scholarly journals Absence of the celiac trunk: definition, classification, MDCT angiographic findings and their probable embryological mechanisms

2019 ◽  
Author(s):  
Yi Mao ◽  
Wei Tang ◽  
Bo Jin ◽  
Lian-Qin Kuang ◽  
Jing Zhang ◽  
...  

Abstract Background: The aim of this study was to identify the types and prevalence of absence of the celiac trunk by using multidetector computed tomography (MDCT) angiography, and analyze their probable embryological mechanisms. Methods: A retrospective study was carried out on 2,500 abdominal MDCT angiography images. The absence of the celiac trunk was defined as that the celiac trunk is not exist, more specifically, there is not such an arterial trunk containing at least two major branches of the celiac trunk. Various types of the absence of the celiac trunk were investigated. Results: Of the 2,500 patients, 19 (0.76%) patients were identified as an absence of the celiac trunk. According to its definition and classification, the absence of the celiac trunk could be divided into five types: type I (LGA + CHA + SA + SMA), type II (HM trunk + LGA + SA), type III (SM trunk + LGA + CHA), type IV (GM trunk + CHA + SA), and type V (other type); and these types were observed in 5 patients (0.20%), 9 patients (0.36%), 3 patients (0.12%), 0 patients (0.00%) and 2 (0.08%) patients, respectively. There were more examples of the types I and II than of the types III–V (P = 0.004). Conclusions: We systematically classified the absence of the celiac trunk based on its MDCT angiography findings. Abnormal interruptions and persistence of the longitudinal anastomosis, and regression of vascular root and emergence of replaced artery could all be the embryological mechanisms of various types of the absence of the celiac trunk.

Author(s):  
Jaynit Tandon ◽  
Sonali Taneja ◽  
Vidhi Kiran Bhalla ◽  
Akshay Rathore

Introduction: Adequate knowledge of the anatomic variation and root canal morphology is paramount for long term endodontic success. The presence of two canals in Mesiobuccal (MB) root is commonly associated with maxillary molars in various populations. Aim: To retrospectively evaluate the prevalence of a second mesiobuccal canal (MB2) in maxillary first and second molars in Delhi-National Capital Region (NCR) population using Cone Beam Computed Tomography (CBCT) analysis. Materials and Methods: This retrospective study evaluated the records of complete maxillary CBCT scans of 204 maxillary first and second molars from January 2016 till May 2019 from different CBCT centres in Delhi-NCR region to determine the anatomy and morphology in June 2019. The prevalence of second MB2 canals was recorded and associated with age, gender and symmetry. The z-test for proportions was used to assess the differences among the subgroups. Results: The number of roots in 204 teeth in both maxillary molars were determined. The prevalence of 3-rooted configuration was 98.55% in maxillary first molars and 79.4% in maxillary 2nd molars. Also, in maxillary 2nd molars, 7.4% were single rooted and 13.2% had 2-rooted configuration. Three rooted configuration and variable canal number was commonly reported in maxillary molars. Prevalence of MB2 canal was 87.2% in maxillary 1st molars and 64.2% in maxillary 2nd molars. Also, the prevalence was 87.2% bilaterally in maxillary first molars and 65.7% on the right and 53.9% on the left in maxillary second molars respectively. Type IV canal configuration was most prevalent in 44.60% of maxillary first molars and type 1 configuration (35.78%) for the maxillary second molars. Conclusion: Prevalence of MB2 canals in maxillary first and second molars was found to be high in North Indian population and the clinician should suspect its presence in all cases. Prevalence of MB2 had bilaterally symmetrical distribution without any association with age or gender. The MB roots were more likely to exhibit type IV and type II canal configurations in maxillary first molars and type I and type II configurations in second molars.


2021 ◽  
Vol 28 (1) ◽  
pp. 50-56
Author(s):  
Soo Young Choi ◽  
So Young Jeon ◽  
Hwa Sung Rim ◽  
Sung Wan Kim ◽  
Jin-Young Min

