Shuang-Qin Yi

Absence of the celiac trunk: case report and review of the literature.

The authors report a rare variation of the absence of the celiac trunk in a Japanese cadaver, with the left gastric, splenic, common hepatic, and superior mesenteric arteries arising independently from the abdominal aorta in the routine dissection of a 95‐year‐old Japanese male cadaver. The incidence and developmental and clinical significance of this variation is discussed with a detailed review of the literature. Knowledge of such case has important clinical significance in an abdominal operation or invasive arterial procedure, that is, Appleby procedure and liver transplantation, laparoscopic surgery, and radiological procedures in the upper abdomen. Clin. Anat. 21:283–286, 2008.

A rare case of inferior mesenteric artery arising from the superior mesenteric artery, with a review of the review of the literature

Anatomical variations of the inferior mesenteric artery (IMA) are uncommon. Generally, the IMA is very stable, arises directly from the abdominal aorta at the level of the third lumbar vertebra. We describe here an extremely rare case in which the IMA arose from the superior mesenteric artery. The findings were made during routine dissection of the cadaver of a 79-year-old Japanese man. This present case is the ninth report of this variation and was associated with gastrophrenic trunk, hepatosplenic trunk, hypoplastic spleen and accessory spleen. Clinically, cases like this highlight the importance of knowing the IMA anatomy and the possibility of its numerous variations in surgical procedures such as right hemicolectomy, resection of the transverse colon, left hemicolectomy, sigmoidectomy, and en bloc resection of the head of the pancreas and the superior mesenteric vessels. The developmental significance of this variation is also discussed with a detailed review of the literature.

Caput epididymitis but not orchitis was induced by vasectomy in a murine model of experimental autoimmune orchitis

Immunization of mice with viable syngeneic testicular germ cells (TGC) alone can induce autoimmune responses against autoantigens of both round and elongating spermatids, resulting in the development of experimental autoimmune orchitis (EAO). Histological lesions in this EAO model without an adjuvant are characterized by lymphocytic infiltration into the testes, spermatogenic disturbance, and a complete lack of epididymitis. In this study, we investigated the effects of vasectomy (Vx) on TGC-induced EAO expecting that Vx augments the severity of testicular inflammation in A/J mice. The results showed that mice receiving Vx alone exhibited no significant inflammatory cell response in either the testes or epididymides, and mice receiving shamVx+TGC immunization had EAO with no epididymitis. In sharp contrast, no EAO was found in the testes of any mice receiving Vx+TGC immunization. Instead, caput epididymitis involving CD4+T cells, CD8+T cells, B cells, and macrophages were induced in them with striking elevation of the tissue levels of both IL6 and IL10 mRNA. Furthermore, serum autoantibodies induced by shamVx+TGC immunization were reactive with both round (immature) and elongating (mature) spermatids; however, those induced by Vx+TGC immunization were specific to acrosomes of mature spermatids and spermatozoa. These unexpected results indicate that Vx may induce the mode by which autoreactive lymphocytes gain access to TGC autoantigens in the epididymides, leading to autoimmune responses against the autoantigens of mature rather than immature spermatids.

A study of the accessory hepatic vein to segments VI and VII with a morphological reconsideration of the human liver

IntroductionThe liver is supplied by the common hepatic artery from the celiac trunk and by the portal vein from the gastrointestine. This double blood supply to the liver by the hepatic artery and the portal vein produced a complicated structure in the liver. For the blood outflow, we can see right, intermediate and left hepatic veins, and irregular veins: the accessory hepatic veins. These veins drain the blood in the liver into the inferior vena cava. In this study, we studied the layout of the accessory hepatic vein draining segments 6 and 7 in the human livers and attempted to reconsider the structure of the liver by the layout of the accessory hepatic vein.MethodsSixty livers were subjected in this study. They were prepared by using forceps to trace the layout of the blood vessels inside the livers. We carefully examined the relation between the layouts of the accessory vein to the segments 6 and 7 and of the portal vein. The confluence patterns of the accessory hepatic vein into the inferior vena cava were also examined to find the character of the vein. The relation between the accessory hepatic vein and standard hepatic veins was also studied.ResultsWe found 2.2 accessory hepatic veins in one liver on average in our study. The vein was always within the area of segments 6 and 7, and did not surpass the boundary. We found at most five accessory hepatic veins in a liver in two cases. The accessory hepatic vein to the segments 6 and 7 always had its stem on the dorsal side to the portal vein. Different from the stem, the periphery of the accessory hepatic vein freely distributed with the peripheral branches of the portal vein. The area distributed by the accessory vein was also always dorsal part within the segments 6 and 7. The vein was small usually, but was big in few cases. When the vein was big, the area became solely drained by the accessory vein, because the standard hepatic veins (right and intermediate hepatic veins) did not reach the area, and we did not find any communication between the accessory vein and the standard veins. As the remaining region in the segments 6 and 7 became smaller, the draining right standard hepatic vein became shorter and smaller.DiscussionThe region drained by the accessory hepatic vein excluded the standard hepatic veins. Therefore, there are two different draining venous networks in the area of segments 6 and 7 classified by Couinaud.ConclusionThe accessory hepatic vein draining segments 6 and 7 distributed somewhere dorsal side in the segments 6 and 7. The area where the accessory vein distributed was the region where standard hepatic veins did not reach. This would suggest that the region drained by the accessory hepatic vein makes an isolated segment in the liver in the segments 6 and 7 by the Couinaud’s Classification. The area might have a unique blood circulation system.

