Heterotaxy: fluctuat nec mergitur

AbstractThe International Pediatric and Congenital Cardiac Code (IPCCC) states that visceral heterotaxy is defined as “a congenital malformation in which the internal thoraco-abdominal organs demonstrate abnormal arrangement across the left-right axis of the body. By convention, in congenital cardiology, heterotaxy syndrome does not include patients with complete mirror-imaged arrangement of the internal organs along the left-right axis also known as “total mirror imagery” or “situs inversus totalis”.” [www.ipccc.net]In patients with heterotaxy, it is important to describe both the cardiac relations and the junctional connections of the cardiac segments, with documentation of the arrangement of the atrial appendages, the ventricular topology, the nature of the unions of the segments across the atrioventricular and the ventriculoarterial junctions, the infundibular morphologies, and the relationships of the arterial trunks in space. Particular attention is required for the venoatrial connections, since these are so often abnormal. The relationship and arrangement of the remaining thoraco-abdominal organs, including the lungs, the spleen, the liver, and the intestines, also must be described separately, because, although common patterns of association have been identified, there are frequent exceptions to these common patterns. Therefore, in patients with heterotaxy, it is important to describe each thoracic and abdominal organ independently.

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Dissecting the Microbial Community Structure of Internal Organs During the Early Postmortem Period in a Murine Corpse Model

10.21203/rs.3.rs-1099733/v1 ◽

2021 ◽

Author(s):

Ruina Liu ◽

Kai Zhang ◽

Huan Li ◽

Qinru Sun ◽

Xin Wei ◽

...

Keyword(s):

Metabolic Pathways ◽

The Body ◽

Time Since Death ◽

Limited Information ◽

Microbial Composition ◽

Internal Organs ◽

Organ Specific ◽

Forensic Microbiology ◽

The Relationship ◽

Early Postmortem

Abstract Background Microorganisms inhabit and proliferate throughout the body both externally and internally, which are the primary mediators of putrefaction after death. However, limited information is available about the changes in the postmortem microbiota of extraintestinal body sites in the early decomposition stage of mammalian corpses. Results This study applied 16S rRNA barcoding to investigate microbial composition variations among different organs and the relationship between microbial communities and time since death over 1 day of decomposition. During 1 day of decomposition, Agrobacterium, Prevotella, Bacillus, and Turicibacter were regarded as time-relevant genera in internal organs at different timepoints. Pathways associated with lipid, amino acid, carbohydrate and terpenoid and polyketide metabolism were significantly enriched at 8 hours than that at 0.5 or 4 hours. The microbiome compositions and postmortem metabolic pathways differed by time since death, and more importantly, these alterations were organ specific. Conclusion The dominant microbes differed by organ, while they tended toward similarity as decomposition progressed. The observed thanatomicrobiome variation by body site provides new knowledge into decomposition ecology and forensic microbiology. Additionally, the microbes detected at 0.5 hours in internal organs may inform a new direction for organ transplantation.

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Situs Inversus Totalis

Neonatal Network The Journal of Neonatal Nursing ◽

10.1891/0730-0832.20.1.63 ◽

2001 ◽

Vol 20 (1) ◽

pp. 63-67 ◽

Cited By ~ 7

Author(s):

Janie Spoon

Keyword(s):

Situs Inversus ◽

Vena Cava ◽

Situs Inversus Totalis ◽

Mirror Image ◽

The Body ◽

Radiographic Examination ◽

Internal Organs ◽

Radiographic Findings ◽

Situs Solitus ◽

The Right

EXTERNALLY, THE HUMAN BODY appears symmetric; if a line is drawn down the middle of the body, each side appears identical. However, this is not true of the internal anatomy. For example, there is one heart, which lies in the left chest, one liver, in the right abdomen, and one stomach, in the left abdomen. The term situs refers to the position or location of an organ, specifically, the position of the atria and abdominal viscera in relation to the midline of the body.1 There are three types of situs: solitus, inversus, and ambiguous. Situs solitus refers to the normal arrangement of organs, with the right atrium, liver, gallbladder, trilobed lung, and inferior vena cava on the right side and the left atrium, stomach, spleen, bilobed lung, and descending aorta on the left side (Figures 1–3). Situs inversus totalis refers to a mirror image reversal of the normal position of the internal organs (Figures 4 and 5). 1 The incidence of situs inversus totalis is 1 in every 8,000 to 25,000 births, and the condition is most often diagnosed by radiographic examination.2Situs ambiguous, often referred to as heterotaxia, is the random arrangement of the internal organs and is associated with splenic abnormalities and congenital heart disease.3 The purpose of this column is to discuss the embryology, pathophysiology, and diagnosis of situs inversus totalis and to review a case study with radiographic findings.

