Variations in hepatic vascularisation : lack of a proper hepatic artery : two case reports

The blood supply of the liver and other abdominal organs plays a significant role during abdominal surgery. Knowledge of the most common patterns of vascularisation should be broadened and new anomalies of the celiac trunk and its branches dutifully reported. This paper presents two case reports which describe the lack of a proper hepatic artery. Case 1 describes the cadaver of a 64-year-old female in whom the right hepatic artery was observed to arise from the common hepatic artery and run behind the portal vein. The common hepatic artery was observed to be divided into three terminal vessels: the left hepatic artery, the gastroduodenal artery, and the right gastric artery. Case 2 describes the cadaver of a 75-year-old male with a liver that was supplied from 3 different sources: the left hepatic artery from the left gastric artery (which arose directly from the aorta), the right hepatic artery from the superior mesenteric artery, and the middle hepatic artery from the common hepatic artery - (branch of the hepato-splenic trunk). Moreover, the left inferior phrenic artery arose from the left hepatic artery

Associations of anthropometric measures on breast cancer risk in pre- and postmenopausal women : a case-control study

Background: The type of silhouette and quantity of fat tissue are correlated with hormonal imbalance which plays a substantial role in breast carcinogenesis. The goal of the study was to investigate the association between various anthropometric characteristics and breast cancer risk. Methods: Detailed anthropometric assessment was conducted on 487 women of whom 193 had diagnosed breast cancer and were consecutive patients in the Oncology Center, Cracow, Poland between 2002 and 2004. Measurements were divided into four categories: overall body size (body mass index [BMI], waist circumference [WC], waist-hip ratio [WHR]), regional body sizes (skinfold thicknesses, circumferences), thickness of the skeleton (widths, chest diameters), and body proportions. Additionally, results were analyzed in regar, to menopausal status. Differences between groups were assessed using Student’s t test and Mann-Whitney’s test. Models of logistic regression for selected data were built to estimate the odds ratio. Results were considered statistically significant when the P value was less than 0.05. Results: The BMI in both groups was negatively associated with the risk of cancer. Among premenopausal women, WHR increased the risk of breast cancer (WHR > 0.83, OR, 2.72; 95 % CI, 1.01-7.27). Anthropometric indices of hip-to-shoulder ratio in postmenopausal (≥84.2 mm, OR, 0.02; 95 % CI, 0.01-0.11) and trunk-to-height ratio in both premenopausal women (≥32.76, OR, 0.09; 95 % CI, 0.03-0.28) and postmenopausal women (≥32.76, OR, 0.13; 95 % CI, 0.05-0.33) were strongly related to a decreased risk of breast cancer. Thicknesses of the triceps and subscapular skinfolds increased the risk of breast cancer. Conclusions: Women with breast cancer present with an obese type of silhouette with a specific concentration of fat tissue in the central and upper parts of the body

Anatomical barriers in the right atrium to the coronary sinus cannulation

Background. The coronary venous system is an increasingly frequent target of minimally invasive cardiac procedures. The purpose of this paper is to assess the anatomical barriers in the right atrium to coronary sinus cannulation.Methods. We examined the anatomy of the right atrium, coronary sinus ostium, inferior and superior vena cava ostia in 110 randomly selected autopsied human hearts of both sexes (27% females; mean age 49.2 ± 17.5 years).Results. The Eustachian valve was present in 79 cases (71.8%) with mean height =4.9 ± 2.6 mm. The valve was perforated in 11 cases (13.9%). It is typically too small to hinder the coronary sinus catheterization, but in some cases (about 2%) a significantly protruding valve may be an obstacle. Chiari’s network (4.6%) is not a barrier to catheter entry into the right atrium but may significantly impede further catheter manipulations inside the heart venous system. A typical Thebesian valve leaves enough space for the passage of the standard catheter to the coronary sinus.Discussion. Detailed anatomy of various anatomical structures within the right atrium that could play a potential role in coronary sinus cannulation is discussed

Normal distal pulmonary vein anatomy

Background. It is well known that the pulmonary veins (PVs), especially their myocardial sleeves play a critical role in the initiation and maintenance of atrial fibrillation. Understanding the PV anatomy is crucial for the safety and efficacy of all procedures performed on PVs. The aim of this study was to present normal distal PV anatomy and to create a juxtaposition of all PV ostium variants.Methods. A total of 130 randomly selected autopsied adult human hearts (Caucasian) were examined. The number of PVs ostia was evaluated and their diameter was measured. The ostium-to-last-tributary distance and macroscopic presence of myocardial sleeves were also evaluated.Results. Five hundred forty-one PV ostia were identified. Four classical PV ostia patterns (two left and two right PVs) were observed in 70.8% of all cases. The most common variant was the classical pattern with additional middle right PV (19.2%), followed by the common ostium for the left superior and the inferior PVs (4.44%). Mean diameters of PV ostia (for the classical pattern) were: left superior = 13.8 ± 2.9 mm; left inferior = 13.3 ± 3.4 mm; right superior = 14.3 ± 2.9 mm; right inferior = 13.7 ± 3.3 mm. When present, the additional middle right PV ostium had the smallest PV ostium diameter in the heart (8.2 ± 4.1 mm). The mean ostium-to-last-tributary (closest to the atrium) distances were: left superior = 15.1 ± 4.6 mm; left inferior = 13.5 ± 4.0 mm; right superior = 11.8 ± 4.0 mm; right inferior = 11.0 ± 3.7 mm. There were no statistically significant differences between sexes in ostia diameters and ostium-to-last-tributary distances.Conclusion. Only 71% of the cases have four standard pulmonary veins. The middle right pulmonary vein is present in almost 20% of patients. Presented data can provide useful information for the clinicians during interventional procedures or radiologic examinations of PVs

Anatomical variations of the anterior communicating artery complex : gender relationship

PURPOSE: The anatomy of the anterior communicating artery complex plays a critical role in surgical treatment of anterior cerebral circulation aneurysms. A thorough description of vascular variations of the anterior communicating artery complex seems to be lacking. The aim of this study was to describe the anatomical variations of the anterior communicating artery complex. METHODS: The study group consisted of 411 subjects (52.31 % women), without any intracranial pathologies, that had undergone head computed tomography angiography. We used maximum intensity projections, volume rendering and multi planar reconstructions to study and classify the anatomical variations of the anterior communicating and anterior cerebral arteries. RESULTS: Male subjects had a significantly higher prevalence of the typical anterior communicating artery complex (59.69 vs. 46.05 %; p < 0.01). The aplastic anterior communicating artery (23.26 vs. 15.88 %; p = 0.04) and triple A2 segment of the anterior cerebral artery (1.86 vs. 0.00 %; p = 0.05) were more common in women than in men. CONCLUSION: Female subjects have a higher incidence of variations in the anterior communicating artery complex. There is a higher incidence of anterior communicating artery aplasia among women