Lokadolalu Chandracharya Prasanna

Variations in the pulmonary venous ostium in the left atrium and its clinical importance.

INTRODUCTION During early embryonic development, absorption of pulmonary venous network by the left primitive atrial chamber results in opening of four pulmonary veins which drain independently into its chamber. The extent of absorption and hence, the number of pulmonary veins which open into the left atrium, may vary. As only few studies have been done, which have shown such variations, the present study was done to evaluate the possible variations in the pulmonary veins which opened into the left atrium. MATERIALS AND METHODS Fifty formalin fixed adult cadaveric hearts were studied for variations in the opening of the pulmonary veins into left atrium. RESULTS Our results showed that 68% of the hearts which were studied, showed usual pattern of 2 pulmonary veins on either side, while remaining 32 % hearts showed variations in the number of pulmonary veins which opened. Twelve percent of the hearts showed 2 left and 3 right pulmonary veins, 14% of hearts showed 2 left and 1 right veins, 4% hearts showed 1 left and 2 right veins and 2% hearts showed 1 left and 4 right pulmonary veins opening into the left atrium. CONCLUSION Knowledge on such variations gains significance in isolation for radiofrequency ablation as a treatment for atrial fibrillation.

Analysis of the distribution of mucins in adult human gastric mucosa and its functional significance

INTRODUCTION Mucins are complex composition of carbohydrates seen in the epithelial cells lining the gastrointestinal tract (GIT). Normal distribution of such mucins in different part of the GIT and its alteration in various inflammatory, benign and malignant lesions of GIT has aroused interest in the field of histochemistry. AIM By applying variety of histochemical techniques an attempt has been made to draw a map of mucin secretion by the different epithelial cell types in different parts of the stomach. MATERIALS AND METHODS Fifty samples were taken each from different parts of the stomach like fundus, body and pylorus, from dissected fresh specimens (total of 150 specimens). Tissue samples were subjected for routine process and studied for histological and different histochemical staining. RESULTS Mucin pattern in adult predominantly secretes neutral mucosubstances. Surface epithelium shows predominant neutral mucin while cardiac and gastric glands with foveolar cells show moderate amount. Sialomucin is present in a few cells of the surface epithelium, foveolar cells and in most of the mucous neck cells. Small amount of sialomucin and sulphomucin are found in surface epithelial foveolar cells while traces of sulphomucin are found in deep foveolar cells. Mucous neck cells secrete both sulphomucin and sialomucin. CONCLUSION Normal gastric mucosa adjacent to gastric ulcers and malignant tumours of stomach secretes mucins which differ histochemically and biochemically from that of normal. Early recognition of such changes could be useful in recognizing the different type of carcinomas and their prognosis.

Accessory pancreatic duct patterns and their clinical implications

CONTEXT AND OBJECTIVE Accessory pancreatic duct (APD) designed to reduce the pressure of major pancreatic duct by forming a secondary drainage channel. Few studies have mentioned the variant types of accessory ducts and their mode of formation, some of these have a clear clinical significance. Present study is aimed to evaluate the possible variations in the APD and its terminations. MATERIALS AND METHODS Forty formalin fixed adult human pancreas with duodenum in situ specimens were studied by injecting 1% aqueous eosin, followed by piece meal dissection of the head of the pancreas from posterior surface. Formation, tributaries, relations, and the termination of the accessory pancreatic duct were noted and photographed. RESULTS Accessory ducts revealed 50% belonged to long type, 22.5% were of short and ansa pancreatica type each, and embryonic type of duct pattern was seen in 5% specimens. 75% of long type ducts showed positive patency with eosin dye, followed by ansa type (44.4%), and least patency was found in short type (22.2%). With regard to the patency of the accessory pancreatic ducts towards their termination, we found 52.5% of the accessory ducts and 5% of the embryonic type pancreatic ducts were patent and in 42.5% of the specimen the ducts were obliterated. In 85% of specimens the minor duodenal papillae was anterosuperior to the major papilla and superior to the major papillae in 10% of the cases, and in 5% minor papillae was absent. The average distance between the two papillae was 2.35 cm. CONCLUSION The knowledge of the complex anatomical relations of the gland with its duct, duodenum and bile ducts are essential for the surgeons and sinologists to plan and perform both the diagnostic as well as therapeutic procedures effectively.

A Rare Case of Bilateral Jugular Venous Malformation

This is an observation of anomaly of the bilateral jugular veins system with regard to their formation, tributaries and drainage pattern. Both right and left external jugular veins drained into the internal jugular veins. The right internal jugular vein, after receiving anomalous tributaries drained into the subclavian veins to form the right brachiocephalic vein. The left internal jugular vein receives variant tributaries just before it joins the left brachiocephalic vein. Both the external jugular veins were larger than normal. Moreover, the left internal jugular vein was almost twice the size of the right internal jugular vein. The current observations are being reported for the first time. The anomalies reported in this observation involve most veins of the jugular system and therefore suggests that anomalies of a particular vein may affect the size and symmetry of veins that drain into it, or communicate with it

A rare case of lobulated complete renal fusion with multiple hila and vasculature

Complete renal fusion without crossed renal ectopia denotes the medial fusion of the renal parenchyma (with or without changes in the microarchitecture) in the pelvis with anteriorly placed short ureters terminating into the bladder. This could be due to the failure of renal analgen to ascent, lateral migration, axial rotation, and persistence of primitive vascular supply. Though remain asymptomatic such cases warrant concomitant congenital anomalies of other organ systems as well as the microarchitecture changes in the renal parenchyma.

Left-Sided Persistent Superior Vena Cava with Superior Hemiazygos Arch.

Persistent Left-side Superior Vena Cava (PLSVC) is the congenital central venous anomaly draining into the right atrium in 82-90% of cases via coronary sinus produce no haemodynamically significant consequences. In few cases it may drain into the left atrium directly or through the pulmonary veins resulting in right to left shunt. During routine undergraduate dissection, we found a PLSVC formed by the union of left subclavian and left internal jugular veins behind the left sternoclavicular joint was terminated into the right atrium through a larger coronary sinus ostium. Before its termination, PLSVC received a left hemiazygos vein formed by the continuation of the superior and inferior hemiazygos veins. A larger but thin communicating vein was noted between the right superior vena cava and PLSVC. Prior knowledge about such variations is essential in all the intervention procedures on right atrium through the left subclavian approach and also like in our case, the larger coronary sinus ostium if found during transthoracic echocardiography should be considered as an indication for the diagnosis of PLSVC.

A rare case of craniofacial morphology with absent face and neck structures, with its review.

The development of the head and the face requires an intimate interaction between two mesenchymal populations, a paraxial mesoderm and neural crest cells for the morphogenesis of the musculoskeletal components of the calvaria, the face and the branchial regions. The disruptions in these interactions can cause foetal fatalities or congenital craniofacial anomalies. We are describing a rarest case with a craniofacial malformation, who was born with complete absence of the facial skeleton and the neck structures, a set of well developed ears in their normal locations and eyelids at the junction between the head and the thorax.