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B Stimec

Publications and source records attributed to B Stimec.

At least 19 recordsLinked to original sources

The basis for splenic segmental dearterialization: a post-mortem study.

The anatomical features of splenic segmental vessels in 102 human spleen autopsy specimens were analyzed. Methods applied were corrosion casting and post-mortem arteriography. The superior terminal splenic branch divided extracapsularly into 2.8+/-0.9 (range 2-5) and the inferior terminal splenic branch into 2.3+/-0.75 (range 2-5) branches per sample. The extracapsular lengths of the segmental branches ranged from 4.0 to 16.7 mm and the calibers from 0.4 to 2.2 mm. Superior polar arteries occurred in 31.3% and inferior polar arteries in 20.6% of cases. Their average extracapsular lengths were 39 mm and 31 mm, respectively. In conclusion, segmental splenic arteries have an extrasplenic origin and course, with an average length and caliber that allow surgical access and ligation, in order to achieve segmental dearterialization for hemostasis purposes and splenic preservation.

Angiography↗

Venous anatomy of the right colon: three-dimensional topographic mapping of the gastrocolic trunk of Henle.

BACKGROUND: The gastrocolic trunk of Henle has not been described in detail in context with right hemicolectomy. The aim of this study was to define the caliber, length and three-dimensional position of the gastrocolic trunk of Henle (GTH). METHODS: We studied 10 fresh (<24 h) cadavers. A corrosion cast method was employed. Cold polymerized methylacrylate was injected into the superior mesenteric vein (SMV) and artery. GTH diameter, length and point of confluence with the SMV were assessed. RESULTS: The GTH was present in all specimens originating from the confluence of the right gastroepiploic and superior-anterior pancreaticoduodenal veins. The GTH joined the SMV at an average distance of 2.2 cm (range, 1.6-3.2 cm) from the inferior pancreatic border and it coursed towards the right side in a ventral-cranial direction. The mean caliber and length of the GTH were 5.2 mm (range, 4.8-5.8 mm) and 16.1 mm (range, 10.1-20.7 mm), respectively. CONCLUSIONS: The GTH is a short, medium-sized vessel of potential clinical significance with a consistent ventral-cranial direction.

Adult↗

[Surgical anatomy of the spleen with special emphasis on its segmental architecture].

The authors have analyzed several aspects of the surgical anatomy of spleen, commencing with historical data, topography, peritoneal ligaments, variations in shape, embryology and accessory spleens and venous system of the spleen. The mode of splenic artery branching, variations of polar arteries, and intra- and extraparenchymatous arterial anastomoses were thoroughly analyzed. It was shown that the spleen in most cases consists of five vascular territories (segments) clearly demarcated from each other, stressing the practical significance of splenic anatomy in segmental dearterialization of the spleen.

Humans↗

Laparoscopic management of consecutive ovarian pregnancy in a patient with infertility.

The diagnosis of ovarian pregnancy is based on the improper rise of serum beta-hCG levels, sonographic findings of an empty uterus, highly characteristic ovarian formation with double hyperechogenic ring surrounding small hypoechogenic field, and the laparoscopic verification of Spiegelberg's criteria. We present a case of ovarian pregnancy in spontaneous cycle in 34-year-old woman following two unsuccessful IVF/ET procedures and ovarian pregnancy on contralateral side laparoscopically treated seven months ago, also achieved in non-stimulated, spontaneous cycle. On admission she had a serum hCG level of 596 mIU/mL on cycle day 46 and an empty uterus. Transvaginal sonography showed a 20 mm ring-like thick-walled hyperechogenic structure within the left ovary. The echogenic ring was surrounded by irregular, hypoechogenic structures suggestive of an ovarian pregnancy with periluteal hemorrhage and blood clots. The ruptured cystic ovarian pregnancy and the corpus luteum were removed by laparoscopy. During the procedure we have seen two clips on the right ovary placed laparoscopically to achieve hemostasis after rupture of the ovarian pregnancy seven months ago. Histopathology showed isolated chorionic villi within hemorrhagic areas in the vicinity of the corpus luteum.

Adult↗

[Surgical importance of anatomic features of the pancreatic head and tail].

The surgical anatomy of the left pancreatic portion includes topography of this entity in relation to the peritoneum and the adjacent organs, variations of the arterial vascularization and venous drainage, and of the ductal system. A particular emphasis was on the practical significance of the variations of the pancreatic tail, the arterial anastomoses of the corporocaudeal region, and the position and morphology of the pancreatic veins. Ending remarks include a small review on distal pancreatectomy.

Humans↗

[Topographic and structural characteristics of the minor duodenal papilla].

