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Introduction: Anterior orthopaedic approaches, much like the Modified Stoppa approach, target fractures of the anterior column of the pelvis and acetabulum. The approach is described as a minimally invasive technique that may lead to iatrogenic haemorrhage and fatality in patients. Such mortality is due to the inadvertent severing of the corona mortis vessels, a clinical term referring to the anastomosis between the obturator vessels and the external iliac vessels typically via an accessory obturator vessel that courses over the pelvic brim. Knowledge regarding the prevalence and clinical significance of the corona mortis, especially within the South African population is lacking, and therefore further investigation of this anomaly is necessary. Materials and methods: This study investigated the incidence and variations of the corona mortis vessels in a South African sample using 63 adult cadavers obtained from the Department of Anatomy, University of Pretoria. After careful dissection of the blood supply to the pelvis, the prevalence of corona mortis was investigated. Variations regarding the composition of the corona mortis and the incidence of aberrant obturator vessels were documented. Results: The incidence of corona mortis was observed in 67.5% of the study sample, with 91.6% being venous and 8.4% being arterial in composition. An incidence of 26.0% of aberrant obturator arteries and 8.1% of aberrant obturator veins were observed originating or draining directly into the external iliac system, respectively. A single rare instance of corona mortis was observed and involved an anastomosis with the superior vesical vein rather than the typical obturator vein. While variations amongst anomalous accessory vessels were observed which resulted in as many as 3 aberrant vessels coursing over the pelvic brim. No significant difference was concluded for the incidence of corona mortis between the left and right sides or between males and females. Conclusion: Mapping out the parameters of the corona mortis and examining the variation linked with the anomaly will aid orthopaedic surgeons in implementing anterior approaches with reduced vascular damage and iatrogenic deficit. Further understanding of its incidence in the South African population will in turn assist in interpreting its clinical significance.

Road traffic injuries and crashes are one of the major public concerns contributing to mortality and morbidity figures across the globe. Researchers estimated that around 90% of all causative factors for crashes are attributed to road users of which drivers are the principal controlling elements. Therefore, understanding complex human driver behavior and their possible violations or errors are necessary to control and prevent accident occurrence to a considerable extent. Studies on driver behavior of commercial vehicles such as trucks are scattered widely and scarcely explored hindering the possibility of road safety outcomes. This underscores the need to excavate and synthesize the past studies for an effective understanding of human factors causing truck crashes. In this paper, an attempt has been made to systematically review the pieces of literature and to identify the causative factors affecting truck driver behavior. The trend of studies shows a promising framework for improving truck driver safety on taking care of human factors influencing crashes. Most kinds of literature have cited unsafe driving behaviors as a predominant source of truck crashes. The outcomes of this research can be utilized by transportation firms and stakeholders for identifying the possible lags to develop pragmatic and possible effective preventive measures featuring truck driver safety.

Person-fit analyses are commonly used to detect aberrant responding in self-report data. Nonparametric person fit statistics do not require fitting a parametric test theory model and have performed well compared to other person-fit statistics. However, detection of aberrant responding has primarily focused on dominance response data, thus the effectiveness of person-fit statistics in detecting different aberrant behaviors in ideal point data is unclear. This study compares the performance of nonparametric person-fit statistics in unfolding and dominance model contexts. Results for dominance data indicate that increases in detection rates depend, among other factors, on type of aberrant responding and person-fit statistic used. The detection of aberrant responses in ideal point data was ineffective using four nonparametric person-fit statistics, with slightly higher type I error and power less than 0.25. Additional research is needed to identify or develop nonparametric or parametric person-fit statistics effective for aberrant behavior exhibited in ideal point data. [ABSTRACT FROM AUTHOR]

Road traffic injuries and crashes are one of the major public concerns contributing to mortality and morbidity figures across the globe. Researchers estimated that around 90% of all causative factors for crashes are attributed to road users of which drivers are the principal controlling elements. Therefore, understanding complex human driver behavior and their possible violations or errors are necessary to control and prevent accident occurrence to a considerable extent. Studies on driver behavior of commercial vehicles such as trucks are scattered widely and scarcely explored hindering the possibility of road safety outcomes. This underscores the need to excavate and synthesize the past studies for an effective understanding of human factors causing truck crashes. In this paper, an attempt has been made to systematically review the pieces of literature and to identify the causative factors affecting truck driver behavior. The trend of studies shows a promising framework for improving truck driver safety on taking care of human factors influencing crashes. Most kinds of literature have cited unsafe driving behaviors as a predominant source of truck crashes. The outcomes of this research can be utilized by transportation firms and stakeholders for identifying the possible lags to develop pragmatic and possible effective preventive measures featuring truck driver safety. [ABSTRACT FROM AUTHOR]

