Anatomical Variants

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Anatomical Variants of Celiac Trunk in Relation to Its Branching: A Preliminary Sub Saharan Study

Anatomical Variants of Celiac Trunk in Relation to Its Branching: A Preliminary Sub Saharan Study

Celiac trunk is the most important collateral of abdominal aorta with irrigation of vital upper mesocolic organs. It can be affected by thrombosis, extrinsic com- pression or tumor invasion [1]. Surgical treatment of these pathologies is im- proved by preoperative diagnosis of anatomical variants (AVs) of celiac trunk. For this purpose CT-angiography is now the gold standard examination, given its good resolution and ease of use [2] [3]. In the absence of an automatic injec- tor, arterial phase of the manually injected abdominal CT-scan also allows celiac trunk study. Since the first description of celiac trunk trifurcation by Haller in 1756 [4], several VAs have been described in nearly half in some populations [1]. More than the topography, the gauge or the path of celiac trunk, VAs focused on the mode of division into terminal branches. The most frequently encountered examples according to a recent study are: stomachic coronary artery of its own origin on the aorta associated with a common hepato-splenic trunk (4.4%), he- pato-mesenteric and gastro-splenic trunks (2.6%), and common celiac and me- senteric trunk (1.1%). Despite the increasing availability of contrast-enhanced ab- dominal CT-scan and the relevance of celiac trunk’s AVs exploration, sub-Saharan literature has just a few studies on this topic. The purpose of our study was to evaluate the prevalence of celiac trunk’s AVs related to its branching, in our context and to compare it with that of previous studies.

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Frequency of non-single canals in mandibular premolars and correlations with other anatomical variants: an in vivo cone beam computed tomography study

Frequency of non-single canals in mandibular premolars and correlations with other anatomical variants: an in vivo cone beam computed tomography study

Endodontic treatment of mandibular first premolars (PM1 s) is challenging due to the existence of numerous variations in canal configurations, including a C-shaped variant; moreover, the relatively small diameter of PM1 s limits direct access to additional canals [13, 14]. To the best of our knowledge, little information is available regarding the frequency of C-shaped canals in PM1 s (as shown in CBCT images) and their correlations with other anatomical variants, such as distolingual roots (DLRs) in mandibular first molars (M1 s) and C-shaped canals in mandibular second molars (M2 s). Therefore, this study aimed to retrospectively investigate the roots and root canal configurations in PM1 s and PM2 s in a Korean population using a large number of CBCT images and to assess correlations between non-single canals in PM1 s and other anatomical variations, including DLRs in M1 s and C-shaped canals in M2 s.

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Anatomical variants of the cervical vertebrae and the first thoracic vertebra in man

Anatomical variants of the cervical vertebrae and the first thoracic vertebra in man

Anatomical variants of the cervical part of the human spine were investigated. Morphological variants were studied on 100 cervical vertebrae (37 female and 63 male). The greatest variability was demonstrated by the first cervical vertebra or atlas. The presence of some accessory bony arches embracing the vertebral artery was observed, namely the posterior bridge restraining the arcuate fora- men (13.8%) and the lateral bridge restraining the transversovertical foramen (2%). Split posterior (3%) or anterior (1%) arches of the atlas were also encoun- tered in this material. The superior articular face of the atlas divided into two parts was found in 47.8%. Variants of the remaining cervical vertebrae were limited only to the presence of a division of the transverse process foramina or their incomplete closure. Some of these anatomical variants may be a cause of certain clinical symptoms which have previously been described in the literature.

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Multiparametric Correlation Between Anatomical Variants of the Paranasal Sinuses and Chronic Rhinosinusitis: Case-control Study

Multiparametric Correlation Between Anatomical Variants of the Paranasal Sinuses and Chronic Rhinosinusitis: Case-control Study

Abstract: Introduction: Chronic rhinosinusitis (RSC) is a disabling disease that can affect up to 70% of people. It is very important to know which are the anatomical variants that the patient presents for surgical planning and often for the treatment of the variants that can present as a risk factor. The evidence shows heterogeneity in the prevalence of these anatomical variants and it is not described quantitatively which are the variants that present the greatest relationship as a risk factor. Establishing the multiparametric correlation between at least one of the most frequent anatomical variants of the paranasal sinuses and the development of rhinosinusitis is the most important objective of this investigation. Materials and methods: Case-control study with multiparametric correlation analysis of the anatomical variants of paranasal sinuses as a risk factor in the development of sinusitis. Analysis with measures of central tendency, Xi2, Fisher's exact test, binary logistic regression. Results: The most frequent anatomical variant was the deviation of the nasal septum on the left side (78%). The second most common variant found was the Agger Nasi cells (68%), followed by the protrusion of the Vidian nerve in the sphenoid sinus (52%). The only anatomical variant that could be determined within the regression model was the obstruction of the osteomeatal complex; which is presented as a risk factor with an OR of 16 (95% CI: 6.9-41.3). Conclusions: Obstruction of the osteomeatal complex is a very important risk factor for the development of chronic rhinosinusitis.

