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Biomedical subjects

L J DiDio

Publications and source records attributed to L J DiDio.

At least 19 recordsLinked to original sources

Anatomical variations of the human suprarenal arteries.

This is on anatomical study of the suprarenal arteries and their variations in 30 cadavers aimed at providing in a subsequent article the anatomical basis of arterial segments of the gland. The suprarenal glands were supplied by 3 main groups of suprarenal arteries: superior, middle and inferior. Only the superior and the inferior groups were present in all cases, since the middle vessels appeared in only 93.3% +/- 4.6 of the cases. The superior group included on each side 4 arteries in males and 5 in females; the middle group presented only 1 artery on each side in both males and females, and the inferior group exhibited on each side 2 arteries in males and 1 artery in females. The most variable group was the middle one, the aortic origin being the most frequent but with a relatively low incidence (53.3% +/- 9.1 on the right and 46.7% +/- 9.1 on the left). The superior group originated from the posterior branch of the ipsilateral inferior phrenic artery in 83.3% +/- 6.8 on the right and 80% +/- 7.3 on the left. The arteries of the inferior group were branches of the ipsilateral renal artery in 70% +/- 8.4 on the right and 50% +/- 9.1 on the left. The origin of the middle suprarenal arteries from the trunk of the inferior phrenic artery on both sides (26.7% +/- 8.1 on the right and 36.7% +/- 8.8 on the left) should be considered relevant. The anatomical findings warrant a further investigation for the identification, illustration and nomenclature of arterial anatomicosurgical segments.

Adrenal Glands↗

Anatomical and surgical aspects of splenic segmentectomies.

Based upon the anatomicosurgical segments of the spleen, suggested by DiDio and demonstrated in cadavers, classified and named by Neder (1958) and Zappalá (1958, 1959, 1963), the normal segmental organization was anatomically and radiologically confirmed in 51 human spleens, after studying corrosion casts and radiograms of intraparenchymal vessels (Christo, 1959 a, b, 1960, 1962, 1963, 1993). From 1958 to 1965, pioneer segmental resections were performed successfully in 34 dogs and in 9 patients to safely remove traumatic injured splenic segments. At the same time, the overwhelming postsplenectomy infection (OPSI) became well identified. Consequently, to save normally functioning splenic parenchyma became the most important issue in the management of splenic injuries. The anatomical basis for partial splenectomy and splenic segmentectomy is discussed. The term "splenorrhaphy" was employed to designate all conservative or parenchyma saving operations of spleen based upon its vascular supply: from topical packings to splenic sutures including "cappings" and partial splenectomies. From analysis of 38 consecutive reports in 20 years, covering 4,076 patients, it was concluded that "splenorrhaphies" had been electively employed in 46% of the injuries and partial splenectomies were identified in 8.6% of these surgical interventions. However, the critical minimal mass of splenic tissue to be preserved after partial splenectomies is still to be defined. Postoperative complications directly related to "splenorrhaphies" are rare. Uncommonly performed after splenectomies, the heterotopical splenic autotransplantation has presented dubious results. Trials with nonoperative management of splenic blunt trauma injuries have been safer among children, whose spleens are predominantly transversally disrupted and have a higher relationship "capsular resistance/parenchymal bulk". Splenectomies have been most frequently the ultimate result of delayed laparotomy and underlying risks of growing blood requirements may surpass the advantages of preventing OPSI.

Adolescent↗

Morphology of the swine ileum terminale.

The morphology of the terminal ileum was studied in 33 male adult pigs of unknown breed. The ileum ended in the cecocolic junction at an acute angle to the cecum. The terminal ileum displayed a cylindrical form (63.6% +/- 8.4 of the cases) more frequently than an ampullary (21.2% +/- 7.1) and/or an infundibular form (15.2% +/- 6.2). The ampullary form is not related to the quadrupedal position of the animal, but is related to the functional phase of the intestine at the time of death. In the mucous tunica of the terminal ileum, longitudinal folds and aggregated lymphoid nodules appeared concentrated along the antimesenteric border.

