scholarly journals Anatomical study on variable disposition of structures in the renal hilum

2021 ◽  
Vol 9 (10) ◽  
pp. 3039
Author(s):  
Pooja Dawani ◽  
Vandana Mehta ◽  
Amandeep Kaur
Keyword(s):  
Renal Vein ◽  
Imaging Techniques ◽  
Anatomical Study ◽  
New Delhi ◽  
Medical College ◽  
Classical Pattern ◽  
Renal Hilum ◽  
Human Cadavers ◽  
Proper Diagnosis ◽  
Hilar Region

Background: The hilum is a deep vertical fissure present anteromedially in the kidney, and contains renal vessels and pelvis. Due to advancements in imaging techniques; nephron sparing surgeries like laparoscopic partial nephrectomy have become more common. In these procedures, only specific branch of renal artery, and tributary of renal vein are ligated in the renal hilum. This requires adequate skill of the surgeon as the structures are crowded in the renal hilum. The knowledge of arrangement of renal hilar structures is also important for radiologists to correctly interpret renal angiograms and other radiological scans.Methods: The present study was conducted in the department of anatomy, Vardhman Mahavir medical college, New Delhi on 64 kidneys derived from embalmed human cadavers. The renal hilum was dissected and the sequence of structures from anterior to posterior direction was noted.Results: The kidneys were classified in 6 patterns, with the classical pattern (renal vein, artery and pelvis from anterior to posterior) observed in 37.5% cases only. Remaining 62.5% cases exhibited variations, of which the pattern 2 (V-A1-P-A2) was seen in maximum cases (26.5%).Conclusions: The classical pattern described in anatomical textbooks is not the only pattern of arrangement of renal hilar structures. Instead, variant patterns are commonly encountered. The present study attempts to elucidate the variant anatomy of the renal hilar region to help radiologists and surgeons in proper diagnosis and treatment.

scholarly journals Upper limb arterial pattern: clinical correlation and embryological perspective

2021 ◽  
Vol 20 ◽  
Author(s):  
Laishram Sophia ◽  
Darshita Singh ◽  
Neha Xalxo ◽  
Anjoo Yadav ◽  
Sneh Agarwal ◽  
...  
Keyword(s):  
Upper Limb ◽  
Brachial Artery ◽  
Axillary Artery ◽  
Common Trunk ◽  
New Delhi ◽  
Palmar Arch ◽  
Medical College ◽  
Human Cadavers ◽  
Median Artery ◽  
Development Methods

Abstract Background Variations in the upper limb arterial pattern are commonplace and necessitate complete familiarity for successful surgical and interventional procedures. Variance in the vascular tree may involve any part of the axis artery of the upper limb, including the axillary artery and brachial artery or its branches, in the form of radial and ulnar arteries, which eventually supply the hand via anastomosing arches. Objectives To study the peculiarities of the arterial pattern of the upper limb and to correlate them with embryological development. Methods The entire arterial branching of forty-two upper limbs of formalin fixed adult human cadavers was examined during routine dissection for educational purposes, conducted over a 3-year period in the Department of Anatomy, Lady Hardinge Medical College, New Delhi. Results The study found: 1) One case in which a common trunk arose from the third part of the axillary artery, which immediately splayed into four branches (2.4%); 2) High division of the brachial artery into ulnar and radial arteries, in 3 cases (7.1%); 3) Pentafurcation of the brachial artery into ulnar, interosseus, radial, and radial recurrent arteries and a muscular twig to the brachioradialis in 1/42 cases (2.4%); 4) Incomplete Superficial Palmar arch in 3/42 cases (7.1%); and 5) Presence of a median artery in 2/42 case(4.8%) Conclusions This study observed and described the varied arterial patterns of the upper limb and identified the various anomalous patterns, supplementing the surgeon’s armamentarium in various surgical procedures, thereby helping to prevent complications or failures of reconstructive surgeries, bypass angiography, and many similar procedures.

scholarly journals Comparative study of Pelvi-calyceal system and relationship of structures at hilum of kidney between Nepalese and North Americans

