Perianal complications in puerperium and associated risk factors

Introduction: Puerperium is defined as the period of about 6 weeks after childbirth during which the mother's reproductive organs return to their original nonpregnant condition. Perianal problems, including constipation, hemorrhoids, and fissure, are among the most common digestive complications among women in puerperium, observed in about 30 to 50 percent of women. Considering this great prevalence and the paucity of similar research in this aspect in an Indian population, the present study was done to assess the prevalence of perianal problems seen in puerperium and the risk factors associated with it. Methods: This was a prospective observational cohort study done over the span of 3 years on 902 puerperal women. A self-structured questionnaire covered detailed history and per-rectal and proctoscopy examination. Patients were followed up telephonically for regression of perianal problems post management. Results: The total prevalence of all the perianal problems in puerperium encountered in the present study, out of 902 subjects, was 36.3% (327 subjects). The perianal problems encountered were fissure in 185 patients (20.5%) followed by hemorrhoids in 110 patients (12.2%), perianal episiotomy infections in 25 patients (2.8%), and perineal tears in 7 patients (0.8%). On comparative analysis, positive family history, macrosomia, past history of perianal diseases, and second stage of labour > 50 minutes showed a higher prevalence in the perianal disease group as compared with the healthy group. Out of these, positive family history of perianal diseases (p= 0.015) and past history of perianal diseases (p= 0.016) were statistically significant. The percentage of multipara with hemorrhoids was more when compared to primipara (p= 0.01), patients who had a past history of any perianal disease have a higher chance of hemorrhoids during puerperium (p= 0.00). Patients with constipation in pregnancy have higher chance of hemorrhoids in pregnancy (p= 0.00). Patients who had a past history of any perianal disease had higher chance of fissure during puerperium (p= 0.00). A total of 27.74% of the study subjects with macrosomic babies had fissure in their puerperal period which on comparison with patients with non macrosomic babies was only 19.22%, which was statistically significant (p= 0.02). Conclusion: Constipation, hemorrhoids, and anal fissures are the most common perianal problems in postpartum period causing significant reduction in the quality of life of those afflicted with them. (AU)

Identification and reporting of anal pathology during routine colonoscopies

The gold-standard procedure for anal canal examination is anoscopy. Nonetheless, patients are referred for a colonoscopy for many reasons, and a routine exam might provide an opportunity to diagnose anal pathologies, such as hemorrhoids, anal fissures, anal polyps, condylomas, and anal squamous cell carcinoma. It is important to know the main features of these conditions and relevant information to report in order to help guide patient treatment and follow-up.

Efecto del tratamiento de la morfología oclusal con materiales para restauraciones preventivas / Effect of treating occlusal morphology with materials for preventive restorations

Introducción: las fosas y fisuras son áreas formadas por delgadas irregularidades de la capa del esmalte de la superficie oclusal. La compleja morfología en dientes posteriores es un determinante biológico asociado al desarrollo de caries. Objetivo: evaluar el efecto de diversas formas de tratar la morfología oclusal en la adaptación y penetración de materiales utilizados en restauraciones preventivas. Material y métodos: diseño experimental e in vitro. Sesenta terceros molares fueron distribuidos aleatoriamente en dos grupos: surco sin ameloplastia y con ameloplastia; además, contaban con acondicionamiento del esmalte que se subdividió en tres subgrupos: 1) sellador de fosas y fisuras, 2) adhesivo/sellador de fosas y fisuras y 3) adhesivo/ resina Flow. Resultados: los subgrupos adhesivo/sellador y adhesivo/ Flow alcanzaron mayores valores de adaptación íntima a las paredes del surco. Las diferencias fueron significativas entre los materiales (p = 0.0009). Las mayores zonas de desadaptación resultaron para el sellador sin y con ameloplastia. La penetración de los materiales fue mayor en los surcos con ameloplastia. En los surcos tratados con ameloplastia, el adhesivo/Flow reveló el mayor porcentaje de penetración y la mejor adaptación a las paredes del surco. Conclusiones: la penetración del material está positivamente correlacionada con la profundidad del surco. El sellador con y sin ameloplastia mostró pobre adaptación a las paredes del surco (AU)

