Morphometry of the ureteric bud branching in the developing mouse kidney / 解剖学报

[Abstract] Objective To investigate the branching pattern of the ureteric bud and the number of the nephron induced by each ureteric bud tip, through the three-dimensional tracing of the ureteric tree, combined with the morphological analysis and measurement of the ureteric tree. Methods The kidneys were obtained from three mice at various developing time points and prepared for paraffin and epoxy sections. Then the microscopic images were digitized and aligned from these sections. Based on the computer-assisted tracing and visualization of ureteric tree, the number of branches and the nephron induced by each ureteric bud tip were obtained by counting. In addition, paraffin sections were stained with HE staining for morphological observation of nephrogenic zone and ureteric bud, while in order to reflect the density of the ureteric bud tips at nephrogenic zone, the distance between two neighboring ureteric bud tips was measured aided with the Claudin-7 immunohistochemical staining. Results The ureteric bud branching tree revealed that the initial bifid iterative branching formed the framework of renal medulla, the branching became complicated and dense in cortex and nephrogenic zone, while the distance between ureteric bud tips were also decreasing. The number of the nephron induced by each ureteric bud tip increased from one (E14. 5) to two (E17. 5), and occasionally to three. Conclusion Threedimeasional Visualization of ureteric bud branching tree reveals regional complication, suggesting molecules in different regions drive different branching patterns; While the density of the ureteric bud tips at nephrogenic zone increases corresponding to decreasing of thickness of the nephrogenic zone, and the disappearance of the ureteric bud tips after birth is also consistent with the gradual consumption of nephron progenitor cells.

Neuronal Histone Methyltransferase EZH2 Regulates Neuronal Morphogenesis, Synaptic Plasticity, and Cognitive Behavior in Mice / 神经科学通报·英文版

The histone methyltransferase enhancer of zeste 2 polycomb repressive complex 2 subunit (EZH2)-mediated trimethylation of histone H3 lysine 27 (H3K27me3) regulates neural stem cell proliferation and fate specificity through silencing different gene sets in the central nervous system. Here, we explored the function of EZH2 in early post-mitotic neurons by generating a neuron-specific Ezh2 conditional knockout mouse line. The results showed that a lack of neuronal EZH2 led to delayed neuronal migration, more complex dendritic arborization, and increased dendritic spine density. Transcriptome analysis revealed that neuronal EZH2-regulated genes are related to neuronal morphogenesis. In particular, the gene encoding p21-activated kinase 3 (Pak3) was identified as a target gene suppressed by EZH2 and H3K27me3, and expression of the dominant negative Pak3 reversed Ezh2 knockout-induced higher dendritic spine density. Finally, the lack of neuronal EZH2 resulted in impaired memory behaviors in adult mice. Our results demonstrated that neuronal EZH2 acts to control multiple steps of neuronal morphogenesis during development, and has long-lasting effects on cognitive function in adult mice.

A Contrast-Enhanced MDCT Study on the Morphology of Renal Vessels, Their Variations and Clinical Implications

Introduction: The kidneys—the main organs of the excretory system, are supplied by a paired renal artery, originating from the Abdominal Aorta at the level of a disc between L1 and L2 and drained by a paired renal vein exiting from the hilum of the kidney to the Inferior vena cava. Aim: To evaluate the morphology of renal vessels, their variations & clinical implications during renal surgeries in the subjects of the North India population by contrast-enhanced MDCT. Materials and Method: The present study was conceptualized & carried out in the Department of Anatomy, in collaboration with the Department of Radiodiagnosis, Santosh Medical College & Hospital, Ghaziabad and from Dr. O.P Gupta Imaging Centre, Meerut. This study was performed on the 108 patients who were referred for abdominal CECT examination with suspected abdominal pathologies. Contrast-enhanced MDCT scan images of the Abdomen were reviewed for normal anatomy of renal vessels and their variants. Result: Out of 108 patients, anatomical variations of the renal vessel were found in 72 (66.66%) patients. Variations of the renal artery were found in 56 patients (51.85%). Out of these 56 patients, 47 had supplementary renal artery, 17 had early branching of the renal artery and 8 patients had both supplementary and early branching of the renal artery. Supplementary renal arteries were seen in 15 patients on the right side, 16 patients on the left side & 16 patients bilaterally. Earlier branching of the renal artery was found in 9 patients on the right side, 10 patients on the left side and in 2 patients bilaterally. Variations of the renal vein were more commonly found on the right side, late renal vein confluence was seen in 28 (25.92%) patients and supplementary renal veins in 9 (8.3%) patients. On the left side, 2 (1.85%) patients had late renal vein confluence and 2 (1.85%) patients had retroaortic vein. Conclusion: Variations of the renal artery are found frequently. Morphological evaluation of renal vessels is useful for planning and performing the endovascular, laparoscopic and urological procedure.

