Objective: It is important to minimize the risk of major vascular injury during pneumoperitoneumestablishment in laparoscopic surgeries for patients with unusual variations in the levels of theabdominal aorta, the inf...Objective: It is important to minimize the risk of major vascular injury during pneumoperitoneumestablishment in laparoscopic surgeries for patients with unusual variations in the levels of theabdominal aorta, the inferior vena cava (IVC), and the left renal vein, which will decrease the morbidityand mortality. The study aims to assess the variations regarding the bifurcation level of the abdominalaorta, formation level of the IVC, and insertion level of the left renal vein into the IVC.Methods: This retrospective study was conducted on 100 patients (50 males and 50 females) referred tothe Department of Radiology, Jordan University Hospital for abdomino-pelvic CT with intra-venouscontrast from January 2018 to December 2019. The three vessels were determined on the axial plane,the coronal plane, and the midsagittal plane. The central vertebral body height as well as the distance ofthe level of the point of interest to the upper end plate of the vertebrae were measured. Afterwards, theresults were classified into the following categories, upper end plate, lower end plate, intervertebral disc,upper half, and lower half of the vertebra.Results: The aortic bifurcation was mainly found at the level of the L4 vertebral body (65, 65%). In theremaining cases, the bifurcation was found to be variably located spanning from L3 in 11 (11%) cases to3 (3%) cases at L5. As for the iliocaval junction, the most common site was also at the level of L4 with41 (41%) cases followed by 39 (39%) cases at the level of L5, and 20 (20%) cases at the intervertebral discof L4/L5. The left renal vein most commonly joined the IVC at the level of L1 with 62 (62%) cases followedby 20 (20%) cases at the intervertebral disc T12/L1. There was wide variation in its entry to the IVCspanning from 4 (4%) cases at T12/L1 to 1 (1%) case at L4.Conclusion: The anatomical variation of the major vessels can be found in the normal population.Therefore, sufficient investigation of the anatomical position of these vessels is essential for patientsbefore laparoscopic surgery.展开更多
Aim: The purpose of this work was to describe the left renal retro-aortic vein. Methodology: A case of left renal retro-aortic vein was discovered on a corpse of male, 45-year-old adult during the dissections to the l...Aim: The purpose of this work was to describe the left renal retro-aortic vein. Methodology: A case of left renal retro-aortic vein was discovered on a corpse of male, 45-year-old adult during the dissections to the laboratory of anatomy of the Faculty of Medicine of Bamako. The way at first was a xypho-pubic median and two side abdominal sections under costal and inguinal. The side sections under costal went of the median section to sides by following the costal edge. The inguinal side sections went of the median section to the anterior and superior iliac thorns. The abdominal wall was opened and reclined by every quoted. The small intestine and the colonist were resected with their meso. The renal pedicle was dissected on each side. The abdominal aorta and the inferior vena cava were dissected by the diaphragm up to the headland. Arteries and iliac veins were also dissected. Results: On male corpse, 45 years old, we discovered a left renal retro-aortic vein in horizontal route, and the trunk of the left renal vein was formed by the confluence of three veins at the level of the left renal hilum. The left renal vein passed almost horizontally below the left renal artery. It passed then behind the abdominal aorta to end in the inferior vena cava at the level of its left side face. The right renal vein had a normal aspect. Conclusion: The left renal retro-aortic vein is one of the variants of the anomalies of the system cellar inferior. The left renal retro-aortic vein could be responsible for renal aplasia.展开更多
Experimental models have allowed inquiry into the pathophysiology of varicocele （VC） beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degre...Experimental models have allowed inquiry into the pathophysiology of varicocele （VC） beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degree of left renal vein constriction on the development of adolescent VC. Fifty adolescent male Sprague-Dawley rats （Rattus norvegicus） were randomly assigned to five groups of 10： the experimental groups （I-IV） underwent partial ligation of left renal veins with 0.5-, 0.6-, 0.7-, and 0.8-mm diameter needles, respectively. The control group （V） underwent a sham operation. The diameter of the left spermatic vein （LSV） was measured at baseline and 30 days postoperatively. In addition, the lesion of the left kidney was examined with the naked eye and assessed by Masson＇s trichrome staining. VC was successfully induced in 2 （20%）, 4 （40%）, 7 （70%）, and 10 （100%） rats in groups I-IV, respectively. The other rats failed to develop VCs primarily due to left renal atrophy. No VC was observed in group V. The postsurgical LSV diameters in VC rats in groups III and IV were 1.54 ± 0. 16 and 1.49 ± 0.13 mm, respectively （P〉 0.05）, and their increments were 1.36±0. 10 and 1.31±0. 10 ram, respectively （P 〉 0.05）. These results suggest that suitable constriction of the left renal vein is critical for adolescent VC development. In addition, the 0.8-mm diameter needle may be more suitable for inducing left renal vein constriction in adolescent rat models.展开更多
Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present,is usually extensive,often encompassing multiple cardiac chambers and valves.We present an unusual ca...Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present,is usually extensive,often encompassing multiple cardiac chambers and valves.We present an unusual case of dystrophic left atrial calcification in the setting of end stage renal disease on hemodialysis diagnosed by echocardiography and computed tomography.Significant calcium deposition is confined within the walls of the left atrium with no involvement of the mitral valve,and no hemodynamic effects.展开更多
