Anatomical Variation

Background and aims Recognition of variations of the inferior laryngeal nerve is essential. We aimed to investigate the relationship of the inferior laryngeal nerve with the inferior thyroid artery. Materials and methods A study was undertaken between August 2005 and August 2006. A total of 253 adult patients undergoing thyroid surgery were included in this prospective, non-randomized study. Both sides of the thyroid gland were considered separately. Results Sixteen variations of the nerve were clarified. In the most observed variation, the nerve was deep to the artery. Two and three nervous branches were seen in 22.5% and 1.6% of the patients, respectively. Bifurcation of the nerve was mostly observed on the left side. No non-recurrent laryngeal nerve was found. Conclusion To avoid the risk of nerve damage during thyroid surgery, a good knowledge of the variations of the inferior laryngeal nerve is essential. This is important to achieve an undisturbed quality of life for the thyroid patient.

Six single burials and several dislocated bones dated to the period between the 15th and the 18th  century were discovered under the floor of the Baptistery of San Giovanni Battista (Settimo Vittone, Turin) during an archaeological excavation undertaken by the Soprintendenza Archeologica, Belle Arti e Paesaggio per la Città Metropolitana di Torino in 2014. The minimum number of individuals recovered is 81 (55 non adults, 26 adults).
In the present study we describe and discuss 5 cases of supracondylar process in infant and perinatal humeri.  The supracondilar processes, both prominent (5 mm long ) or extremely rudimentary (1 mm long)  appear as a hook-like bony spine of variable size that project distally from the anteromedial surface of the humerus.  The outgrowth of bone is oriented towards the distal end above the medial epicondyle. Only in one case the process occurs bilaterally.
In the scientific literature this lesion, also called supra-epitrochlear process, epicondylar process, epicondylic process or supratrochlear spur, is considered a normal anatomical variation.
The high occurrence of the process is striking and it may suggest a family relationships among the individuals buried.

Degenerative lumbar spinal stenosis manifests primarily after the sixth decade of life as a result of facet hypertrophy and degenerative disc disease. Congenital stenosis, on the other hand, presents earlier in age with similar clinical findings but with multilevel involvement and fewer degenerative changes. These patients may have subtle anatomic variations of the lumbar spine that may increase the likelihood of thecal sac compression. However, to the authors' knowledge, no quantitative studies have addressed various radiographic parameters of symptomatic, congenitally stenotic individuals to normal subjects. To radiographically quantify and compare the anatomy of the lumbar spine in symptomatic, congenitally stenotic individuals to age- and sex-matched, asymptomatic, nonstenotic controlled individuals. A prospective, control-matched, cohort radiographic analysis. Axial and sagittal magnetic resonance imaging (MRI) and lateral, lumbar, plain radiographs of 20 surgically treated patients who were given a clinical diagnosis of congenital lumbar stenosis by the senior author were randomized with images of 20, asymptomatic age- and sex-matched subjects. MRIs and lateral, lumbar, plain radiographs were independently quantitatively assessed by two individuals. Measurements obtained from the axial MRIs included: midline anterior-posterior (AP) vertebral body diameter, vertebral body width, midline AP canal diameter, canal width, spinal canal cross-sectional area, pedicle length, and pedicle width. From the sagittal MRIs, the following measurements were calculated: AP vertebral body diameter, vertebral body height, and AP canal diameter at the mid-vertebral level. On the lateral, lumbar, plain radiograph (L3 level), the AP diameters of the vertebral body spinal canal were measured. The images of these 40 individuals were then randomized and distributed in a blinded fashion to five separate spine surgeons who graded the presence and severity of congenital stenosis utilizing a five-tier scale. Images consisting of 15 symptomatic individuals, graded definitely congenitally stenotic (mean age, 51.7 years; range, 43-65 years), and 15 asymptomatic individuals, graded definitely not stenotic (mean age, 50.7 years; range, 41-55 years), were age- and sex-matched and included for further review. From these 30 patients, a lateral, lumbar, plain radiograph and axial and sagittal MRIs (T1/T2 weighted) from L2-L5 were quantitatively analyzed. Rater reliability was assessed by Kappa coefficient testing. The cross-sectional area of the canal was significantly smaller in the congenitally stenotic patients at all lumbar levels measured (L2: 176 mm(2) vs. 259 mm(2), L3: 177 mm(2) vs. 275 mm(2), L4: 183 mm(2) vs. 283 mm(2), L5: 213 mm(2) vs. 323 mm(2), p<.05). Pedicle length was markedly shorter in the stenosis group at each lumbar level (L2: 5.9 mm vs. 8.9 mm, L3: 6.0 mm vs. 8.8 mm, L4: 6.5 mm vs. 9.2 mm, L5: 5.8 mm vs. 9.1 mm, p<.05). Furthermore, midline, axial AP canal diameter, vertebral body width, and sagittal AP canal diameter were all significantly smaller than the control patients (p<.05). A ratio of the AP diameter of the pedicle length to the vertebral body was also noted to be statistically significant on both the lateral plain radiographs (L3: 0.426 vs. 0.704) and sagittal MRI (L2: 0.343 vs. 0.461, L3: 0.361 vs. 0.461, L4: 0.362 vs. 0.481, L5: 0.354 vs. 0.452, p<.05). No difference was noted comparing the AP diameter of the vertebral body (axial and sagittal images), vertebral body height, canal width, and pedicle width. Kappa…

BACKGROUND. Intraductal papillary mucinous neoplasm (IPMN) is an increasingly recognized cystic neoplasm of the pancreas, histologically classified by the degree of epithelial atypia and by the presence or absence of invasion of the cyst wall. To the authors' knowledge, the cytologic features of this neoplasm are poorly characterized, especially with respect to tumor grade.