Classification of the patterns of the emerging branches of the superficial cervical plexus / Clasificación de los patrones de las ramas emergentes del plexo cervical superficial

SUMMARY: The cutaneous branches of the superficial cervical plexus (SCP) emerge at variable points, from beneath the posterior margin of the sternocleidomastoid muscle and from this point radiate like "spokes of a wheel" antero-inferiorly and postero-superiorly. This study aimed to classify the emerging points of the branches of the superficial cervical plexus in relation to their location on the sternocleidomastoid muscle. In order to classify the emerging points of the superficial cervical plexus, the sternocleidomastoid muscle was first measured from mastoid process to clavicle; subsequently each branch of the superficial cervical plexus was measured from the mastoid process to their exit points. The emerging points of the superficial cervical plexus branches were classified according to Kim et al. (2002) seven categories: Type I (32 %); Type II (13 %); Type III (35 %); Type IV (13 %); Type V, VI, VII (2 %). The order in which the superficial cervical plexus branches emerged from the posterior margin of the sternocleidomastoid muscle remained constant, i.e. lesser occipital, great auricular, transverse cervical and supraclavicular nerves. Knowledge of emerging points may assist in the effective anaesthesia to all branches of the superficial cervical plexus during surgical procedures of the neck, viz. carotid endarterectomy and thyroid surgery.

RESUMEN: Las ramas cutáneas del plexo cervical superficial (SCP) emergen en puntos variables, desde el margen pos- terior del músculo esternocleidomastoideo y desde este punto inferior irradian como "radios de rueda" anteroinferior y postero-superior. Este estudio tuvo como objetivo clasificar los puntos emergentes de las ramas del plexo cervical superficial en relación a su ubicación en el músculo esternocleidomastoideo. Para clasificar los puntos emergentes del plexo cervical superficial, primero se midió el músculo esternocleidomastoideo desde el proceso mastoides hasta la clavícula; posteriormente se midió cada rama del plexo cervical superficial desde el proceso mastoideo hasta sus puntos de salida. Los puntos emergentes de las ramas del plexo cervical superficial se clasificaron según Kim et al. (2002) en siete categorías: Tipo I (32 %); Tipo II (13 %); Tipo III (35 %); Tipo IV (13 %); Tipo V, VI, VII (2 %). El orden en el que las ramas del plexo cervical superficial emergían del margen posterior del músculo esternocleidomastoideo se mantuvo constante, es decir, los nervios occipital menor, auricular magno, cervical transverso y supraclavicular. El conocimiento de los puntos emergentes puede ayudar a la anestesia eficaz de todas las ramas del plexo cervical superficial durante los procedimientos quirúrgicos del cuello, a saber, endarterectomía carotídea y cirugía de tiroides.

Descrição anatômica da artéria carótida externa e seus ramos na preguiça-comum / Anatomical description of external carotid artery and its branches in sloth

Bradypus variegatus, espécie pertencente à família Bradypodidae e à superordem Xenarthra, pode ser considerada modelo biológico de caráter multidisciplinar. Assim, realizou-se um trabalho de descrição anatômica da artéria carótida externa (ACE) e dos seus ramos no bicho-preguiça B. variegatus. Utilizaram-se 10 animais adultos, sendo todos fêmeas, que foram submetidos à dissecação, constatando-se que a artéria (a.) carótida comum se bifurca, em externa e interna, no nível do primeiro anel traqueal. A ACE, então, segue estendendo-se até a maxila, onde emite ramos para a região temporal e para o polo posterior do olho. Em todos os animais estudados, foram observados sete ramos principais da ACE, que, segundo a sua origem e localização, foram denominados como a. auricular, a. lingual, a. facial, a. alveolar, a. inferior, a. temporal, a. maxilar e a. oftálmica. Os ramos maxilar e oftálmico correspondem aos terminais e os demais são ramos colaterais. Em 50% dos animais analisados, foi verificada a presença de anastomoses arteriais e 40% deles apresentaram o acréscimo de um ramo aos principais. Desses, 30% demonstraram a presença de um ramo traqueal e 10% de um ramo sublingual, sendo esses ramos colaterais.(AU)