Introduction: pits and fissures are areas formed by fine irregularities in the enamel layer of the occlusal surface. The complex morphology in posterior teeth are biological determinants associated with the development of caries. Objective: to evaluate the effect of various ways of treating occlusal morphology on the adaptation and penetration of materials used in preventive restorations. Material and methods: experimental design, in vitro. Sixty third molars were randomly distributed into two groups: groove without ameloplasty and with ameloplasty, with enamel conditioning with three subgroups: 1) pit and fissure sealer, 2) adhesive/pit and fissure sealer, 3) adhesive/resin flow. Results: the adhesive/sealant and adhesive/flow subgroups reached higher values of intimate adaptation to the furrow walls. The differences were significant between the materials (p = 0.0009). The largest areas of maladjustment were found for the sealant without and with ameloplasty. The penetration of the materials was greater in the grooves with ameloplasty. In the grooves treated with ameloplasty, the adhesive/flow revealed the highest percentage of penetration and the best adaptation to the walls of the groove. Conclusions: the penetration of the material is positively correlated with the depth of the furrow. The sealant with and without ameloplasty showed poor adaptation to the sulcus walls (AU)

Pit and fissure depth in the enamel of mandibular third molars / Profundidad de fosas y fisuras en el esmalte de terceros molares inferiores

ABSTRACT The aim of this descriptive ex vivo study was to evaluate qualitatively the depth of pit and fissures (P&F) of the enamel in human mandibular third molars. Fifty (n=50) extracted human mandibular third molars were cleaned and disinfected. All tooth surfaces were coated with nail varnish except for a 1-mm margin around the periphery of the occlusal surface. The teeth were immersed for 48 hours at 37 °C in 1% methylene blue dye solution prepared in artificial saliva. After cleaning, the crowns were separated from the root at the cementoenamel junction and subsequently sectioned longitudinally in buccolingual direction at the location of the central fossa. All sections were examined using a stereoscopic microscope and photographed. The images were downloaded on a computer. The length of penetration of the P&F was recorded using the following scoring system: C1: P&F extended to half of the enamel thickness; C2: P&F extended beyond half of the enamel thickness without reaching the dentine-enamel junction; C3: P&F extended to the dentine-enamel junction. For pits, C1, C2 and C3 were observed in 35, 9 and 6 teeth, respectively, while for fissures, C1, C2 and C3 were observed in 15, 18 and 17 teeth, respectively. The P&F detected in the samples extended to the deepest portions of enamel, quite frequently reaching the enamel-dentine junction. Clinicians should recognize that even if pits and fissures are not clinically obvious, they penetrate deep into the enamel and frequently reach the dentine-enamel junction. Effective treatment is recommended to block access to P&F, thus preventing ingress of bacteria.

RESUMEN Objetivos: El objetivo del presente estudio descriptivo fue evaluar cualitativamente mediante un ensayo ex vivo la profundidad de las fosas y fisuras (F&F) del esmalte en terceros molares inferiores humanos. Materiales y métodos: Cincuenta (n=50) terceros molares inferiores sanos extraídos se lavaron, se descontaminaron y se recubrieron con esmalte para uñas hasta 1 mm menos del área de las F&F. Luego se sumergieron durante 48 horas a 37°C en una solución de azul de metileno al 1% (pH 7,4) preparada con saliva artificial. Posteriormente se lavaron y se separaron las coronas a nivel del límite amelocementario. En cada molar se realizó una sección longitudinal de 1 mm de espesor con orientación vestíbulo-lingual a nivel de la fosa central. Las secciones fueron analizadas con microscopio estereoscópico y fotografiadas. Las imágenes se transfirieron a una computadora. Se determinó cualitativamente la extensión de las F&F en el espesor del esmalte y se las clasificó de acuerdo a 3 categorías. C1: extensión hasta la mitad del espesor del esmalte; C2: extensión que supera la mitad del espesor del esmalte sin afectar el límite amelodentinario; C3: extensión que llega al límite amelodentinario. Resultados: Para las fosas, 35, 9 y 6 especimenes correspondieron a las categorías C1, C2 y C3 respectivamente. Para las fisuras, 15, 18 y 17 especimenes correspondieron a las categorías C1, C2 y C3 respectivamente. Conclusiones: Las fosas y fisuras de la muestra analizada se extienden hasta la zona más profunda del espesor del esmalte. Con cierta frecuencia llegan hasta el límite amelodentinario.

