Background: Intraneural (intrafascicular) injection of various solutions can result in a mechanical injury to the fascicle(s). Additional injury can be expected when injectate has neurotoxic properties. In this study we examined the neurologic consequences of intraneurally injected lidocaine 2% and 0.9% NaCl. We postulated that intraneural injection of lidocaine 2% results in greater and longer-acting neurologic deficit in rats compared to intraneural injection of 0.9% NaCl. Methods and Materials: The study was conducted in accordance with the principles of laboratory animal care and was approved by the Laboratory Animal Care and Use Committee. Twenty four adult Wistar rats (300 g) both sexes were studied. After induction of general anesthesia (ether), the median nerve was exposed bilaterally. Under direct vision, a 27-gauge needle was placed either perineurally (n=24) or intraneurally (n=24), and 3 mL of preservative-free lidocaine 2% or 0.9% was injected using an automated infusion pump (3ml/min). Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the rats were awakened and subjected to serial neurologic examinations. Neurologic examination protocol was followed to determine grip strength and toe pinch reaction. Day 7 of the experiment, the animals were sacrificed and the neural tissue histologically examined. Results: Over the week following the procedure, all animals in both injection protocols (intraneural and perineural) initially lost and subsequently regained grip strength and paw pinch withdrawal reflex. Animals in the perineural group fully recovered grip strength and toe pinch score within 24-hours of surgery; the saline group showed more rapid recovery. In contrast, neither the lidocaine 2% or 0.9% saline intraneural group fully recovered a grip strength or toe pinch until the 7th or 4th day of recovery, respectively. There were no differences in the extent of neurologic impairment or speed of recovery between the saline and lidocaine 2% groups. Post-hoc comparisons of the four injection group by treatment condition effect at each testing interval post-surgery showed superior recovery in the perineural injected preparations at all intervals tested after hour 4 (p < 0.001). The average peak pressure for the intraneural injection group was 80.96 ± 20.94 kPa versus 21.63 ± 5.58 kPa for the perineural injection group (p < 0.0001). Histologic features of the injured tissues ranged from perineural ablation, cellular infiltration to destruction of neural architecture and axonal degeneration in intraneural preparations. No differences in this regard were found between lidocaine 2% and saline 0.9% groups. Conclusions: Intraneural injection of lidocaine 2% or 0.9% NaCl result in an indistinguishable neurologic deficit that is similar both in extent and duration. Intraneural injection is associated with significantly higher injection pressure as compared to the perineural injection. These results suggest that the main mechanism of neurologic injury resulting from an intraneural injection of lidocaine 2% may be a mechanical, injury to the fascicle(s), rather than a direct neurotoxicity.

Objectives: Th e objective of this research was to determine the morphometric characteristics of lateral pterygoid plate, incidence and detailed anatomy of pterygospinous and pterygoalar bony bridges and their correlation with oval foramen. Material and methods: Th e anatomical variations of lateral pterygoid plate were studied at 100 dried human skulls (50 males, 50 females), bilaterally. Th e statistical analyses were conducted according to the side of cranium, gender and age. Results: Th e presence of complete pterygospinous foramen was found in 4% and presence of pterygoalar foramen in 15% of cases. Th e signifi cant diff erence of incomplete pterygospinous bony bridges incidence according to gender has not been confi rmed. However, it has been established higher frequency of complete pterygospinous and pterygoalar foramen, as well as incomplete pterygoalar foramen in men compared with female skulls. Higher frequency of pterygospinous foramen was noticed on male skulls in comparing to female skulls with a ratio 3/1. Th e pterygoalar foramen had left-sided predominance, independently to gender. We found a signifi cantly higher frequency in presence of complete ossifi ed pterygoalar bony bridges on the left side (12% cases), comparing to right side (3% cases) regardless to gender. Conclusion: Ossifi cations of pterygospinous and pterygoalar ligaments aren’t as rare as previously thought. While interpreting radiological images and performing procedures that require access to foramen ovale, infratemporal fossa and parapharyngeal region, variable ossifi ed formations at lateral plate’s posterior border of pterygoid process should be kept in mind.