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Unusual form of relationship between parasitic nematodes of the genus Philonema (Philonemidae) and salmonids

Russian Journal of Parasitology ◽

10.31016/1998-8435-2020-14-4-24-33 ◽

2020 ◽

Vol 14 (4) ◽

pp. 24-33

Author(s):

V. V. Pospekhov ◽

V. P. Nikishin

Keyword(s):

Sockeye Salmon ◽

Negative Impact ◽

Thick Layer ◽

Body Cavity ◽

The Body ◽

Parasitic Nematodes ◽

Dolly Varden ◽

Internal Organs ◽

Peculiar Form ◽

The Relationship

The purpose of the research is studying the relationship between nematodes of the genus Philonema (Philonemidae) and salmonids at the organismic level and justification for their interpretation as a peculiar form of encapsulation.Materials and methods. We studied the sockeye salmon, as well as the freshwater white-spotted char and Dolly Varden trout from lakes Kisi and Chistoye (basin of the Ola River, Taui Bay, Sea of Okhotsk). 7 males for breeding sockeye salmon, 39 freshwater white-spotted chars and 16 Dolly Varden trouts were dissected for infection by Philonema. We used well-known generally accepted techniques in the parasitological studies. The nematodes were preserved in 70 % ethanol and clarified in glycerol.Results and discussion. Phylonema causes pathological processes of various intensity in the body cavity of salmonids. As a rule, this is the adhesion of fish’s internal organs and the formation of a thick layer of connective tissue that surrounds the host's organs from outside and forms a kind of a "cocoon". Our studies combined with literature data allow us to consider the formation of a "cocoon" as a peculiar form of encapsulation and an adaptation that minimizes mutual negative impact of the parasite and the host on each other. Further research should determine how widespread this form of encapsulation is in nature, and it is also necessary to study the mechanism of the "cocoon" formation.

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Genetic basis of human left–right asymmetry disorders

Expert Reviews in Molecular Medicine ◽

10.1017/erm.2014.22 ◽

2014 ◽

Vol 16 ◽

Cited By ~ 23

Author(s):

Hao Deng ◽

Hong Xia ◽

Sheng Deng

Keyword(s):

Situs Inversus ◽

Genetic Basis ◽

Chromosomal Abnormalities ◽

The Body ◽

Disease Genes ◽

Internal Organs ◽

Abdominal Organs ◽

Pathogenic Genes ◽

Left Right Asymmetry ◽

Reduced Penetrance

Humans and other vertebrates exhibit left–right (LR) asymmetric arrangement of the internal organs, and failure to establish normal LR asymmetry leads to internal laterality disorders, includingsitus inversusandheterotaxy.Situs inversusis complete mirror-imaged arrangement of the internal organs along LR axis, whereasheterotaxyis abnormal arrangement of the internal thoraco-abdominal organs across LR axis of the body, most of which are associated with complex cardiovascular malformations. Both disorders are genetically heterogeneous with reduced penetrance, presumably because of monogenic, polygenic or multifactorial causes. Research in genetics of LR asymmetry disorders has been extremely prolific over the past 17 years, and a series of loci and disease genes involved insitus inversusandheterotaxyhave been described. The review highlights the classification, chromosomal abnormalities, pathogenic genes and the possible mechanism of human LR asymmetry disorders.

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A comparative analysis of the relationship between stature and ultrasound dimensions of internal organs in adolescents

Pediatrician (St Petersburg) ◽

10.17816/ped12219-27 ◽

2021 ◽

Vol 12 (2) ◽

pp. 19-27

Author(s):

Valerii O. Yerkudov ◽

Andrey P. Pugovkin ◽

Aleksej J. Volkov ◽

Oksana I. Musaeva ◽

Dmitriy J. Volkov ◽

...