Bradypus variegatus is a species belonging to the family Bradypodidae and superorder Xenarthra, which should be considered as a multidisciplinary biological model. Thus, an anatomical description of the external carotid artery (ACE) and its branches in sloth B. variegatus was studied. Ten adult animals, all of them female, were submitted to dissection, and it was observed that the common carotid artery (a.) bifurcates in external and internal at the level of the first tracheal ring. Then, ACE extends through the maxilla where it launches branches to the temporal region and posterior eye side. For all sampled animals, seven principal branches of ACE were observed, and according to their origin and location were denominated as auricular, lingual, facial, bottom alveolar, temporal, maxillary and ophthalmic arteries. The maxillary and ophthalmic branches correspond to the terminals and the other branches are collateral. Presence of arterial anastomoses was observed in 50% of the sampled animals and 40% of them had increase of a branch on the principal. In these, 30% had presence of one tracheal branch and 10% of a sublingual branch, considering these branches as collateral.(AU)

Spectral domain OCT for the differentiation of polypoidal choroidal vasculopathy from wet age-related macular degeneration / 中华实验眼科杂志

Objective@#To evaluate the sensitivity and specificity of spectral domain optical coherence tomography (SD-OCT) for the differentiation of PCV from wet age-related macular degeneration (wAMD).@*Methods@#A cross-sectional study was conducted from Jun 2014 to Apr 2016 at Peking Union Medical College Hospital.The case series included 132 eyes of 126 patients with clinical diagnosis of PCV or wAMD.Eyes with three or more of the following SD-OCT findings were diagnosed with PCV: double layer sign, pigment epithelium detachment (PED), a sharp PED peak, a PED notch and a hyporeflective lumen representing polypoidal lesion.The sensitivity and specificity of the OCT-based diagnosis was estimated.Levels of agreement were determined by κ analyses.@*Results@#One hundred and twenty-six patients (132 eyes) with PCV or wAMD were enrolled in the study.In PCV patients, PED notch, a hyporeflective lumen representing polypoidal lesion, PED peak, double layer sign and PED were 38, 35, 48, 40 and 46, accounting for 67.9%, 62.5%, 85.7%, 71.4% and 82.1%, respectively.In wAMD patients, PED notch, a hyporeflective lumen representing polypoidal lesion, PED peak, double layer sign and PED were 12, 3, 11, 8 and 26, accounting for 14.5%, 10.5%, 34.2%, 15.8% and 3.9%, respectively, which were all lower than PCV, with statistically significant differences (all at P<0.001). SD-OCT detected PCV in 49 of 56 eyes and 10 PCV patients were misdiagnosed as wAMD.The sensitivity and specificity of SD-OCT for the differentiation of PCV from wAMD were 87.5% and 86.8%, respectively.The consistence between SD-OCT and imdocyanine green angiography (ICGA) was moderate (κ=0.738, P<0.001).@*Conclusions@#SD-OCT exhibits high sensitivity and specificity in PCV diagnosis.The presence of DLS, PED, a sharp PED peak, a PED notch, and a hyporeflective lumen representing polypoidal lesion is suggested to be a new diagnostic strategy for PCV.