INTRODUCTION: Sphenoid sinus is located in the body of sphenoid, closed with a thin plate of bone tissue that separates it from the important structures such as the optic nerve, optic chiasm, cavernous sinus, pituitary gland, and internal carotid artery. It is divided by one or more vertical septa that are often asymmetric. Because of it’s location and the relationships with important neurovascular and glandular structures, sphenoid sinus represents a great diagnostic and therapeutic challenge. AIM: The aim of this study was to assess the septation of the sphenoid sinus and relationship between the number and position of septa and internal carotid artery in the adult BH population. PARTICIPANTS AND METHODS: A retrospective study of the CT analisys of the paranasal sinuses in 200 patients (104 male, 96 female) were performed using Siemens Somatom Art with the following parameters: 130 mAs: 120 kV, Slice: 5 mm axial. Secondary coronal scans were then generated from original axial slices. Since the aim of this study was to evaluate anatomical variations of sphenoid sinus septation, only patients with no diseases within sphenoid sinus were included. RESULTS: Based on analysis of CT scans of patients we come to the conclusion of existence more than 1 sphenoid septum in 32% of male patients and 22.1% of female patients. In total, tying for the septum to the carotid canal at posterolateral wall of sinus was registered in 19.4% of male, and 16.8% female patients. CONCLUSION: Performing CT of paranasal sinuses before surgery is essential to avoid potential complications resulting from anatomical variations.

Although some myocardial bridges can be asymptomatic, their presence often causes coronary disease either through direct compression of the "tunnel" segment or through stimulation and accelerated development of atherosclerosis in the segment proximally to the myocardial bridge. The studied material contained 30 human hearts received from the Department of Anatomy. The hearts were preserved 3 to 5 days in 10% formalin solution. Thereafter, the fatty tissue was removed and arterial blood vessels prepared by careful dissection with special reference to the presence of the myocardial bridges. Length and thickness of the bridges were measured by the precise electronic caliper. The angle between the myocardial bridge fibre axis and other axis of the crossed blood vessel was measured by a goniometer. The presence of the bridges was confirmed in 53.33% of the researched material, most frequently (43.33%) above the anterior interventricular branch. The mean length of the bridges was 14.64 ± 9.03 mm and the mean thickness was 1.23 ± 1.32 mm. Myocardial bridge fibres pass over the descending blood vessel at the angle of 10-90 degrees. The results obtained on a limited sample suggest that the muscular index of myocardial bridge is the highest for bridges located on RIA, but that the difference is not significant in relation to bridges located on other branches. The results obtained suggest that bridges located on other branches, not only those on RIA, could have a great contractive power and, consequently, a great compressive force, which would be exerted on the wall of a crossed blood vessel.

In this paper, we demonstrate a capability of surface coil magnetic resonance imaging in the review of orbital blood vessels anatomy. Surface coil allows a better detection of small anatomic structures including vessels such as ophtalmic artery and its branches, and also orbital veins, particularly superior and inferior ophtalmic veins with accompanying branches. The best results are obtained by the use of T1 sequences with short TE and TR.

Research in this study had the character of retrospective study for which we used 24 adult female Wistar rats, who we reared under standardized laboratory conditions and divided into two groups: experimental and control. The experimental group consisted of a total of 12 animals who were classified into 2 subgroups: Z1 and Z2. The control group consisted of 12 untreated animals who were divided into 2 subgroups: K1 and K2. Once a day at regular intervals we applied by the gastric probe mycotoxin zearalenone previously dissolved in sunflower oil. To the animals in the control group we applied sunflower oil only. Dose of toxin administered was 0,5 mg/kg body weight, and a period of observation spanned two different time intervals-14 and 28 days. After completing the application of toxins, the animals were sacrificed under the general ether anesthesia and by the rules of autopsy techniques. Taken ovaries were prepared for histological and stereological analysis. Structural changes in the ovaries of treated animals were observed as degenerative changes, primarily at the level of the ovarian follicles and corpora lutea. The apparent findings in the stroma were in terms of its hipercelularity and marked hyperemia of the blood vessels. The longer the application period, the more pronounced the changes. The resulting qualitative histological changes in the ovaries of treated rats were objectified quantitatively - by stereology. We found changes in terms of decreasing volume density of functional elements of the parenchyma (ovarian follicles and corpora lutea), and increased volume density of ovarian stroma with blood vessels. Key words: zearalenone, rat, ovary, qualitative changes, stereology

