Anatomical variations of hepatic veins in Vietnamese adults

The hepatic venous anatomic variations on hepatic resection and transplantation are very important and the least understood aspect of the liver. In particular, data are lacking in the literature with reference to Vietnamese patients. The objective of this study was to examine the morphologic and biometric variations of the hepatic veins in Vietnamese cadavers. Livers from 20 Vietnamese cadavers preserved in formalin solution were used in this study. Specimens were carefully scraped by curette to expose the branches of hepatic veins. Diameters, lengths and morphologic hepatic variations were recorded. The average diameters of veins were: 34.78 mm (IVC), 20.26 mm (RHV), 14.35 mm (MHV), 14.76 mm (LHV), and 22.49 mm (common trunk). The average length of the common trunk was 6.45 mm; 35% of cases in the short group (< 10 mm), and 65% in the long group (≥ 10 mm). A common trunk was present in 90% of specimens. The morphology of the common trunk was comparable to that observed by other investigators. Only 10% of cases had accessory RHVs of Type II, with a main trunk and accessory branches to the IVC, in contrast to 90% of Type I, with a main trunk alone. The anatomical variations of the hepatic veins are very diverse. Knowledge of these variations prior to surgery is useful during both partial hepatectomy and segmental liver transplantation. Pre-operative hepatic venous imaging can allow for assessment of venous flow and morphology, and may lessen surgical complications

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Small team-based medical imaging of human cadavers: an innovative tool for interdisciplinary learning inHuman Gross Anatomy andRadiologic Sciences

The purpose of this study was to develop an interdisciplinary activity that merged the disciplines of human gross anatomy and radiology early in the educational process of doctors and radiographers allowing students to use human cadavers to learn anatomy and medical imaging (technique and in-terpretation) through small-group problem-solving sessions. Over 10 years, 734 student doctors and radiographers were divided into small groups and assigned cadavers. Images of cadavers included x-rays, CT and MRI regional and full-body series. Students problem-solved radiographic parameters and interpreted images. Student radiographers completed a semester project labeling anatomical structures in a CT or MRI series. Student doctors used images during dissection and presented radiographic series to demonstrate understanding of anatomy, radiology and skilled use of image analysis software. Participants completed a 100-question LIKERT Scale survey. Data were ana-lyzed based on overall group, cadaver experience, and radiography experience. Students produced high-quality images for use in the laboratory andclassroom, and 95% agreed that this activity helped them to learn anatomy and radiography. Students agreed that x-rays, CT and MRI scans were 92.0%, 91.1% and 90.1% beneficial, respectively, in learning anatomy and radiology, and 90% of participants documented that this program had a positive impact in knowledge and competency development for his or her chosen career. Both radiography and medical students reported that working on interprofessional teams enhanced their knowledge of anatomy and radiology and under-scored the importance of partnerships in healthcare. This program serves as a novel model for interdisciplinary team-based-learning of human anatomy and radiology

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A morphometric anatomical study of the right coronary artery in Vietnamese

Coronary artery disease (CAD) is a major cause of death and disability in developed countries, and incidence of CAD is increasing annually in the underdeveloped world. Today, percutaneous coronary intervention plays a major role both in diagnosis and treatment of CAD. As a result, an understanding of the anatomy of the coronary artery system is vital cardiologists. Yet, studies are lacking that focus on Vietnamese hearts. The objective of this study was to examine the morphometric anatomical variation of the right coronary artery (RCA) in Vietnamese cadavers. The hearts from 125 cadavers were used in the study. In all hearts, the RCA originated from the right aortic sinus, had a right marginal branch, and gave rise to one to three right posterior ventricular (RPV) branches. In 96.8% of hearts, the posterior interventricular branch (PIV) originated from the RCA; in 3.2% from the left circumflex artery (LCX), and the mean diameter was 2.09 mm ± 0.62 mm. The RCA had a mean diameter and length of 4.21 mm ± 0.64 mm and 122.5 mm ± 17.8 mm, respectively, and terminated between the crux and left border (72%) and at the crux (14.4%). The origin of the sinoatrial node artery was 81.6% from the RCA, 16.8% from the LCX, and 1.6% from both the RCA and LCX. There were one to four right atrial branches observed across the hearts studied; a maximum of 32% (one branch) and a minimum of 12.8% (four branches). In 68.8% of hearts the conus artery originated from the RCA. In 8.8%, it arose from the right aortic sinus at the same site as the RCA, but in 22.4% away from this site of origin. The RCA gave rise to one to eight right anterior ventricular (RAV) branches (i.e., because they are at the anterior surface of the right ventricular); with the highest incidence of 3 branches in 37.6% of hearts. The RCA gave rise to one to seven left posterior ventricular branches; the majority of cases, 28.8% gave rise to 4 branches. The rare incidence of myocardial bridging in the right coronary system occurred in 7.2% of hearts, and each case involved the posterior interventricular branch. Anatomical variations of the RCA system can cause difficulties in imaging interpretation and interventional procedures. This study is the first to document these variations of the RCA system in Vietnamese hearts, contributing knowledge that is essential for physicians

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Kyphoscoliosis and hiatal hernia: anatomical analysis stimulates new clinical interest

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Characterization of kyphoscoliosis and associated giant hiatal hernia in a 97-year-old female cadaver

The purpose of this investigation was to characterize severe kyphosis and scoliosis (kyphoscoliosis) and giant hiatal hernia (HH) in a 97-year-old female cadaver. Kyphosis is a ventral curvature of the thoracic spine that exceeds 50°. Scoliosis (lateral spinal curvature) is usually combined with vertebral rotation. HH is a hernia in which part of the gastrointestinal (GI) tract protrudes through the esophageal opening of the diaphragm. Although kyphoscoliosis has been suggested as a causative factor in the development of HH, scarce published data exist. If true, then this is clinically important in the evaluation and treatment of patients that present with spinal deformities and GI symptoms. Gross anatomical dissection was done. Vertebral deformities and displacement of structures were visualized with digital radiologic imaging using full-body x-ray films, and high-resolution CT and MRI Scans. Image analysis, multi-planar reformatting, and 3D- reconstruction were done on radiographic series. The Cobb and Aaro-Dahlborn Methods were used to determine the degree of spinal curvature and vertebral rotation, respectively. To examine the possible relationship between kyphoscoliosis and HH, intra-abdominal volume (IAV) was measured and compared to the IAV of unaffected cadavers. The heart was displaced superior and to the left with the apex touching the thoracic cage, whereas the aorta was 7.3 cm to the right of midline. The stomach was completely within the mediastinum. Thoracic dextroscoliosis, lumbar levoscoliosis and thoracic kyphosis had Cobb Angles of 45°, 34° and 78°, respectively. All thoracic and lumbar vertebrae were left-rotated; maximum rotations were T12 (18°) and L5 (29°). IAV was 4224 cm3, and that of unaffected females ranged from 4449 to 7927 cm3. This study provides insight into the relationship between kyphoscoliosis and HH. We suggest that reduced IAV caused by kyphoscoliosis may contribute to the development and progression of paraesophageal hernias in patients with laxity of the diaphragmatic hiatal musculature

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