Animals↗

Propranolol-like action of amiodarone. An electronmicroscopic study in rats under cold stress.

The cold stress leads to increased levels of catecholamines, of their precursors and metabolites, with increased oxygen consumption by the myocardium. Atrial cardiomyocytes of amiodarone-treated rats, previously stressed by cold, showed a marked decrease of the morphological alterations observed in the animals submitted to cold stress without amiodarone protection. Such results indicate, at the subcellular level, that amiodarone could improve cardiac function by a propranolol-like action when there is heart failure, a condition in which there is a high level of catecholamine.

Amiodarone↗

Variations of the origin of the artery of the sinoatrial node in normal human hearts.

The artery of the sino-atrial node was studied in 100 normal human hearts after injection of each coronary artery with coloured gelatine containing a radiopaque substance. The hearts belonged to 69 males and 31 females, being 64 Caucasians and 36 non-Caucasians (Negroes and Mulattoes) whose age ranged from 7 to 80 years. Since the individuals had committed suicide or were victims of accidents, their hearts, after pathologists' evaluation, were considered normal. The sinoatrial node of the normal human heart is supplied by the right coronary artery more frequently (58% +/- 4.9% of the cases) than by the left (42% +/- 4.9). The right anterior medial atrial artery, originating from the right coronary at the level of the medial third of the right anterior quadrant of the atrial dome, is most frequently (50% +/- 5) responsible for the blood supply of the sinoatrial node. Among the branches of the left coronary artery, the left anterior medial atrial artery, originating at the level of the medial third of the left. anterior quadrant of the atrial cupola, was the most frequent blood supplier (25% +/- 4.3) of the sinoatrial node. The origin of the artery of the sinoatrial node from the proximal portion or trunk of the left coronary artery was less frequent (12% +/- 3.2) than the origin from the circumflex artery (30% +/- 4.5). Neither sex nor race influenced the variations of the origin of the sino-atrial node.

Adolescent↗

Marcello Malpighi: the father of microscopic anatomy.

Biographical data of Malpighi to justify naming him "the father of microscopic anatomy", as he used the microscope, soon after its invention, to study and discover and accurately describe many biological, particularly anatomical, structures. Although he utilized the microscope as a scientific instrument, his ideas, innovations and discoveries caused such an opposition that the microscope could be considered as Malpighi's weapon to start a scientific revolution. He was a naturalist for whom the "natural world, known and experienced scientifically, was all that existed". He was also a "cardiocentrist", who opposed Galen's "hepatocentrism". Several anatomical structures known eponymically to honor Malpighi are listed followed by their synonyms. Malpighi is another example of a genius as an extraordinary man who stood on the shoulders of giants, such as Galilei, Hans and Zacharias Janssen, Borelli, Harvey, B. Massari, among others.

Anatomy, Comparative↗

Variations of the area and shape of the left atrioventricular valve and its cusps and leaflets.

Measurement of the areas of the cusps and leaflets of the left atrioventricular valve (LAV) and a study of their shape were performed in 91 normal human hearts, to assess the range of variation and determine the most frequent morphologic pattern. The average areas were as follows: LAV, 904.9 mm2; anterior cusp, 447 mm2; posterior cusp, 457 mm2; anterolateral leaflet, 118.6 mm2; intermediate leaflet, 212.7 mm2; and posteromedial leaflet, 126 mm2. The commonest shape of the leaflets of the posterior cusp, proved to be rectangular.

Adolescent↗

Endoscopic study of the ileal papilla in a normal case and in patients under several pathological conditions.

