Browsing by Author "Puškaš, Laslo (7003598901)"

Background/Aim. The radial nerve (RN) is the largest terminal branch of the posterior cord of the brachial plexus. Upon leaving the axilla, the RN moves to the posterior compartment of the arm, where it makes close contact with the humerus. By penetrating the lateral intermuscular septum, RN enters the anterior compartment and, in the very proximity of the lateral epicondyle, divides into two terminal branches. The anatomy of this nerve is characterized by remarkable variability, the knowledge of which is of utmost importance in the fields of orthopedics and traumatology. The aim of the study was to examine the anatomy of the RN, including two parameters: the location and the way the RN divides into terminal branches, with a particular emphasis on the clinical implications of this data. Methods. The research was conducted on 27 cadavers, 15 female and 12 male, with a total of 54 upper extremities. After careful dissection, variations in the location and way of termination of the RN were observed on both the right and left hands. Collected data were then analyzed using Microsoft Office Excel. A classification where the division of the RN into terminal branches above the biepicondylar line (BEL) is defined as type A, while the division of RN below BEL is defined as type B was used. Results. According to the proposed classification, we observed a higher incidence of type A (66.7%) compared to type B (33.3%) in the total sample of 54 extremities. In addition, a higher prevalence of type A was observed in the female population, while a higher prevalence of type B was observed in the male population. There were differences in the distribution of types A and B between the left and right arms, but there were no variations in the way of termination of the RN. Conclusion. The present study showed an important complexity in the domain of RN anatomy with significant clinical implications. With that in mind, it is crucial for every patient that the limits of safe zones be defined while performing surgical procedures in the elbow to protect the RN and its branches from iatrogenic injuries. © 2023 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Objective: There is a low incidence of the medullary infarctions and sparse data about the vascular territories, as well as a correlation among the anatomic, magnetic resonance imaging (MRI) and neurologic signs. Materials and methods: Arteries of the 10 right and left sides of the brain stem were injected with India ink, fixed in formalin and microdissected. The enrolled 34 patients with medullary infarctions underwent a neurologic, MRI and Doppler examination. Results: Four types of the infarctions were distinguished according to the involved vascular territories. The isolated medial medullary infarctions (MMIs) were present in 14.7%. The complete MMIs comprised one bilateral infarction (2.9%), whilst the incomplete and partial MMIs were observed in 5.9% and 8.9%, respectively. The anterolateral infarctions (ALMIs) were very rare (2.9%). The complete and incomplete lateral infarctions (LMIs), noted in 35.3%, comprised 11.8% and 23.6%, respectively, that is, the anterior (5.9%), posterior (8.9%), deep (2.9%), and peripheral (5.9%). Dorsal ischemic lesions (DMIs) occurred in 11.8%, either as a complete (2.9%), or isolated lateral (5.9%) or medial infarctions (2.9%). The remaining ischemic regions belonged to various combined infarctions of the MMI, ALMI, LMI and DMI (35.3%). The infarctions most often affected the upper medulla (47.1%), middle (11.8%), or both (29.5%). Several motor and sensory signs were manifested following infarctions, including vestibular, cerebellar, ocular, sympathetic, respiratory and auditory symptoms. Conclusions: There was a good correlation among the vascular territories, MRI ischemia features, and neurologic findings regarding the medullary infarctions. © 2022 The Author(s)

Purpose: The anterolateral ligament, a structure that has been known for 130 years, has again attracted the attention both of orthopaedic doctors and anatomists. Since its initial description until now, this structure has had different names. Whether labelled as the mid-third lateral capsular ligament, the anterior oblique band of the fibular collateral ligament or the anterolateral ligament of the knee, this structure has been responsible for the so-called Segond avulsion fractures. The aim of this study was to determine the precise position and layer of the lateral knee compartment within which the anterolateral ligament is located, as well as its type. Methods: In this study, the anatomical dissection of the lateral segment of 14 cadaveric knees (six male, eight female; seven right, seven left; average age of subjects: 78 years) was performed. The dissection was carried out in keeping with Seebacher, layer by layer. Results: The anterolateral ligament was identified in seven out of 14 cadaveric knee joints (50 %). The length of the ligament was 41 ± 3 mm, while the width was 4 ± 1 mm and the thickness 1 mm (in the middle section). In 14 % of the cases, the anterior oblique band was identified as a part of the FCL. In all of the knee joints, a part of the fibres of the ITT with the same insertions and direction as the ALL was found, located, however, at a much more superficial level than the ALL. Conclusion: Analysis of the current scientific literature related to the anterolateral ligament and layer-by-layer dissection of the lateral region of 14 cadaveric knees has led to the conclusion that the anterolateral ligament is a thickening of the knee joint capsule located in the third layer of the lateral region of the knee (according to Seebacher) which is not always clearly morphologically differentiated from the remainder of the joint capsule. The anterolateral ligament is unequivocally a part of the joint capsule, which is why any damage to it should be treated in the same way as any other damage to the joint capsule. © 2014, European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA).