Aberrant T-cell phenotype or aberrant B-cell phenotype in B-cell non-Hodgkin's lymphoma or T-cell non-Hodgkin's lymphoma, respectively, are uncommon phenomenon and a diagnostic challenge. Multiple T-cell antigen, including CD3 expression in large B-cell lymphomas, which is considered a specific marker for T cells, is extremely rare and have scattered instances in the literature; however, none of those showed myc and bcl2 rearrangement. This is a case of stage IV NHL, previously diagnosed as T-cell NHL, which on detailed immunohistochemical and molecular diagnostic workup, later was confirmed as "Double hit" B-cell lymphoma with aberrant T-cell phenotype. With the 1st ever-reported case, we wish to bring into the notice of such aberrancy so as to not misdiagnose or wrongly classify high-grade lymphomas. [ABSTRACT FROM AUTHOR]

Introduction: Aberrant DNA methylation is one of the important molecular markers in acute lymphoblastic leukemia (ALL). Objectives: To determine Aberrant DNA methylation profiles of the CDKN2A and CDKN2B genes in ALL samples from T1DM cases. Results: Aberrant hypermethylation of CDKN2B gene and cytogenetic abnormalities were analyzed in >60% of subjected cases. Total cholesterol, triglycerides and low-density lipoprotein cholesterol were not significantly varied between experimental and control (p >0.05). Expression analysis of human peripheral blood mononuclear cells revealed decreased mRNA levels of CDKN2B. The decreased level of p21 and CDK4 expression in the T1DM cases than control. The number of monocytes, lymphocytes and neutrophils significantly varied in T1DM samples and control (p

Background: Arch of aorta is the continuation of ascending aorta and lies in the superior mediastinum. Normally three main branches arise from the aortic arch in humans- Brachiocephalic trunk (BCT), left Common Carotid artery (LCCA), and left Subclavian artery (LSCA). Brachiocephalic trunk is the first and largest branch of arch of Aorta (AoA). At the level of the upper edge of the right Sternoclavicular joint, it divides into right subclavian and right common Carotid artery. Significant variations are seen in branching pattern of arch of aorta which have been reported by different researchers from time to time. Aims: Anatomical knowledge of the arch of aorta and its branching pattern is important for surgeons and interventional radiologists and cardiologists as the variations in this region are not rare. The present study was aimed at to determine the variations of branching pattern of arch of aorta in humans by cadaveric dissection. Settings and Design: observational study. Materials and methods: The study was carried in 50 formalin fixed cadavers used for dissection training of medical students, at department of Anatomy, Government medical College Srinagar. Dissection was done following the guidelines of Cunningham's Manual of Practical Anatomy. The observations were recorded in the department for future references. All the data was retrieved and analysed. Data was also collected from pictures available in the department. Statistical analysis used: MS excel. Results: In this study, normal branching pattern of AoA was found to be present in 47(94%) cadavers. 3 (6%) showed variation in branching pattern of AoA. Out of these 3 cadavers, 2 (4%) had vertebral artery arising directly from AoA (Type C). One cadaver showed three branches (2%), BCT, LCCA and LSCA, but origin of BCT lied to the left of mid-vertebral line. Conclusions: The percentage of anomalous branching pattern of AoA was 6%, lower when compared with the previous studies. The most common variation found was four branch pattern of AoA. Left vertebral artery originated directly from AoA between LSA and LCCA. The most interesting finding was the occurrence of three branch pattern an aberrant pattern of BCT wherein its originlied on left side of mid-vertebral line. [ABSTRACT FROM AUTHOR]

