ABSTRACT
Background: Anatomic variations of cystic ducts are common and continuously encountered during Surgical andradiological interventions. Failure to identify these clinically important variations may result in complicationsduring surgical or endoscopic procedures.Patients and methods: This is an observational descriptive cross-sectional study. 65 cadavers in the dissectingrooms of the medical colleges, in which the length and mode of insertion of cystic duct (CD) into common bileduct (CBD) were observed.Results: The mean length of the CD in the cadavers examined was (2.06 ± 1.03) with a minimum length of d” 0.5 cmand a maximum of 5 cm. Regarding the mode of insertion of CD into the CBD; 53.8% were found to have a lowjunction between the CD and common hepatic duct (CHD) which is considered the normal insertion. 46.2% foundto be abnormal variations of insertion; short CD (d”0.5 cm) observed in 10.8%; whereas in 13.8% of cadavers wefound that the CD is adherent to the CHD and runs in parallel to it. In 7.8% there was a high junction between theCD and CBD and in 9.2% we found that CD courses anterior or posterior to CBD and joins it medially.Conclusion: CD variations are not uncommon and it is important to identify these anatomical variations. Adetailed knowledge of the extra hepatic biliary tract, as well as of its variations, is important for the diagnosticand therapeutic success in many clinical situations since they allow the surgeon prompt identification ofcertain pathologies, making surgical procedures more accurate and affective.
ABSTRACT
The aim of this work was to study the possible physiological role of adiponectin and resistin as mediators linking obesity and insulin resistance in type 2 diabetes mellitus. Seventy-five female Egyptian subjects were enrolled in this study. They were divided into four groups as follows: obese nondiabetics [ONDM], obese diabetic type 2 [0DM], nonobese nondiabetic [NONDM] and nonobese diabetic [NODM]. Anthropometric measurements were taken. Abdominal ultrasound was also done to measure visceral fat [VF], subcutaneous fat [SCF] and visceral fat index [VFI]. Fasting blood samples were taken for analysis of serum insulin, blood glucose, plasma adiponectin and resistin. In the diabetic group adiponectin had an inverse correlation with resistin,VF and VFI [P < 0.01, P < 0.05, P < 0.01]. Resistin had a weak positive correlation only with VF, [P = 0.05] and RAI [resistin /adiponectin index] showed a positive correlation with VFI and SCF. In the nondiabetics adiponectin had no correlation with resistin, but had negative correlation with HOMA, age, VF and VFI, whereas resistin had no correlation with the same variables. RAI had a positive correlation with HOMA and SCF. In conclusion it can be said that resistin has no direct relation to insulin resistance either in diabetics or non diabetics. However, it may have a weak relation to visceral obesity only in diabetics. Hypoadiponectinemia is related to visceral obesity and increased resistin level in diabetics, while in non diabetics it is related to visceral obesity, insulin resistance and age. RAI is more informative than resistin which indicates a possible interaction between resistin and adiponectin especially in diabetics. RAI correlates positively with some anthropometrics but not to insulin resistance in diabetics, while it correlates positively with both variables in non diabetics