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Investigative Ophthalmology & Visual... Mar 2016To examine the anatomical variation of normal human collector channel orifices and their relationship with Schlemm's canal.
PURPOSE
To examine the anatomical variation of normal human collector channel orifices and their relationship with Schlemm's canal.
METHODS
Ten human anterior segments fixed by immersion or perfusion were dissected radially and further divided by fine dissection into corresponding inner and outer wall segments. The tissues were dehydrated, critical-point dried, sputter coated, and examined by scanning electron microscopy. Images were obtained at magnifications from ×200 to ×10,000. Selected radial collector channel regions were processed for plastic embedding.
RESULTS
Two classes of collector channel orifices were identified. Simple oval orifices (54.7 ± 4.6-μm diameter) were lined with endothelial cells and most often occurred on a planar region of Schlemm's canal outer wall. Complex orifices (62.7 ± 3.4-μm diameter) were often found associated with septal columns and bridges, and typically covered with flap-like structures (10-40 μm) that extended between the inner and outer wall and over the collector channel orifices. Both simple and complex orifices had complete or partial lip-like rims. In orifices with partial rims, a trough-like groove was often visible on the outer wall surface opposite the lip. Transected septa and inner and outer wall adhesion sites were often found in association with complex collector channel orifices.
CONCLUSIONS
Collector channel orifice structure varied from simple ovals to complex tethered flaps and bridges. Collector channel orifices with complex flaps connect the inner and outer walls of Schlemm's canal, and may serve to enhance and regulate aqueous outflow in these regions.
Topics: Adult; Aged; Aged, 80 and over; Anterior Eye Segment; Aqueous Humor; Female; Humans; Intraocular Pressure; Male; Microscopy, Electron, Scanning; Middle Aged; Sclera; Trabecular Meshwork
PubMed: 26975026
DOI: 10.1167/iovs.15-17753 -
Frontiers in Cardiovascular Medicine 2023The aim of the current study was to investigate the potential relationship between anatomical characteristics of pulmonary veins (PVs) and atrial fibrillation recurrence... (Review)
Review
Relationship between anatomical characteristics of pulmonary veins and atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review and meta-analysis.
BACKGROUND
The aim of the current study was to investigate the potential relationship between anatomical characteristics of pulmonary veins (PVs) and atrial fibrillation recurrence (AFR) following radiofrequency catheter ablation (RFCA), specifically focusing on PV diameter and cross-sectional orifices index (CSOA). The analysis was based on a comprehensive review of currently available literature, providing valuable insights for the prevention and treatment of AFR.
METHODS
Data was collected from five databases, including PubMed, MEDLINE, EMBASE, and Cochrane, spanning the period from 2004 to October 2022. The search strategy utilized Medical Subject Headings (MeSH) terms related to PV diameter, PV size, PV anatomy, and AFR. Indicators of PV diameter and CSOA from the included studies were collected and analyzed, with Weight mean difference (WMD) and 95% confidence intervals (CIs) representing continuous variables.
RESULTS
The meta-analysis included six studies. The results revealed that patients with AFR had a significant larger mean PV diameter compared to those without AFR (MD 0.33; 95% CI: 0.01, 0.66; = 0.04; = 33.80%). In a meta-analysis of two studies involving a total of 715 participants, we compared the diameters of the left superior pulmonary vein (LSPV), left inferior pulmonary vein (LIPV), right superior pulmonary vein (RSPV), right inferior pulmonary vein (RIPV) between patients with AFR and patients without AFR. The results showed that there were no statistically significant differences between the two groups in any of the four data items (all > 0.05). Additionally, the pooled estimate revealed that LSPV-CSOA, LIPV-COSA, RSPV-COSA, and RIPV-CSOA were greater in the AFR group compared to the non-AFR group, but the differences were not statistically significant (all > 0.05).