2019 ◽  
Vol 12 (2) ◽  
pp. 10-16
Author(s):  
P. Baral ◽  
S. Koju ◽  
R. Shrestha ◽  
S. Kumar ◽  
R. Baidya
Keyword(s):  
New York ◽  
Renal Artery ◽  
Renal Pelvis ◽  
Renal Vein ◽  
Medical College ◽  
North Americans ◽  
Pelvicalyceal System ◽  
Renal Hilum ◽  
The Common ◽  
Relationship Of

Introduction: Pelvi-calyceal system consists of renal pelvis along with major and minor calyces.The minor calyces unite with their neighbors two or three chambers to form the major calyces. The major calyces drain into the infundibula. The renal pelvis is formed from the junction of the infundibula. The common pattern of arrangement of structures at the renal hilum, antero-poteriorly is renal vein, renal artery and pelvis. Objectives: To compare the study of pelvi-calyceal system and relationship of structures at hilum of kidney between Nepalese and North Americans. Methodology: The gross and prosected kidney specimens were studied for pelvi-calyceal system and relationship of structures at hilum of kidney in Anatomy department. In Nepal, the study was undertaken in Gandaki Medical College, Kaski and in USA, it was done in Well-cornel University, New York. Result: Tricalyceal major calyx were found in 63.8% in Nepalese and Bicalyceal were found in 65.6% North Americans which is statistically significant variations. The number of minor calyces and pyramids varying 6 in Nepalese and 9 in North Americans were also statistically significant (p<0.05). The arrangement of structures at hilum of kidney from anterior to posterior(renal vein, artery and pelvis) in Nepalese and North American kidneys was 86.1% and 62.5% respectively whereas the structures arranged as renal artery, vein and pelvis from anterior to posterior was 13.9% and 37.5% . Conclusion: There are significant variations in pelvicalyceal system and relations of structures at hilum of kidneys of Nepalese and North-Americans.

scholarly journals Anatomical Study of Variations in the Origin of Axillary Artery Branches and Its Clinical Emphasis

2020 ◽  
Vol 6 (1) ◽  
pp. 05-09
Author(s):  
Suman Tiwari ◽  
M Khizer Hussain Afroze
Keyword(s):  
Cardiopulmonary Bypass ◽  
Axillary Artery ◽  
Anatomical Study ◽  
Upper Limbs ◽  
Surgical Exploration ◽  
Medical College ◽  
Thoracoacromial Artery ◽  
Human Cadavers ◽  
Dissection Method ◽  
Number Of Branches

Introduction: Axillary artery, one of the most important arteries of the upper limb is gaining increasing interest in the cardiac and cardiopulmonary bypass surgeries. The present study describes the number of branches arising from axillary artery and variations in their origin. Subjects and Methods: 40 upper limbs from 20 adult embalmed human cadavers of both the sexes were studied by dissection method at the Department of Anatomy, MVJ Medical College, and Bangalore. Results: The number of branches arising from axillary artery varied from 4 -7.The most common variation in the present study was observed in the origin of subscapular artery(15%), followed by posterior circumflex humeral (10%), anterior circumflex humeral & lateral thoracic (7.5% each) and superior thoracic artery (2.5%). Any type of variation in the origin of thoracoacromial artery was not found in the present study. Conclusion: Knowledge of variations in the origin of axillary artery branches is of immense significance to anatomists, anaesthetists, cardiovascular and orthopaedic surgeons during surgical exploration of axilla, during flap or reconstructive surgeries, shoulder dislocation and for radiologists during angiography.

The desperate plea of women with the nutcracker syndrome

Phlebologie ◽  
2010 ◽  
Vol 39 (02) ◽  
pp. 104-111
Author(s):  
J. L. Villavicencio
Keyword(s):  
Renal Vein ◽  
Imaging Techniques ◽  
Left Renal Vein ◽  
Diagnostic Tools ◽  
Nutcracker Syndrome ◽  
Treatment Techniques ◽  
Children And Young Adults ◽  
Good Number ◽  
Pelvic Congestion

