• Journal of Cerebrovascular and Endovascular Neurosurgery
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• v.26 no.2
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• pp.119-129
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• 2024

Knowledge of the venous anatomy is essential for appropriately treating dural arteriovenous fistulas (AVFs). It is challenging to determine the overall venous structure despite performing selective angiography for dural AVFs with feeder from multiple selected arteries. This is because only a part of the veins can be observed through the shunt in the selected artery. Therefore, after performing selective angiography of all vessels to understand the approximate venous anatomy, the venous anatomy can be easily understood by closely examining the source image of computed tomographic angiography or magnetic resonance angiography. Through this, it is possible to specify the vein that is to be blocked (target embolization), thereby avoiding extensive blocking of the vein and avoiding various complications. In the case of dural AVF with feeder from single selected artery, if the multiplanar reconstruction image of the three-dimensional rotational computed tomography obtained by performing angiography is analyzed thoroughly, a shunted pouch can be identified. If embolization is performed by targeting this area, unnecessary sinus total packing can be avoided.

• Journal of Chest Surgery
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• v.45 no.3
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• pp.155-160
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• 2012

Background: Cryosurgery was recently introduced as a treatment for varicose veins in the lower extremities. Cryosurgery with freezing probes can be used to remove the great saphenous vein (GSV) via an inguinal incision alone. The aim of this study was to assess early outcomes and the feasibility of cryosurgery for varicose veins. Materials and Methods: Forty patients were enrolled in the present study from March 2009 to July 2010. All patients underwent careful physical examinations, and their GSV reflux was demonstrated by duplex ultrasonography. Clinical severity was measured according to the clinical-etiology-anatomy-pathophysiology (CEAP) classification. The impaired GSVs were removed with rigid cryoprobes after freezing. Patients had follow-up appointments at 1 week, 1 month, 3 months, and 6 months after surgery. Sclerotherapy was performed during follow-up on an outpatient basis as needed. Results: A total of 19 men and 21 women were enrolled. The mean follow-up duration was 3.4 months (range, 1 to 12 months). The clinical severity ranged from CEAP 2 to CEAP 6a. Thirty-eight patients underwent concomitant phlebectomy during surgery. No recurrences were reported during follow-up. There were three cases of minor complications. Two patients had paresthesia, and one had thrombophlebitis. Conclusion: Using cryosurgery techniques to treat varicose veins, the complication rates were minimal and outcomes were comparable to those of previous reports. This procedure is a safe and feasible treatment modality for varicose veins.

• Anatomy and Cell Biology
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• v.57 no.1
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• pp.1-6
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• 2024

Clinical case reports and research regarding the mental spines and their associated structures create a detailed picture of the floor of the mouth for assessment during clinical treatment. This compilation of information covers the mental spines, the attached geniohyoid and genioglossus muscles, the lingual foramina, and the veins and arteries of the jaw and floor of the mouth. It is important to consider the variations in the mental spines for oral and maxillofacial treatment involving the mandible. Differences in anatomy of the mental spine, including their number, location, and size, can impact diagnosis and treatment approaches.

• Anatomy and Cell Biology
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• v.56 no.4
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• pp.448-455
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• 2023

The azygos vein can be formed as a single root, two roots, and three roots, namely lateral, intermediate and the medial roots respectively. The hemiazygos vein and the accessory hemiazygos vein are the tributaries of azygos vein rather than its left side equivalents. Its variations, especially in young persons without any relevant risk factors, may result in thromboembolic illness. This study aimed to describe the morphological and morphometric variations of azygos system of veins. The present study was conducted on thirty formalin fixed adult human cadavers by dissecting azygos vein from formation to termination and variations were noted. The azygos vein was formed by a single root in 56.7%, by two roots: the lateral root and intermediate root in 36.7% cases and by the lateral root and medial root in 6.6%. The vertebral level of termination of azygos vein was seen at the level of T4 vertebrae in 70% cases, at the level of T3 vertebrae in 20% of cases and at the level of T5 vertebrae in 10% cases. The course of azygos vein was varying in 13.3%. These morphological variations can be useful while performing mediastinal surgery, mediastinoscopy, surgery of the deformations of the vertebral column, neurovascular surgeries of the retroperitoneal organs, disc herniation and fracture of thoracic vertebrae.

