A CASE REPORT : A CASE OF SUPERIOR MESENTERIC ARTERY SYNDROME

Superior mesenteric artery (SMA) syndrome is an uncommon but well recognized clinical entity characterized by compression of the third, or transverse, portion of the duodenum between the aorta and the superior mesenteric artery. This results in chronic, intermittent, or acute complete or partial duodenal obstruction. Superior mesenteric artery syndrome was rst described in 1861 by Von Rokitansky, who proposed that its cause was obstruction of the third part of the duodenum as a result of arterio-mesenteric compression. Some studies report the incidence of superior mesenteric artery syndrome to be 0.1- 0.3%.

Superior mesenteric artery syndrome

Superior mesenteric artery syndrome (SMAS) is a rare condition caused by compression of the transverse portion of the duodenum between the superior mesenteric artery (SMA) and the aorta, causing symptoms of duodenal outflow obstruction. We report a case of superior mesenteric artery syndrome in a 25-year-old female associated with rapid loss of weight and intermittent vomiting and resulting in severe duodenal compression that necessitated surgical treatment.

The Transverse Occipital Ligament: Anatomy and Potential Functional Significance

Background: Knowledge of the anatomy of ligaments that bind the craniocervical junction is important for treating patients with lesions of this region. Although the anatomy and function of these ligaments have been well described, those of the transverse occipital ligament (TOL) have remained enigmatic. Objective: To describe the anatomy and functions of the transverse occipital ligament. Methods: Via a posterior approach, 9 cadaveric specimens underwent dissection of the craniocervical junction with special attention to the presence and anatomy of the TOL. Results: The TOL was identified in 77.8% of the specimens. The ligament was found to be rectangular with fibers running horizontally between the lateral aspects of the foramen magnum. The attachment of each ligament near the occipital condyle was consistent, and each ligament was found superior to the transverse portion of the cruciform ligament and inserted just posterior to the lateral attachment sites of the alar ligaments. The average width, length, and thickness of the TOL was 0.34, 1.94, and 0.13 cm, respectively. The TOL in some specimens also had connections to the alar and transverse ligaments. Conclusion: The TOL was found in the majority of our specimens. The possible functions of this ligament when attached to the alar ligaments include providing additional support to these structures in stabilizing lateral bending, flexion, and axial rotation of the head. Knowledge of this ligament may aid in further understanding craniocervical stability and help in differentiating normal from pathology via imaging modalities.

Quantitative anatomy of the transverse ligament tubercles

Object. The medial tubercles of the atlas serve as the attachments of the transverse ligament and provide an important anchoring site for which no discussion of their fine anatomy is published in the literature. In this study the authors examine this anatomy along with its osseous relationships. Methods. One hundred dry cadaveric atlantal tubercles were assessed for size and relationship to nearby anatomical osseous structures. In addition, eight cadaveric specimens were evaluated for their anatomy in this area. All specimens exhibited atlantal tubercles for the attachment of the transverse portion of the cruciate ligament of the atlas. Right-sided tubercles tended to be of a larger caliber. Overall, right-sided vertical distances between these tubercles and the superior articular facets and inferior articular facets were greater, although distances from each tubercle to the lateral margin of the dental facets anteriorly were found to be constant, as were intertubercular distances. The mean angle formed between both tubercles and the dental facet was 75°. Conclusions. The data derived in this study should be useful to the clinician for whom the craniocervical junction is a vital anatomical area.

Three-Dimensional Black Blood Mr Angiography of the Liver during Breath Holding

In 2-D time-of-flight MR angiography (2-D TOF MRA) of the liver, artifacts caused by respiratory motion are unavoidable. Therefore, a 3-D black blood MRA of the liver was attempted in 7 healthy volunteers, using a 3-D gradient echo sequence which allows imaging during breath holding. 2-D TOF MRA was performed as well. In all subjects, 3-D MRA allowed visualization of the trunk, 1st-, and 2nd-order branches of the portal vein without interruption. Right 3rd-order branches were visualized without interruption in 6 of 7 subjects (85%). However, with 2-D MRA, the transverse portion of the left main portal vein could not be visualized in any subject, and the periphery of the portal vein was less clear than with 3-D MRA.

Memoirs: Two Polymastigote Flagellates of the Genera Pseudodevescovina and Caduceia

1. The previously published description of Pseudodevescovina uniflagellata from Kalotermes (Neotermes) insularis is incorrect in practically all points. The flagellate is a devescovinid which, like other members of the subfamily, has three anterior and one trailing flagellum. The trailing flagellum is relatively small and slender. 2. The most unusual characteristic is the parabasal apparatus, which consists of a C-shaped or L-shaped main limb adjacent to the nucleus and seven to nineteen cords attached to the transverse portion of this. 3. A sinuous movement of the cresta has been observed in living material. 4. The flagellate moves forward steadily with considerable vigour as compared to Devescovina lemniscata and even Stephanonympha with its hundreds of flagella. Yet the small trailing flagellum seems to be the main cause of this movement, as the anterior whip often is turned back against the body and trailed. This suggests that increase in size of the trailing flagellum, which is a broad ribbon in Devescovina lemniscata, or increase in number as in Stephanonympha, does not necessarily enhance the locomotor efficiency of the flagellate. 5. The body is completely covered with a dense investment of relatively short spirochaetes, the ends of which appear actually to be embedded in the cytoplasm and, taking an iron-haematoxylin stain, simulate basal granules. 6. There are eight chromosomes, which can be recognized most clearly when they are granules or short, stout rods in the early telophase. 7. At the beginning of binary fission, the main limb of the parabasal apparatus breaks. A portion of length about equal to that of the nucleus is left attached to the centriole at one pole of the spindle; at the other pole a parabasal develops de novo, doubtless in connexion with the centriole. This is at first a filament, which reaches a size equal to the part of the old parabasal that remains attached, then both grow equally. After division of the body, new cords grow out from this main limb. 8. The detached part of the old parabasal apparatus breaks up into successively smaller vesicular bodies, which are noteworthy for a deeply staining cap sharply distinguished from the chromophobe substance, appearing like diagrams of dictyosomes. These fragments are resorbed before plasmotomy. 9. Grassi's Devescovina nova has been found in the species of termite from which he described it, Kalotermes (Neotermes) erythraeus from Eritrea. Its characters indicate that it must be removed from Devescovina, and it has been placed in the genus Caduceia. 10. The parabasal apparatus consists of a main limb, which in this case is loosely spiralled around the trunk of the axostyle, and from one to six attached cords directed more or less parallel to it.