Background: The current treatment of Erectile Dysfunction (ED) is mainly based on the use of drugs that provide erections shortly after use but they do not really treat the problem. Stem cell therapy is a novel treatment with regenerative properties that can possibly treat erectile dysfunction. Methods: Five patients with erectile disease were treated with Adipose-Derived Stem Cells (ADSCs) and Platelet Lysate Plasma (PLP). ADSCs were obtained through abdominal liposuction and PLP was prepared after obtaining blood samples from peripheral veins. Erectile function was evaluated with the International Index of Erectile Function questionnaire (IIEF-5) questionnaire, penile triplex at the 1st, 3rd, 6th and 12th month post-treatment. A CT scan of the head, thorax and abdomen was done before treatment and at the 12th month. Results: IIEF-5 scores were improved in all patients at the 6th month although not in the same pattern in all patients. Peak Systolic Velocity (PSV) also improved at the 6th month in all patients but also with different patterns in each patient, while End Diastolic Velocity (EDV) was more variable. Two patients decreased the treatment they used in order to obtain erection (from Intracavernosal injections (ICI) they used PDE-5Is), two had unassisted erections and one had an initial improvement which decreased at the 6th month. There were no side effects noted. Conclusions: Stem cell therapy in combination with PLP appears to show some improvement in erectile function and has minimal side effects in the short term.

Background/Objectives: Skin spot biopsy is the gold standard for diagnosing small fiber neuropathy. A systematic approach to intraepidermal nerve fiber density (IENFD) was conducted to estimate its value precisely in healthy and neuropathic subjects, independent of the neuropathy disease. The findings will serve as a guidance model for IENFD as an indicator of neuropathy predisposition. It was also investigated how IENFD was influenced by age, gender, and neuropathy. Methods: A systematic search of PubMed, Web of Science, and ScienceDirect was conducted to identify clinical studies from 1997 to 2022 concerning IENFD in healthy and neuropathic adult populations. Data were retrieved from longitudinal cohort studies, including 5–188 healthy and 6–40 neuropathic patients. Multilevel meta-regression was employed to assess associations between the anatomical region, mean patient age, and male/female ratio with IENFD. This method accounted for correlations between multiple outcomes from the same survey, offering a more nuanced analysis than standard meta-regression. Results: In the healthy population, the estimated (95% CI) IENFD values (fibers/mm) were 21.4 (19.9, 22.9) in the thigh, 17.7 (15.3, 20.1) in the forearm, 12.9 (11.8, 14.0) in the distal leg, 11.3 (6.1, 16.5) in the fingers, and 6.5 (4.4, 8.6) in the toes. The corresponding estimates in the neuropathic population were 17.2 (15.2, 19.2) in the thigh, 6.3 (2.3, 10.2) in the forearm, 5.1 (3.8, 6.4) in the distal leg, and 2.0 (0.0, 5.7) in the toes. In a healthy population, IENFD decreased with aging by 1.35 fibers/mm every 5 years (p < 0.001). Gender dimorphism in IENFD existed, with females showing higher values in the distal leg (13.6–10.5) compared to males (9.3–7.2). Conclusions: The systematic study and meta-analysis integrate evidence of IENFD in skin biopsies. This analysis reconciles findings from various methodologies and populations over two decades. Meta-regression techniques address variability due to biopsy site, fixation protocols, immunohistochemical markers, and demographics. To reduce future study heterogeneity, using the thigh is advisable as it shows the least variability. Additionally, standardizing the biopsy site internationally will ensure comparability. These findings urge further investigation into IENFD changes in neurodegenerative diseases and whether IENFD can be a reliable prognostic marker for neuropathy diagnosis.

The pancreas exhibits a uniquely intricate vascular architecture characterized by frequent and clinically significant morphological variations. These variations—impacting both arterial supply and venous drainage—are critical determinants in surgical planning, radiologic interpretation, and interventional outcomes. This comprehensive review examines the full spectrum of pancreatic vascular anatomy, with particular emphasis on embryological development, imaging manifestations, and surgical relevance. Key arterial structures, including the superior and inferior pancreaticoduodenal arteries (SPDAs and IPDAs) and the dorsal pancreatic artery (DPA)—are explored in detail alongside accessory branches. On the venous side, focus is placed on the gastrocolic trunk (GCT) of Henle, the uncinate and centro-inferior pancreatic veins, and the dorsal pancreatic vein (DPV). The review highlights that arterial aberrations, such as a DPA originating from the superior mesenteric artery (SMA), or duplicated patterns of the IPDA, as well as venous anomalies such as variant drainage of the GCT or the centro-inferior pancreatic vein, have substantial implications during pancreaticoduodenectomy, distal pancreatectomy, and transplantation procedures. With advances in multidetector computed tomography (MDCT), magnetic resonance angiography (MRA), and three-dimensional (3D) modeling, high-risk vascular variants can now be accurately mapped preoperatively, facilitating safer and more effective minimally invasive and robotic-assisted surgeries. In conclusion, the recognition and understanding of pancreatic vascular variations are imperative for optimal surgical and interventional management. This review underscores the importance of multidisciplinary collaboration among surgeons, radiologists, and anatomists, which will allow them to integrate detailed anatomical knowledge into clinical workflows, ultimately improving patient outcomes in pancreatic procedures.