Background/Aim. The iliopsoas muscle [musculus (m.) iliopsoas] originates from the Greek word psóa, which means loin and represents the only muscle in the body with anatomical preconditions to simultaneously and directly contribute to the stability and movement of the trunk, pelvis, and legs. M. iliopsoas belongs to the inner thigh muscle group and forms part of the posterior abdominal wall. This muscle is the major flexor of the hip joint, and it is functionally essential for proper posture, walking, running, and other physical activities. The aim of this study was to determine the relationship between the anatomical parameters of the pelvis and nervus (n.) femoralis, as well as the relationship between the same pelvic parameters and m. psoas major. Methods. The study was conducted at the Faculty of Medicine, University of Belgrade, on cadaveric material of the Institute of Anatomy “Niko Miljanić”. For measurement purposes, 14 cadavers were used, seven of which were male and seven female, aged 67–79 years. The measuring instruments used in this study were a ruler and an electronic digital caliper (measuring range 0–500 mm, resolution 0.01 mm). Statistical data processing was performed in the SPSS 11.0 program using the Mann-Whitney U test. Results. The results of this study indicate a significant statistical difference in pelvic width between male and female cadavers, which was observed in the reduction of the bituberal line in females, while the parameters of the bispinal line showed no significant difference between the two genders. The decrease of the bituberal line in females was followed by an increase in the width of the proximal origin with a statistically significant decrease in the length of the proximal origin of the m. psoas major. Furthermore, the vertical distance of n. femoralis from the exit point of the muscle to the bispinal line was significantly reduced in the male cadavers. Conclusion. Based on our results, we can assume that, in most cases, due to the smaller bituberal and bispinal line or narrower pelvis, a shorter proximal attachment of the m. psoas major will occur with greater width (L2–L5 level) in the female than in the male gender, resulting in a longer vertical distance of n. femoralis. Such results indicate a close correlation between the anatomical parameters of the m. psoas major, which may affect the distance of n. femoralis exit from the muscle. © 2023 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim. In-depth knowledge of the vascular network of the hand is of great importance in modern medicine. The main vessel of the hand is the superficial palmar arch (SPA). As typically described in anatomical textbooks, it arises as a terminal branch of the ulnar artery, which then anastomoses with the superficial palmar branch of the radial artery. However, the SPA is characterized by remarkable variability, which has been the area of interest of many researchers so far. The aim of this study was to exert a comprehensive examination of the anatomy of the SPA. Methods. The research was conducted at the Institute of Anatomy “Niko Miljanić” on a total number of 14 cadavers. After careful dissection, variations of the modality of formation of the SPA and its distance of the SPA from Kaplan’s cardinal line were observed on the right hands. Collected data were then analyzed statistically in SPSS 11.0 using the Mann-Whitney U test, with the accepted level of statistical significance of p < 0.05. Results. According to Coleman and Anson’s classification, the higher incidence of the incomplete type (57.14%) of the SPA was observed compared to the complete type (42.86%). In addition to this, a statistically significant difference was discovered in the distance of the SPA from Kaplan’s cardinal line between two groups with complete and incomplete types, respectively. The parameter examined in the group with the complete type took the value of 2.13 ± 0.32 cm, while in the group with the incomplete type measured 3.33 ± 0.87 cm. Conclusion. The present study showed a very important complexity in the domain of anatomy of the SPA with numerous clinical implications. For that reason, a thorough evaluation of the hand circulatory system should be considered while planning surgical procedures in order to avoid operative and postoperative complications. © The Author(s) 2022.