Spectral domain OCT for the differentiation of polypoidal choroidal vasculopathy from wet age-related macular degeneration / 中华实验眼科杂志

Objective To evaluate the sensitivity and specificity of spectral domain optical coherence tomography (SD-OCT) for the differentiation of PCV from wet age-related macular degeneration (wAMD).Methods A cross-sectional study was conducted from Jun 2014 to Apr 2016 at Peking Union Medical College Hospital.The case series included 132 eyes of 126 patients with clinical diagnosis of PCV or wAMD.Eyes with three or more of the following SD-OCT findings were diagnosed with PCV:double layer sign,pigment epithelium detachment (PED),a sharp PED peak,a PED notch and a hyporeflective lumen representing polypoidal lesion.The sensitivity and specificity of the OCT-based diagnosis was estimated.Levels of agreement were determined by κ analyses.Results One hundred and twenty-six patients (132 eyes) with PCV or wAMD were enrolled in the study.In PCV patients,PED notch,a hyporeflective lumen representing polypoidal lesion,PED peak,double layer sign and PED were 38,35,48,40 and 46,accounting for 67.9％,62.5％,85.7％,71.4％ and 82.1％,respectively.In wAMD patients,PED notch,a hyporeflective lumen representing polypoidal lesion,PED peak,double layer sign and PED were 12,3,11,8 and 26,accounting for 14.5％,10.5％,34.2％,15.8％ and 3.9％,respectively,which were all lower than PCV,with statistically significant differences (all at P＜0.001).SD-OCT detected PCV in 49 of 56 eyes and 10 PCV patients were misdiagnosed as wAMD.The sensitivity and specificity of SD-OCT for the differentiation of PCV from wAMD were 87.5％ and 86.8％,respectively.The consistence between SD-OCT and imdocyanine green angiography (ICGA) was moderate (κ:=0.738,P＜0.001).Conclusions SD-OCT exhibits high sensitivity and specificity in PCV diagnosis.The presence of DLS,PED,a sharp PED peak,a PED notch,and a hyporeflective lumen representing polypoidal lesion is suggested to be a new diagnostic strategy for PCV.

Protective Effect of Environmental Enrichment on the Morphology of Neurons in the Motor Cortex of Diabetic and Stressed Rats

Background:The present study aimed to evaluate the effects of EE on the morphology of pyramidal neuron at the motor cortex of diabetic and stressed rats.Methods and materials:Male Wistar rats were grouped into Normal Control (NC), Vehicle Control (VC), Diabetes (D), Diabetes + Stress (D+S), Diabetes + Environmental Enrichment (D+EE) and Diabetes + Stress +Environmental Enrichment (D+S+EE) (n=8). Hyperglycemia was induced in Westar rats using streptozotocin (40mg/kg; ip). Blood sugar levels and body weight was measured at regular intervals to monitor the development of hyperglycemia. All experimental groups were housed in standard cages throughout the experiment. Rats in groups D+S and D+S+EE were transferred into space restrained cages for 6 hours daily. D+S+EE group were transferred into EE cages immediately after the space restrained session for subsequent 6 hours daily. On day 30, all rats were sacrificed and brains were harvested and prepared for rapid Golgi staining protocol. Dendritic branchings and dendriticintersections of the motor cortex neurons were quantitated using a camera lucida attached to Biolux research microscope. Data was analyzed using ANOVA with Bonferroni’s test.

Variations In Branching Pattern Of Brachial Artery – A Study In Cadavers

Brachial artery in arm is commonly used for percutaneous arterial catheterization, angiography, vascular flaps for reconstructive surgeries, and can be injured in fractures of arm or elbow region. Knowledge of variations in branching pattern is must for all clinicians and especially for vascular and orthopaedic surgeons to avoid complications like haemorrhage, ischemia and necrosis during various surgical procedures. This study was done to observe variations in branching pattern of brachial artery in cadavers and its clinical applications. The study was conducted on eighty upper limbs of 40 cadavers (30 males and 10 females) of age group 50-70 years in the Dept of Anatomy, R.N.T. Medical College, Udaipur (Raj). In 30 cadavers branching pattern of brachial artery was normal. In 10 cadavers either unilaterally or bilaterally variable branching pattern was noticed in the form of (1) Absence of profunda brachial artery (2) Origin of Profunda brachii artery from axillary artery (3) Termination of brachial artery i.e. in the middle of arm into radial and ulnar artery (4) Termination of brachial artery in arm into medial and lateral branches continuing distally as radial and ulnar artery respectively. Genetic predisposition, chemical factors or hemodynamic forces can be the reasons for arterial variations in the upper limb.