Management of chronic anal fissures: a narrative review

Anal fissures are often encountered in surgical practice in both sexes. It is a distressing disease impacting quality of life and causes profound morbidity among those affected. If left untreated, it may lead onto perianal abscess or even malignancy in long standing cases. Surgery is the gold standard management for chronic anal fissures. Recently the widespread use of pharmacologic agents for chronic fissures has increased. The management of chronic anal fissures has migrated to an era of multifaceted approach. This narrative review looks into various studies spanning over a period of 16 years. Various articles were shortlisted and analyzed for efficacy of various treatment methods, their impact in hospital stay, quality of life improvement, recurrence rate and complications among various treatment methods. We concluded from this review, that open lateral internal sphincterotomy is still the gold standard method of treatment for chronic anal fissure. Among pharmacological agents, 2% diltiazem has the best effectiveness with good compliance rate. Modern surgical techniques like VY plasty can be reserved for special situations. We do not recommend the practice of manual anal dilatation.

Variação morfológica no padrão lobar e nas fissuras dos pulmões: relato de caso / Morphological variation in the lobar pattern and in the fissures of the lungs: a case report

Modelo do estudo: Relato de caso. Importância do problema: Lobos e fissuras acessórias nos pulmões podem induzir a erros de interpretação e diagnóstico, além de favorecer a disseminação de patologias como a pneumonia para lobos adjacentes. Dessa forma, a constatação dessas alterações anatômicas pode colaborar em diagnósticos clínicos e procedimentos cirúrgicos. Comentários: Relatamos um caso raro de modificação anatômica nos lobos e fis-suras dos pulmões. O pulmão esquerdo exibia um lobo médio acessório e uma fissura horizontal completa. Por outro lado, o pulmão direito apresentava duas fissuras acessórias incompletas situadas inferiormente na face costal do lobo médio. Além disso, observamos que o hilo do pulmão esquerdo continha dois brônquios lobares (superior e inferior), um brônquio lobar acessório e três artérias pulmonares. O conhecimento das variações anatômicas aqui relatadas é fundamental, pois auxiliam os profissionais da saúde nos diagnósticos e nas decisões terapêuticas e cirúrgicas.(AU)

Study: Case Report. Importance: Lobos and accessory fissures in the lungs can induce errors of interpretation and diagnosis, as well as favor the spread of pathologies such as pneumonia to adjacent lobes. Thus, the confirmation of these anatomical alterations can collaborate in clinical diagnoses and surgical procedures. Comments: We report a rare case of anatomical variation in the lobes and fissures of the lungs. The left lung showed an accessory middle lobe and a complete horizontal fissure. On the other hand, the right lung had two incomplete accessory fissures located inferiorly in the costal face of the middle lobe. In addition, we observed that the left lung hilum contained two lobar bronchi (upper and lower), one accessory lobar bronchus and three pulmonary arteries. Knowledge of the anatomical variations reported here is fundamental, as they help health professionals in diagnoses and therapeutic and surgical decisions (AU)