CONCLUSION
We found evidence supporting the notion that the PV diameter of patients who experienced AFR after RFCA was significantly larger than that of patients without AFR. The findings suggested that the PV diameter could serve as a potential predictor of the risk of AFR following RFCA.
PubMed: 37795484
DOI: 10.3389/fcvm.2023.1235433 -
Otolaryngologic Clinics of North America Feb 2013Office-based vocal fold injection (VFI), though initially described more than a century ago, has recently reemerged as an attractive alternative to VFI performed during...
Office-based vocal fold injection (VFI), though initially described more than a century ago, has recently reemerged as an attractive alternative to VFI performed during microsuspension laryngoscopy. Multiple office-based approaches exist, including percutaneous, peroral, and transnasal endoscopic approaches. Surgeon preference typically dictates the approach, although patient tolerance or anatomic variations are also key factors. Regardless of the approach or indication, a myriad of technical considerations make preparation and familiarity requisite for optimal patient outcomes. Office-based VFI offers several distinct advantages over traditional direct or microsuspension laryngoscopy VFI, making it a standard of treatment for a variety of indications.
Topics: Ambulatory Surgical Procedures; Glucocorticoids; Humans; Injections; Intraoperative Complications; Laryngoscopy; Methylprednisolone; Natural Orifice Endoscopic Surgery; Patient Care Planning; Postoperative Complications; Preoperative Period; Treatment Outcome; Vocal Cord Paralysis; Vocal Cords
PubMed: 23177408
DOI: 10.1016/j.otc.2012.08.020 -
Annual Review of Animal Biosciences Feb 2023Talpid moles and spotted hyenas have become the paradigms of anatomical and behavioral female masculinization. Females of many mole species develop ovotestes that... (Review)
Review
Talpid moles and spotted hyenas have become the paradigms of anatomical and behavioral female masculinization. Females of many mole species develop ovotestes that produce testosterone, show external genitalia that resemble that of males, and close their vaginal orifice after every estrus, and female spotted hyenas lack an external vaginal orifice and develop a pseudoscrotum and a large pseudopenis through which they urinate, mate, and give birth. We review current knowledge about several significant aspects of the biology and evolution of these females, including () their specific study methods; () their unique anatomical features, and how these peculiarities influence certain physiological functions; and () the role that steroid hormones as well as genetic and environmental factors may have in urogenital system development, aggressive behavior, and social dominance. Nevertheless, both mole and hyena females are exceptionally efficient mothers, so their peculiar genitalia should not call into question their femininity.
Topics: Male; Female; Animals; Hyaenidae; Moles; Steroids; Genitalia; Biology
PubMed: 36130099
DOI: 10.1146/annurev-animal-050622-043424 -
Seminars in Thoracic and Cardiovascular... 2023Patients with anomalous aortic origin of a coronary artery (AAOCA) require imaging to clarify the multiple potential anatomic sites of obstruction (fixed or dynamic).... (Review)
Review
Patients with anomalous aortic origin of a coronary artery (AAOCA) require imaging to clarify the multiple potential anatomic sites of obstruction (fixed or dynamic). Once repaired, the pathway of blood to the myocardium must not encounter: (1) intrinsic ostial stenosis, (2) obstruction from compression or distortion near the commissure or the intercoronary pillar, (3) stenosis where the artery exits the aortic wall (due to an acutely angled "take-off"), (4) compression due to a pathway between the great vessels, (5) stenosis or compression along an intramural course, or (6) compression due to an intramuscular (intraseptal/intraconal) course. Detailed anatomic evaluation of each of these locations allows the surgeon to select an appropriate repair strategy, and each of these abnormal anatomic features should be "matched" with a particular surgical correction. We speculate that the most common surgical repair, unroofing with or without tacking, is often inadequate, as in isolation, it may not allow for correction with a large orifice from the appropriate sinus, without an interarterial course. While the evidence base is insufficient to call these recommendations formal guidelines, these recommendations should serve as a basis for further validity testing, and ultimate evolution to more granular guidelines on AAOCA management.
