatment that considers the relation between the activity coefficients according to the Gibbs−Duhem equation. The results are compared with Rubingh's treatment, which considers the activity coefficients given by the regular solution theory. The conductivity of the samples and the aggregation numbers at low mixture concentration are also given.

This chapter addresses the role of private insurance in the Dutch healthcare system wherein public and private funds were put into competition in 2006. This system has always been characterized by both public and private interactions, and its recent marketization has not terminated the state regulation. Its functioning also demonstrates an innovative way of governing and regulating competition in the healthcare and health insurance markets, combining EU law and national legislation. However, it can be debated whether EU competition law is adequate in regulating such a system based on managed competition. As the improvement of these competitive conditions is unlikely to eliminate market failures, the state has even increased its role in monitoring, controlling and, when necessary, intervening on these markets.

This chapter addresses the very peculiar role of the private health insurance (PHI) market in Ireland. Because the public statutory system is not actually universal, the legislation has strongly regulated the PHI market to make it play a general interest role in healthcare coverage. This was achieved through an original transposition of the 1992 Insurance directive, in which Irish legislation combined market rules and the interests of the common good. Nevertheless, it involved serious legal issues that led to EU law and national public policy being accommodated. In addition, the economic and financial crisis seriously challenged the two-tier Irish Healthcare system, as the proportion of people faced with unaffordable private health expenditure significantly increased. The chapter finally explores the recent Irish reform plan that reconsiders the question of universal coverage. This might lead to a fundamental transformation of the role of PHI.

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