• Anatomy and Cell Biology
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• v.55 no.3
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• pp.284-293
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• 2022

The Brachial artery is a continuation of the axillary artery, from the inferior border of the tendon of teres major to the neck of the radius, terminating into radial and ulnar arteries just a cm distal to the elbow joint. Unlike veins, variations in the arteries are comparatively less common. Anatomical variations of the brachial artery occur in almost 20% of the cases and are commonly found during routine dissection or clinical practice. To observe the variations in the course and termination of brachial artery by dissection and computed tomography (CT) angiography methods. The present study was conducted on 40 upper limbs each in the department of Anatomy & Radiology of JSS Medical College and Hospital, Mysuru. The brachial artery was traced from origin to termination and variations were noted and photographed. Patients who were undergoing CT angiography of the upper limbs in JSS Hospital were included in the study. Variations noted and compared with the dissection method. In the present study, normal patterns of the brachial arterial course and termination were observed in 31 specimens. The remaining 9 specimens showed variant course and termination in the brachial artery like an unusually tortuous superficial brachial artery, superficial brachio-ulnar artery and brachio-radial artery. CT angiography showed 6 variations and a tortuous brachial artery. A detailed description of the vascular pattern of upper limbs especially variations in their origin and termination is of extreme importance in clinical practice. The knowledge of these variations is important for catheterization, graft harvesting, arteriovenous fistula creation, shunt application and astrup examination.

• Journal of Plant Biology
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• v.28 no.1
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• pp.21-28
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• 1985

The bipinnate-compound leaf of Parkia clappertoniana has prominent, long petiole with a pulvinal base. The pulvinus has wood, periderm, lenticels and extensive cortical layer. Its vascular bundles are elongated with alternating rays. The vascular bundles of the petiole, rachis and veins are oval, with conspicuous bundle caps. Stomatal complex is predominantly paracytic with occasional occurrence of anomocytic stomata near the midrib. The oval stomata have conspicuous stomatal ledges. Trichomes are unicellular, acicular and restricted to the rachis, petiole and pinnule mid-ribs and margin. Ecological and taxonomic significance of features is discussed.

• Anatomy and Cell Biology
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• v.51 no.4
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• pp.232-235
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• 2018

Portal vein provides about three-fourths of liver's blood supply. Portal vein is formed behind the neck of pancreas, at the level of the second lumbar vertebra and formed from the convergence of superior mesenteric and splenic veins. The purpose of this study is to review the normal distribution and variation, morphometry of portal vein and its branches for their implication in liver surgery and preoperative portal vein embolization. It is also helpful for radiologists while performing radiological procedures. A total of fresh 40 livers with intact splenic and superior mesenteric vein were collected from the mortuary of Forensic Department, JSS Medical College and Mysuru Medical College. The silicone gel was injected into the portal vein and different segments were identified and portal vein variants were noted. The morphometry of portal vein was measured by using digital sliding calipers. The different types of portal vein segmental variants were observed. The present study showed predominant type I in 90% cases, type II 7.5% cases, and type III 2.5% cases. Mean and standard deviation (SD) of length of right portal vein among males and females were $2.096{\pm}0.602cm$ and $1.706{\pm}0.297cm$, respectively. Mean and SD of length of left portal vein among males and females were $3.450{\pm}0.661cm$ and $3.075{\pm}0.632cm$, respectively. The difference in the Mean among the males and females with respect to length of right portal vein and left portal vein was found to be statistically significant (P=0.010). Prior knowledge of variations regarding the formation, termination and tributaries of portal vein are very helpful and important for surgeons to perform liver surgeries like liver transplantation, segmentectomy and for Interventional Radiologists.