Background: The anterior cerebral artery (ACA), a critical component of the cerebral arterial circle, exhibits substantial morphological variability. While previous studies have explored ACA morphology using cadaveric and imaging methods, a comprehensive meta-analysis incorporating the latest evidence is lacking. Methods: Following current guidelines, a systematic review and meta-analysis were performed across four major databases, supplemented by the gray literature and targeted journal searches. Ninety-nine studies, encompassing 85,316 patients, met the inclusion criteria. Statistical analyses were conducted using R, applying random effects models to estimate pooled prevalence and morphometric parameters. Results: The pooled prevalence of typical ACA morphology was 93.75%, whereas variants were noted in 6.25% of cases. The predominant variation identified was the accessory ACA (aACA) (1.99%), followed by unilateral absence of the A1 segment (1.78%), with the latter being more frequently recognized in imaging studies (p < 0.0001). Rare variants encompassed azygos ACA (azACA) (0.22%), fenestrated ACA (fACA) (0.02%), and bihemispheric ACA (bACA) (0.02%). The mean diameter and length of the A1 segment were measured at 2.10 mm and 14.24 mm, respectively. Hypoplasia of the A1 segment (<1 mm diameter) was recorded in 3.15% of cases. The influences of imaging modality, laterality, and population distribution on prevalence estimates were minimal. No significant publication bias was detected. Conclusions: Although infrequent, variants of the ACA possess significant clinical importance attributable to their correlation with aneurysm formation and the impairment of collateral circulation. The aACA and the absence of the A1 segment emerged as the most common variations. This meta-analysis presents an updated and high-quality synthesis of ACA morphology, serving as a valuable reference for clinicians and anatomists.

Introduction The brachiocephalic artery (BCA) is the largest branch that arises from the aortic arch, which varies in length. The present study focuses on BCA length and its probable correlation with height and torso length. Methods The BCA length (from the artery's origin to the arcus aortae), the length of the torso, and height were measured in 76 embalmed adult human cadavers of Caucasian (Hellenic) origin. Results A total of 74 arteries were measured (36 females and 38 males). The mean length was found to be 3.82 cm (SD=+/- 0.947, SE=0.110). In male cadavers, the mean BCA length was 3.94 cm (SD=+/- 0.980, SE=0.159) and in females, it was found to be 3.69 cm (SD=+/- 0.905, SE=0.151). No statistically significant difference was found (p=0.248, p>0.05) The mean torso length was 62.27 cm (SD=+/- 4.325, SE=0.496) and the mean height was 155.3 cm (SD=+/- 10.124, SE=1.161). The BCA length was correlated with body height and torso length in both sexes. A statistically significant correlation was found only between BCA length and body height in male cadavers (r=0.267, p=0.021). Conclusion The morphometric characteristics of the BCA are of great importance in a number of surgical procedures, such as stenting and catheterization in cases of aneurysms. One statistically significant correlation was observed in our study, which could be considered an important finding, as it could lead to the plausible assumption that greater height leads to the formation of larger arteries.

The vascular anatomy of the stomach is both complex and highly variable, with direct implications for oncologic, bariatric, esophageal, and interventional procedures. This comprehensive review combines anatomical, radiological, and surgical evidence on arterial and venous variations in the stomach. The left gastric artery, traditionally the first branch of the coeliac trunk, often shows variants such as a direct aortic origin or association with an abnormal left hepatic artery. The right gastric artery most frequently arises from the proper hepatic artery, but its origin can vary significantly. The gastroepiploic arteries exhibit diversity in their origin, size, and connection patterns, with occasional duplication or absence. Additional vessels, including the posterior gastric artery and the short gastric arteries, also contribute to variations in arterial supply. Venous drainage largely follows the arterial pattern. The left and right gastric veins and the gastroepiploic venous arcade are major routes, while variants of the left gastric vein and the gastrocolic trunk (Henle’s trunk) contribute to complexity through different convergence patterns. These vascular variations have significant clinical implications, as they impact the safety of D2 lymphadenectomy, the risk of ischemic complications during laparoscopic sleeve gastrectomy, the success of gastric conduit formation in esophagectomy, and the effectiveness of transarterial embolization for upper gastrointestinal bleeding. Preoperative vascular mapping with multidetector computed tomography angiography and 3D reconstruction reliably defines individual anatomy, allowing for customized surgical planning and reducing operative risks. Recognizing both common and rare gastric vascular variants is essential for safe and effective surgical and endovascular management of gastric disease.