Summary Objective: To increase awareness on the severe impact of the nutcracker syndrome in women with undiagnosed disease. Patients and methods: We reviewed the medical literature and analyzed six representative series with 73 patients with nutcracker syndrome. Women with left flank pain, dyspareunia, dysuria, dysmenorrhea, micro- or macrohaematuria and pelvic congestion symptoms, should be carefully investigated for evidence of meso aortic left renal vein compression. A good number of our colleagues do not believe in the existence of the nutcracker syndrome and send these patients in a long pilgrimage in search of someone who can help them to get relief to their pain. New and improved imaging techniques can assist in the diagnosis but retrograde reno-gonadal phlebography and renocaval gradient are the most reliable diagnostic tools. Results: Among an assortment of treatment techniques, renal vein transposition and endovenous stenting were the two most commonly used procedures. There are no long term studies on renal vein stenting in children and young adults. Its use in these cases should be carefully considered. The nutcracker syndrome may present with pelvic congestion symptoms and its diagnosis missed. The patient's age, severity of symptoms and haemo dynamic renal studies should guide the treatment. Conclusion: An increased awareness of the existence of the nutcracker syndrome may prevent many unfortunate undiagnosed women from spending many months and often years of suffering.

The Volar Distal Radioulnar Portal in Wrist Arthroscopy: An Anatomical Study

2020 ◽  
Author(s):  
Francisco J. Lucas ◽  
Vicente Carratalá ◽  
Ignacio Miranda ◽  
Cristobal Martinez-Andrade
Keyword(s):  
At Risk ◽  
Ulnar Nerve ◽  
Surgical Techniques ◽  
Anatomical Study ◽  
Neurovascular Bundle ◽  
Wrist Arthroscopy ◽  
Iatrogenic Injuries ◽  
Flexor Carpi Ulnaris ◽  
Human Cadavers ◽  
Triangular Fibrocartilage

Abstract Background Advances in wrist arthroscopy and the emergence of novel surgical techniques have created a need for new portals to the wrist. The aim of this study was to define and verify the safety of the volar distal radioulnar (VDRU) portal. Description of the Technique The VDRU portal is located ∼5 to 10 mm proximal to the proximal wrist crease, just on the ulnar edge of flexor carpi ulnaris tendon and radial to the dorsal cutaneous branch of the ulnar nerve. The ulnar styloid marks the distal point of the portal. Methods An anatomical study was performed on 12 upper extremity specimens of 6 human cadavers. Iatrogenic injuries of neurovascular structures potentially at risk were assessed, and the distance from the portal to these structures was measured. Results No iatrogenic injuries of the structures at risk occurred. Mean distances from the VDRU portal to the ulnar neurovascular bundle, the radial branch of the dorsal sensory branches of the ulnar nerve (DSBUN), and the ulnar branch of the DSBUN were 9.29 ± 0.26 mm, 8.08 ± 0.25 mm, and 10.58 ± 0.23 mm, respectively. There were no differences between left and right wrists. The distances from the VDRU portal to the ulnar neurovascular bundle and the ulnar branch of the DSBUN were significantly shorter in women; this distance was not less than 7 mm in any case. Conclusions The VDRU portal is safe, reproducible, and facilitates the implementation of various techniques related to triangular fibrocartilage complex pathology.

scholarly journals Mediastinal anatomical landmarks, their variants and tips for video-assisted thoracoscopic navigation during oesophageal extirpation

2021 ◽  
Author(s):  
Sergey Dydykin ◽  
Friedrich Paulsen ◽  
Tatyana Khorobykh ◽  
Natalya Mishchenko ◽  
Marina Kapitonova ◽  
...  
Keyword(s):  
Prone Position ◽  
Anatomical Study ◽  
Structural Features ◽  
Posterior Mediastinum ◽  
Visual Navigation ◽  
Anatomical Landmarks ◽  
Video Assisted ◽  
Before And After ◽  
Human Cadavers ◽  
The Right