Variations, relations and clinical significance of carotid arterial system in anterior neck: a cadaveric study

Background: The common carotid, internal and external carotid arteries and their branches serve as major source of blood supply in head-neck region of human and are often encountered during numerous surgical and clinical interventions of neck.Methods: We dissected and examined both sides of neck in 49 well embalmed cadavers (98 sides). We recorded the following anatomical parameters of carotid arterial system-level of bifurcation, the relation between internal and external carotid arteries, branching pattern of anterior branches of external carotid artery, tortuosity in carotid arterial system, and relation of hypoglossal nerve with the carotid arteries.Results: In 56.16 % cases, the common carotid arterial bifurcation took place at the upper border of thyroid cartilage though high bifurcation was quite common (43.88%). The external carotid artery was located antero-medial to internal carotid artery in most cases (93.87%). Abnormal tortuosity of carotid arterial system was detected in 2.04% cases only. In 86.73% cases, the hypoglossal nerve crossed the internal and external carotid artery superior to carotid bifurcation above the level of hyoid bone while in 1 case it crossed immediately inferior to carotid bifurcation. In branching pattern, following variations were observed- linguo-facial trunk in 15.3% cases, thyro-lingual trunk in 5.1% cases, origin of superior thyroid artery from common carotid in 10.02% cases and origin of superior thyroid from internal carotid in one case (1.02%).Conclusions: The carotid arterial system has complex and variable anatomy in neck and this information should be kept in mind to avoid unwanted damage during surgical procedures of neck.

Anomalies of Arch of Aorta and Its Branches - Computed Tomography Angiography Study

Introduction: The arch of aorta is a curved structure between the ascending aorta and the descending aorta.Three branches arise from the superior aspect of the arch- Brachiocephalic trunk, Left common carotid artery and Left subclavian artery. The aortic arch and its branches are well known for their anomalies which are important causes of cardio-vascular morbidity and mortality. The present study contribute for awareness and alertness regarding their incidence and prevalence for radiologists, cardiologists and endo-thoracic surgeons and to prevent complications during therapeutic procedures. Subjects and Methods: 500 CTA images were studied retrospectively from the patients who underwent chest and neck CTA for different reasons. Results: Out of 500 patients 474 (94.8%) patients had the classical branching pattern with left sided aorta. Six types of anomalies of the aortic arch and its branches were found in 26 (5.2%) patients. The most common anatomical variant was a common trunk for Brachiocephalic trunk and Left Common Carotid artery (bovine arch) found in 9 (1.8%) patients. In five (1%) patients, Left Vertebral Artery arises directly from the arch of aorta between left common carotid artery and left subclavian artery. Five (1%) patients had Right sided arch of aorta. Aberrant Right subclavian artery was found in four (0.8%) patients. Double arch in 2 (0.4%) cases and in one (0.2%) patient, we observed five branches arising directly from the arch, they are Right Common Carotid artery, Left Common Carotid artery, Left Vertebral artery, Left Subclavian artery and Aberrant Right Subclavian artery. Conclusion: With the ever increasing day to day advancements in complex endovascular interventions for the aorta and other great vessels of head and neck regions, early identification of aortic arch variant anatomy is of clinical significance to the radiologists and endovascular surgeons.

A comparative analysis of robotic partial nephrectomy with selective versus main artery clamping in the management of early-stage kidney cancer / 中华泌尿外科杂志

