Branching pattern of the left coronary artery and an important branch - The median artery

Objectives: This study was performed to assess the variations in the branching pattern and diameters of the terminal branches of the left coronary artery and discuss various names given to the third branch

Chronic Degenerative Changes In The Myocardium Supplied By Bridged Coronary Arteries In Eight Postmortem Samples

In humans, the coronary arteries course not only subepicardially but also intramyocardially. The intramyocardial course of the coronary artery is reported to lead to acute ischemic heart disease and, as well, it may be symptomless. The aim of this study was to investigate the long-term ischemic effects of bridged arteries on the myocardium, and was carried out on 8 autopsy hearts with myocardial bridges and 2 hearts without myocardial bridges. The samples from the myocardium were examined with light microscopy. In the myocardium supplied by the bridged arteries, it was observed that there was an increase in the intercellular connective tissue, which was rich in collagen bundles, lymphocytes, fibroblasts and macrophages. Compression of the coronary artery by myocardial bridges may cause chronic degenerative changes, which may remain silent for a long time.WoSScopu

Branching Pattern Of The Left Coronary Artery And An Important Branch - The Median Artery

Objectives: This study was performed to assess the variations in the branching pattern and diameters of the terminal branches of the left coronary artery and discuss various names given to the third branch. Methods: Hearts of 21 autopsies and 19 cadavers were fixed with 10% formalin and their coronary arteries were examined by dissecting the epicardium. The dissections were performed at the Anatomy Departments of Faculties of Medicine, Ankara and Hacettepe Universities, Ankara, and Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey, between April 2001 and June 2003. Results: There were 2 branches in 19 hearts, 3 branches in 19 hearts, 4 branches in one heart and 5 branches in another. Diameter and length of these vessels are noted. Conclusion: Upon examination of the diameters and important variations of the branches of the left coronary artery, the importance of the median artery has been noted. Various names given to this artery in the literature should be replaced with the name "median artery".Wo

An anatomic study of the lateral femoral cutaneous nerve

In this study, the course of the lateral femoral cutaneous n. was examined bilaterally in 22 cadavers. Seven of these 44 lateral femoral cutaneous nn, showed variations in their course, especially in their number of branches under the inguinal ligament. During operations where the lateral femoral cutaneous n. may be damaged or in its decompression surgery, the nerve is to be found under the inguinal ligament. 1.52 +/- 0.84 cm medial to the anterior superior iliac spine. This nerve can be found passing through the inguinal ligament in as many as four branches

Arterial vascularization of the pineal gland

The arterial vascularization of the pineal gland (PG) remains a debatable subject. This study aims to provide detailed information about the arterial vascularization of the PG.Thirty adult human brains were obtained from routine autopsies. Cerebral arteries were separately cannulated and injected with colored latex. The dissections were carried out using a surgical microscope. The diameters of the branches supplying the PG at their origin and vascularization areas of the branches of the arteries were investigated.The main artery of the PG was the lateral pineal artery, and it originated from the posterior circulation. The other arteries included the medial pineal artery from the posterior circulation and the rostral pineal artery mainly from the anterior circulation. Posteromedial choroidal artery was an important artery that branched to the PG. The arterial supply to the PG was studied comprehensively considering the debate and inadequacy of previously published studies on this issue available in the literature.This anatomical knowledge may be helpful for surgical treatment of pathologies of the PG, especially in children who develop more pathology in this region than adults

Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study

Background: No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer.Method: This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III-V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI95%).Results: Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI95%: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI95%: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI95%: 0.54-1.32, p = 0.5), compared to HIC.Conclusion: Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer. (C) 2020 Elsevier Ltd, BASO similar to The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved

Comparison of short-term outcomes from the International Oesophago-Gastric Anastomosis Audit (OGAA), the Esophagectomy Complications Consensus Group (ECCG), and the Dutch Upper Gastrointestinal Cancer Audit (DUCA)

Background: The Esophagectomy Complications Consensus Group (ECCG) and the Dutch Upper Gastrointestinal Cancer Audit (DUCA) have set standards in reporting outcomes after oesophagectomy. Reporting outcomes from selected high-volume centres or centralized national cancer programmes may not, however, be reflective of the true global prevalence of complications. This study aimed to compare complication rates after oesophagectomy from these existing sources with those of an unselected international cohort from the Oesophago-Gastric Anastomosis Audit (OGAA). Methods: The OGAA was a prospective multicentre cohort study coordinated by the West Midlands Research Collaborative, and included patients undergoing oesophagectomy for oesophageal cancer between April and December 2018, with 90 days of follow-up. Results: The OGAA study included 2247 oesophagectomies across 137 hospitals in 41 countries. Comparisons with the ECCG and DUCA found differences in baseline demographics between the three cohorts, including age, ASA grade, and rates of chronic pulmonary disease. The OGAA had the lowest rates of neoadjuvant treatment (OGAA 75.1 per cent, ECCG 78.9 per cent, DUCA 93.5 per cent; P<0.001). DUCA exhibited the highest rates of minimally invasive surgery (OGAA 57.2 per cent, ECCG 47.9 per cent, DUCA 85.8 per cent; P<0.001). Overall complication rates were similar in the three cohorts (OGAA 63.6 per cent, ECCG 59.0 per cent, DUCA 62.2 per cent), with no statistically significant difference in Clavien-Dindo grades (P=0.752). However, a significant difference in 30-day mortality was observed, with DUCA reporting the lowest rate (OGAA 3.2 per cent, ECCG 2.4 per cent, DUCA 1.7 per cent; P=0.013). Conclusion: Despite differences in rates of co-morbidities, oncological treatment strategies, and access to minimal-access surgery, overall complication rates were similar in the three cohorts