Simple Summary: The surface of a human cell is coated by glycans, which play an important role in many of the physiological processes that include cell–cell communication, interaction, and adhesion. The aberration of the process of glycan synthesis plays a role in inflammatory conditions, tumour progression and metastasis. The process of O-glycosylation is complex and takes place in the Golgi apparatus, regulated by specific enzymes called ppGalNAc transferases. The incomplete synthesis or truncated forms of O-glycans such as Tn, STn, T and ST antigens are commonly seen in cancer states. The increased expression of these truncated glycans is associated with increased invasion potential, leading to metastasis and poor prognosis in a wide range of cancers. Understanding the expression of truncated glycans by cancers paves the way for targeted therapies, which have the potential to be used as serum biomarkers of disease progression and prognosis. Glycans are an essential part of cells, playing a fundamental role in many pathophysiological processes such as cell differentiation, adhesion, motility, signal transduction, host–pathogen interactions, tumour cell invasion, and metastasis development. These glycans are also able to exert control over the changes in tumour immunogenicity, interfering with tumour-editing events and leading to immune-resistant cancer cells. The incomplete synthesis of O-glycans or the formation of truncated glycans such as the Tn-antigen (Thomsen nouveau; GalNAcα- Ser/Thr), its sialylated version the STn-antigen (sialyl-Tn; Neu5Acα2–6GalNAcα-Ser/Thr) and the elongated T-antigen (Thomsen–Friedenreich; Galβ1-3GalNAcα-Ser/Thr) has been shown to be associated with tumour progression and metastatic state in many human cancers. Prognosis in various human cancers is significantly poor when they dedifferentiate or metastasise. Recent studies in glycobiology have shown truncated O-glycans to be a hallmark of cancer cells, and when expressed, increase the oncogenicity by promoting dedifferentiation, risk of metastasis by impaired adhesion (mediated by selectins and integrins), and resistance to immunological killing by NK cells. Insight into these truncated glycans provides a complimentary and attractive route for cancer antigen discovery. The recent emergence of immunotherapies against cancers is predicted to harness the potential of using such agents against cancer-associated truncated glycans. In this review, we explore the role of truncated O-glycans in cancer progression and metastasis along with some recent studies on the role of O-glycans in endocrine cancers affecting the thyroid and adrenal gland. [ABSTRACT FROM AUTHOR]

Ankylosing Spondylitis (AS) is an aberrant inflammatory chronic disorder characterized by an inflammation to joint particularly vertebrae of spine potentially instigates them to inter-fuse. This disease is also well known as Bekhtrev disease, Bechterew's disease or marie-strumpell disease. Symptoms such as pulmonary fibrosis, restrictive lung disease, aortitis often occur rarely and these are often misdiagnosed with some other disease condition. Although recent research and genomic studies suggests that there were many etiological factors that contributed to this disease onset and progression. Among these it's association with HLA B-27 gene is widely researched one or established one. Several genomic studies had also revealed the association of innate immunity with ankylosing spondylitis while other studies define K. pneumoniae infection as a perpetuating factor in AS. However this association has not been fully understood. One of the interesting mechanism by which this disease progress is the co-stimulation of TNF and IL-17 (interlukin-17) and the involvement of SOX9+ve (SRY Box Transcription Factor 9+ve). The probability of occurrence of HLA-B27 gene in general population is (~8%). [ABSTRACT FROM AUTHOR]

Arteria Lusoria, an aberrant or anomalous right subclavian artery is the most frequent anomaly of aortic arch. It may be associated with other congenital anomalies of the heart and great vessels – rarely including truncus bicaroticus and even more rarely-aneurysmal formation. Here we report the case of 50- year old male with complaints of chest pain, spread out toward chest bone, pain in the left region of neck, who had aneurysms of ascending aorta, aortic arch and a.lusoria and truncus bicaroticus too. A.Lusoria aneurysm was with 6h8 sm size and ostium from the side of thoracic aorta. We made one after another mediastinal aortic debranching with right and left carotid-subclavian artery baypass and endovascular treatment with two stent-grafts implantatipn in ascending aorta and aortic arch. The early postoperative period was uneventful, with stable hemodynamic without catecholamins usage. We didn’t have high level of enzymes for myocardial necrosis, without rhythm and heart conduction disorders and without ischemic disturbances of left upper limb with pulsatile flow to the distal artery and so too without neurological deficit from central nervous system. Aneurysm of arteria Lusoria should be suspected in the presence of a right superior mediastinal mass on X-Ray and should be considered as a cause of new-onset dyspnea, chest pain, or dysphagia. Despite disagreement among investigators regarding the need to restore pulsatile blood flow to the right arm, we recommend reconstructing that flow, when possible. [ABSTRACT FROM AUTHOR]

Flow cytometry of intestinal lymphocytes is discussed to be a stronger predictor of enteropathy-associated T-cell lymphoma development in refractory celiac disease than T-cell clonality analysis. To investigate possible associations between clinical characteristics of refractory celiac disease patients and aberrant intraepithelial lymphocytes and to evaluate the accuracy of immunophenotyping for the identification of high-risk refractory celiac disease. Flow cytometry of isolated lymphocytes from duodenal biopsies of controls and celiac disease patients was performed and results were compared to clinical data. Flow cytometry analysis was performed on 42 controls, 37 non-complicated celiac disease and 30 refractory celiac disease cases with or without T-cell receptor clonality. Elevated aberrant intraepithelial lymphocyte counts were significantly associated with severe malabsorption. A 15% cut-off (aberrant lymphocytes among all lymphocytes) had the best discriminatory ability to identify high-risk patients. However, this technique failed to identify some high-risk cases (sensitivity 63%, specificity 100%). The severity of malabsorption was added to the criteria for high-risk refractory celiac disease, improving the correct patients' allocation (sensitivity 100%, specificity 96%). Immunophenotyping of aberrant intraepithelial lymphocytes is a good predictor for high-risk refractory celiac disease. Furthermore, adding the evaluation of malabsorption to the diagnostic assessment of refractory celiac disease optimizes accuracy. [ABSTRACT FROM AUTHOR]