Objective To compare the clinical outcomes of selective artery (SAC) with main artery (MAC) clamping of robotic partial nephrectomy (RPN) in patients with early-stage (cTiN0M0) renal masses.Methods Between October 2016 and September 2018,a total of 343 cT1 renal mass patients receiving RPN with SAC (n =21) or MAC (n =322) in our center,were retrospectively analyzed.There were 13 males and 8 females in SAC group with a mean age of (53.1 ± 10.6) years old,mean tumor size of (2.5 ±0.7)cm,and mean R.E.N.A.L.score of 6.2 ± 1.5.There were 149 males and 173 females in MAC group,with a mean age of (51.6 ± 12.3) years old,mean tumor size of(3.5 ± 1.4)cm,and mean R.E.N.A.L.score of 7.9 ± 1.6.There was statistical significance between two groups in tumor size and R.E.N.A.L score(P ＜ 0.001).The group covariates were balanced through propensity score matching (PSM) using 1:2 nearest neighbor matching method.After matching,mean age,tumor size,R.E.N.A.L.score and preoperative eGFR in the SAC and MAC groups were (3.1 ± 10.6) vs.(52.7 ± 10.2) years,(2.5 ± 0.7) vs.(2.6±0.7) cm,6.2 ±1.5 vs.6.2 ±0.9,and (101.7 ± 19.8)vs.(101.6 ±20.3) ml/(min · 1.73m2),respectively (P ＞ 0.05).Perioperative outcomes and follow-up data were compared between the two matched groups.Results There was no significant differences resulted regarding operating time [(127.0 ±54.8)min vs.(130.0 ±49.9) min],blood loss[(166.0 ± 173.5)ml vs.(124.0 ± 101.0)ml],ischemia time [(18.9 ± 6.4) vs.(18.1 ± 5.8) min],hospital stay [(8.7 ± 3.4) d vs.(8.5 ± 2.5) d],incidences of complications (28.6％ vs.19.0％),surgical conversions (0 vs.2.4％),transfusions (4.8％ vs.2.4％) or positive surgical margin(0 vs.0) and malignant pathological outcomes(95.2％ vs.92.9％).The follow-up durations ranged from 3 to 24 months with a mean duration of 9.1 and 12.4 months in SAC and MAC,respectively.At the end of follow-up,the two groups had similar decrease in estimated glomerular filtration rate [(7.5 ± 17.2) ％ vs.(12.1 ± 18.2) ％,P =0.466],but the difference was statistically significant with ECT-GFR both of function reduction in the operated kidney [(21.6 ± 14.6) ％ vs.(38.4 ± 20.7)％,P =0.001] and in two kidneys [(2.5 ±16.4)％ vs.(14.8 ±20.0)％,P =0.002].Conclusions Robotic partial nephrectomy with selective vascular control lead to better postoperative renal function compared with main vascular clamped PN techniques and does not lead to a higher surgical risk following a strict patient selection criteria.

Comprehensive Optimization of Rehabilitation Measures of Traditional Chinese Medicine to Elderly Patients with COPD at Stable Period / 中国实验方剂学杂志

Objective:To discuss the clinical efficacy of comprehensive optimization of rehabilitation measures of traditional Chinese medicine(TCM) on elderly patients with COPD at stable period, in order to study its effect on immune function and inflammatory factors. Method:One hundred and forty-four patients were randomly divided into control group and observation group by random number table. Patients in control group got ipratropium bromide, 40-80 μg/time, 2-4 times/days, salmeterol roticasone powder, 1 suction/time, 2 times/days, as well as comprehensive western medical treatment measures of healthcare education, oxygen therapy and respiratory muscle exercise. In addition to the basic therapy of ipratropium bromide and salmeterol roticasone powder, patients in observation group was added with syndrome differentiation therapy of TCM, foot bath with TCM and respiratory function exercise with TCM. The course of treatment was 6 months, and 6-month follow-up were recorded. Comprehensive assessment of COPD was recorded. Before and after treatment, respiratory questionnaire (mMRC), self-assessment test for patients with chronic obstructive pulmonary disease (CAT), forced expiratory volume in the first second (FEV1), FEV1%, St George's respiratory questionnaire (SGRQ), 6-minute walking distance (6 MWD) were scored. And levels of CD3+, CD4+, CD8+, CD4+/CD8+, interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-alpha) and hypersensitive C-reactive protein (hs-CRP) were detected. Result:Comprehensive assessment of COPD in the two groups were better than those before treatment (PZ=2.066, Pα were lower than those in control group (P+ was lower than that in control group (P1 and FEV1% were higher than those in control group (P+, CD4+, CD4+/CD8+ and 6-minute walking distance were more than those in control group (PConclusion:Comprehensive optimization of rehabilitation measures in TCM can inhibit inflammatory factors, improve immune function, alleviate clinical symptoms, improve lung function, improve exercise endurance and quality of life of patients, and promote the lung rehabilitation.

