Journal of Morphology and Anatomy

Introduction: The current literature proves that the frequency of anatomical variants of circle of Willis (CoW) has not yet been sufficiently evaluated both in the Romanian population and internationally, and in the North East region of Romania there is no evidence of such research so far. The aim of this study is to identify the frequency and types of anatomical variants of the constituent arteries of the posterior part of the CoW in patients with cerebrovascular diseases diagnosed within the main Neurology hospital in the Northeastern region of Romania, based on macroscopic analysis of arterial specimens obtained at autopsy and to compare the results with data from updated literature.

Material and Methods: Our research represents a descriptive observational study, conducted retrospectively on 96 patients with cerebrovascular diseases who died over a period of 30 months and underwent an anatomo-clinical autopsy. We analysed the general macroscopic aspects of all anatomical variants of the constituent arteries of the posterior part of the CoW, comparing these to the opposite arteries.

Result: Out of the total of 96 available human brains, 28 cases (29.17%) presented anatomical variants of CoW, among which 11 cases (39.28%) presented at least one anatomical variant of the constitutive arteries of its posterior part. The average age of these patients was 59.18 years. 36.36% cases had a single anatomical variant, 54.54% cases had two anatomical variants, and 9.09% all of cases associated an anatomical variant of the posterior part of CoW and one of the vertebral arteries. Anatomical variations of the arteries of the posterior part of the CoW were observed in 14 arteries (31.81%) of all the 44 available, and consisted in unilateral or bilateral hypoplasia (20.45%) or absence (15.90%), located either on the right or on the left, and partial fetal posterior communicating artery (2.27%) located on the left side. We identified seven morphological patterns of the posterior part of CoW in the conditions in which its anterior part does not present any anatomical variants.

Conclusion: The data obtained in the present research allow us to affirm that circle of Willis represents an anatomical structure with a great morphological diversity of its posterior part. This study contributes to the knowledge of this topic in Romania and allows comparisons with data obtained both in the country and abroad.

Background: Total Hip Arthroplasty (THA) is a good solution of Developmental Dysplasia of the Hip (DDH). However, patients diagnosed with Crowe type IV are difficult to deal with. With traditional operation skills, the operation time is quite long and the patients will lose a lot of blood.

Case presentation: We present the case of a 58-year-old male patient who underwent left THA due to Crowe type IV DDH with the help of 3D printing models. Before the operation, we put the CT image into computer software named mimics. After getting the stl. Document, we use 3D printer to print the models out. By using the models, we planned the operation in advance. And after sterilizing the models, we put them in the operation area, which saves a lot of operation time and reduces much blood loss by giving surgeons a better anatomy view.

Methods: A health institution-based retrospective cohort study was conducted among 421 children with HIV/AIDS from to 2009-2018. The Time to develop TB was defined as the time from enrollment for ART care until the development of TB among children on ART. Variables with a P-value <0.25 at bivariate Cox regression analysis, were entered into the multivariable Cox model. Multivariable-Cox-regression model with 95% CI and AHR was used to identify significant predictor variables to develop TB at P< 0.05.

Conclusion: THA with the help of 3D printing pelvis and femur can result in a relatively short recovery time and provide good clinical efficacy of type IV DDH patients.

Background: Lumbar vacuum phenomenon (VP) within the intervertebral disc has been classified based on CT imaging. We compared same-patient sagittal CT images and dynamic flexion-extension x-rays to determine if there is a difference in the amount of vertebral instability present between three VP morphologies on CT.

Methods: Anterior subluxation measurements on x-ray were compared with same-segment VP on CT images from the same patient when both findings were present. VP were classified as spot, island, or linear. It was determined if there was a difference in the amount of anterior subluxation between the three morphologies. Secondary analysis looked at whether there was a difference in anterior subluxation between the three groups if patients had undergone a prior lumbar fusion surgery or not.

Results: There was no difference in anterior subluxation between the three groups on dynamic flexionextension x-rays. There was also no difference between the three groups on flexion-extension x-rays when patients were separated based on if they had received or not received a previous lumbar fusion surgery.

Conclusion: IVD VP morphology is not a useful indicator in determining vertebral instability preoperatively according to CT scan. Further fine-tuning of an IVD VP CT classification is needed to help radiologists and spine surgeons know when IVD VP presence is important.