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.26 no.3
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• pp.229-234
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• 2022

When planning pancreaticoduodenectomy for pancreatic head cancer, the prevalence of anatomical variation of the proximal jejunal vein (PJV), the associated short-term surgical outcomes, and the level of PJV convergence to the superior mesenteric vein must be carefully analyzed from both technical and oncological points of view. The prevalence of the first jejunal trunk (FJT) and PJV located ventral to the superior mesenteric artery is 58%-88% and 13%-37%, respectively. Patients with the FJT had a larger amount of intraoperative bleeding and a higher proportion of patients requiring transfusions compared to those without a common trunk. The risk of transfusion was higher in patients with ventral PJV compared to those with dorsal PJV. Although less frequent, sacrificing the FJT can result in fatal venous congestion of the jejunum. Therefore, a well-planned approach for pancreaticoduodenectomy, based on preoperative evaluation of anatomical variation in the PJV, may help reduce intraoperative bleeding and postoperative morbidity. Additionally, the importance of invasion into the PJVs should be revisited in terms of resectability and oncological clearance.

• Journal of Korean Medical classics
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• v.29 no.2
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• pp.31-54
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• 2016

Objectives : The goal of this paper is to research what affected diagrams of liver originated from Mingtangzangfutu while they were changed. Methods : Diagrams of liver in Traditional Chinese and Japanese medical books had been gathered as many as possible. After they were divided into ones which were originated from Mingtangzangfutu and the others, diagrams originated from Mingtangzangfutu, were again classified into 4 filiations according to Huang Longxiang(黃龍祥)'s standard. Apart from his classification, they were analysed by 4 form factors, e.g. shape, number, veins and petiole of leafs. Results : Reliability of this methods had been confirmed by the correspondence with Huang's 14 standard books, before 29 diagrams of liver were derived from 33 books including 13 books that Huang had already suggested. The lobes of liver in most of diagrams resembled 7 lanceolate or long oval leafs, or a maple leaf with 6 indentations, 4 left lobes and right 3 ones. In most of diagrams, veins of leafs were described variously, and petioles of leafs were drawn more shortly or longer. Analysing 29 diagrams by 4 form factors proved that Huang's classification had crossing features among 4 filiations. This phenomenon implied the painters or doctors drawing diagrams might not convince if the shape of liver was correct or not. Although veins and petiole of leafs in diagrams of liver could be compared with tissues in liver in modern human anatomy, diagrams were not been affected by dissection from Yuan(元) to middle Qing(淸) dynasty. Conclusions : Lingshu(靈樞), Nanjing(難經) and Wang Bing would had constantly acted on 29 diagrams of liver, since diagram of liver originated from Mingtangzangfutu, appeared first in Zhenjiujuying(鍼灸聚英). But they did not come from dissection during same periods.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.387-393
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• 2023

Background: The aim of this study was to evaluate the clinical efficacy of a modified surgical procedure for the treatment of varicose veins. Methods: This retrospective analysis was conducted on lower extremities with symptomatic great saphenous vein (GSV) incompetence that underwent stripping from the groin to the knee, with preservation of the superficial epigastric vein (SEV), between January 2015 and April 2022. Follow-up assessments were performed using Doppler ultrasound, Venous Clinical Severity Score (VCSS), and the Aberdeen Varicose Vein Questionnaire (AVVQ) at 6 and 12 months after surgery. Results: The study included 179 limbs from 120 patients (47 men and 73 women). The mean patient age was 56.5 years (range, 20-78 years), and the distribution of preoperative Clinical-Etiology-Anatomy-Pathophysiology clinical classes was 8% C0-C1, 88% C2, and 4% C3-C6. The preoperative diameter of the saphenofemoral confluence averaged 6.9 mm (range, 2.7-15.8 mm). After a mean postoperative follow-up period of 24 months, evidence of neovascularization around the stump of the saphenofemoral junction (SFJ) was observed in 2 limbs (1.1%). Additionally, varicose vein recurrence was found in 1 limb (0.6%) and was associated with an incompetent thigh perforator. At postoperative follow-up, both VCSS and AVVQ scores were significantly lower than the preoperative scores. Conclusion: Modified surgical treatment of GSV incompetence, involving preservation of the SEV and stripping of a short segment up to the knee, demonstrated favorable clinical results in terms of postoperative complication rate, neovascularization rate around the SFJ stump, varicose vein recurrence rate, and improvement in lower extremity symptoms.