The study of minor duodenal papilla topography and structure was carried out on 36 fresh autopsy specimens of human duodenopancreas. We performed precise measurements of its distance to the major duodenal papilla and to the superior duodenal flexure. There was no correlation between the position of the minor papilla and the incidence of duodenal ulcer disease. Microdissection and histological staining of the minor papilla did not reveal an anatomically defined sphincter around the terminal portion of the accessory pancreatic duct. All the specimens of the minor papilla contained within acini of pancreatic tissue. A terminal dilation of the accessory pancreatic duct was found in 22% of the cases.

Adult↗

Computerized planimetry of normal and abnormal postmortem pancreatograms.

The aim of this study was to evaluate postmortem pancreatograms by means of computerized planimetry of the ductal drainage area. This method was applied to a total of 136 pancreatograms from autopsy specimens of the human duodenopancreas, with and without pathological changes. The mean value of the total ductal drainage surface area was 5,054 mm2 for normal specimens and 3,938 mm2 in cases with chronic pancreatitis; this difference was statistically highly significant. The analyses also included measuring the accessory duct drainage area (if an accessory duct was present), and the percentage of its share in the total gland area. This share was significantly larger in cases with chronic pancreatitis (24.4%) in comparison to the normal specimens (16.8%). In conclusion, computerized planimetry of pancreatograms supplies valuable data not only on the pathogenesis of chronic inflammation of the gland, but also on some of the possible predisposing factors for this condition.

Adult↗

Anatomoclinical significance of splenic artery anastomotic bridges.

The authors analyzed the frequency of anastomotic bridges between the terminal branches of the splenic artery, their location related to the splenic surface, length and caliber on a total of 102 autopsy specimens of human spleen and pancreatic tail. The methods applied were corrosion casting and postmortem arteriography. The incidence of cases with the splenic artery anastomotic bridges was 33.3%. They were located as follows: intrasplenic 25.5%, extrasplenic 4.9%, both intra- and extrasplenic 2.9%. The remaining two-thirds of spleens were free of anastomoses and thus hypothetically acceptable for partial and segmental splenectomy, as arterial bridges can jeopardize such surgical procedures. Intrasplenic arterial anastomotic bridges were of small caliber and ruled negligible, while the extrasplenic arterial anastomoses are of large caliber being of surgical importance.

Corrosion Casting↗

The blood supply of the hypoglossal nerve: the microsurgical anatomy of its cisternal segment.

BACKGROUND: While the characteristics of the vasculature of the second (intracanalicular) segment of the hypoglossal nerve are well known, the vascularization of the first (cisternal) segment of this nerve has not been examined so far. Many pathologic processes and malformations can be located in the premedullary cistern, which may affect the vasculature of the cisternal segment. Consequently, we decided to examine the blood supply of the cisternal segment. METHODS: The anatomic features of the cisternal segment and its vasculature were examined in 15 hypoglossal nerves after injection of india ink and gelatin into the vertebrobasilar arterial system. RESULTS: The cisternal segment was noted to consist of 3-15 long roots, which usually formed two trunks of the hypoglossal nerve. The roots of each nerve received blood from the anterolateral and the lateral medullary arteries, which ranged from 3 to 5 in number and between 100 microns and 500 microns in caliber. These arteries may arise from the perforating branches or the pontomedullary branch of the basilar artery; the vertebral artery or its perforators; the anterior spinal artery or its vascular roots; the posterior spinal artery; and the posterior inferior cerebellar artery. The main hypoglossal arteries, which ranged in diameter from 20 microns to 80 microns, always coursed along the dorsal surface of the roots of the hypoglossal nerve. CONCLUSIONS: The cisternal segment of the hypoglossal nerve was always vascularized by several vessels, which mainly originated from the vertebral artery and its branches. This observation was discussed from the neurosurgical point of view.

Cadaver↗

Endoscopic manometry of the sphincter of Oddi and pancreatic duct in patients with chronic pancreatitis.

CONCLUSION: Endoscopic manometry in patients with chronic pancreatitis has demonstrated some manometric abnormalities in the sphincter of Oddi, but these abnormalities have no significant role in the pathogenesis of chronic pancreatitis. BACKGROUND: The study was undertaken to determine whether the sphincter of Oddi dysfunction plays a significant role in the pathogenesis of chronic pancreatitis. METHODS: Manometric investigation was performed in 32 patients with chronic pancreatitis. Twenty-three of them had alcohol-induced chronic pancreatitis, seven had biliary pancreatitis, and two patients had annular pancreas with chronic pancreatitis. Fifteen of them had dilated main pancreatic duct. Twenty-one cholecystectomized patients with no abnormality of the pancreas and biliary system served as controls. RESULTS: This study showed no significant difference in the mean pressures in the pancreatic duct, sphincter of Oddi (basal and phasic), and frequency of the sphincter of Oddi phasic contractions when comparing patients and controls. Sphincter of Oddi basal pressure (26-44 mmHg) was markedly increased in seven patients, whereas three patients (two of them had increased sphincter of Oddi basal pressure) had increased pancreatic duct pressure (20-24 mmHg). Increased numbers of retrograde contractions were found in seven patients.