”Double-layer sign” on spectral domain optical coherence tomography in pachychoroid spectrum disease

Purpose: The “double-layer sign (DLS)” describes the shallow and irregular elevation of the retinal pigment epithelium from the underlying intact Bruch's membrane visualized on the spectral domain optical coherence tomography. In this study, we evaluated the frequency, characteristics of the space within the double layer and other features in the pachychoroid spectrum to aid the clinical diagnosis of these variants. Methods: This retrospective study evaluated the features of the DLS on multimodal imaging in consecutive patients with a clinical diagnosis of one of the four variants of pachychoroid: pachychoroid pigment epitheliopathy (PPE), pachychoroid neovasculopathy (PCN), chronic central serous chorioretinopathy (CCSCR), and polypoidal choroidal vasculopathy (PCV). The features of the DLS were graded by two masked graders. Results: Overall, 102 eyes of 79 consecutive patients with pachychoroid spectrum were identified for grading. Sixteen eyes with PPE did not show any evidence of DLS. The DLS was identified in 15/16 (93.75%) eyes with PCN, 11/35 (31.43%) with CCSCR, and 32/35 (91.43%) with PCV (P < 0.001). The space within the DLS showed moderate hyperreflectivity in all eyes with PCV and PCN, while the space in the DLS in CCSCR showed uniform hyporeflectivity in 10/11 (%) eyes. Conclusion: The DLS sign was most frequent in polypoidal vasculopathy and PCN. A hyporeflective gap within the DLS favored the diagnosis of CCSCR.

Anatomic Variations In The Middle Cerebral Artery In Human Cadavers

Introduction: Middle cereal artery (MCAis the largest anch among all the anches of internal carotid artery,abnormal development of which in the emyonic period can lead to developmental anomalies of the cereal arteries. The present study was aimed to describe the anatomical variations in the MCA in the formalin preserved ains of human cadavers. Methodology: This study was conducted in the Department of Anatomy, Mahatama Gandhi Mission Medical College, Aurangabad in which 50 formalin preserved specimens of ain were dissected. We carefully dissected the MCA on either side from its origin to its termination and its course was traced through the lateral cereal fissure. We carefully and delicately separated the arterial networks of the Circle of Willis along with the MCA of both sides and using a verniercaliper the dimensions of the MCA were measured. Results:In all specimens, MCA originated from the internal carotid artery, and it ran towards the posterior end of the lateral sulcus of the cereal hemispheres lateral to the optic chiasma. The length ranged from 11.3 to 26.2 mm, with mean length being 18.9 and 17.6 mm in the right and left side respectively. Diameter of the MCA ranged from 2.5 cm to 4.8 cm, with mean diameter being 3.12 and 3.24 cm in the right and left side respectively. Symmetric anching of MCA was seen in 22 specimens and rest had asymmetric anching. Conclusions: Awareness about the anatomical variations in the morphometric measurements and anching patterns of MCA are essential from the clinical viewpoint. Since these variations are rare, multi-centric studies with larger sample size are required in future.

Bilateral Prehilar Branching Of Renal Arteries

Background: Variation in renal arteries are very common but bilateral variation is rare and is clinically importantfor urologist especially during the renal transplantation. Generally main renal artery divides into anterior andposterior branches just before entering the hilum of kidney, but sometimes two or more polar arteries; prehilarbranching and segmental arteries arise from main renal artery .Renal artery variations are often seen and aregenerally categorized into presence of accessory or aberrant renal arteries, polar arteries and prehilar branches.Prehilar multiple branching of main renal artery variation is frequently seen.Materials and Method: The present study was conducted in 80 kidneys from 40 cadavers during the routinedissection in the Department of Anatomy Maharishi Markandeshwar Medical College and Muzaffarnagar MedicalCollege .Out of 80 kidneys studied bilateral prehilar branching of renal arteries from the main renal artery wereobserved in 5 kidneys (6.5%).Conclusion: Different arterial branching patterns was observed in five cases in which prehilar branches originateddirectly from main renal artery, entering the upper pole of kidney. Knowledge of such variation is important forradiologists, anatomists and urologists while performing renal transplantation, laparoscopic renal surgeries,nephrectomies, and other renal surgeries and diagnosis.