Morphological Changes In Human Fetal Spleen At Different Gestational Ages

Background: The purpose of the study was desired to investigate and observe the variations in the morphology ofspleen in human fetuses. The spleen is the largest secondary lymphoid organ, in the fetal stage it also performsthe role of haematopoiesis. It acts as a blood filter, and also acts as storage site for iron, erythrocytes, andplatelets.Materials and Methods: This study has been carried out on spleen of 40 formalin preserved human fetuses (19males and 21 females) of different gestational ages, in the Department of Anatomy, Government Medical College,Haldwani over a period of two years (i.e. 2014- 2016), with due regards on ethical grounds. Various grossparameters of spleen such as its location, shape, relations, notches & fissures and ligaments were observed andthe results were statistically analyzed.Results: Spleens in all the fetuses was located in the left hypochondrium. 60% of the fetal spleens were wedgeshaped. While stomach was related to the spleen in all the gestational ages, kidney and left colic flexure were notrelated to the spleen in the early age of the fetus. Liver and left adrenal gland also showed relations with the fetalspleen. Maximum number of notches was present in the superior border followed by inferior border and lateralpole. Fissures were also seen in 11 spleens.Conclusion: Knowledge about prenatal ontogenesis of the spleen will help to understand the mechanisms ofpathology in the organ and create methods of diagnosis and prevention.

Morphological Study Of Human Lungs

Background and aims: Knowledge of anatomical variations in lung morphology is not only of academic interestbut is essential during surgery and also while interpreting various radiological images. The present study wasundertaken with the aim to observe the variations of lung morphology.Materials and Methods: The shape of the lungs, variations of fissures, lobes and hilar structures were studied in42 right and 37 left isolated lungs.Results: Unusual shape was seen in 4 lungs. Among the right lungs, oblique fissure was incomplete in 42.86% andabsent in 7.14% and horizontal fissure was incomplete in 61.90% and absent in 19.05%. Inferior accessoryfissure (IAF) was present in 21.43% and superior accessory fissure (SAF) in 7.14%. Usual right hilar architecturehaving a pulmonary artery with 2 pulmonary veins and 2 bronchi was not seen in any case however, the usualarchitecture with a superior lobar artery was seen in 28.57% cases. Among the left lungs, oblique fissure wasincomplete in 40.54% and absent in 2.70%. Horizontal fissure was present in 24.32%, left minor fissure (LMF) in29.73%, inferior accessory fissure (IAF) in 43.24% and superior accessory fissure (SAF) in 2.70%. Usual left hilararchitecture having a pulmonary artery, 2 pulmonary veins and a bronchus was seen in 54.06%.Conclusion: The knowledge of variations in the lung morphology observed in this study will be of academicinterest and also useful for diagnostic and clinical management of pulmonary and even cardiac cases

Assessment of Morphological Variations in Human Liver in Tertiary Healthcare Institute: A Cross Sectional Study in Maharashtra

Introduction: Liver is the largest gland of the body. Itis situatedunder the right dome of the diaphragm andmainlyoccupies the right hypochondriac and epigastricregions. In man, the liver is essentialfor survival since there iscurrently no artificial organ orequipment that has the capacityto compensate for theabsence of liver function. Henceknowledge of variation in liver anatomy is required for goodsurgical outcome, diagnostic imaging and minimally invasivesurgical procedures.Material and Methods: The present study was conducted in160 human livers from embalmed cadavers in the Departmentof Anatomy, KIMS, Karad, during the study duration of July2017 to August 2018. The liver specimens were removed fromadult human cadavers during routine dissection for medicalundergraduate students and then preserved in 10% of formalin.Results: We analyzed 160 livers, with its morphologicalcharacteristics and structural variations. Mean weight ofthe liver was reported to be 1.05 Kg (Minimum 0.461 andMaximum 2.137 Kg) with SD of 0.34 Kg. Mean breadth ofliver was reported to be 18.44 cm (Maximum 25.5 cm andMinimum 2.4 cm) with SD of 2.45 cm. Mean thickness of liverwas reported to be 10.52cm (Maximum 18.3 and Minimum3.4) with SD of 1.82 cm.Conclusion: The present study focuses upon the frequentoccurrence of morphological variations on the surface of theliver.