Leukocyte common antigen (LCA), or CD45, is classically thought of as a leukocyte-exclusive protein, and as such, CD45 immunohistochemistry (IHC) is often used as a key differentiator between non-Hodgkin lymphomas (NHLs) and morphologically similar neuroendocrine neoplasms (NENs). Herein, we report our experience regarding aberrant CD45 immunoreactivity in a series of NENs. A natural language search was used to retrieve desired archival patient files. All prior NENs which had a positive neuroendocrine diagnosis or IHC results (synaptophysin, chromogranin, CD56, and/or neuron-specific enolase), as well as CD45 staining performed, were reviewed for possible CD45 positivity (n = 686). Among these 686 NENs, 10 were aberrantly positive for CD45 staining. CD45 showed nuclear, cytoplasmic, and/or membranous staining in tumor cells. The significance of such staining is unclear. Albeit for a minority of patients, pathologists should be aware that NENs may aberrantly stain with CD45 and thereby pose a diagnostic pitfall. Therefore, broadening routine IHC panels is recommended to differentiate NENs more clearly from NHLs. [ABSTRACT FROM AUTHOR]

BACKGROUND: The identification of aberrant phenotypes in acute leukemia is crucial for treatment monitoring and minimal residual disease analysis. Flowcytometric immunophenotyping in acute leukemia is an important tool for the detection of these aberrancies. There is wide variation in the incidence of aberrant antigens in acute leukemia in different studies and its correlation with prognostic markers. AIMS AND OBJECTIVES: The aim and objective of this study is to assess the frequency of aberrant markers in acute leukemia and determine any association with hematological parameters. MATERIALS AND METHODS: A total of 150 newly diagnosed cases of acute leukemia during the period January 2018–December 2020 were included. The flowcytometric immunophenotyping of all the above cases was done using BD FACS Canto II. RESULTS: Out of the total 150 cases of acute leukemia, 56.7% expressed aberrant phenotype. The proportional frequency of aberrant antigen expression in B-acute lymphoid leukemia (ALL), T-ALL and acute myeloid leukemia (AML) was 56.6%, 50%, and 58.5%, respectively. CD13, CD13, and CD7 were the most common aberrancies in B-ALL, T-ALL, and AML, respectively. Aberrant myeloid phenotype in B-ALL was associated with lower mean total leukocyte count (TLC) and blast percentage in peripheral blood as compared to the B-ALL with conventional phenotypes. Aberrant lymphoid phenotype in AML was associated with a higher TLC and greater blast percentage in peripheral blood than the AML with conventional phenotypes. CONCLUSION: Aberrant lymphoid phenotype in AML is associated with unfavorable hematological features. However, aberrant myeloid phenotype in B-ALL is not associated with adverse features.

Background: Few studies have assessed interventions aimed at managing nonmedical opioid use (NMOU) behavior among patients with cancer. The authors developed the Compassionate High-Alert Team (CHAT) intervention to manage patients receiving opioids for cancer pain who demonstrate NMOU behavior. The objective of this study was to determine the change in frequency of NMOU behaviors, pain intensity, and opioid requirements among those who received the intervention.Methods: A total of 130 patients receiving opioids for cancer pain that had documented evidence of NMOU and received the CHAT intervention were reviewed. Demographic and clinical information such as NMOU behaviors, pain scores, and morphine equivalent daily dose at baseline, 3, and 6 months post-intervention was obtained.Results: NMOU behaviors significantly decreased from a median (interquartile range) of 2 (1-3) at baseline to 0 (0-1) at both 3 and 6 months post-intervention (p < .001). A total of 45 of 75 (60%) and 31 of 50 (62%) of CHAT recipients achieved complete response to the intervention at 3 and 6 months, respectively. Higher baseline number of NMOU behaviors was independently associated with patient response to the intervention (odds ratio [OR], 1.97; 95% confidence interval [CI],1.09-4.28, p = .049 at 3 months; OR, 2.5; 95% CI, 1.20-6.47, p = .03 at 6 months). The median pain score decreased from 7 at baseline to 6 at both 3 and 6 months (p = .01). Morphine equivalent daily dose did not significantly change during that same period (143 mg/day vs. 139 mg/day, p = .13).Conclusions: Most patients who received the CHAT intervention improved in their NMOU behaviors and pain intensity scores 3 and 6 months post-intervention. These preliminary findings support the efficacy of CHAT in managing patients receiving opioids for cancer pain who demonstrate NMOU behavior. [ABSTRACT FROM AUTHOR]