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Development of a novel classification system for anatomical variants of the puboprostatic ligaments with expert validation

Development of a novel classification system for anatomical variants of the puboprostatic ligaments with expert validation

Results: Inverted V-shaped ligaments were noted most frequently (29.97%), parallel and V-shaped ligaments were found at 19.19% and 11.11%, respectively and fused ligaments were noted less fre- quently (6.06%). There was good intra-rater agreement (κ = 0.66) and inter-rater agreement (κ = 0.67) for the classification system. Conclusions: This classification system provided standardized descriptions of ligament variations that could be adopted uni- versally to help clinicians categorize the variants. The system, validated by several blinded expert surgeons, demonstrated that surgeons were able to learn and correctly classify the variants. The system may be useful in helping to predict peri- and postoperative outcomes; however, this will require further study.

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Computerized Tomographic Evaluation Of Anatomical Variations Of Paranasal Sinus And Nose

Computerized Tomographic Evaluation Of Anatomical Variations Of Paranasal Sinus And Nose

Paediatric ages, pregnant women, patients with history of sinonasal surgery or past history of surgery in the paranasal region were not included in the study. Analysis of anatomical variants was performed both using a soft part window and bone density window. In all cases existence of following variants was investigated— 1. Nasal septum 2. Turbinates 3. Uncinate process 4. Ethmoid air cells 5. Other variants e.g. Hypoplasia of maxillary sinus, nasal septum, frontal sinus & asymmetry of both cavities of sphenoid sinus. Additional points were noted for mucosal thickening, polyp & bone destruction.

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Physical activity in elderly Kidney Transplant patients with Multiple Renal Arteries

Physical activity in elderly Kidney Transplant patients with Multiple Renal Arteries

Between January 1999 and December 2018, 740 transplants from cadaveric donors were performed at the Department of Nephrology, Urology, General Surgery and Kidney Transplants, Anesthesiology and Intensive Care, University Federico II, Naples. Between these 740, we selected 34 kidneys with vascular anatomical variants, i.e. sub-optimal kidneys (Group 1). The 34 patients who received these 34 kidneys were compared with 34 single renal artery (SRA) recipient (Group 2), chosen for homogeneity of characteristics (pair-matched by age, dialysis age, donor age, comorbidity).

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Brain MR Image Segmentation: From Multi-Atlas Method To Deep Learning Models

Brain MR Image Segmentation: From Multi-Atlas Method To Deep Learning Models

class of a voxel, in the application of brain anatomical structure segmentation, a couple of networks encode the position information into the inputs to augment the segmentation. Wachinger et al. [112] uses the combination of spectral brain coordi- nates and Cartesian coordinates. de Brebisson et at. [28] adopts relative coordinates which compute the distance from voxel to the centroid of each segmentation. The aforementioned research experimentally demonstrated that the incorporation of the position information leads to improvement in the anatomical structure segmentation. Imbalanced data among different class is a challenging task for brain segmentation even in the other medical image segmentation field. To address this problem, data resampling technique is applied to balance the sample numbers of different classes. Kamnitsas et al. [61] built training batches by cropping the segments with 50% prob- abilities being centered on foreground (tumor) or background (non-tumor) voxel. Havaei et al. [14, 39] adopted a two-phase training strategy to alleviate the class imbalance. In the first training phase, equally sampled training samples are used while the uniformed sampled batches are used in the second training phase with only fine-tuning the last layer. In [112], the authors employed another two-phase training strategy, which separates the brain tissues from the background in the first phase and identifies the anatomical structures in the second phase.

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Newly developed histological tray for the application of identifying exact lymph node dissections in uro logical surgical oncology

Newly developed histological tray for the application of identifying exact lymph node dissections in uro logical surgical oncology

For the solution of the outlined issues, with improve- ment of a former notion [9], we have created a lymph node tray. This tray illustrates the anatomical position of important lymph nodes and develops a method for working in a unified way. In this method, the removed tissues can be placed in the tray by the surgeon himself. The goal of our method is to localize the removed lymph nodes appropriately in the tray in order to recognize the exact anatomical position of the lymph node.