Background / Aim. The sciatic nerve (SN) is a mixed nerve formed in pelvis by joining of L4 - S3 anterior spinal nerve roots. SN can be under the pressure in different regions throughout its course. However, the most frequent site of impingement is under the piriformis muscle which causes the occurrence of piriformis syndrome. High division of SN has its relevance considering the fact that it leads to the compression of nerve resulting in piriformis syndrome. The aim of this study was to determine the connection between anatomical parameters of pelvis and high division of SN, which is considered to be one of the most common causes of piriformis syndrome in both genders. Methods. This study was conducted on 28 formalin fixed cadavers of both genders at the Institute of Anatomy, Faculty of Medicine, University of Belgrade (Belgrade, Serbia) and the Department of Anatomy, School of Medicine, University of St Andrews (St Andrews, United Kingdom). For the measuring of required dimensions, we used a ruler and a caliper. Results. A statistically significant difference in the values of bispinal and bituberal lines was observed. A high division of SN was found on 58.33% of the male cadavers and 80% of the female cadavers. A statistically significant difference in the mean value of the bituberal line between the male and female sex was also recognised. Conclusion. The connection between the anatomical parameters of the pelvis and the level of division of the SN is confirmed. Although on the basis of the results it could be assumed that people with smaller pelvic dimensions would have greater likelihood of developing a piriformis syndrome, the other factors, such as biomechanics related to a wider „Q angle“in women that could result in a higher incidence of piriformis syndrome, should also be considered. © 2021 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

The aim of this study was the micromorphological analysis of the distribution of microvessels, mast cells and ganglionic neurons in two parts, proximal and distal of the human superior cervical sympathetic ganglions (SCSGs). Statistical analyses were applied to detect the possible metric regional differences in their densities. Five injected human SCSGs with colored India ink and gelatin were microdissected and examined. Second group of five human SCSGs was prepared and serially sliced for CD34 and mast cell tryptase immunostaining. The microscopic fields of two parts of the SCSGs were analyzed for the following quantifications: microvessel density (MVD), mast cell density (MCD), and ganglionic cell count and measurements. The mean number of CD34-positive microvessels in microscopic fields, the MVD, had a value of 83 for the upper parts, and 82.7 for the lower parts of SCSGs. The mean number of tryptase-positive mast cells in microscopic fields, the MCD, was 4.5 in the proximal parts, and 4.7 in the distal parts of SCSGs. The mean number of ganglionic neurons in microscopic fields was 19.5 in the proximal parts, and 19.8 in the distal parts of SCSGs. The density of CD34-positive microvessels, the density of tryptase-positive mast cells, and the density, mean diameters and mean areas of ganglionic neurons were not significantly different in two observed parts, upper and lower of the SCSGs. In conclusion, the distributions of microvessels, mast cells, and neurons in two parts of the SCSGs were uniform with no specific micromorphological variations, there is a homogenous vascular and cellular pattern within the SCSGs. Copyright © 2024 Boljanović, Milisavljević, Latas, Puškaš, Bogosavljević, Vujačić, Aleksandrić, Ćetković, Branković, Dožić and Ćetković.

The aim of this study was the micromorphological analysis of the distribution of microvessels, mast cells and ganglionic neurons in two parts, proximal and distal of the human superior cervical sympathetic ganglions (SCSGs). Statistical analyses were applied to detect the possible metric regional differences in their densities. Five injected human SCSGs with colored India ink and gelatin were microdissected and examined. Second group of five human SCSGs was prepared and serially sliced for CD34 and mast cell tryptase immunostaining. The microscopic fields of two parts of the SCSGs were analyzed for the following quantifications: microvessel density (MVD), mast cell density (MCD), and ganglionic cell count and measurements. The mean number of CD34-positive microvessels in microscopic fields, the MVD, had a value of 83 for the upper parts, and 82.7 for the lower parts of SCSGs. The mean number of tryptase-positive mast cells in microscopic fields, the MCD, was 4.5 in the proximal parts, and 4.7 in the distal parts of SCSGs. The mean number of ganglionic neurons in microscopic fields was 19.5 in the proximal parts, and 19.8 in the distal parts of SCSGs. The density of CD34-positive microvessels, the density of tryptase-positive mast cells, and the density, mean diameters and mean areas of ganglionic neurons were not significantly different in two observed parts, upper and lower of the SCSGs. In conclusion, the distributions of microvessels, mast cells, and neurons in two parts of the SCSGs were uniform with no specific micromorphological variations, there is a homogenous vascular and cellular pattern within the SCSGs. Copyright © 2024 Boljanović, Milisavljević, Latas, Puškaš, Bogosavljević, Vujačić, Aleksandrić, Ćetković, Branković, Dožić and Ćetković.