A 9-year-old spayed female boxer suffered from lameness in both hindlimbs with a perforated paw wound. Additionally, a linear, worm-like creature was penetrating out from the wound. On examination, the dog was emaciated and infected with heartworms, detected through a fresh blood smear, echocardiography, and transabdominal ultrasonography. Adult heartworms were detected at the right atrium (RA), right ventricle (RV), and pulmonary artery (PA), including the distal abdominal aorta, external iliac, and femoral arteries. During the surgery, adults heartworms were removed from both the heart (n = 8) and the femoral arteries (n = 5). Unfortunately, not all heartworms could be removed from these locations due to the extent of the heartworm infection. The opened, ischemic wounds in the distal limbs progressively expanded and the dog subsequently died, possibly due to caval syndrome complications and septicemia. The necropsy showed no evidence of an atrial septal defect, and a total of 25 adult heartworms were collected from the perforated paw, heart, pulmonary, and femoral arteries. All worms collected during the necropsy process were molecularly confirmed to be Dirofilaria immitis.

Background: Pseudopterygium, also known as aberrant conjunctival growth, is poorly described in the literature, although it is known that this abnormality is uncommon and affects dwarf rabbits and their crossbreeds. The etiology of this disease is unknown, but there are hypotheses that the conjunctival growth cause may have its origins in immunological factors, inflammation, traumatic conditions, or cartilage dysplasias. Thus, this study reports the treatment efficacy applied in a rabbit, through the continuous use of tracolimus eye drops, after surgical procedure of conjunctival fold resection, as a way of controlling the pseudopterygium in rabbits. Case: This case report discusses the positive results from the surgical and therapeutic conduct of a clinical case attended by the Ophthalmology and Microsurgical Veterinary Service at the Hospital Veterinário Universitário (HVU) of the UFSM. The patient was a male rabbit, sterilized, approximately 2-year-old, crossed with a dwarf rabbit. The owner’s main complaint was the change in the aspect of the left eye, with progressive worsening in the previous four weeks. In the ophthalmological examination, the animal did not present impaired vision or discomfort, however, a vascularized pink membrane was noted, which consisted of a fold of the bulbar conjunctiva, that grew centripetally and covered 90% of the cornea in 360 degrees. The diagnosis was confirmed through visual inspection and the patient’s history. The eye alteration had a characteristic aspect, described as proliferation of the bulbar conjunctiva over the cornea, in a centripetal manner and without signs of inflammation. In addition, other ophthalmological alterations were ruled out during the patient’s physical and specific examination. The patient was referred for anesthetic evaluation and, in addition, pre-surgical blood tests were performed, which were normal, according to the expected ranges for the species. Subsequently, the animal was submitted to surgical treatment, which consisted of dividing the exuberant conjunctiva, followed by three radial incisions in equal portions. Next, the conjunctival fold was completely incised to the edge of the limbus, without the need of sutures. Anterior lamellar keratectomy was performed on the portion where the membrane was attached to the cornea. For home care, tobramycinbased eye drops (QID, for 7 days) and 0.02% aqueous tacrolimus eye drops (BID - continuous use) were prescribed. The animal was reevaluated 7, 14, 30, 60, 120 and 180 days after surgical correction, and no recurrence of pseudopterygium was observed during the follow-up period. The prognosis of patients with pseudopterygium is reserved, as it is known that the disease may recur after surgical treatment. Therefore, the continuous use of the chosen immunomodulating eye drops was recommended as well as periodic follow-up of the patient. Discussion: In the current study, it was not possible to increase knowledge regarding about the pseudopterygium etiology. Although the condition is not serious, it can cause partial impairment of vision and chronic discomfort. However, the vision field described in the rabbit in this current case remained unchanged, in accordance with other cases described in the literature. Furthermore, no signs of patient discomfort were detected. Some surgical techniques described in the literature for correction of pseudopterygium, shows membrane’s growth recurrence. The use of immunomodulatory drugs is suggested for relapses controlling. In this study, the tracolimus eye drops efficacy was tested, and presented good results in the patient’s evaluations for a long period after surgery. The use of immunomodulators is an option for adjuvant topical treatment for controlling pseudopterygium growth, which, associated with corrective surgical treatment, has shown positive results. [ABSTRACT FROM AUTHOR]