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Dysfunctional lung anatomy and small airways degeneration in COPD

Dysfunctional lung anatomy and small airways degeneration in COPD

Abstract: Chronic obstructive pulmonary disease (COPD) is characterized by incompletely reversible airflow obstruction. Direct measurement of airways resistance using invasive techniques has revealed that the site of obstruction is located in the small conducting airways, ie, bronchioles with a diameter , 2 mm. Anatomical changes in these airways include struc- tural abnormalities of the conducting airways (eg, peribronchiolar fibrosis, mucus plugging) and loss of alveolar attachments due to emphysema, which result in destabilization of these airways related to reduced elastic recoil. The relative contribution of structural abnormalities in small conducting airways and emphysema has been a matter of much debate. The present article reviews anatomical changes and inflammatory mechanisms in small conducting airways and in the adjacent lung parenchyma, with a special focus on recent anatomical and imaging data suggesting that the initial event takes place in the small conducting airways and results in a dramatic reduction in the number of airways, together with a reduction in the cross-sectional area of remaining airways. Implications of these findings for the development of novel therapies are briefly discussed.

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Controlled vocabularies for plant anatomical parts optimized for use in data analysis tools and for cross-species studies

Controlled vocabularies for plant anatomical parts optimized for use in data analysis tools and for cross-species studies

or ‘collective plant structure’ may be semantically useful terms, but they are not understood by the majority of biological researchers. A further problem is the attempt to incorporate multiple dimensions of an experimental design into a single ontology, such as anatomical parts, stages of organism development, and perturbations. As a result, some of the existing ontologies are very exten- sive and possess tree depths that can exceed a dozen levels. This depth represents a major handicap for their use in analysis tools alongside a data matrix. The same holds true for term redundancies, which impair a proper clustering of e.g. a data matrix composed of genes and anatomical parts. An example of term redundancy can be found in the current Plant Structure Ontology [1], in which the term ‘endosperm’ can be found at three locations (in ‘sporophyte/infructescence/fruit/seed/’, in ‘sporophyte/seed/’, and in ‘/tissue/’). This representation is impractical in the context of data analysis because a category may occur multiple times in a given data matrix. In this work, we present a simplified but precise set of controlled vocabularies for plant anatomy that were devel- oped specifically for their use together with data analysis tools. The vocabularies are based on publicly accepted terms and ontologies from the Plant Ontology Consor- tium (POC) [2,3], Gramene [4], MaizeGDB [5], and The Arabidopsis Information Resource (TAIR) [6], and their classification structure was built to be cross-species com- patible. For the purpose of using them directly in an analytical context, the proposed ontologies had to fulfill the following requirements:

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Multigene prognostic tests in breast cancer: past, present, future

Multigene prognostic tests in breast cancer: past, present, future

equally good prognostic models can be built from the same dataset. This redundancy in the prognostic variable space for ER-positive cancers explains the existence of many different prognostic gene signatures in the com- mercial space and in academic research laboratories. Since each model uses different gene sets and was opti- mized in distinct training sets, when multiple models are applied to the same independent validation set they all identify low-risk and high-risk cohorts but also tend to show substantial discordance (20 to 30%) in risk assign- ment at the individual case level. Somewhat surprisingly, no molecular markers emerged that are associated with tumor size and nodal status, which are the two most im- portant anatomical prognostic variables. This also im- plies that prognostic information embedded in size and nodal status is not captured in empirically developed prognostic gene signatures. For this reason, multivariate clinical prognostic models such as AdjuvantOnline and molecular models tend to result in highly discordant risk assignment at the individual case level.

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The Use of a High Frequency Linear Transducer in the Assessment of Fetal Anatomy at the Routine 11 to 13 + 6 Week Scan among Chinese Population

The Use of a High Frequency Linear Transducer in the Assessment of Fetal Anatomy at the Routine 11 to 13 + 6 Week Scan among Chinese Population

Objectives: To determine if the use of high frequency linear transducer (HFLT) in addition to con- ventional curvilinear transducer (CCT) aids assessment of fetal cardiac and non-cardiac anatomy in the first trimester. Methods: Transabdominal CCT (4 - 8 MHz) followed by HFLT (9 MHz) was used to study prospectively the visualization rate of basic and optional anatomical structures ac- cording to international guidelines. McNemar and Chi-square test were used to compare corre- lated and independent proportions respectively. Postnatal outcomes were traced. Results: Com- paring with CCT alone, additional use of HFLT did not improve the completion rate of basic anom- aly screen (95.0% vs. 97.0%, p = 0.5) in the 101 women studied, but it improved the visualization rate of some optional structures including lens (57.4% vs. 73.3%), three-vessel view (3 VV) (17.8% vs. 48.5%), left ventricular outflow tract (17.8% vs. 51.5%), kidneys (8.9% vs. 47.5%), and um- bilical artery (86.1% vs. 93.1%) (all p < 0.05). Favourable fetal position was associated with a bet- ter visualisation of four-chamber view and 3VV (p < 0.05). Conclusions: Our findings supported that the use of HFLT in addition to CCT does not improve the completion of basic anomaly screen, nor does it achieve a high visualisation rate of different cardiac views in the first trimester.