Objective: In recent years regional anesthesia has gained great popularity. However, like any other medical procedure, the regional anesthesia carries certain risk of unintended intraneural injection and consequential neurological complications. Studies in animals have suggested that intraneural application of local anesthetics may cause mechanical injury. Previous studies, however, have used small animal models and clinically irrelevant injection speed or equipment. In this study we used equipment and injection methods in common clinical use to study the consequences and pressure dynamics of intraneural injection. Our hypothesis is that an intraneural injection is heralded by higher injection pressure and leads to neurologic impairment in pigs. Materials and Methods: Ten pigs of mixed breed (21-26 kg, 4-6 months old) were studied. After general anesthesia, the sciatic nerves (n = 20) were exposed bilaterally. Under direct vision, a 25-gauge insulated nerve block needle was placed either intraneurally (n = 10) or perineurally (n = 10), and 4 ml of preservative-free lidocaine 2% was injected using an automated infusion pump (15 ml/min). Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the animals were awakened and subjected to serial neurologic examinations during next 7 days. Results: All perineural injections resulted in injection pressures below 40 kPa. In contrast, intraneural injections resulted in significantly higher peak pressures (P 140 k Pa. Conclusion: High injection pressure (>140 kPa) predicts intraneural injection and consequential neurologic deficit. As long as the injection pressure is low, injection into poorly compliant tissue can be avoided and neurological complication can be prevented.

The aim of this work is to measure clinically important dimensions of thoracic and lumbal vertebras. Charts of one-hundred and seventeen patients with implanted internal fixateur on the thoracic and lumbal spine between 01.01. 2008. and 31.3.2010. at the Department for Orthopedics and Traumatology, of the Sarajevo Clinical center were retrieved, and only 14 patients, with 46 vetrtebras and 89 pedicles have had complete documentation (clearly visible measured structures on X-ray and CT scans). Digitalized antero-posterior and latero-lateral X-ray, and transversal and sagital CT scans were basic inputs for measurement of height and width of the pedicle--PH, PW, axial and vertical cortico-cortical transpedicular distances--AL, VL, and interpedicular distance--IP. The correction of enlargement on X-ray pictures was performed according to known dimensions of implants and length scale on CT scans. Enlargement of those parameters, from T1 to L5 level was from 50 to 150%. This increasing was not always linear, sometimes there was even decreasing. For instance, the IP on second and third thoracic vertebra was shorter compared to the first thoracic vertebra. Pedicles from the third to the eighth thoracic vertebra were narrower compared to the second thoracic vertebra. The importance of this work is in to analyze the mentioned dimensions by methods available to the clinician. Every other in vivo measurement is impossible because of the excessive surgical approach, while preoperative CT scanning with a great number of slices per one millimeter for this purpose is not ethical.