An Anatomical Study Of Variation In Fissures And Lobar Pattern Of Human Lungs

Introduction: Awareness of anatomical variations in lungs is essential during segmental or lobar resections oflungs. Hence the proposed aim of the study was to study the fissures and lobes of the lungs and their variationsand to compare them with previous studies and to find their clinical implications.Materials and Method: Seventy lungs obtained from cadavers in the department of anatomy, Govt DharmapuriMedical College were used for study. Any variation in the fissures and lobes of the lungs and accessory fissurewere studied.Result: Out of seventy lungs studied, 32 were from right side and 38 were from left side. Out of 32 right lungsexamined, the horizontal fissure was absent in 4 lungs (12.5%), incomplete in 10 lungs (31.25%), Complete in 18lungs (56.25%). Oblique fissure was incomplete in 5 lungs (16%) and complete in 27 lungs (84%). Out of 38 leftlungs, the oblique fissure was incomplete in 8 lungs (21%), complete in 30 lungs (79%) and accessory fissure in5 lungs.Conclusion: Knowledge of such variations will be helpful to the radiologists, clinicians to make correct diagnosisand plan for the surgical procedure. This will help to reduce the morbidity and mortality associated with lungsurgeries.

A Cadaveric Study On Morphological Variations Of Lobar And Hilar Anatomy Of Human Lungs

Background: Knowledge of variations in fissures and hilar structures of the lungs is necessary for the appreciationof lobar anatomy and hilar anatomy of lungs.Materials and Methods: Morphological variations of fissures, lobar and hilar structures were studied in 50formalin fixed lungs belonged to 40-80 years age group.Results: In the present study following observation was made: Right sided lungs had, Incomplete Horizontalfissures in 7 lungs, absent horizontal fissures in 2 lungs, among Hilar structures 2 arteries in 5 lungs, 3 veinsin 2 lungs, 1 bronchus in 2 lungs. Left sided lungs had, Incomplete horizontal fissures in 2 lungs, among hilarstructures, 1 vein in 2 lungs, 3 vein in 2 lungs and 2 bronchus in 7 lungs.Conclusion: Awareness regarding variations in fissures, lobes and hilar anatomy of the lungs is importantclinically while interpreting the radiological images as well as to plan various surgical procedures to avoidpostoperative complications.

Morphometric Study Of Lung Fissure And Its Variations; A Cadaveric Study From Marathwada Region

Background: With the increase in air pollution; incidence of respiratory diseases varying from viral infections tolung cancers is increased and hence to know lung anatomy and its variation is important for physicians,cardiopulmonary surgeons and medical undergraduates.Purpose of study: to study the morphological variation of the lung fissures. 46 formalin preserved cadavericlungs allotted to undergraduate students in Anatomy Department of MGM medical college Aurangabad werestudied for variations and morphometry of lung fissures.Results: Out of 46 cadaveric lungs of unknown gender 22 were right sided and 24 were of left side. Amongst 22right lungs; 17 (77.27%) lungs have well developed oblique fissure; while 5 (22.72%) lungs had incompleteoblique fissures. Only 5(22.72%) right lungs had complete horizontal fissure, 14(63.63%) right lungs had incompletehorizontal fissures 3(13.63%) lungs had absent horizontal fissure. Out of 24 left lungs 18(75%) specimens havewell developed oblique fissure,6 (25%) left lungs have incomplete oblique fissure while 1(4.16%) left lung hadincomplete horizontal fissure. Present study had incomplete accessory fissure in 3 lung specimen of which 1right lung had superior accessory fissure and 2 left lungs had inferior accessory fissure. There are very fewstudies on lung fissure for Marathwada population.Conclusion: Present study gives idea about possible variations in lung fissures. Present study supports thefrequent occurrance of variations of lungs fissures and lobes. Prior information of such variations is importantfor cardiothoracic surgeons and pulmonologists to avoid post operative complications of surgery or lungprocedures.