Although the general vascular supply of the basal ganglia and internal capsule is well known, precise data are lacking regarding the variations of the vascular territories in the two regions. Twelve hemispheres were studied following an injection of coloured ink into the main cerebral arteries, namely the anterior cerebral (ACA), middle cerebral (MCA), anterior choroidal (AChA) and posterior cerebral artery (PCA). Serial sections of the injected hemispheres were taken in the axial or coronal plane. In 75% of the hemispheres, ACA perforators were seen to supply the inferomedial part of the head of the caudate nucleus and the anterior limb of the internal capsule, as well as the anterior and inferior portions of the putamen and globus pallidus. The MCA vessels perfused the superolateral part of the head and body of the caudate nucleus, the superior part of the entire internal capsule, most of the putamen and part of the globus pallidus. The AChA perforators perfused the medial segment of the globus pallidus, the inferior part of the posterior limb, the retrolenticular and sublenticular portions of the internal capsule, and occasionally its genu. The same segment of the globus pallidus and the inferior part of the genu of the internal capsule were most likely supplied by the perforators of the internal carotid artery. A predominance of ACA territory was noticed in one specimen (8.33%) and a predominance of MCA territory in two specimens (16.67%). The obtained anatomical data may help radiologic determination of perforators involved in ischemic events, as well as a better understanding of the neurological deficits in the same events. © 2015 Elsevier Ltd. All rights reserved.

Although the general vascular supply of the basal ganglia and internal capsule is well known, precise data are lacking regarding the variations of the vascular territories in the two regions. Twelve hemispheres were studied following an injection of coloured ink into the main cerebral arteries, namely the anterior cerebral (ACA), middle cerebral (MCA), anterior choroidal (AChA) and posterior cerebral artery (PCA). Serial sections of the injected hemispheres were taken in the axial or coronal plane. In 75% of the hemispheres, ACA perforators were seen to supply the inferomedial part of the head of the caudate nucleus and the anterior limb of the internal capsule, as well as the anterior and inferior portions of the putamen and globus pallidus. The MCA vessels perfused the superolateral part of the head and body of the caudate nucleus, the superior part of the entire internal capsule, most of the putamen and part of the globus pallidus. The AChA perforators perfused the medial segment of the globus pallidus, the inferior part of the posterior limb, the retrolenticular and sublenticular portions of the internal capsule, and occasionally its genu. The same segment of the globus pallidus and the inferior part of the genu of the internal capsule were most likely supplied by the perforators of the internal carotid artery. A predominance of ACA territory was noticed in one specimen (8.33%) and a predominance of MCA territory in two specimens (16.67%). The obtained anatomical data may help radiologic determination of perforators involved in ischemic events, as well as a better understanding of the neurological deficits in the same events. © 2015 Elsevier Ltd. All rights reserved.

Early life adversities leave long-lasting structural and functional consequences on the brain, which may persist later in life. Dopamine is a neurotransmitter that is extremely important in mood and motor control. The aim of this study was to investigate the effect of maternal deprivation during the ninth postnatal day on the volume of dopaminergic nuclei and the number of dopaminergic neurons in adolescence and adulthood. Maternally deprived and control Wistar rats were sacrificed on postnatal day 35 or 60, and the dopaminergic neurons were stained in coronal histological sections of ventral midbrain with the tyrosine hydroxylase antibody. The volume of dopaminergic nuclei and the number of dopaminergic neurons in the substantia nigra (SN) and ventral tegmental area (VTA) were analyzed in three representative coordinates. Maternal deprivation caused weight loss on postnatal day 21 (weaning) and corticosterone blood level elevation on postnatal days 35 and 60 in stressed compared to control rats. In maternally deprived animals, the volumes of SN and VTA were increased compared to the controls. This increase was accompanied by an elevation in the number of dopaminergic neurons in both nuclei. Altogether, based on somatic and corticosterone level measurements, maternal deprivation represents a substantial adversity, and the phenotype it causes in adulthood includes increased volume of the dopaminergic nuclei and number of dopaminergic neurons. © Copyright © 2020 Kapor, Aksić, Puškaš, Jukić, Poleksić, Milosavljević, Bjelica and Filipović.