Topics: Humans; Constriction, Pathologic; Coronary Vessel Anomalies; Aorta; Cardiac Surgical Procedures; Retrospective Studies
PubMed: 36842800
DOI: 10.1053/j.pcsu.2022.12.007 -
Computerized Medical Imaging and... Jun 2023Left atrial appendage (LAA) occlusion (LAAO) is a minimally invasive implant-based method to prevent cardiovascular stroke in patients with non-valvular atrial...
Left atrial appendage (LAA) occlusion (LAAO) is a minimally invasive implant-based method to prevent cardiovascular stroke in patients with non-valvular atrial fibrillation. Assessing the LAA orifice in preoperative CT angiography plays a crucial role in choosing an appropriate LAAO implant size and a proper C-arm angulation. However, accurate orifice localization is hard because of the high anatomic variation of LAA, and unclear position and orientation of the orifice in available CT views. With the major research focus being on LAA segmentation, the only existing computational method for orifice localization utilized a rule-based decision. Nonetheless, using such a fixed rule may yield high localization error due to the varied anatomy of LAA. While deep learning-based models usually show improvements under such variation, learning an effective localization model is difficult because of the tiny orifice structure compared to the vast search space of CT volume. In this paper, we propose a centerline depth-based reinforcement learning (RL) world for effective orifice localization in a small search space. In our scheme, an RL agent observes the centerline-to-surface distance and navigates through the LAA centerline to localize the orifice. Thus, the search space is significantly reduced facilitating improved localization. The proposed formulation could result in high localization accuracy compared to the expert annotations. Moreover, the localization process takes about 7.3 s which is 18 times more efficient than the existing method. Therefore, this can be a useful aid to physicians during the preprocedural planning of LAAO.
Topics: Humans; Atrial Appendage; Echocardiography, Transesophageal; Atrial Fibrillation; Computed Tomography Angiography
PubMed: 36848765
DOI: 10.1016/j.compmedimag.2023.102201 -
World Neurosurgery Jan 2020Interest in endoscopic transnasal access has increased with continued technological advances in endoscopic technology. The goals of this study were to review the normal...
OBJECTIVE
Interest in endoscopic transnasal access has increased with continued technological advances in endoscopic technology. The goals of this study were to review the normal anatomy in transnasal endoscopic neurosurgery and outline the anatomical basis for an expanded surgical approach. Defining anatomical aspects of surgical endoscopy helps guide the surgeon by defining normal anatomy of the access vector.
METHODS
This anatomic study was conducted on 15 adult male cadaver specimens using various microsurgical tools and endoscopic instruments and 1 intraoperative case. The vasculature was injected with colored silicone to aid visualization. Different transnasal approach techniques were used, with angles of endoscope access at 0°, 30°, 45°, and 70° accordingly for extensive anatomical mapping.
RESULTS
The proximity of critical structures is different in each approach degree. A full understanding of the possible structures to be met during transnasal access is described. As a result of the study, anatomical aspects and important structures were outlined, and a surgical protocol was defined for minimal risk access in respect to normal anatomy of the area.
CONCLUSIONS
Thorough knowledge of topographic anatomy of the craniovertebral junction is required for performing minimal-risk surgical intervention in this region. It is important to know all anatomical aspects of the transnasal approach in order to reduce the risk of damage to vital structures. Transnasal endoscopic surgery of the craniovertebral junction is a relatively new direction in neurosurgery; therefore, anatomical studies such as the one described in this article are extremely important for the development of this access method.