Study Of Morphology Of Fissures Of Lung In Central Karnataka Region

The adult human lungs are two in number, the right & left lungs which are concerned with the aeration andexchange of gases. The right lung is comparatively larger & heavier and has 2 fissures oblique fissure & horizontalfissure & has 3 lobes in it. The left lung is longer & has only 1 fissure in it with 2 lobes.The present study was done on adult lungs in the Dept. of Anatomy SUIMS & R.C. Shimoga where only the obliquefissure was seen and horizontal fissure were missing in 7 out of 40 right lungs studied. Incomplete horizontalfissures were in 3 right lungs out of 40. Accessory fissure was seen in 1 specimen of right lung. Accessory fissureswere seen in 3 out of 40 left lungs studied. The presence of normal fissures in lung will help in proper expansionof lungs & also helps in localising the lesions to specific areas in the lungs. Incidence of absence of fissures inlungs varies from one geographical region to other region and is variable with the samples collected by differentworkers for the study.The incomplete fissures when present give a atypical appearance of the pleural effusion and may also alter theusual patterns of collapse of the lungs. The knowledge of such absence or incomplete fissures in lungs is helpfulfor anatomists, radiologists and surgeons operating on lungs during lobar resections of the lung

Efectividad del lisado plaquetario en la cicatrización de las fisuras anales / Effectiveness of platelet lysate in anal fissures cicatrization

Introducción: las fisuras anales son un problema de salud importante en la población cubana, incluso con la supresión de los factores desencadenantes, muchas de ellas tienden a la cronicidad; su evolución es tórpida, y es elevado el riesgo de complicación de las mismas. Objetivo: evaluar la cicatrización de las fisuras anales mediante lisado plaquetario en el Hospital General Docente Comandante Pinares de San Cristóbal. Método: se realizó un estudio cuasi experimental en el servicio de cirugía general del Hospital General Docente Comandante Pinares desde enero 2015 hasta junio 2017. Se incluyeron en el estudio todos los pacientes adultos, de ambos sexos, atendidos por el diagnóstico de fisura anal con inadecuada respuesta al tratamiento convencional y sin otras enfermedades de base que impidieran el uso de la terapia regenerativa. A todos los pacientes se les solicitó el consentimiento informado previa explicación de las características del estudio. Resultados: la hemorroidectomía fue el proceder más frecuente asociado a las fisuras anales. El dolor fue el síntoma predominante antes del tratamiento. La reducción del área de la fisura fue evidente en los tratados con lisado. El efecto final en los pacientes tratados con el método fue positivo. Conclusiones: se comprobó que el lisado plaquetario usado para la cicatrización de la fisura anal crónica fue efectivo con un resultado de satisfacción por parte de los pacientes, con un mínimo de reacciones adversas. Puede representar un futuro promisorio en el tratamiento de esta enfermedad(AU)

Introduction: Anal fissures are an important health problem in the Cuban population, even with the suppression of the triggering factors, many of them tend to chronicity; its evolution is torpid, and their risk for complication is high. Objective: To evaluate the healing of anal fissures by platelet lysate in Comandante Pinares General Teaching Hospital in San Cristóbal. Method: A quasi-experimental study was performed in the general surgery service of Comandante Pinares General Teaching Hospital, from January 2015 to June 2017. All adult patients, of both sexes, were attended upon diagnosis of anal fissure and were included in the study. with inadequate response to conventional treatment and without other underlying diseases that could prevent the use of regenerative therapy. All patients were asked for their informed consent prior explanation of the study characteristics. Results: Hemorrhoidectomy was the most frequent procedure associated with anal fissures. Pain was the predominant symptom before treatment. The reduction in the area of ​​the fissure was evident in those patients treated with the lysate. The final effect in patients treated with the method was positive. Conclusions: The usage of the platelet lysate for the healing of chronic anal fissure proved effective, with a result of patient satisfaction, with a minimum of adverse reactions. It may represent a promising future in the treatment of this disease(AU)

Variation In Lobes And Fissures Of Lung

Introduction: Lungs are the paired vital organs meant for respiration situated in the thoracic cavity on either sideof the heart. The right lung is divided into supe-rior, middle & inferior lobes by oblique and horizontal fissure.While the left lung is divided into supe-rior & inferior lobes by an oblique fissure. The fissures permit distensionof the lobes during respiration. The fissures may be complete, incomplete or absent.Aim: To find out the variations in fissures and lobes along with their patterns, in human lungs; collected fromcadavers.Result: Out of 50 right lung specimen, the horizontal fissure was absent in two cases whereas the horizontalfissure was incompletely seen in 18 specimens. Incomplete oblique fissure was seen in 7 right sided lungs. Wereported accessory fissures and accessory lobes in 14 specimens. The oblique fissure was absent in 4 left lungsand it was incomplete in 14 lungs. Accessory fissures and lobes were present in 8 specimens.Conclusion: Knowledge of any variations is necessary in performing segmental resection and lobectomy. Accessoryfissures indicate persistence of prenatal fissures.