Early life adversities leave long-lasting structural and functional consequences on the brain, which may persist later in life. Dopamine is a neurotransmitter that is extremely important in mood and motor control. The aim of this study was to investigate the effect of maternal deprivation during the ninth postnatal day on the volume of dopaminergic nuclei and the number of dopaminergic neurons in adolescence and adulthood. Maternally deprived and control Wistar rats were sacrificed on postnatal day 35 or 60, and the dopaminergic neurons were stained in coronal histological sections of ventral midbrain with the tyrosine hydroxylase antibody. The volume of dopaminergic nuclei and the number of dopaminergic neurons in the substantia nigra (SN) and ventral tegmental area (VTA) were analyzed in three representative coordinates. Maternal deprivation caused weight loss on postnatal day 21 (weaning) and corticosterone blood level elevation on postnatal days 35 and 60 in stressed compared to control rats. In maternally deprived animals, the volumes of SN and VTA were increased compared to the controls. This increase was accompanied by an elevation in the number of dopaminergic neurons in both nuclei. Altogether, based on somatic and corticosterone level measurements, maternal deprivation represents a substantial adversity, and the phenotype it causes in adulthood includes increased volume of the dopaminergic nuclei and number of dopaminergic neurons. © Copyright © 2020 Kapor, Aksić, Puškaš, Jukić, Poleksić, Milosavljević, Bjelica and Filipović.

Background: Early life stress is a major risk factor for later development of psychiatric disorders, including post-traumatic stress disorder (PTSD). An intricate relationship exists between various neurotransmitters (such as glutamate, norepinephrine or serotonin), calcium/calmodulin-dependent protein kinase II (CaMKII), as an important regulator of glutamatergic synaptic function, and PTSD. Here, we developed a double-hit model to investigate the interaction of maternal deprivation (MD) as an early life stress model and single prolonged stress (SPS) as a PTSD model at the behavioral and molecular levels. Methods: Male Wistar rats exposed to these stress paradigms were subjected to a comprehensive behavioral analysis. In hippocampal synaptosomes we investigated neurotransmitter release and glutamate concentration. The expression of CaMKII and the content of monoamines were determined in selected brain regions. Brain-derived neurotrophic factor (BDNF) mRNA was quantified by radioactive in situ hybridization. Results: We report a distinct behavioral phenotype in the double-hit group. Double-hit and SPS groups had decreased hippocampal presynaptic glutamatergic function. In hippocampus, double-hit stress caused a decrease in autophosphorylation of CaMKII. In prefrontal cortex, both SPS and double-hit stress had a similar effect on CaMKII autophosphorylation. Double-hit stress, rather than SPS, affected the norepinephrine and serotonin levels in prefrontal cortex, and suppressed BDNF gene expression in prefrontal cortex and hippocampus. Limitations: The study was conducted in male rats only. The affected brain regions cannot be restricted to hippocampus, prefrontal cortex and amygdala. Conclusion: Double-hit stress caused more pronounced and distinct behavioral, molecular and functional changes, compared to MD or SPS alone. © 2024

Background: Early life stress is a major risk factor for later development of psychiatric disorders, including post-traumatic stress disorder (PTSD). An intricate relationship exists between various neurotransmitters (such as glutamate, norepinephrine or serotonin), calcium/calmodulin-dependent protein kinase II (CaMKII), as an important regulator of glutamatergic synaptic function, and PTSD. Here, we developed a double-hit model to investigate the interaction of maternal deprivation (MD) as an early life stress model and single prolonged stress (SPS) as a PTSD model at the behavioral and molecular levels. Methods: Male Wistar rats exposed to these stress paradigms were subjected to a comprehensive behavioral analysis. In hippocampal synaptosomes we investigated neurotransmitter release and glutamate concentration. The expression of CaMKII and the content of monoamines were determined in selected brain regions. Brain-derived neurotrophic factor (BDNF) mRNA was quantified by radioactive in situ hybridization. Results: We report a distinct behavioral phenotype in the double-hit group. Double-hit and SPS groups had decreased hippocampal presynaptic glutamatergic function. In hippocampus, double-hit stress caused a decrease in autophosphorylation of CaMKII. In prefrontal cortex, both SPS and double-hit stress had a similar effect on CaMKII autophosphorylation. Double-hit stress, rather than SPS, affected the norepinephrine and serotonin levels in prefrontal cortex, and suppressed BDNF gene expression in prefrontal cortex and hippocampus. Limitations: The study was conducted in male rats only. The affected brain regions cannot be restricted to hippocampus, prefrontal cortex and amygdala. Conclusion: Double-hit stress caused more pronounced and distinct behavioral, molecular and functional changes, compared to MD or SPS alone. © 2024