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Obstructive sleep apnea: current perspectives

Obstructive sleep apnea: current perspectives

Abstract: The prevalence of obstructive sleep apnea (OSA) continues to rise. So too do the health, safety, and economic consequences. On an individual level, the causes and consequences of OSA can vary substantially between patients. In recent years, four key contributors to OSA pathogenesis or “phenotypes” have been characterized. These include a narrow, crowded, or collapsible upper airway “anatomical compromise” and “non-anatomical” contributors such as ineffective pharyngeal dilator muscle function during sleep, a low threshold for arousal to airway narrowing during sleep, and unstable control of breathing (high loop gain). Each of these phenotypes is a target for therapy. This review summarizes the latest knowledge on the different contributors to OSA with a focus on measurement techniques including emerging clinical tools designed to facilitate translation of new cause-driven targeted approaches to treat OSA. The potential for some of the specific pathophysiological causes of OSA to drive some of the key symptoms and consequences of OSA is also highlighted.

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The Incidence of Early Recurrence After Anatomical Versus Non-Anatomical Liver Resection in Patients with Hepatocellular Carcinoma

The Incidence of Early Recurrence After Anatomical Versus Non-Anatomical Liver Resection in Patients with Hepatocellular Carcinoma

Abstract: Aim: This retrospective study compares the incidence of early recurrence after anatomical versus non-anatomical resection in patients with hepatocellular carcinoma (HCC). Patients and Methods: This retrospective study included 26 patients who had a preoperative diagnosis of a single hepatocellular carcinoma (HCC) and who underwent anatomical and non- anatomical liver resection. The patients were divided into two groups. AR Group; anatomical resection group (n= 12) and NAR Group; Non-anatomical resection group (n = 14). The effect of the type of resection (anatomic vs non-anatomic) on early HCC recurrence was studied in both groups. Other risk factors that might play a role in early tumor recurrence such as the TNM staging, tumor size, vascular invasion, pathologic grading and high AFP values were also evaluated. Results: During the follow up period, 5 patients (41.7 %) from AR Group and 6 patients (42.9 %) from NAR Group developed recurrence. Mean time of recurrence was 13.05 ± 4.63 versus 12.53 ± 4.12 months (p 0.764). The univariate analysis method was used to analyze different epidemiological, clinical and pathological variables and there was no statistically significant risk factor in both groups in terms of recurrence. The mean disease-free survival was calculated for both groups using Kaplan–Meier curve and it was 16.013±2.324 for AR group versus 15.657±2.765 months for NAR group (p: 0.98). The cumulative overall survival proportion at end of research was 59.6% for AR group versus 69.87% for NAR group. The mean overall survival was 17.956±2.254 months for AR group versus 20.876±1.263 for NAR group (p: 0.21). The recurrence rate was 41.7%% in AR group and 42.9% in NAR group (p = 0.951). This suggests that the type of resection did not have an impact on early recurrence in HCC patients undergoing liver resection. Conclusion: This study concluded that recurrence-free and overall survivals after both anatomical and non-anatomical resection were not significantly different from the statistical point of view. Liver resection in cirrhotic patients should be performed with good expertise and should pursue strict selection criteria. Non-Anatomical resection may be more appropriate in cirrhotic patients with small HCC to preserve adequate functioning hepatic parenchyma and to avoid increased postoperative morbidity and mortality.

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The complexity of anatomical systems

The complexity of anatomical systems

b. The dynamics of anatomical form, which studies the tem- poral transformations of an anatomical form in relation to the causes of the changes. An anatomical form in a state of morphological stability tends to preserve its shape in the surrounding space. However, if we apply any (internal or external) factor u, it abandons this state of 'rest' and enters a phase of modification (Figure 4b). This factor, which can be considered a true physical force, may act on the elements determining the shape of the system (e.g. in the cell sys- tem: the plasmalemma or cytoskeleton) and/or those determining its function or its internal points (e.g. the nucleus, mitochondria, and the smooth and rough endo- plasmic reticulum) [53]. The change in shape can be con- sidered as a non-linear dynamic system that advances through states that are qualitatively different (Figure 4). The word 'state' denotes the pattern configuration of a system at a particular instant, which is specified by a large number of dynamic variables. A dynamic system can be character- ised by a set of different states or possible pattern config- urations (x) and a number of transitions or steps (x) from one state to another during a certain time interval (t). When the transitions are caused by a generating element (u), the temporal behaviour of the system can be described by the general equation:

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Neuroimaging in Iran: A Review

Neuroimaging in Iran: A Review

euroimaging refers to techniques that either directly or indirectly image the structure or function of the nervous system (mainly brain) in vivo. It is a relatively new disci- pline within medicine and neuroscience, emerged from the improvements in the medical imaging systems and computer hardware and algorithms. Nowa- days, medical imaging systems including X-ray com- puted tomography (CT), magnetic resonance imaging (MRI), single photon emission computed tomography (SPECT), and positron emission tomography (PET) are used to provide insight into the anatomical structure and functional organization of the brain. In addition, signal

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A Study on the Anatomy of Zanthoxylum macrophylla (L.) Sarg. (Rutaceae)

A Study on the Anatomy of Zanthoxylum macrophylla (L.) Sarg. (Rutaceae)

Anatomical studies were carried out on various parts of Zanthoxylum macrophylla to determine its taxonomical data with regards to anatomical characters. Anatomical study of the transverse sections of the parts (leaf, stem, petiole and root) was carried out using microtomy while leaf epidermal study was carried out using impression technique. Results showed that the transverse sections of various parts (leaf, stem, petiole and root) of the Zanthoxylum macrophylla had similar features including rays in the secondary stem and root. The leaf epidermal study showed the presence of stomata on the abaxial surface only with paracytic stomatal type. The obtained data can be used to enhance proper taxonomic characterization and identification of the plant species.

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Evaluation of anatomical pelvic parameters between normal, healthy men and women using three-dimensional computed tomography: a cross-sectional study of sex-specific and age-specific differences

Evaluation of anatomical pelvic parameters between normal, healthy men and women using three-dimensional computed tomography: a cross-sectional study of sex-specific and age-specific differences

We found no differences in anatomical references, such as PI, anatomical-SS, and anatomical-PT, between men and women. However, there was a strong correlation be- tween PI and anatomical-SS among younger and older subjects in both sexes. This novel measurement concept may be useful to estimate PI from anatomical-SS be- cause the measurements of PI are not always suitable in all patients, especially those with osteoarthritis of the hip joint whose femoral head is not spherical or whose femoral head is subluxed or dislocated.

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Correlation of tilt of the anterior pelvic plane angle with anatomical pelvic tilt and morphological configuration of the acetabulum in patients with developmental dysplasia of the hip: a cross-sectional study

Correlation of tilt of the anterior pelvic plane angle with anatomical pelvic tilt and morphological configuration of the acetabulum in patients with developmental dysplasia of the hip: a cross-sectional study

Methods: We examined 84 female patients with bilateral developmental dysplasia of the hip who had undergone curved periacetabular osteotomy at author ’ s institution. Radiographs of the thoracic to lumbar spines and the pelvis were obtained in the standing position to measure spino-pelvic parameters before surgery. Morphological parameters of the acetabulum such as the anterior center-edge (CE) angle, posterior CE angle, lateral CE angle, and acetabular anteversion were measured using a preoperative three-dimensional pelvic model reconstructed from computed tomography images. Pearson ’ s correlation analysis was conducted to evaluate the relationship of these parameters. Results: With regard to correlations between pelvic incidence (PI) and other parameters, the sacral slope (SS) value ( r = 0.666) was the highest among functional parameters and the anatomical-SS value ( r = 0.789) was the highest among morphological parameters. There were moderate correlations of the anterior pelvic plane angle (APPA) with pelvic tilt (PT) ( r = − 0.594) and anatomical-PT ( r = 0.646). With regard to correlations between spino-pelvic parameters and bony morphological parameters of the acetabulum, there was a moderate correlation between anatomical-PT and acetabular anteversion (AA) ( r = 0.424). There were moderate correlations of APPA with the anterior CE angle ( r = − 0.478), posterior CE angle ( r = 0.432), and AA ( r = 0.565). APPA had a stronger correlation with anatomical-PT ( r = 0.646) than with AA. Conclusions: The tilt of the pelvis may be more dependent on anatomical-PT, a morphological parameter of the pelvis, than the lateral CE angle, anterior CE angle, posterior CE angle, and acetabular anteversion on bony coverage of the acetabulum. This study is the first to investigate the correlation between functional parameters of the pelvis and spine and morphological parameters of the pelvis and acetabulum besides PI.

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