Abstract Purpose There is no systematic description of primary anatomical landmarks that allow a surgeon to reliably and safely navigate the superior and posterior mediastinum’s fat tissue spaces near large vessels and nerves during video-assisted endothoracoscopic interventions in the prone position of a patient. Our aim was to develop an algorithm of sequential visual navigation during thoracoscopic extirpation of the esophagus and determine the most permanent topographic and anatomical landmarks allowing safe thoracoscopic dissection of the esophagus in the prone position. Methods The anatomical study of the mediastinal structural features was carried out on 30 human cadavers before and after opening the right pleural cavity. Results For thoracoscopic extirpation of the esophagus in the prone position, anatomical landmarks are defined, their variants are assessed, and an algorithm for their selection is developed, allowing their direct visualization before and after opening the mediastinal pleura. Conclusion The proposed algorithm for topographic and anatomical navigation based on the key anatomical landmarks in the posterior mediastinum provides safe performance of the video-assisted thoracoscopic extirpation of the esophagus in the prone position.

Intravascular Papillary Endothelial Hyperplasia of Renal Vein: Report of 2 Cases

2005 ◽  
Vol 129 (4) ◽  
pp. 516-519
Author(s):  
Mohammed Akhtar ◽  
Muhammed Aslam ◽  
Hadeel Al-Mana ◽  
Hana Bamefleh ◽  
Sultan S. Al-Khateeb ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Renal Vein ◽  
Renal Mass ◽  
Malignant Neoplasms ◽  
Renal Neoplasm ◽  
Intravascular Papillary Endothelial Hyperplasia ◽  
Process Thought ◽  
Papillary Endothelial Hyperplasia ◽  
Hilar Region ◽  
Characteristic Features

Abstract Intravascular papillary endothelial hyperplasia is a benign intravascular process thought to arise from an organizing thrombus. The lesion may present clinically as an abnormal mass and, depending on the location, may be confused with benign or malignant neoplasms. It has been described in a variety of locations. Involvement of the renal vein by papillary endothelial hyperplasia is extremely rare, with only 4 cases reported in the literature. We describe 2 additional cases. In both cases, the radiologic examination revealed a well-circumscribed mass in the hilar region of the kidney, which was considered to be a renal neoplasm. Nephrectomy specimen in each case revealed characteristic features of intravascular papillary endothelial hyperplasia. It is suggested that intravascular papillary endothelial hyperplasia should be included in the differential diagnosis of a hilar renal mass.

COMPREHENSIVE ANATOMICAL STUDY OF VARIATIONS IN LINGUAL AND FACIAL ARTERIES IN ADULT CADAVERS FOR SURGICAL PRACTICE

2021 ◽  
pp. 69-70
Author(s):  
Ramitha Enakshi Kumar. S ◽  
P. Vahini
Keyword(s):  
Carotid Endarterectomy ◽  
Plastic Surgery ◽  
Anatomical Study ◽  
Anatomical Variations ◽  
Malignant Tumours ◽  
Surgical Practice ◽  
Hospital Acquired Infections ◽  
The Face ◽  
Human Cadavers ◽  
Hospital Acquired

Objective: The objective of this study is to comprehensively put forth the anatomical variations in the origin and course of lingual and facial arteries found in adult cadavers. Methods: Ten human cadavers were dissected and studied for variations from the norm regarding facial and lingual arteries . Results: 80% of the cadavers displayed classical origin and course of the arteries. There was a deviation from normal regarding origin of the arteries in 20% of the cadavers. Meanwhile, abnormality in the course amounted to 10%. Conclusion: In 20% of cadavers, there were variations in origin of facial and lingual arteries , meanwhile, changes in the course of the stated arteries is 10%. These variations prove to be of signicance to surgeons to prevent mishaps and hospital acquired infections, while performing carotid endarterectomy, intra-arterial catheterizations, plastic surgery of the face and resection of malignant tumours.

scholarly journals Anatomical Study of Variations in the Branches of Superior Mesenteric Artery – A Study from a Teaching Hospital in Chennai, India

2021 ◽  
Vol 10 (20) ◽  
pp. 1506-1510
Author(s):  
Ganga Venkatachalam ◽  
Kanagavalli Paramasivam ◽  
Lakshmi Valliyappan
Keyword(s):  
Superior Mesenteric Artery ◽  
Abdominal Aorta ◽  
Mesenteric Artery ◽  
Lumbar Vertebra ◽  
Anatomical Study ◽  
Middle Colic Artery ◽  
Branching Pattern ◽  
Colic Artery ◽  
Human Cadavers ◽  
Derivatives Of