The optic strut and the anterior clinoid process represent bony structures that are closely related to anatomically and clinically significant elements such as the cavernous sinus, the internal carotid artery, the optic nerve and the pituitary gland. The objective of our study was to quantify dimensions of the optic strut and anterior clinoid process, and to determine variations in positions and forms of these structures. A descriptive anatomical study was performed on 200 dry human skulls. We analyzed dimensions and variations in position of the optic strut, dimensions of the anterior clinoid process as well as the incidence and forms of the caroticoclinoid foramen. The average thickness of the optic strut on skulls belonging to males was 3 mm and 2.8 mm on those belonging to females. The optic strut was most commonly attached to the anterior two fifths on the lower side of the anterior clinoid process. On the male skulls the average width of the anterior clinoid process was 9.4 mm (right) and 9.1 mm (left). Its length was 9.9 and 9.3 mm. On female skulls the average width of the process was 8.7 mm (right) and 8.3 mm (left), while the length measured 9.3 mm on the right and 8.9 mm on the opposite side. In our sample, a complete caroticoclinoid foramen appeared in 4.25%, a contact form in 2.75%. At last, an incomplete form of the foramen was observed in 9.75%. The anatomic variations of the investigated structures must be considered during the approaches to the cavernous sinus and neurovascular elements of the sellar region.

Studies in animals have suggested that intraneural application of local anesthetics may cause mechanical injury and pressure ischemia of nerve fascicles. Previous studies, however, have used small animal models and clinically irrelevant injection speed or equipment. Our hypothesis is that an intraneural injection is heralded by higher injection pressure and leads to neurologic impairment in pigs. Ten pigs of mixed breed were studied. After general anesthesia, the sciatic nerves (n = 20) were exposed bilaterally. Under direct vision, a 25-gauge insulated nerve block needle was placed either extraperineurally (n = 10) or subperineurially (n = 10), and 4 ml of preservative-free lidocaine 2% was injected using an automated infusion pump (15 ml / min). Injection pressure data were acquired using an in-line manometer coupled to a computer via an analog-to-digital conversion board. After injection, the animals were awakened and subjected to serial neurologic examinations during the 24 post-intervention hours. All but two perineural injections resulted in injection pressures below 20 psi. In contrast, intraneural injections resulted in significantly higher peak pressures. In 7 (70%) intraneural injections, the injections pressures were over 20 psi (20-50 psi). Neurologic function returned to baseline within 24 hours in all sciatic nerve receiving perineural injections. In contrast, residual neurologic impairment was present in 7 sciatic nerves after intraneural injection; residual neurologic impairment was associated with injection pressures > 20 psi. The results indicate that high injection pressure during intraneural injection may be indicative of intrafascicular injection and may predict the development of neurologic injury. Key words: nerve block, injection pressure, neurologic injury, pigs

Kratak sadržaj - Istraživanja na životinjama su pokazala da intraneuralna primjena lokalnih anestetika može uzrokovati mehanicke ozljede i ishemiju živcanih vlakana. Prethodne studije su, međutim, koristile male životinje i klinicki irelevantnu brzinu ubrizgavanja ili opremu. Nasa hipoteza je da je intraneuralna injekcija pracena vecim injekcionim pritiskom i da dovodi do neuroloskog ostecenja kod svinja. Istraživanje je rađeno na 10 svinja. Nakon opce anestezije,obostrano su prikazani ishijadicni nervi (n = 20). Pod izravnom kontrolom, igla promjera 25 gejdža plasirana je ekstraperineuralno (n = 10) ili subperineuralno (n = 10) i aplicirano je 4 ml 2% lidokaina, pomocu automatske infuzione pumpe (15 ml / min). Podaci o injekcionom pritisku su dobiveni pomocu inline manometra povezanog s racunalom preko analognodigitalne kartice. Nakon ubrizgavanja, životinje su probuđene i podvrgnute serijskim neuroloskim pregledima, tokom 24 sata nakon intervencije. Sve, osim dvije perineuralne injekcije rezultirale su injekcionim pritiskom manjim od 20 psija. Nasuprot tome, intraneuralne injekcije su rezultirale znacajno vecim injekcionim pritiskom. Kod 7 (70%) intraneuralnih injekcija, pritisci su bili veci od 20 psija (20-50 psija). Neuroloska funkcija vratila se na pocetnu u roku od 24 sata kod svih