The ileal protrusion into the lumen of the large intestine was studied in 9 patients (8 adults and 1 girl), 6 females and 3 males, all Brazilians and Caucasians. One of the patients resulted to have no disease, whereas in the others was confirmed the suspected diverticulosis, non specific ulcerative colitis, polyposis, regional ileitis or tuberculosis. In all cases the papillary and bilabial types of the termination of the ileum was documented by endoscopic photography, justifying the change of the expression "Bauhin's ileocecal valve" to that of "eminentia ilealis". Even in cases (one with regional ileitis and the other with tuberculosis) in which the disease altered the eminentia ilealis, it was possible to recognize the ileal papilla. Endoscopy confirmed direct, in vivo observations of ileal papilla, excluding the influence of the surgical procedure (incision and exteriorization in cases of cecostomy) in the morphological aspect of the normal eminentia ilealis.

Adult↗

Scanning electron microscopy study of endocardial regeneration in bovine pericardial patch-grafts implanted in the canine heart.

The pattern of endocardial regeneration was studied in bovine parietal pericardial patch-grafts implanted in canine hearts. The grafts consisted of fibrous tissue without a cellular lining. They were implanted with either the thoracic or the cardiac surface facing the lumen of the canine ventricle to evaluate the effect on endocardial regeneration. The grafts were retrieved 7, 21, 45 and 60 days after implantation and were examined using scanning electron microscopy. At 7 days, both the thoracic and the cardiac aspect exhibited connective tissue fibers, focally covered by fibrin, platelets and blood cells. The cardiac aspect showed finer and more highly intermingled filamentous fibers than the thoracic aspect. At 21-60 days, the thoracic surface displayed a continuous network of connective fibers with a few blood cells and isolated groups of spindle-shaped cells resembling fibroblasts. At 21-60 days, the cardiac surface showed a diffuse growth of cells on the connective fiber substratum. Regenerating cells first lined the periphery of the grafts (21 days) and then proliferated towards the centrum (45-60 days). These cells varied in size and shape, were mostly closely packed, exhibited numerous microvilli or longer cytoplasmic projections, and resembled regenerating endothelial cells and mature endocardial cells. The topographic arrangement of the new lining cells suggests that they were the result of a per continuitatem regeneration (endothelial re-endothelialization) and that they they originated from the healthy endocardium of the host surrounding the implantation site. The arrangement of the connective fibers, finer on the cardiac than on the thoracic aspect, probably facilitated the development of a cellular lining.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

The relationship between the directions of myocardial bridges and of the branches of the coronary arteries in the human heart.

The variations of the direction of the myocardial bundles of the bridges over coronary arteries and branches were studied in relation to the direction of the vessels over which they are found. The investigation was performed on 82 hearts of individuals whose death was accidental and unrelated to cardiac disease. The hearts were obtained from cadavers of individuals of either sex and different racial groups, whose age ranged from 7 to 68 years. The angle between the direction of the musculature and of the vessels may explain why in some cases there is no change in the structure of the "pontine portion" of the wall.

Adolescent↗

Myocardial bridges over coronary arteries in Cercopithecus.

The presence of myocardial bridges over the coronary arteries has been studied in 29 monkey (Cercopithecus aethiops) hearts. The great resemblance between the Cercopithecus subepicardial arterial net with the corresponding one in humans has been revealed. There is a high incidence (83%) of myocardial bridges only over the ventricular branches of both coronary arteries. Myocardial bridges are usually (90%) located over the left coronary artery branches, and the left anterior interventricular branch is the most frequently (69%) overbridged vessel. The bridges are always single over the vessel examined and their length varies from 0.5 mm to 31.6 mm. No statistically significant sexual difference in myocardial bridges distribution is reported.

Animals↗

Subcellular structure of the atrial myocardium of children in cases of atrial septal defect.

In order to study the initial development of myocardial ultrastructural changes owing to right atrium volume overload, myocytes have been studied in specimens taken from the right atrial wall and auricle of four children aged 1 to 6 years with ostium secundum atrial septal defect undergoing cardiac surgery. The younger patients (1 to 4-year-old children) we observed did not show diffuse and significant myocardial ultrastructural damages. The most significant myocardial changes were observed in the 2 older patients (six years old) as we found subcellular signs of myocardial hypertrophy such as an increased number of mitochondria, increased glycogen inclusions, areas of new sarcomerogenesis and nuclei lobulated and variably shaped. Focal degenerative changes, such as rupture of mitochondrial cristae and intercellular fibrosis were also noted. These changes may be considered as the initial features of myocardial hypertrophy because they were not as severe and diffuse as those usually seen in a marked functional failure.