Background and Objectives: The purpose of this study was to investigate the prevalence of incidental paranasal sinus (PNS) opacification in nasal septal deviation (NSD) using computed tomography (CT) and to identify contributing factors.Subjects and Method: We analyzed 216 patients who underwent septoplasty for the correction of NSD and who underwent preoperative PNS CT. We assessed the prevalence of incidental PNS opacification in these patients and determined the type of NSD according to Mladina classification. We also evaluated whether the direction of NSD affected the presence of PNS opacification on CT, and whether the presence of PNS opacification was associated with other rhinologic symptoms.Results: Of 216 patients with NSD, 86 showed opacified PNS on CT. According to Mladina classification, NSD patients were classified as type I (24.1%), type II (36.1%), type III (20.8%), type IV (5.6%), type V (9.7%), type VI (2.3%), or type VII (1.4%). Patients with type II NSD showed a significantly higher incidence of PNS opacification compared with other types of NSD (p=0.001). However, the direction of NSD did not significantly influence the presence of incidental PNS opacification. Furthermore, regardless of the presence of PNS opacification, there was no significant difference in rhinologic symptoms such as olfactory dysfunction, among others.Conclusion: We found that incidental PNS opacification on CT was common in NSD patients, especially in patients with type II NSD. Thus, we suggest that CT evaluation of patients with NSD may be helpful for assessing comorbid PNS pathologies as well as objectively identifying nasal septal deformities.


2020 ◽  
Vol 92 (4) ◽  
pp. 1-5
Author(s):  
Greta Berger ◽  
Vitalii Grinevych ◽  
Anna Justyna Milewska ◽  
Adam Łukasiewicz ◽  
Eugeniusz Tarasów

The aim is to assess the relationship of Anterior Ethmoid Artery with the Upper Attachment of the Uncinate Process and their relation with the Lateral Lamella of the Cribriform Plate in multiplanar reconstructions (i.e. coronal, axial and sagittal) of Computed Tomography. We measured the depth of the olfactory fossa, the length of the LLCP and determined the most superior attachment of the uncinate process, which designates boundaries of the frontal recess anteriorly, laterally and medially [20,22]. Methods: All CT examinations were performed using the 320-detector Aquilion ONE CT Scanner (Canon Medical Systems, Otawara, Japan). Axial, coronal,sagittal reconstructions were performed by using dedicated workstation software (Vitrea Enterprice Siute, Version 6.7; Vital Images, Minnetonka USA). The Statistica 13 software was used for the analysis, results were considered statistically significant at the level of p<0,05. Results: The most frequent types of Uncinate Process according to Landsberg- Friedman criteria in group of mens are: type I-30,77%,type II-30,77%, type III-26,92%, type VI-7,69%, type V-3,85%, type IV-0% respectively. In women's group: type III-44,12%,type II-32,35%, type I-8,82%,type V-8,82%, type IV-5,88%, type VI-0%. The median LLCP length in the anterior-posterior dimension measures 13 mm i. e. Yenigun type II on the both sides. The median value of depth in the superior-inferior dimension of the LLCP in the ethmoid roof is 5 mm i.e. Keros type II on both sides. The mean distance between Anterior Ethmoid Artery and Upper Attachment of the Uncinate Process measures approximately 9,73 mm and 9,16 mm on the right and left side respectively. Conclusions: The assessment of the AEA, UAUP and configuration of the anterior skull base on CT multiplanar reconstructions contribute to optimazing the results of frontal sinus surgery.


2021 ◽  
Author(s):  
Ping Wang ◽  
Heng Ma ◽  
Qinglin Yang ◽  
Chengzhou Zhang

Abstract Objective The aim of the present study is to investigate the relationship between pulmonary hamartomas (PHs) and bronchi on multislice spiral computed tomography (MSCT) images. Methods The MSCT scans of 218 PHs from 216 pathologically confirmed patients were reviewed. The PHs were divided into two groups, namely, the central endobronchial and intraparenchymal groups, in accordance with location. Multiplanar reconstruction was used to demonstrate PH–bronchus relationship patterns. The PH–bronchus relationships in the intraparenchymal group were classified into five patterns: type I, the bronchus was cut off by the tumor; type II, the bronchus was contained within the tumor (air bronchogram sign); type III, the bronchus ran at the tumor periphery or was compressed by the tumor; and type IV, no tumor–bronchus relationship was observed. Results Nine (4.1%) PHs were assigned to the central endobronchial group and 209 (95.9%) PHs were assigned to the intraparenchymal group. In the endobronchial group, 1 (11.1%) PH was located in the trachea with the partial stenosis of the trachea, whereas the remaining 8 (88.9%) PHs were located in the lobar or segmental bronchus with the complete occlusion of the corresponding bronchus. In the intraparenchymal group, type IV (147, 70.3%) was most common pattern, followed by type III (54, 25.8%). Type I (8, 3.8%) was rare, and type II was not observed. Conclusion Central endobronchial PHs often obstructed bronchi, whereas only a few intraparenchymal PHs cut off bronchi. No air bronchogram sign was observed.