Morphological Study Of Fissure And Lobes In Fetal Lungs

Background: The lungs are the essential organs of respiration which are divided into lobes and fissures. Fissureshelp in a more uniform expansion of lungs. Knowledge about the fissures is helpful in appreciation of lobaranatomy and for locating bronchopulmonary segments and it is important for anatomists, pediatrician,radiologists, cardiothoracic surgeons and also for clinicians.Materials and methods: 50 spontaneously aborted fetuses were collected from labour room of Obstretrics andGynaecology Department of PSG Institute of Medical Science and Research Centre, Coimbatore and the study wasconducted in the Department of Anatomy. The morphological details of fissures and lobes of the lungs andpresence of any variation in the fissures and accessory fissure were studied.Results: Out of 50 specimens in the age group of 10 weeks to 39 weeks of gestation, the horizontal fissure wasincomplete in 35 fetuses (68%), complete in 14 fetuses (28%), absent in 1 fetus (2%) and accessory fissure wasfound in 1 fetus (2%).Conclusion: Awareness of the variations in the lobes and fissures of the lungs is important for radiologists forproper diagnosis and to surgeons for performing segmental lung resections.

Variations in human pulmonary fissures and lobes: a study conducted in nepalese cadavers / 대한해부학회지

The fissures of lungs are embryologically separating the bronchopulmonary segments, which later on persist in interlobar planes of fully developed lung. Fifty lungs (23 right side and 27 left side), obtained during routine dissection and preserved in formalin constituted the material for present study. In them, variations in fissures and lobes of lung were observed and compared with the previous studies. Seven right sided and 14 left sided lungs showed incomplete oblique fissure. Incomplete horizontal fissure of right lung was observed in eight lungs while it was completely missing in three specimens. A right lung with “lobe of the azygos vein” separated by a supernumerary fissure in medial surface was found. One of the right lung had both superior accessory fissure and inferior accessory fissure and four other right lungs and one left lung presented only with inferior accessory fissure. A vertical notch was found in middle lobe of one right lung. Eight left lungs exhibited with left minor fissure among them two lungs had lingula appearing as a separate lobe. Knowledge of variations in fissures and lobes is of interest to all medical professionals to exactly interpret radiographs, computed tomography scans, to diagnose, plan and modify a surgical procedure depending on the merit of the case and also in certain classical clinical cases pertaining to lung pathologies.

Morphological Study of Cadaveric Human Spleen.

Background: This study deal with the morphology of spleen regarding to shape, notches, and fissure on superior, inferior and diaphragmatic, visceral surface and compared with different study done previously. Methods: This study was done in the department of Anatomy, Chattishgarh Institute of Medical Science, Bilaspur, C.G. India. The study was done on 50 formalin fixed human middle age cadaveric spleen. The spleen was observed grossly and photograph was taken. The data was displayed in tabulated form. Results: The present study was done on 50 formalin fixed human cadaveric spleen, out of which 23(46%) spleen showed wedge shape, 19 (38%) spleen showed tetrahedral shape, 8(16%) spleen showed triangular shape. Among 50 spleen 35 (70%) exhibit notches on the superior border ,4(8%) exhibit notches on the inferior border, 6 (12%) exhibit no notches on either border of spleen, 5(10%) exhibit notches on the both border of spleen, 3 (6%) having fissures on the diaphragmatic surface of spleen . Notches on the superior border are commonly observed but it varies between 1 to 6 and in majority of spleen, it exhibits 1-3 notches respectively. Conclusion: This study provide knowledge about shape, notches, fissures of spleen hence this study useful for clinicians, surgeon, anatomist, radiologist for proper diagnosis and treatment of disease.