Variation In Branch Free Length Of Renal Artery And Its Clinical Significans: A 64-slice Ct Angiographic Morphometric Study

Background: Length of renal artery is an important morphological parameter while performing surgeries in renalarea. The present study was conducted to evaluate variations in length of renal artery.Materials and Methods: The study was conducted in the department of anatomy and department of radiology ofKing George’s Medical University, Lucknow. 53 subjects (106 renal arteries), undergoing 64-slice CT angiographyfor different indications were included in the study group. The angiographic images of all the subjects in abdominalregion were analyzed for renal arteries and their length was measured utilizing computerized tools.Results: The length of main renal artery varied from 8.5mm to 54.8mm on the right side. On the left side minimumlength was 7.7mm and maximum length was 48.8mm. The average length of renal artery was 30.5±10.4 mm on theright side and 26.91±10.0 mm on the left side. There was great variation in the length of renal artery due tovariation in site of ramification.Conclusion: The variation of renal artery length is critically important for maintaining vascularity of kidney aftersurgery

A Study On Course And Variations Of Facial Artery On The Face

Introduction: Face is mainly supplied by the Facial artery supplemented by transverse facial artery. Variations inthe course and branching pattern of facial artery are commonly seen. The understanding of these variations offacial artery plays a very important role in facio-maxillary surgeries. It is also of immense importance toradiologists in interpreting facial artery angiography.Materials and Methods: The present study was conducted in the Department of Anatomy, Subbaiah Institute ofMedical Sciences on 50 formalin fixed adult hemi-faces irrespective of sex. The branching pattern, terminationsand variations of facial artery on the face were studied.The facial artery predominantly terminated as angular artery in 28 (56%) hemi-faces, as superior labial arteryin 15 (30%) hemi-faces and as lateral nasal artery in 6 (12%) hemi-faces.Results: An inconstant posterior (pre-masseteric) branch of facial artery was observed in 3 (6%) hemi-faces. Inone of the hemi-face we found a deviation in the usual course of facial artery, where the artery deviated towardsthe infra-orbital foramen then continued and terminated as the lateral nasal artery. An unusual termination offacial artery was observed in one of the hemi-faces where the artery terminated by giving 4 branches in the lowerbuccal region.Conclusion: Knowledge of these variations and anomalous branching pattern is of great academic and clinicalsignificance in general practice, Otorhinology, Traumatology, Plastic and Maxillofacial surgeries and Radiology

A cadaveric study on variations in branching pattern of external carotid artery / 대한해부학회지

Variations in the vascular anatomy of the carotid triangle have been reported in current scientific literature. The carotid arteries, being the major feeding arteries of the head and neck deserve special importance and protection from iatrogenic injury during radiological evaluations and surgical interventions. The present study was carried out over a period of 4 years from 2012–2016 to assess the variant anatomy of external carotid artery. The external carotid artery and its branches were dissected bilaterally in 40 formalin embalmed cadavers. The external carotid artery was traced from its origin to termination and variations in the branching pattern as well as the level of the carotid bifurcation were observed and analysed. A higher carotid bifurcation was observed in 25% cases. The linguofacial trunk was the commonest variation noted in the branching pattern seen in 20% cases. A single case of unilateral thyrolinguofacial trunk was also observed. The external carotid artery gave rise to accessory branches in 7.5% cases namely the superior laryngeal, accessory ascending pharyngeal and masseteric branches. A slender branch to the internal jugular vein was also observed in one case. These findings may provide further insight into the understanding of the vascular anatomy of the carotid triangle to the curious student, the discerning radiologist and the vigilant surgeon to avert complications and help improve overall treatment outcome.

A Case of Glycogen Storage Disease IV with Rare Homozygous Mutations in the Glycogen Branching Enzyme Gene / 대한소아소화기영양학회지

Glycogen storage disease (GSD) IV is a rare autosomal recessive inherited disorder caused by mutations in the gene coding for glycogen branching enzyme leading to progressive liver disease. GSD IV is associated with mutations in GBE1, which encodes the glycogen branching enzyme. We report a case of GSD IV with rare homozygous mutations in the GBE1 gene (c.791G>A (p.Gly264Glu), which was successfully treated by liver transplantation.