2020 ◽  
Author(s):  
Deepshikha Bhowmik ◽  
Shiela Chetri ◽  
Bhaskar Jyoti Das ◽  
Debadatta Dhar Chanda ◽  
Amitabha Bhattacharjee

Abstract Objective: This study was designed to discover the dissemination of virulence genes in Methicillin-resistant Staphylococcus aureus from clinical and environmental settings. Results: The virulence gene such as sea (n=54), seb (n=21), eta (n=27), etb (n=2), cna (n=24), ica (n=2) and tst (n=30) was revealed from this study. Different SCCmec types such as type I, type II, type III, type IV, type V, type VI, type VII, type VIII and type XII were detected among sixty three MRSA isolates where SCCmec type II having ST1551 and type V with ST2416 were found to be associated with multidrug resistance and were highly prevalent in the study area.


2018 ◽  
Vol 88 (6) ◽  
pp. 819-829 ◽  
Author(s):  
Wentian Sun ◽  
Kai Xia ◽  
Li Tang ◽  
Chenlu Liu ◽  
Ling Zou ◽  
...  

ABSTRACT Objective: To investigate the accuracy of panoramic radiography (PR) in diagnosing maxillary sinus-root relationships (SRRs). Materials and Methods: PubMed, EMBASE, CENTRAL, Web of Science, ScienceDirect, CBM, Baidu Scholar, and SIGLE were searched. The studies comparing the diagnostic accuracy of PR and computed tomography/cone-beam computed tomography (CT/CBCT) for SRR were included. Results: Eleven studies were included. Meta-analyses showed that, for type I SRR, PR had the highest specificity, positive likelihood ratio (+LR), diagnostic odds ratio (DOR), and area under the curve (AUC), with a high sensitivity and a low negative LR (−LR). For type IV, PR had a high DOR and AUC, with the highest sensitivity but a low +LR, the lowest –LR, and the lowest specificity. For type II, PR had the lowest AUC, with a low sensitivity, +LR, and DOR and a high −LR. For type III, PR had the lowest sensitivity, +LR, and DOR and the highest −LR. The distance from root tips to the maxillary sinus floor on PR was significantly longer (mean difference: −1.88 mm; 95% confidence interval: −2.19 to −1.57; P &lt; .0001) than that on CT/CBCT. Conclusions: Currently available evidence suggests PR could be reliable for detecting type I SRR. PR has a good ability to confirm true type IV SRR but a poor ability to rule out false type IV SRR. For type II and III SRR, PR shows poor accuracy and tends to overestimate the extent of protrusion of the roots into the maxillary sinus. When PRs display type II, III, or IV SRR and related treatment is needed, CBCT should be used for further examinations.


Synthesis ◽  
2019 ◽  
Vol 51 (14) ◽  
pp. 2737-2758 ◽  
Author(s):  
Hyeonggeun Lim ◽  
Sikwang Seong ◽  
Sunkyu Han

Post-iboga alkaloids are secondary metabolites that are biosynthetically derived from iboga-type alkaloids via rearrangements of the indole and/or isoquinuclidine moieties. Herein, we categorize post-iboga alkaloids into five types based on the biosynthetic mode of transformation of the iboga scaffold. We then describe reported syntheses of post-iboga alkaloids, including our laboratory’s recent contributions, based on our own categorization.1 Introduction1.1 Iboga and Post-Iboga Alkaloids1.2 Classification of Post-Iboga Alkaloids1.2.1 Introduction to Type I Post-Iboga Alkaloids1.2.2 Introduction to Type II Post-Iboga Alkaloids1.2.3 Introduction to Type III Post-Iboga Alkaloids1.2.4 Introduction to Type IV Post-Iboga Alkaloids1.2.5 Introduction to Type V Post-Iboga Alkaloids2 Syntheses of Post-Iboga Alkaloids2.1 Syntheses of Type I Post-Iboga Alkaloids2.1.1 Syntheses of Monomeric Type I Post-Iboga Alkaloids2.1.2 Syntheses of Dimeric Type I Post-Iboga Alkaloids2.2 Syntheses of Type II Post-Iboga Alkaloids2.3 Synthetic Studies Toward Type III Post-Iboga Alkaloids2.4 Syntheses of Type IV Post-Iboga Alkaloids2.5 Synthesis of Type V Post-Iboga Alkaloids3 Conclusion and Outlook