Keyword(s):

Thyroid Gland ◽

Body Length ◽

Individual Characteristics ◽

The Body ◽

Comparative Characteristic ◽

Z Score ◽

Internal Organs ◽

Average Group ◽

The Individual ◽

The Relationship

The aim of the study was a comparative characteristic of the size of internal organs according to ultrasonography data in subjects with various deviations in stature, determined using international standardized norms. Materials and methods. The stature was measured in 93 adolescents, aged 13 to 17 years. Based on the measurements, the Z-score of body length was calculated according to the WHO Growth Reference, 2007 and three groups were formed for comparing the sizes of internal organs: average, above average, below average. Ultrasonography data of the internal organs dimensions and thyroid gland was performed using a Toshiba Aplio 500 ultrasound scanner. Results. There were statistically significantly lower values of the liver span and the longitudinal size of the gallbladder in the examined subjects from the below average group compared to the rest of the subjects. The length of the spleen and the total volume of the thyroid gland were statistically significantly different in subjects from all three groups, with the highest values in volunteers from the above average group. A weak direct correlation was shown between the Z-score of body length and liver span, the length of the cauda of the pancreas, and the width of the spleen. An average direct statistical relationship was found between the Z-score of stature and the length of the spleen, as well as the total volume of the thyroid gland. Conclusion. To a greater extent, body length is associated with the size of the parenchymal organs with a pronounced connective tissue frame - the liver and spleen, as well as the thyroid gland due to the relationship of its volume with hormones that regulate growth and development. Clinical substantiation of the relationship between the structure of the body and internal organs opens up the possibility of creating anatomical standards that allow ultrasound morphometric assessment of internal organs, taking into account the individual characteristics of the patients body size.

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Rare case of septum primum malposition defect in dextrocardia and situs inversus totalis without heterotaxy syndrome

Cardiology in the Young ◽

10.1017/s1047951118002263 ◽

2018 ◽

Vol 29 (3) ◽

pp. 419-421

Author(s):

Simone Jhaveri ◽

Francine Erenberg ◽

Malek Yaman

Keyword(s):

Situs Inversus ◽

Rare Case ◽

Superior Vena ◽

Venous Drainage ◽

Situs Inversus Totalis ◽

Heterotaxy Syndrome ◽

Superior Vena Caval ◽

Anomalous Pulmonary Venous Drainage ◽

Septum Primum ◽

Visceral Heterotaxy

AbstractSeptum primum malposition defect is an extremely rare CHD and is often found in patients with visceral heterotaxy, particularly of the polysplenia type. We describe a unique patient with dextrocardia, situs inversus totalis, and bilateral superior vena caval veins without heterotaxy syndrome who was diagnosed with an interatrial defect and partial anomalous pulmonary venous drainage due to malposition of the septum primum.

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Laparoscopic Cholecystectomy for Severe Acute Cholecystitis in a Patient with Situs Inversus Totalis and Posterior Cystic Artery

Diagnostic and Therapeutic Endoscopy ◽

10.1155/2008/465272 ◽

2008 ◽

Vol 2008 ◽

pp. 1-3 ◽

Cited By ~ 9

Author(s):

Theodoros E. Pavlidis ◽

Kyriakos Psarras ◽

Apostolos Triantafyllou ◽

Georgios N. Marakis ◽

Athanasios K. Sakantamis

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Situs Inversus ◽

Anatomical Variations ◽

Situs Inversus Totalis ◽

Mirror Image ◽

Cystic Artery ◽

Quadrant Pain ◽

Abdominal Organs ◽

Thoracic And Abdominal

Situs inversus totalis is an inherited condition characterized by a mirror-image transposition of thoracic and abdominal organs. It often coexists with other anatomical variations. Transposition of the organs imposes special demands on the diagnostic and surgical skills of the surgeon. We report a case of a 34-year-old female patient presented with left upper quadrant pain, signs of acute abdomen, and unknown situs inversus totalis. Severe acute cholecystitis was diagnosed, and an uneventful laparoscopic cholecystectomy was performed. A posterior cystic artery was identified and ligated. Laparoscopic cholecystectomy is feasible in patients with severe acute calculus cholecystitis and situs inversus totalis; however, the surgeon should be alert of possible anatomic variations.

