Variations of the cephalic vein anterior to the clavicle in humans.

BACKGROUND: Clinicians should understand that jugulocephalic vein (JCV) variants may be occasionally found. This study aims to classify JCV variants and obtain their frequency. MATERIALS AND METHODS: We investigated anatomical variants of the cephalic vein in 55 human cadavers during a gross anatomy course at our medical school. RESULTS: The percentage of JCVs that pass through the anterior part of the clavicle and anastomose to the jugular vein as per previous studies and our study was 2-5%. Five cases with anastomosis between the cephalic and external jugular veins that pass through the anterior part of the clavicle were found. The courses were classified into 1A, 1B, 2A, and 2B. Type 1 extends beyond the clavicle and anastomoses with the external jugular vein. Type 2 follows the same course as type 1, but anastomoses with the subclavian vein. Subtype A does not have a branch that anastomoses with the axillary vein, whereas subtype B does. We encountered two cases of type 1A and three of type 1B. CONCLUSIONS: Four anatomical variants of the cephalic vein around the clavicle were identified. Clinicians' knowledge of these variants is expected to decrease possible complications if venous access via the cephalic vein is needed.

Common and separate origins of the left and right inferior phrenic artery with a review of the literature.

In a 94-year-old male cadaver, upon which routine dissection was being conducted, a rare variation was found in the gastrophrenic trunk (GPT), the common trunk of the left gastric artery (LGA), right inferior phrenic artery (RIPA), and left inferior phrenic artery (LIPA); the GPT arises from the abdominal aorta. A hepatosplenic trunk accompanied the variation. In this variation, the RIPA first branched from the GPT and then to the LIPA and LGA. Variations in the common trunk of the LIPA and RIPA in the GPT are common, but to our knowledge, a variation (separate inferior phrenic artery in the GPT) similar to our findings has not been previously reported. We discuss the incidence and developmental and clinical significance of this variation with a detailed review of the literature. Knowledge of such a case has important clinical significance for invasive and non-invasive arterial procedures. Therefore, different variations concerning the LGA and inferior phrenic artery should be considered during surgical and non-surgical evaluations.

The clinical efficacy of CA 72-4 as serum marker for gastric cancer in comparison with CA19-9 and CEA.

The clinical efficacy in preoperative assessment with CA72-4 for gastric cancer was studied in comparison with CA19-9 and CEA. These three tumor markers were examined simultaneously, preoperatively in 100 cases (44: early cancer, 56: advanced cancer) of gastric cancer. Additionally the efficacy of CA72-4 in follow-up postoperative monitoring for the recurrence was investigated. Positive rate of CA72-4, CA19-9 and CEA for early cancer was 2.3%, 11.4% and 9.1% and that for advanced cancer was 37.5%, 17.9% and 35.7% respectively, thus CA72-4 gave the highest positive rate for advanced cancers. And CA72-4 revealed higher positive findings in stage IV, in infiltrating type, in diffuse type, in cancer invading deeper than p-T3. Further, CA72-4 was positive in 50% for cancer with peritoneal dissemination, whereas CEA was positive in 8.3%, CA19-9 in 16.3%. The most beneficial combination among these three tumor markers was CA72-4 and CEA, and by which, positive rate was 53.6%. Regarding follow-up, CA72-4 showed first elevation prior to other markers in some cases before clinical recurrence was confirmed. CA72-4 appeared to be a useful marker for managing gastric cancer.