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0003
Author(s):  
Timothy Charlton ◽  
Danielle Thomas ◽  
David Thordarson ◽  
Melodie Metzger ◽  
Trevor Nelson

Category: Midfoot/Forefoot Introduction/Purpose: The flexor hallucis longus (FHL) tendon is commonly used for tendon transfers in reconstructive Achilles tendon procedures. A subset of patients who undergo this procedure complain of first great toe weakness and loss of push off strength after FHL tendon transfer. Despite the frequency of this procedure, there is currently little information available to surgeons to help understand this potential complication. Therefore, the objective of this biomechanical cadaveric study was to quantify plantar flexion strength after FHL harvest and correlate it to variations in anatomy to determine if distinct tendon crossover patterns at the Knot of Henry are more likely to lead to forefoot weakness. Methods: Cadaveric specimens were procured from an approved tissue bank. The proximal end of the tibia was potted and secured to the Mechanical Testing System. A pressure mapping system was used to measure plantar force though the great toe and lesser toes. The Achilles, FHL, and flexor digitorum longus (FDL) tendons were attached to linear actuators for load application. Pressure under the toes was measured with the Achilles alone, Achilles with FHL, Achilles with FDL, and Achilles with both FHL and FDL. The resultant loading patterns were recorded in the greater and lesser toes and compared between the different states. After biomechanical testing, all specimens were carefully dissected and the tendinous slips between the FHL and FDL were documented and classified based on a previously determined system (Types I-V, LaRue; Edama) Functional and anatomical relationship between the classification type and loading patterns were statistically analyzed using repeated measures ANOVA. Results: 23 specimens (13M / 10F) with a mean age of 71 years (range: 54-90) were used in this study. 61% were anatomically classified as type I, followed by type II (26%), IV (9%), and type V (4%), and type III (0%). Simulated FHL harvest in type I specimens resulted in a 29% decrease in great toe flexion pressure and an 21% decrease in total forefoot flexion pressure, p<0.05. In type II feet, FHL harvest led to a greater reduction in flexion pressure in the great toe (34%) and forefoot (25%), p<0.05. Type IV specimens also had a decrease in flexion pressure in both the great toe (21%) and forefoot (15%), p<0.05. Type V specimens trended similar to type I specimens. Conclusion: This study is the first to quantify loss of great toe and lesser toe flexion pressure after FHL harvest. In addition, it is the first to correlate these losses to variations in anatomic crossover patterns at the Knot of Henry. Specimens classified as type II had the greatest reduction in flexion pressure, followed by type I and type IV. This information is clinically important for preoperative discussions about post-surgical expectations and surgical planning.


2022 ◽  
Author(s):  
Peng Liu ◽  
Wenbin Yu ◽  
Meng Wei ◽  
Danping Sun ◽  
Xin Zhong ◽  
...  

Abstract Objection: To investigate the clinical value and significance of preoperative three-dimensional computerized tomography angiography (CTA) in laparoscopic radical gastrectomy for gastric cancer.Methods: The clinical data were analyzed retrospectively from 214 gastric cancer patients. We grouped according to whether to perform CTA. The gastric peripheral artery was classified according to CTA images of patients in the CTA group, and we compared and analyzed the difference of the data between the two groups.Results: The celiac trunk was classified according to Adachi classification: Type I (118/125, 94.4%),Type II (3/125, 2.4%),Type III (0/125, 0%),Type IV (1/125, 0.8%),Type V (2/125, 1.6%),Type VI (1/125, 0.8%).Hepatic artery classification was performed according to Hiatt classification standard:Type I (102/125, 81.6%),Type II (9/125, 7.2%),Type III (6/125, 4.8%),Type IV (2/125, 1.6%),Type V (3/125, 2.4%),Type VI (0, 0%),Others (3/125, 2.4%).And this study combined vascular anatomy and clinical surgical risk to establish a new splenic artery classification model. It was found that the operation time and estimated blood loss in the CTA group were significantly lower than those in the non-CTA group. In addition, the blood loss in the CTA group combined with ICG (Indocyanine Green) labeled fluorescence laparoscopy was significantly less than that in the group without ICG labeled. Conclusion: Preoperative CTA can objectively evaluate the vascular course and variation of patients, and then avoid the risk of operation, especially in combination with ICG labeled fluorescence laparoscopy, can further improve the quality of operation.


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