BACKGROUND Superior Mesenteric Artery (SMA) is one of the anterior branches of the abdominal aorta. It originates from abdominal aorta at the level of lower border of first lumbar vertebra, one centimeter below the coeliac trunk. It gives the first branch inferior pancreaticoduodenal artery (IPDA), The colic branches arise from concave right side of the superior mesenteric artery, these are middle colic artery (MCA), right colic artery (RCA), ileo colic artery (ICA). Jejunal and ileal branches arise from left side of the SMA. Superior mesenteric artery supplies derivatives of midgut. Knowledge of branching pattern of the SMA is clinically important to gastroenterologists operating on gut and neighboring structures like pancreas, duodenum, and liver. We wanted to study the variations in the branches of superior mesenteric artery. METHODS This is a descriptive study conducted on 50 adult embalmed human cadavers by conventional dissection method, the findings were noted and tabulated. RESULTS Present study shows that inferior pancreatic duodenal artery orginated from SMA in 47 (94 %) specimens. IPDA was absent in 3 (6 %) specimens. Middle colic artery was found to arise from SMA in 48 (94 %) and MCA was absent in 2 (4 %) specimens. Right colic artery was found to arise from SMA in 47 (94 %) specimens and it was absent in 3 (6 %) specimens. Ileo-colic artery was found to arise from SMA in all 50 (100 %) specimens. CONCLUSIONS Awareness of these complex variations may prevent devastating complications during colonic surgeries. Variations in the branching pattern of superior mesenteric artery is essential for surgeons operating on derivatives of midgut, liver, pancreas. KEY WORDS Branches, Colic, Superior Mesenteric Artery, Variations

scholarly journals SARS-CoV-2 Immunoglobulin g (IgG) Kinetics in Healthcare Workers and Their Close Contacts Reduced Risk of Re-infection: South-East Asian Region

2021 ◽  
Author(s):  
Mradul Kumar Daga ◽  
Govind Mawari ◽  
Vijay Kumar Karra ◽  
Meghachandra Singh ◽  
Siddharth Chand ◽  
...  
Keyword(s):  
Immunoglobulin G ◽  
Healthcare Workers ◽  
Close Contact ◽  
Antibody Test ◽  
New Delhi ◽  
Igg Antibody ◽  
Symptomatic Infection ◽  
Medical College ◽  
Reduced Risk ◽  
Close Contacts

Abstract BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for global pandemic, and it has caused more than 2.3 million deaths. Persistence and stability of immunoglobulin G (IgG) response after recovery from COVID-19 infection is still uncertain. MethodsWe performed a longitudinal cohort study in healthcare workers (HCW) and their close contacts (Non-HCW) with known resolved SARS-CoV-2 infection and undiagnosed infection at Maulana Azad Medical College and associated Lok Nayak hospital, New Delhi. Baseline IgG antibody titers was determined and the participants were followed over a period of six months. We also examined relationship between SARS-CoV-2 immunoglobulin G (IgG) response and new symptomatic infection in HCW and Non-HCW over time. Results176 (70.9%) healthcare workers and 72 (29.0%) non-healthcare workers were recruited from two cohorts. 82 subjects recovered from SARS-CoV-2 infection and 166 undiagnosed for the infection having history of close contact with COVID-19 patients were followed up for a median of 227 days (interquartile range, 166 to 202) after a positive IgG antibody test. In the recovered subjects 70.7% (58) were seropositive for first anti-spike IgG assay at baseline, followed by 80.0%, 90.6% and 82.6% at three visits respectively. In undiagnosed subjects 37.3% (62) were seropositive at baseline, followed by 70.9%, 75.8% and 82.2% respectively. Also, 46.8% (29) were asymptomatic with no symptoms of COVID-19 and were seropositive at baseline. However, presence of IgG antibodies was associated with substantial reduced risk of re-infection over the follow up duration.ConclusionOur data showed that the antibodies levels measured increased over the first three months and decreased slightly after that and remained at a plateau and relatively stable for at least a period of six months.

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