Resistance to fracture evaluation of endodontically treated roots of first maxillary premolars

Introduction:One of the most common dental procedures associated to vertical root fractures is the endodontic treatment with excessive dentin wall wear and another increasing risk factor is the use of intraradicular post. Objective: This study evaluated the resistance to fracture of the buccal and palatal roots of maxillary first premolars with endodontically treated canals and spaces for posts. Material and methods: Twenty two first permanent premolar roots (11 buccal and 11 palatal) composed the experimental sample. The canals were prepared with Protaper Universal® system until file F3 and then filled with gutta-percha cone F3 and endodontic sealer and received spaces for posts keeping 4 mm of filling at the apical third. The roots were subjected to compression test in a universal testing machine (Kratus). The roots were subjected to a progressive compression stress at a speed of 0.5 mm / min. A load cell of 200 kg was used. Results: Statistical analysis revealed significant differences between the strength values and resistance limit between groups (P<0.05), as analyzed by t Student test. The values of resistance to fracture of 0.44 kgf/mm2 for group 1 (buccal roots) and 0.31 kgf/mm2 for group 2 (palatal roots) were found. Conclusion: The resistance to fracture of the buccal roots was higher than that of palatal roots of first premolars submitted to biomechanical preparation and root preparation for intraradicular post.

Avaliação de fraturas radiculares em imagens digitais com variações de angulagens / Evaluation of root fracture using digital images with angular

O objetivo da pesquisa foi avaliar a influência da variação da angulagem horizontal no diagnóstico de FRVs em dentes tratados endodonticamente. Vinte e dois pré-molares permanentes com raízes retas e ápices formados foram divididos em grupos: Grupo 01(controle): dois dentes, um deles com núcleo intrarradicular; Grupo 2: dez dentes com fratura; Grupo 3: dez dentes com fratura e núcleo intrarradicular. As amostras foram submetidas a testes de compressão com uma carga de 200 kg a uma velocidade de 0,5 mm / min. Radiografias periapicais foram obtidas (70 kVp, 10 mA, e tempo de exposição de 0,3 seg.) pelo Sistema Digora® em ângulos horizontais, na direção orto radial e com uma mudança de ângulo de 25º para a direita e para a esquerda. As imagens foram avaliadas por cinco endodontistas. O diagnóstico de dentes fraturados e não fraturados foi maior para o 1.º pré-molar (51,66%) que para o 2.º (43,1%). A presença de fratura vertical foi registrada em 60,9% e 66,7% para o 1.º e 2.º prémolares, respectivamente. A presença de fratura mostra associação estatisticamente significante com a presença de núcleo intrarradicular e a variação de angulagem no 2.º pré-molar (p-valor = 0,011). Esses resultados sugerem que variações na angulagem horizontal podem otimizar o diagnóstico de FRVs... (AU)

This study aimed to evaluate the influence of changing horizontal angle during periapical radiography on the diagnosis of VRFs in endodontically treated teeth. Twenty-two single-rooted premolars with straight root canals and apex formation were divided into groups: Group 1 (control) - two non-fractured teeth, one of them with intraradicular post; Group 2 - ten fractured teeth; and Group 3 - ten fractured teeth with intraradicular post. Specimens were subjected to compression testing with a load of 200 kg at a speed of 0.5 mm/min. Periapical radiographs were obtained (70 kVp, 10mA, and 0.3 sec exposure time) in a Digora™ system at horizontal angles in the orthoradial direction and with a 25º angle shift to the right and to the left. Images were evaluated by five endodontists. The diagnosis of fractured and non-fractured roots was higher for the first premolar (51.6%) than for the second premolar (43.1%). The presence of VRFs was recorded in 60.9% of cases for the first premolar, and in 66.7% for the second premolar. Presence of VRFs showed a statistically significant association with presence of intraradicular post and angle variation in the second premolar (p=0.011). These results suggest that changes in horizontal angulation, may optimize the diagnosis of VRFs... (AU)