BACKGROUND: The identification of aberrant phenotypes in acute leukemia is crucial for treatment monitoring and minimal residual disease analysis. Flowcytometric immunophenotyping in acute leukemia is an important tool for the detection of these aberrancies. There is wide variation in the incidence of aberrant antigens in acute leukemia in different studies and its correlation with prognostic markers. AIMS AND OBJECTIVES: The aim and objective of this study is to assess the frequency of aberrant markers in acute leukemia and determine any association with hematological parameters. MATERIALS AND METHODS: A total of 150 newly diagnosed cases of acute leukemia during the period January 2018-December 2020 were included. The flowcytometric immunophenotyping of all the above cases was done using BD FACS Canto II. RESULTS: Out of the total 150 cases of acute leukemia, 56.7% expressed aberrant phenotype. The proportional frequency of aberrant antigen expression in B-acute lymphoid leukemia (ALL), T-ALL and acute myeloid leukemia (AML) was 56.6%, 50%, and 58.5%, respectively. CD13, CD13, and CD7 were the most common aberrancies in B-ALL, T-ALL, and AML, respectively. Aberrant myeloid phenotype in B-ALL was associated with lower mean total leukocyte count (TLC) and blast percentage in peripheral blood as compared to the B-ALL with conventional phenotypes. Aberrant lymphoid phenotype in AML was associated with a higher TLC and greater blast percentage in peripheral blood than the AML with conventional phenotypes. CONCLUSION: Aberrant lymphoid phenotype in AML is associated with unfavorable hematological features. However, aberrant myeloid phenotype in B-ALL is not associated with adverse features. [ABSTRACT FROM AUTHOR]

Background: Tortuosity of the internal carotid artery (ICA) is not a rare condition, but its clinical impact is underestimated. The differences in the course and shape of the ICA in the oropharynx just beneath the mucosa were investigated to determine the possible fatal bleeding for both major oropharyngeal tumor resection and less extensive procedures. We report two cases to reveal that the awareness of such an anatomical variation before performing oropharyngeal procedures. Methods and results: We report two different pathologies of retropharyngeal ICAs, which presented with otolaryngological symptoms. Case 1 Retropharyngeal right ICA. The vessel's minimum distance to the pharyngeal wall was 1 mm (very high risk of vascular injury) with a tortuous pathway. Case 2 Retropharyngeal right ICA. A tortuous ICA was in contact with the posterior pharyngeal wall (very high risk of vascular injury). Conclusion: The otolaryngologists surgeons must use caution in evaluating patients with masses in the pharynx and augment a careful and complete head and neck examination with appropriate imaging studies before operating. [ABSTRACT FROM AUTHOR]

Variations in vascular anatomy are of great concern to surgeons, as proper identification of aberrant arteries can reduce the risk of iatrogenic injury and improve patient outcomes. Several studies have highlighted the irregular branching pattern of pelvic arteries, with a recent focus on the obturator artery (OA). The OA has an inconstant origin from the internal iliac artery, external iliac artery, or inferior epigastric artery. Within the pelvis, the OA can give off muscular branches and nutrient vessels to the ilium and pubis. Though occasionally described in text, few resources employ images of human donors that depict branches arising from the OAs. Out of the 34 hemisected pelves studied, we identified 1 individual with a substantial nutrient vessel branching unilaterally from the OA. Herein, we present the first image of this unconventional nutrient artery. This vessel should be highlighted given that its size and course make it particularly vulnerable during intrapelvic surgeries such as pelvic lymph node dissection or in procedures requiring arterial embolization of the OA. [ABSTRACT FROM AUTHOR]

Variations in vascular anatomy are of great concern to surgeons, as proper identification of aberrant arteries can reduce the risk of iatrogenic injury and improve patient outcomes. Several studies have highlighted the irregular branching pattern of pelvic arteries, with a recent focus on the obturator artery (OA). The OA has an inconstant origin from the internal iliac artery, external iliac artery, or inferior epigastric artery. Within the pelvis, the OA can give off muscular branches and nutrient vessels to the ilium and pubis. Though occasionally described in text, few resources employ images of human donors that depict branches arising from the OAs. Out of the 34 hemisected pelves studied, we identified 1 individual with a substantial nutrient vessel branching unilaterally from the OA. Herein, we present the first image of this unconventional nutrient artery. This vessel should be highlighted given that its size and course make it particularly vulnerable during intrapelvic surgeries such as pelvic lymph node dissection or in procedures requiring arterial embolization of the OA.