Topics: Adult; Cadaver; Cervical Vertebrae; Humans; Male; Nasal Cavity; Natural Orifice Endoscopic Surgery; Neuroendoscopy; Skull
PubMed: 31520764
DOI: 10.1016/j.wneu.2019.09.011 -
JNMA; Journal of the Nepal Medical... 2011Natural orifice transluminal endoscopic surgery (NOTES), which utilises natural anatomical passages for gaining access to the intra-abdominal organs for surgical... (Review)
Review
Natural orifice transluminal endoscopic surgery (NOTES), which utilises natural anatomical passages for gaining access to the intra-abdominal organs for surgical interventions, that result in scarless surgery, is a recent advancement in the specialty of minimally invasive surgery and has gained significant momentum, It has been postulated as a promising alternative to laparoscopic surgery in the field of minimal invasive surgery. Significant advantages over conventional open surgery, such as less postoperative pain, a shorter hospital stay, early return to activity, avoidance of wound-related complications and better cosmesis have been demonstrated. This article provides an update in the development, principles, practice and future applications of NOTES.
Topics: Abdominal Cavity; Humans; Natural Orifice Endoscopic Surgery; Pain, Postoperative
PubMed: 22922904
DOI: No ID Found -
Folia Morphologica 2022This study aimed to investigate the incidence, number, diameter, and relative location of the parietal foramen (PF) as well as communication of intracranial and...
BACKGROUND
This study aimed to investigate the incidence, number, diameter, and relative location of the parietal foramen (PF) as well as communication of intracranial and extracranial orifices and their direction, and sagittal suture morphology and length.
MATERIALS AND METHODS
A total of 280 dry Chinese adult skull specimens from the Department of Anatomy, Southern Medical University, were observed and measured. The occurrence rate and quantity of the PF near the sagittal suture were recorded. The aperture of the PF, the vertical distance between PF and sagittal suture, and the linear distance between PF and lambda were measured using a Vernier calliper. The length of the sagittal suture was measured by a flexible ruler; the direction and communication of intracranial and extracranial orifices were detected using a probe.
RESULTS
The total incidence of the PF was 82.86%, slightly higher on the right side than on the left side. The single-foramen type was the most prevalent. The mean diameter of the PF on the left and right sides were 1.02 ± 0.72 mm and 1.07 ± 0.67 mm, respectively, and the diameter of the PF on the sagittal suture was 1.77 ± 0.44 mm. The mean vertical distance between the PF and the sagittal suture was 5.90 ± 2.78 mm and 5.85 ± 2.75 mm on the left and right sides, respectively. The shape of the sagittal suture in the PF area was primarily dentate shaped, with an average arc length of χ = 124.36 ± 7.76 mm, of which the majority were completely healed type. The intracranial and extracranial communication was 39.97%, and the majority of the PF were anteromedial direction.
CONCLUSIONS
The current study provided an anatomical basis for imaging diagnosis and neurosurgery by investigating the incidence, diameter, and relative location of the PF and intracranial and extracranial communication and direction.
Topics: Adult; Humans; East Asian People; Sphenoid Bone; Cranial Sutures
PubMed: 34699055
DOI: 10.5603/FM.a2021.0106 -
Journal of Clinical Ultrasound : JCU Jul 2017The anatomic causes for fetal right atrial dilatation with tricuspid regurgitation include Ebstein anomaly, tricuspid dysplasia, unguarded tricuspid orifice, and Uhl... (Review)
Review
The anatomic causes for fetal right atrial dilatation with tricuspid regurgitation include Ebstein anomaly, tricuspid dysplasia, unguarded tricuspid orifice, and Uhl anomaly. Unguarded tricuspid orifice is characterized by complete or partial agenesis of the tricuspid valvular and subvalvular structures. It is commonly associated with pulmonary atresia. Its prenatal diagnosis is usually associated with unfavorable prognosis. We present a prenatally diagnosed case of fetal unguarded tricuspid orifice with description of its diagnostic workup, along with a review of literature, to enhance the understanding of this rarely reported entity. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:370-374, 2017.
Topics: Abortion, Eugenic; Adult; Dilatation, Pathologic; Echocardiography, Doppler, Color; Female; Humans; Pregnancy; Tricuspid Valve; Ultrasonography, Prenatal
PubMed: 27753109
DOI: 10.1002/jcu.22416