Surgical anatomy of the innervation of the major duodenal papilla in human and Suncus murinus, from the perspective of preserving innervation in organ-saving procedures.

Objectives: Few studies have focused on the detailed surgical anatomy of the innervation of the major duodenal papillary region, especially in relation to duodenum-preserving pancreatic head resection (DPPHR) and its modified procedures, which is crucial to preserving the innervation of the papillary region. The aim of this study is to clarify the neural distribution of the major duodenal papilla in humans. Methods: The pancreas, duodenum, and surrounding structures were dissected in 10 cadavers and immersed in a 0.001% solution of alizarin red S in ethanol to stain the peripheral nerves. The details of the innervation in the above areas were confirmed using a binocular microscope. Similarly, the distribution in 10 Suncus murinus was examined by whole mount immunohistochemistry method with antineurofilament protein antibody. Results: The innervation of the papillary region in humans involved 2 systems. One arose from the celiac plexus, which through the anterior hepatic plexus running along the arcades of the superior pancreaticoduodenal arteries and through the posterior hepatic plexus running along or accompanying the common bile duct (CBD) or Wirsungs duct, innervated the papillary region. The other arose from the superior mesenteric plexus wound around the arcades of the inferior pancreaticoduodenal arteries innervating the papillary region. The results in S. murinus supported those in humans. Conclusions: We emphasize the importance of the nervus-preserving of the major duodenal papilla and CBD by a suitable pancreatic head remnant, preserving the pancreaticoduodenal arterial arcades and avoiding kocherization of the CBD in DPPHR and its modified procedures.

Gross anatomical study of the sympathetic cardiac nerves in the house musk shrew (Suncus murinus)

The sympathetic cardiac nerves originating from the cervical and upper thoracic sympathetic ganglia in the house musk shrew (Suncus murinus) were examined using macroscopic and whole‐mount immunohistochemical methods. Based on the results, the nerves were macroscopically classified into the following three groups: nerves innervating the cervical sympathetic ganglia mainly to the arterial porta of the heart; nerves supplying the stellate and thoracic sympathetic ganglia at the level of T2–T5 or T6 for both the arterial and venous portae of the heart; and nerves innervating the thoracic sympathetic ganglia at the level of T4–T9 to the esophagus and lung and then the heart via the blood vessels within the mediastinal pleura. These findings in the house musk shrew suggest a possible primitive morphological pattern of the cervical and thoracic sympathetic nervous system that may be related to those in other mammals, including humans. Anat Rec, 2007.

Structure of thymic cysts in congenital lymph nodes-lacking mice.

The ALY (aly/aly) mouse, a mutant of the C57BL/6j strain, has a severe immunodeficiency because of immature development of the immune organs. Both lymph nodes and Peyer’s patches are lacking and both the thymus and spleen are small. Previous microscopical observation of their thymus glands revealed the presence of an indistinct border between the cortex and medulla, the absence of Hassal’s corpuscles and the reduction of the medullary epithelial cell population. However, other microscopical findings for these glands have not yet been reported. In the present study, we performed light and electron microscopical observation of the thymus and found the consistent presence of extremely irregular shaped cystic cavities lined by microvilli‐bearing epithelium in the medulla. The cysts comprised ceca and did not open into adjacent capillaries, although they contained some lymphocytes and macrophages in their lumens. In the thymus glands of normal C57BL/6j mice, only some small cysts oval in shape could be inconspicuously found in the medulla. Therefore, the thymic cysts may normally regress during thymic development, however, in ALY mice, the cysts may remain because of the organ immaturity.

Sequential Histopathology of Pancreatic Tissues in aly/aly Mice

C57BL/6J strain mice carrying the homozygous autosomal recessive mutation alymphoplasia (aly) lack peripheral lymph nodes and Peyer’s patches and exhibit chronic infiltration of lymphocytes into various organs. Pancreatitis, one of the inflammatory lesions, is considered to be of autoimmune origin; however, the target autoantigens have not yet been determined. In this study, pancreatic tissues of male aly/aly mice and wild-type mice at 1–65 weeks of age were light- and electron-microscopically examined to investigate when and how pancreatitis develops. The results showed that macrophages had first appeared and remained in the lymphatic lumen at 3 weeks of age and then a lot of eosinophilic granulocytes infiltrated into the interlobular connective tissues at 5 weeks of age. After the subsidence of eosinophilic inflammation, macrophages and B220+ cells appeared at the perivascular tissues at 9 weeks of age. Thereafter, both CD4+ and CD8+ cells finally participated in the interstitial inflammation from 11 weeks of age. It was noted that these leukocytes had infiltrated into the perivascular interstitium rather than the parenchymal tissues during the course of pancreatitis, although a large parenchymal area was finally degenerated and replaced by adipose tissue.

A case of spontaneous splenorenal shunt associated with splenic artery aneurysm

A case of large spontaneous splenorenal (S-R) shunt accompanied with splenic artery aneurysm is reported in this paper. The large blood vessel, a shunt, anatomizing the splenic vein and left renal vein is macroscopically found during the autopsy of a 71-year-old male, accompanied with liver cirrhosis and splenomegaly. Though there are many reports demonstrating medical imaging, anatomical findings are relatively poor besides describing and illustrating the appearances of the S-R shunt, the splenic artery aneurysm and related branches of the splenic vein and left renal vein, the embryologic and pathogenetic origins of these anomalies are also discussed with the description of the relationship between the S-R shunt and the splenic artery aneurysm.