Cholangiopancreatography, Endoscopic Retrograde↗

Unusual variants of the tributaries of the main pancreatic duct revealed by postmortem and endoscopic pancreatography.

Analysis of 97 human postmortem pancreatograms and 103 endoscopic pancreatograms revealed a total of 3 cases (1.5%) with isolated variants in the branches of the main pancreatic duct. In the first one, tortuous branches were present in the upper head-body region. The second case involved joint tributaries bridging over an unstenosed segment of the main pancreatic duct. In the third case, we found three branches from the uncinate process running down to the main duct. In all of these cases no pathological substrate was found, and they should be considered as anatomical variants observed during interpretation of a radiogram.

Adult↗

The significance of aductal zones on pancreatograms: an anatomo-clinical assessment.

The authors analyzed 177 endoscopic retrograde pancreatograms (ERPs) with normal findings. The complete visualization of the side branches was achieved in 128 patients (72.3%), and aductal zones in the isthmus and mid-body of the pancreas were noted in 49 (27.3%) of these patients. The existence and incidence of the aductal zones were evaluated and verified in 141 anatomical duodenopancreas specimens. Thirty-two corrosion casts and 109 postmortem pancreatograms were analyzed. The postmortem specimens had a 36.2% incidence of aductal zones in the same location, with no statistically significant difference compared with the clinical pancreatograms. The visualization of the side branches was 100% on the postmortem pancreatograms, indicating that the clinical ERCP incidence of aductal zones is realistic.

Cholangiopancreatography, Endoscopic Retrograde↗

The role of beta-endorphin in pregnancy and delivery.

This paper deals with beta-endorphin determination in 20 autopsy specimens of human fetal and neonatal pancreas, as well as in the placental tissue specimens of the same fetoplacental units, by means of radioimmunoassay (RIA-Nichols Institute). Peripheral blood samples of 10 healthy non-gravids were taken as controls. Our results present a marked increase of beta-endorphin levels with the progression of gestation, reaching a peak of 3960 pg/g at term. The data obtained indicate that beta-endorphin plays an important role in pregnancy and delivery regulation.

Female↗

Is there a link between beta-endorphin and diabetes in pregnancy?

The possible influence of both beta-endorphin and insulin secretion on diabetes development in pregnant women was studied by means of radioimmunoassay technique (RIA-Nichols Institute). The study was carried out by determination of beta endorphins in peripheral blood samples of 28 pregnant women with gestational diabetes. They consisted of two subgroups: 14 women with insulin independence, and 14 with insulin-dependent disease. Beta endorphin increase was found in both groups, according to the progression of gestation, and the rise was significantly higher in the insulin-dependent group. At the same time, insulin application caused a marked growth of beta-endorphins in insulin-dependent group. Beta-endorphins, inhibiting insulin secretion, can influence gestational diabetes development.

Diabetes Mellitus, Type 1↗

The neurovascular relationships and the blood supply of the abducent nerve: surgical anatomy of its cisternal segment.

Twenty-eight abducent nerves were examined after injecting india ink and gelatin into the vertebrobasilar arterial system. All the abducent nerves were found to be crossed and/or penetrated by the surrounding vessels. The ventral surface of the nerves was crossed by the anterior inferior cerebellar artery (AICA) (75.0%), the posterior inferior cerebellar artery (17.85%), the common trunk of the AICA and posterior inferior cerebellar artery (7.14%), the internal auditory artery (14.28%), the anterolateral artery (46.43%), the pontomedullary artery (92.86%), and the corresponding veins (46.43%). The dorsal surface of the cisternal segment was crossed by the AICA (35.71%), the inferolateral pontine artery (10.71%), the anterolateral artery (82.14%), and the certain veins (46.43%). Sixty-four percent of the cisternal segments were penetrated by one or more of the following vessels: the AICA (25.0%), the anterolateral artery (17.86%), the pontomedullary artery (3.57%), and/or by the corresponding veins (42.86%). The majority of the cisternal segments of the abducent nerves were supplied by the anterolateral arteries (85.71%), and only some of them by the AICA (14.29%) or the pontomedullary artery (7.14%). The authors discuss the possible clinical significance of the anatomical data.

Abducens Nerve↗

Immature ovarian teratoma in a young girl: very short course and lethal outcome. A case report.

Immature teratomas of the ovary represent less than 1% of all ovarian teratomas. They contain several tissues that derive from the three embryologic layers: ectoderm, mesoderm, and endoderm. We report the case of a 17-year-old girl who presented with an immature teratoma of the left ovary that recurred 3 months later as an inoperable malignant neuroepithelial peritoneal tumor resembling a glioblastoma. She died 3 weeks after the second explorative operation. The very aggressive course and fast lethal outcome could be explained by the patient's refusal to receive chemotherapy after the initial operation.

Adolescent↗