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International Journal of General... 2022Situs inversus totalis is a rare congenital abnormality characterized by a mirror-image transposition of both the abdominal and the thoracic organs. While this anomaly... (Review)
Review
Situs inversus totalis is a rare congenital abnormality characterized by a mirror-image transposition of both the abdominal and the thoracic organs. While this anomaly is known since the ancient times, practicing doctors do not have much experience with it. Laterality is established early in development, and any failure in that process might lead to a wide variety of disorders which may be partial or complete. describes the normal anatomy, is the complete reversal, and is used for any other abnormality of left-right development. Sidedness is regulated by genes: over 100 genes have been linked to laterality defects. Frequency of situs inversus is 1:10,000 and is more frequent in males: 1.5:1. Advanced imaging modalities can be used to assess fine anatomical details, which play a crucial role in these cases to plan radiologic or surgical interventions. Percutaneous biliary procedures, portal vein embolization are really challenging procedures in SIT patients due to the mirror effect. As most surgeons are right-handed, SIT operations can cause difficulties: handling the instruments with their left hand or the pedals with their left foot can be uncomfortable Organ, especially liver transplantation represents an extraordinary surgical challenge. Solutions to overcome the anatomic differences include the use of segment or reduced size graft with rotation, modified piggy-back technique, side to-side caval anastomosis, and vascular conduit. Because of its rarity and special nature, surgical patients with situs inversus may require more flexibility and creativity from the surgical team.
PubMed: 35264880
DOI: 10.2147/IJGM.S295444 -
Indian Journal of Thoracic and... Jan 2021Patients with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction are managed by various techniques.... (Review)
Review
Patients with transposition of the great arteries, ventricular septal defect, and left ventricular outflow tract obstruction are managed by various techniques. Traditional techniques include intracardiac baffling with a right ventricle to pulmonary artery conduit (Rastelli procedure) and the "reparation a l'etage ventriculaire" (REV) procedure. However, other techniques such as aortic root translocation (Bex-Nikaidoh procedure), pulmonary root translocation, and double root translocation are equivalent or in fact provide better results than the traditional techniques. In this review we will have a detailed discussion about aortic root translocation which allows a more normal and anatomically aligned left ventricular outflow tract. However, the operation is technically demanding, and coronary translocation remains one of the major challenges for successful root translocation.
PubMed: 33603284
DOI: 10.1007/s12055-020-00956-7 -
Diagnostic and Interventional Imaging Feb 2022Postoperative imaging plays a key role in the identification of complications after Ivor-Lewis esophagectomy (ILE). Careful analysis of imaging examinations can help... (Review)
Review
Postoperative imaging plays a key role in the identification of complications after Ivor-Lewis esophagectomy (ILE). Careful analysis of imaging examinations can help identify the cause of the presenting symptoms and the mechanism of the complication. The complex surgical procedure used in ILE results in anatomical changes that make imaging interpretation challenging for many radiologists. The purpose of this review was to make radiologists more familiar with the imaging findings of normal anatomical changes and those of complications following ILE to enable accurate evaluation of patients with an altered postoperative course. Anastomotic leak, gastric conduit necrosis and pleuropulmonary complications are the most serious complications after ILE. Computed tomography used in conjunction with oral administration of contrast material is the preferred diagnostic tool, although it conveys limited sensitivity for the diagnosis of anastomotic fistula. In combination with early endoscopic assessment, it can also help early recognition of complications and appropriate therapeutic management.