To systematically assess available information about all variations of obturator vessels and to present the most surgically relevant types, their prevalence and calibre in order to provide a comprehensive overview for both anatomists and clinicians. A total of 2689 studies were found via searching the online databases. After applying exclusion criteria 44 studies were assessed. The cadaveric studies, CT angiographies, and clinical studies were included. Number of hemipelves, prevalence of each variation and calibre of identified vessels were studied. Each variation was classified as aberrant obturator artery/vein, aberrant accessory obturator artery/vein or anastomosis. In included studies the average incidence of the variant obturator artery was 26% with the aberrant obturator artery being the most frequent type (with the mean calibre 2.10 mm, SD = 0.35 mm), while the overall incidence of the variant obturator vein was 55%. Presented venous structures had the mean calibre of 2.98 mm (SD = 0.56 mm). According to reviewed studies, variant obturator vessels are present in a great number of patients. Due to their possible calibre larger than 3 mm they represent a structure of high clinical importance. It is important to unify the terminology and to stress out the significance to all clinicians. • Systematic review of 6113 hemipelves concerning variability of obturator vessels. • Incidence of arterial variants of corona mortis incidence is 26.06%. • Incidence of arterial variants of corona mortis incidence is 54.57%. • The most common is the aberrant obturator artery but anastomotic venous arrangement. • The mean length between the corona mortis and the pubic symphysis is 55 mm. [ABSTRACT FROM AUTHOR]

Purpose: Neck dissection is often performed in patients with oral cancer to both treat and reduce the risk of subsequent neck metastases. Injury to the hypoglossal nerve may result in dysarthria, dysphagia, and profound difficulty with upper airway control. Although surgical landmarks facilitate intra-operative identification of vital structures to be preserved, they should not be an absolute measure, due to anatomical variants. We present a rare case of unilateral aberrant anatomy of the hypoglossal nerve, passing superficial to the internal jugular vein. Methods: A 70-year-old female presented to the emergency department with an indurated and ulcerated floor of mouth lesion, later confirmed to be a squamous cell carcinoma. She was treated with wide local excision, bilateral selective neck dissection of levels I to III, surgical tracheostomy, anterior mandibulectomy and reconstruction with a left composite radial forearm free flap. Results: A nerve-like structure was identified crossing superficially and perpendicular to the internal jugular vein within the left neck, which was later determined to be an anatomical variant of the hypoglossal nerve. This was carefully dissected and preserved, and the remainder of the surgery completed uneventfully. On the right, the hypoglossal nerve followed its normal anatomical course. The patient made a good recovery and suffered no neurological complications. Conclusion: Identification, meticulous dissection and preservation of the hypoglossal nerve is essential in lymphadenectomy involving levels I and II. Detailed knowledge of both normal and variant anatomy is fundamental for surgeons, which will allow for identification and protection of important neurovascular structures, thereby minimising surgical morbidity. [ABSTRACT FROM AUTHOR]

Aberrant DNA methylation is one of the important molecular markers in acute lymphoblastic leukemia (ALL). To determine Aberrant DNA methylation profiles of the CDKN2A and CDKN2B genes in ALL samples from T1DM cases. Aberrant hypermethylation of CDKN2B gene and cytogenetic abnormalities were analyzed in >60% of subjected cases. Total cholesterol, triglycerides and low-density lipoprotein cholesterol were not significantly varied between experimental and control (p >0.05). Expression analysis of human peripheral blood mononuclear cells revealed decreased mRNA levels of CDKN2B. The decreased level of p21 and CDK4 expression in the T1DM cases than control. The number of monocytes, lymphocytes and neutrophils significantly varied in T1DM samples and control (p < 0.05). Aberrant methylation is one of the important mechanisms involved in the expression of CDKN2B genes and is an important prognostic marker for the early detection of ALL risks. [ABSTRACT FROM AUTHOR]

Aberrant internal carotid artery is a rare birth defect. It occurs when the artery takes an abnormal course, the discovery of which is fortuitous but in the presence of dysphonia or chronic cough; this anomaly remains a diagnosis of exclusion. Cervicothoracic CT scan with injection of contrast product confirms the diagnosis. We report the case of a 64-year-old patient who presented with an aberrant course of an aneurysmal internal carotid artery revealed by dysphonia and chronic cough. [ABSTRACT FROM AUTHOR]