Cardiomegaly↗

Dimensions of the left atrioventricular valve and its components in normal human hearts.

The posterior cusp of the left atrioventricular valve was studied in 100 cadavers of Brazilians. There were 58 Caucasians and 42 non-Caucasians, 65 males and 35 females. Their age ranged from 18 to 72 years. In 91% of the cases the posterior cusp had 3 leaflets (posteromedial or right, intermediate, and anterolateral or left). The intermediate leaflet was wider (mean 18.8mm) and higher (mean 12.7mm) than the other two. All leaflets of the posterior cusp were shorter than the anterior cusp, a feature that confers on the posterior cusp the role of a supporting structure in addition to its role in the completion of closure of the left atrioventricular ostium.

Adolescent↗

Action of propranolol on the atrial cardiomyocytes of rats submitted to cold stress.

Subcellular changes of the atrial cardiomyocytes of rats caused by cold showed a) altered mitochondria with edema and lysis of crests; b) myofibrils with marked heterogeneity of patterns and ruptures, c) myofilaments disarrangement, partial necrosis and disintegration of filaments, d) lesser concentration of atrial granules in the perinuclear area. Atrial muscle fibers of propranolol-treated rats previously stressed by cold showed a marked decrease of the morphological alterations observed in the animals submitted to cold stress without propranolol protection.

Actin Cytoskeleton↗

The membranous portion of the interventricular septum and its relationship with the aortic valve in humans.

Investigation of the membranous portion of the interventricular septum (MPIS) and its relationship with the aortic valve was performed in 32 human hearts of adult individuals (19 Caucasians and 11 non-Caucasians). With transillumination of the MPIS the specimens were photographed and 35 mm slices obtained. These were digitized into Apple Macintosh II using a Dage Model 68 video camera and a Data Translations DT 2255 frame grabber. The areas and the distances were traced manually, using the NIH Image program (Wayne Rasband, NIH, Research Services Branch, NIHM). The following forms of MPIS were found: oval (31.3%), triangular (28.1%), quadrangular (18.8%), circular (15.6%) and semilunar (6.2%); its surface area varied from 5.65 mm2 to 142.63 mm2 (mean 48.82 +/- 29.17 mm2). The superior border of the MPIS was in close relationship with the aortic valve, and its upper part was usually (41%) in direct continuity with the attachments of both right (RAC) and posterior (PAC) aortic cusps, or with PAC (34%) or RAC (6%) only. Rarely (19%) the MPIS lay below the attachments of both cusps. The distance between the MPIS superior border and the attachment of the RAC was not greater than 5.89 mm (mean 1.69 mm +/- 1.9 mm). The distance between the superior border of the MPIS and the attachment of the PAC was not greater than 5.63 mm (mean 0.77 +/- 1.49 mm). Differences between sex, race and age groups were not statistically significant.

Aortic Valve↗

Atrioventricular and ventriculoatrial branches of the coronary arteries in human hearts.

Atrioventricular (AV) and ventriculoatrial (VA) branches of the coronary arteries are vessels which supply simultaneously atrial and ventricular walls by means of recurrent rami. The terminology indicates the name of the main vessel followed by the name of the recurrent vessel both combined in an adjective. These branches establish a vascular 'suture' across the coronary sulcus in front (superficially to) or behind (deeply to) the trunks of the right coronary artery and of the left coronary artery (circumflex artery). The AV and VA branches, found in 95% of 40 human hearts, should be considered a normal characteristic of the coronary circulation and an important anatomical factor for the clinical interpretation of pathological cardiac phenomena.

Adult↗