文摘Objective: It is important to minimize the risk of major vascular injury during pneumoperitoneumestablishment in laparoscopic surgeries for patients with unusual variations in the levels of theabdominal aorta, the inferior vena cava (IVC), and the left renal vein, which will decrease the morbidityand mortality. The study aims to assess the variations regarding the bifurcation level of the abdominalaorta, formation level of the IVC, and insertion level of the left renal vein into the IVC.Methods: This retrospective study was conducted on 100 patients (50 males and 50 females) referred tothe Department of Radiology, Jordan University Hospital for abdomino-pelvic CT with intra-venouscontrast from January 2018 to December 2019. The three vessels were determined on the axial plane,the coronal plane, and the midsagittal plane. The central vertebral body height as well as the distance ofthe level of the point of interest to the upper end plate of the vertebrae were measured. Afterwards, theresults were classified into the following categories, upper end plate, lower end plate, intervertebral disc,upper half, and lower half of the vertebra.Results: The aortic bifurcation was mainly found at the level of the L4 vertebral body (65, 65%). In theremaining cases, the bifurcation was found to be variably located spanning from L3 in 11 (11%) cases to3 (3%) cases at L5. As for the iliocaval junction, the most common site was also at the level of L4 with41 (41%) cases followed by 39 (39%) cases at the level of L5, and 20 (20%) cases at the intervertebral discof L4/L5. The left renal vein most commonly joined the IVC at the level of L1 with 62 (62%) cases followedby 20 (20%) cases at the intervertebral disc T12/L1. There was wide variation in its entry to the IVCspanning from 4 (4%) cases at T12/L1 to 1 (1%) case at L4.Conclusion: The anatomical variation of the major vessels can be found in the normal population.Therefore, sufficient investigation of the anatomical position of these vessels is essential for patientsbefore laparoscopic surgery.
文摘Aim: The purpose of this work was to describe the left renal retro-aortic vein. Methodology: A case of left renal retro-aortic vein was discovered on a corpse of male, 45-year-old adult during the dissections to the laboratory of anatomy of the Faculty of Medicine of Bamako. The way at first was a xypho-pubic median and two side abdominal sections under costal and inguinal. The side sections under costal went of the median section to sides by following the costal edge. The inguinal side sections went of the median section to the anterior and superior iliac thorns. The abdominal wall was opened and reclined by every quoted. The small intestine and the colonist were resected with their meso. The renal pedicle was dissected on each side. The abdominal aorta and the inferior vena cava were dissected by the diaphragm up to the headland. Arteries and iliac veins were also dissected. Results: On male corpse, 45 years old, we discovered a left renal retro-aortic vein in horizontal route, and the trunk of the left renal vein was formed by the confluence of three veins at the level of the left renal hilum. The left renal vein passed almost horizontally below the left renal artery. It passed then behind the abdominal aorta to end in the inferior vena cava at the level of its left side face. The right renal vein had a normal aspect. Conclusion: The left renal retro-aortic vein is one of the variants of the anomalies of the system cellar inferior. The left renal retro-aortic vein could be responsible for renal aplasia.
文摘Experimental models have allowed inquiry into the pathophysiology of varicocele （VC） beyond that possible with human patients. A randomized controlled study in rats was designed to clarify the influence of the degree of left renal vein constriction on the development of adolescent VC. Fifty adolescent male Sprague-Dawley rats （Rattus norvegicus） were randomly assigned to five groups of 10： the experimental groups （I-IV） underwent partial ligation of left renal veins with 0.5-, 0.6-, 0.7-, and 0.8-mm diameter needles, respectively. The control group （V） underwent a sham operation. The diameter of the left spermatic vein （LSV） was measured at baseline and 30 days postoperatively. In addition, the lesion of the left kidney was examined with the naked eye and assessed by Masson＇s trichrome staining. VC was successfully induced in 2 （20%）, 4 （40%）, 7 （70%）, and 10 （100%） rats in groups I-IV, respectively. The other rats failed to develop VCs primarily due to left renal atrophy. No VC was observed in group V. The postsurgical LSV diameters in VC rats in groups III and IV were 1.54 ± 0. 16 and 1.49 ± 0.13 mm, respectively （P〉 0.05）, and their increments were 1.36±0. 10 and 1.31±0. 10 ram, respectively （P 〉 0.05）. These results suggest that suitable constriction of the left renal vein is critical for adolescent VC development. In addition, the 0.8-mm diameter needle may be more suitable for inducing left renal vein constriction in adolescent rat models.
基金Supported by the "East Carolina Heart Institute"
文摘Dystrophic cardiac calcification is often associated with conditions causing systemic inflammation and when present,is usually extensive,often encompassing multiple cardiac chambers and valves.We present an unusual case of dystrophic left atrial calcification in the setting of end stage renal disease on hemodialysis diagnosed by echocardiography and computed tomography.Significant calcium deposition is confined within the walls of the left atrium with no involvement of the mitral valve,and no hemodynamic effects.