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Nesfatin-1: Pleiotropic hormone

Medycyna Weterynaryjna ◽

10.21521/mw.6329 ◽

2020 ◽

Vol 76 (01) ◽

pp. 6329-2020

Author(s):

GRZEGORZ TYMICKI ◽

IWONA PUZIO ◽

MARTA PAWŁOWSKA-OLSZEWSKA

Keyword(s):

Physiological Role ◽

Pleiotropic Effect ◽

The Body ◽

Anatomical Location ◽

Internal Organs ◽

Peripheral Tissues ◽

The Central Nervous System ◽

Anorexigenic Peptide ◽

Near Future ◽

The Relationship

Nesfatin-1 was first identified in 2006 as an anorexigenic peptide involved in appetite regulation. It is expressed both in the central nervous system and in the peripheral tissues. The anatomical location of neurons expressing nesfatin-1 and its co-occurrence with other neurotransmitters in the CNS indicate that its physiological role involves not only the regulation of food intake, but also neuroendocrine regulation and autonomic control of internal organs and behavioral responses. It affects the functions of the digestive tract and the cardiovascular system and plays an important role in the regulation of water intake, sleep, and reproductive functions. It plays an important role in the mechanism of metabolic control of the body, regulation of energy balance and body temperature, and development of obesity. Nevertheless, both the main source of nesfatin-1 in the circulation and the exact mechanisms of its functioning are not fully understood. Considering the pleiotropic effect of nesfatin-1, the relationship between the degree of body fatness and the risk of various diseases and the increase in the expression of nesfatin-1 in adipocytes with the development of obesity, it can be assumed that in the near future it will be taken into account as an important factor in the development, and perhaps treatment, of various diseases.

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Living donor hand-assisted laparoscopic nephrectomy in a healthy individual with situs inversus totalis: no need to turn down the donor

BMJ Case Reports ◽

10.1136/bcr-2019-233523 ◽

2020 ◽

Vol 13 (1) ◽

pp. e233523

Author(s):

Stan Benjamens ◽

Tamar Alice Johanne van den Berg ◽

Johan Frédéric Michel Lange ◽

Robert Alexander Pol

Keyword(s):

Situs Inversus ◽

Living Donor ◽

Sagittal Plane ◽

High Volume ◽

Situs Inversus Totalis ◽

Laparoscopic Nephrectomy ◽

Close Relative ◽

Living Kidney Donors ◽

Abdominal Organs ◽

Thoracic And Abdominal

A 70-year-old healthy male individual offered to undergo a living donor hand-assisted laparoscopic nephrectomy to enable kidney transplantation for a close relative. As required for all living transplant donor candidates, extensive screening was performed to exclude potential contraindications for donation. Tests revealed a situs inversus totalis, meaning a complete transposition of the thoracic and abdominal organs in the sagittal plane. As other contraindications for living kidney donation were absent, the feasibility of this procedure was determined multidisciplinary. A successful donation procedure was performed without surgical complications for the donor and good short-term transplant outcomes. In line with current developments that have resulted in more liberal criteria for potential living kidney donors, major anatomical deviations should not automatically be a contraindication. With multidisciplinary efforts and thorough surgical preparation at a high-volume transplant centre, this procedure is feasible and safe.

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Minimally invasive esophagectomy with intrathoracic anastomosis in a situs inversus totalis patient

Journal of Surgical Case Reports ◽

10.1093/jscr/rjaa480 ◽

2020 ◽

Vol 2020 (11) ◽

Author(s):

Yunchong Meng ◽

Han Xiao ◽

Zheng Zhang ◽

Kuo Li ◽

Quanfu Huang ◽

...

Keyword(s):

Esophageal Cancer ◽

Situs Inversus ◽

Minimally Invasive Esophagectomy ◽

Rare Condition ◽

Situs Inversus Totalis ◽

Intrathoracic Anastomosis ◽

Invasive Esophagectomy ◽

Abdominal Organs ◽

Congenital Condition ◽

Thoracic And Abdominal

Abstract Situs inversus totalis (SIT) is a rare congenital condition, which is characterized by abnormal placement of the thoracic and abdominal organs. The incidence of this condition is estimated to be from 1/8000 to 1/25,000. There have been minimal reports on SIT patients with esophageal cancer. In this report, we discuss a patient with SIT complicated by middle and lower esophageal cancer who underwent laparoscopic and thoracoscopic esophagectomy with intrathoracic anastomosis, and provide useful information with regards to treatment of this rare condition.

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