Topics: Anastomotic Leak; Esophageal Neoplasms; Esophagectomy; Humans; Postoperative Complications; Retrospective Studies
PubMed: 34654670
DOI: 10.1016/j.diii.2021.09.003 -
Tomography (Ann Arbor, Mich.) Jun 2023The skull base provides a platform for supporting the brain while serving as a conduit for major neurovascular structures. In addition to malignant lesions originating... (Review)
Review
The skull base provides a platform for supporting the brain while serving as a conduit for major neurovascular structures. In addition to malignant lesions originating in the skull base, there are many benign entities and developmental variants that may simulate disease. Therefore, a basic understanding of the relevant embryology is essential. Lesions centered in the skull base can extend to the adjacent intracranial and extracranial compartments; conversely, the skull base can be secondarily involved by primary extracranial and intracranial disease. CT and MRI are the mainstay imaging methods and are complementary in the evaluation of skull base lesions. Advances in cross-sectional imaging have been crucial in the management of patients with skull base pathology, as this represents a complex anatomical area that is hidden from direct clinical exam. Furthermore, the clinician must rely on imaging studies for therapy planning and to monitor treatment response. It is crucial to have a thorough understanding of skull base anatomy and its various pathologies, as well as to recognize the appearance of treatment-related changes. In this review, we aim to describe skull base tumors and tumor-like lesions in an anatomical compartmental approach and present imaging methods that aid in diagnosis, management, and follow-up.
Topics: Humans; Skull Base Neoplasms; Diagnostic Imaging; Brain
PubMed: 37489465
DOI: 10.3390/tomography9040097 -
American Journal of Botany Apr 2021Gymnosperm taxa are incredibly diverse in many traits, including taxa with evergreen or deciduous leaves; broad, compound, needle-like or scale-like leaves; trees,... (Review)
Review
Gymnosperm taxa are incredibly diverse in many traits, including taxa with evergreen or deciduous leaves; broad, compound, needle-like or scale-like leaves; trees, shrubs, and lianas; and taxa with seed cones that range from fleshy to woody. Although less appreciated, xylem conduits are also diverse in structure among extant gymnosperm taxa. Within the xylem of gymnosperms, axial transport occurs predominantly via tracheids, although 10-40% of gymnosperm taxa, particularly within the Gnetophyta and Cycadophyta, also contain vessels. Gymnosperm taxa vary greatly in their inter-conduit pit structure, with different types of pit membranes and pitting arrangements. While some taxa display torus-margo bordered pits (60%), many others do not contain tori (40%), and at least some taxa without tori occur within each of the four extant phyla (Coniferophyta, Cycadophyta, Ginkgophyta, and Gnetophyta). Pit membrane types vary within families but appear relatively conserved within genera. Woody species with torus-bearing pit membranes occur in colder environments (lower mean annual temperature) compared to those without tori; but occurrence does not differ with mean annual precipitation. Detailed descriptions of pit membrane types are lacking for many species and genera, indicating a need for increased anatomical study. Increased knowledge of these traits could provide a unique experimental context in which to study the evolution of conduit networks, the hydraulic implications of conduit and pit structure, and the diverse structural and functional strategies utilized by gymnosperms. There are myriad potential study questions and research opportunities within this unique and diverse group of plants.
Topics: Cycadopsida; Tracheophyta; Trees; Water; Xylem
PubMed: 33861866
DOI: 10.1002/ajb2.1641 -
Cellular and Molecular Life Sciences :... Oct 2020Plant vascular development is a complex process culminating in the generation of xylem and phloem, the plant transporting conduits. Xylem and phloem arise from... (Review)
Review
Plant vascular development is a complex process culminating in the generation of xylem and phloem, the plant transporting conduits. Xylem and phloem arise from specialized stem cells collectively termed (pro)cambium. Once developed, xylem transports mainly water and mineral nutrients and phloem transports photoassimilates and signaling molecules. In the past few years, major advances have been made to characterize the molecular, genetic and physiological aspects that govern vascular development. However, less is known about how the environment re-shapes the process, which molecular mechanisms link environmental inputs with developmental outputs, which gene regulatory networks facilitate the genetic adaptation of vascular development to environmental niches, or how the first vascular cells appeared as an evolutionary innovation. In this review, we (1) summarize the current knowledge of the mechanisms involved in vascular development, focusing on the model species Arabidopsis thaliana, (2) describe the anatomical effect of specific environmental factors on the process, (3) speculate about the main entry points through which the molecular mechanisms controlling of the process might be altered by specific environmental factors, and (4) discuss future research which could identify the genetic factors underlying phenotypic plasticity of vascular development.
Topics: Arabidopsis; Arabidopsis Proteins; Phloem; Plant Growth Regulators; Plant Roots; Stress, Physiological; Xylem
PubMed: 32193607
DOI: 10.1007/s00018-020-03496-w