Introduction: Sphenoid sinus is located in the body of sphenoid, closed with a thin plate of bone tissue that separates it from the important structures such as the optic nerve, optic chiasm, cavernous sinus, pituitary gland, and internal carotid artery. It is divided by one or more vertical septa that are often asymmetric. Because of its location and the relationships with important neurovascular and glandular structures, sphenoid sinus represents a great diagnostic and therapeutic challenge. Aim: The aim of this study was to assess the septation of the sphenoid sinus and relationship between the number and position of septa and internal carotid artery in the adult BH population. Participants and Methods: A retrospective study of the CT analysis of the paranasal sinuses in 200 patients (104 male, 96 female) were performed using Siemens Somatom Art with the following parameters: 130 mAs: 120 kV, Slice: 3 mm. For the coronal scan, patients were placed in supine position with their chin hyper extended and scan plane angled such that it was as perpendicular to the hard palate. Scanning was completed from the anterior frontal sinus to the sphenoid sinus. Axial scans were performed from the maxillary sinus floor to the level of the frontal sinus roof, in a plane parallel with the hard palate. Since the aim of this study was to evaluate anatomical variations of sphenoid sinus septation, only patients with no diseases within sphenoid sinus were included. Results: Based on analysis of CT scans of patients we come to the conclusion of existence more than 1 sphenoid septum in 32% of male patients and 22.1% of female patients. In total tying for the septum to the carotid canal at posterolateral wall of sinus was registered in 19.4% of male, and 16.8% female patients. Conclusion: Performing CT of paranasal sinuses before surgery is essential to avoid potential complications resulting from anatomical variations

The aim of this study was to investigate possible differences in blood glucose levels between male and female rats immediately after acute bout of forced swimming exercise. Adult male Wistar rats (weight 300350 g) were divided into two groups by gender: males (n =8) and females (n =8). All the rats were given standard rat chow and tap water ad libitum and were housed at 25±3o C on a 12-hour dark/light cycle. Both groups of rats were exposed to forced swimming stress daily, for 6 days. Duration of each swimming session progressively increased from 5 minutes on the first day to 30 minutes on sixth day, allowing adaptation to swimming conditions. The rats were forced to swim in plastic tanks (90 cm wide, 120 cm deep) containing tap water (temperature ca. 25 degrees C). The depth of water was 40 cm. Seventh day we performed acute bout of 40 minutes swimming exercise. Animals were fasted 12 hours before start of last swimming sessions to obtain fasting blood glucose levels. Preexercise blood samples were taken immediately before th last swimming session (7 day) and postexercise samples immediately after the last swimming session from rat's tail vein. Glucose levels in blood were determined using Optium XceedTM Diabetes Monitoring System (Abbot). Before last swimming session male rats had slightly lower glucose levels in comparation with female rats, but this difference was not statistically significant (3.77vs4.64 mmol/l). Acute bout of forced swimming exercise raised blood glucose level and established values in postexercise period were significantly higher in both study group in comparation to values before exercise. Male rats had greater postexercise glucose blood levels (11.85 mmol/l) in comparation with female rats (6.26 mmol/l). Our findings document the existence of gender impact on the glucose postexercise concentrations confirming the differences in the energy substrates utilization and glucose metabolism regulation during and after exercise.

Introduction. A thorough knowledge of the variations ofthe renal artery has grown in importance with the increasingnumbers of renal transplants. The literature indicates thatmultiple renal arteries are found in 9-76% cases. The purposeof this study was to establish the incidence and characteristicsin cadavers. Methods. The examinations were performed on39 cadavers dissected in the Department of Anatomy Facultyof Medicine University of Sarajevo. Results. The anatomicalfindings included the presence of multiple renal arteries in18 (46.15) cases. Most often the hilar and lower polar arterieswere found, while the upper polar artery was present in only5.1% cases. Conclusions. In preparation for interventions,such as live renal donation, vascular reconstruction, renovascularhypertension, or radical nephrectomy, preoperativerenal imaging is necessary and operative techniques shouldbe considered with attention to multiple renal arteries. Therecognition of multiple renal arteries is both