Aberrant internal carotid artery is a rare birth defect. It occurs when the artery takes an abnormal course, the discovery of which is fortuitous but in the presence of dysphonia or chronic cough; this anomaly remains a diagnosis of exclusion. Cervicothoracic CT scan with injection of contrast product confirms the diagnosis. We report the case of a 64-year-old patient who presented with an aberrant course of an aneurysmal internal carotid artery revealed by dysphonia and chronic cough., Competing Interests: Déclaration de liens d'intérêts Les auteurs déclarent ne pas avoir de liens d'intérêts., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

• Multifunctional collagen bio matrix cross-linked with redox modulatory bio actives. • Redox modulating biomatrix for aberrant cancer wounds. • Selective killing of remnant cancer cells at tumour surgical sites. The present study demonstrates the fabrication of Lawsone cross-linked collagen bio-scaffold for management of aberrant wound healing especially wound healing in post-surgical cancer margins. Lawsone reinforced with collagen resulted in increased thermal and mechanical stability, structural integrity, decreased proteolytic susceptibility and biocompatibility. It exhibited anti-angiogenic, anti-migratory and apoptotic effect selectively in cancer cells mediated by intrinsic increase of reactive oxygen species production in cancer cells. The biological properties exhibited by Lawsone cross-linked collagen bio-scaffold makes it a promising anti-cancerous wound dressing 3-D bio-matrix biomaterial for healing of postsurgical wound margins. [ABSTRACT FROM AUTHOR]

Anatomy of the biliary tree is made up of a complex system with multiple variants of the intrahepatic and extrahepatic ducts. Thorough and in-dept knowledge of the extrahepatic biliary anatomy and its variants coupled with imaging modalities and a high index of suspicion while operating will help prevent major catastrophe when performing hepatobiliary surgery. We report a case of a lady presenting with obstructive jaundice secondary to distal common bile duct stone. An incidental finding of an aberrant right posterior sectoral duct draining into the cystic duct was identified during endoscopic retrograde cholangiography. She subsequently was planned for laparoscopic cholecystectomy. Her surgery was uneventful, and no biliary injury was encountered. A thorough knowledge of the extrahepatic biliary anatomy and its variants coupled with imaging modalities and a high index of suspicion while operating will help prevent major catastrophe. [ABSTRACT FROM AUTHOR]

The arterial morphology in patients with aberrant subclavian artery (ASA) and its association with type B aortic dissection are important for treatment and prevention. In the present study, we examined the arterial morphology of ASA patients with type B dissection and evaluated its association with type B dissection in vivo. Patients with aortic dissection who had undergone computed tomography angiography were screened for the presence of ASA and type B dissection from January 2011 to May 2021. The angles of ascending aorta, aortic arch, and aortic deviation and the diameters of the ascending aorta, aortic arch, ASA ostium, and middle ASA segment were measured on the computed tomography angiography scans of the ASA patients with type B dissection (group 1; n = 16), clinically matched counterparts without type B dissection (group 2; n = 32), and patients with clinically matched type B dissection without ASA (group 3, n = 32). The correlation between ASA morphology and type B dissection was analyzed using variance analysis or the Wallis H test. Compared with group 2, group 1 had a sharper ascending aortic angle (131.5° ± 13.7° vs 148.1° ± 7.8°; P =.001), a larger aortic deviation angle in plane 2 (28.2° ± 6.0° vs 22.1° ±7.2°; P =.005) and plane 3 (26.4° ±7.3° vs 21.8° ± 6.3°; P =.028). Similarly, group 1 had a greater diameter in the ascending aorta and aortic arch and the ostium and middle of the ASA (38.3 ± 4.1 mm vs 33.6 ± 4.5 mm [ P =.001]; 34.0 ± 9.3 mm vs 26.2 ± 2.9 mm [ P =.004]; 20.3 ± 9.3 mm vs 14.0 ± 3.2 mm [ P =.018]; 10.8 ± 2.3 mm vs 9.0 ± 1.5 mm [ P =.002], respectively), without a significant difference in the aortic arch angle. Compared with group 3, group 1 had a sharper ascending aortic angle (131.5° ± 13.7° vs 142.5° ± 11.7°; P =.026) and smaller aortic deviation angle in plane 1 (21.7° ± 6.2° vs 28.9° ± 6.2°; P =.04) and plane 3 (26.4° ± 7.3° vs 21.8° ± 6.3°; P =.007), although with no significant differences in the aortic arch angle, aortic deviation angle in plane 2, and ascending aortic diameter. The diameters of the ostium and middle segment of the ASA and ascending aorta and the angles of the ascending aorta and aortic deviation are potential risk factors for type B dissection in patients with ASA, which could provide new insights into the mechanism of type B dissection in patients with ASA. [ABSTRACT FROM AUTHOR]

Competing Interests: None declared.