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Fetal gall bladder development: A histo-morphometric study 胎儿胆囊发育:组织形态计量学研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/NJCA.NJCA_89_21
A. Jaiswal, Ankit Kaushik, Akshay K. Singh, D. Sinha
Background: The gall bladder development in fetal life is complex and starts as early as the 4th week of gestation; the abnormal development of the gall bladder is associated with various congenital abnormalities. The objective of the present study was to study fetal gall bladder development in relation to gestational age (GA) among fetuses. Methodology: In a cross-sectional observational study of 29 fetuses, the gall bladder parameters and histological changes are evaluated at different gestational age. The fetus was categorized based on GA into three categories of <20 weeks, 21–30 weeks, and 31 weeks and above. After dissection of the abdomen, the shape and location of the gall bladder were observed. The relationship of gall bladder with liver was observed. The gall bladder length (GBL) and gall bladder width (GBW) were measured. The histogenesis of the gall bladder was observed among all fetuses and developmental changes were noted. Results: The study included 29 fetuses, 14 males and 15 females. The first, second, and third groups comprised 5, 14, and 10 fetuses. The GA ranged from 13 to 35 weeks. The mean crown-rump length (CRL) of the fetuses was 19.34 ± 6.32 cm. The mean GBL was 2.06 ± 0.83 cm and the mean GBW was 0.77 ± 0.32 cm. The GBL and GBW increased with CRL, GA, and weight. The strong positive correlation was observed between GBL, GBW with GA and CRL. On microscopy, among the first group, fetal gall bladder at 13 weeks showed solid structure with obliterated lumen and area of early canalization. The muscular layer initially was very thin and comprised only few haphazardly arranged muscle fiber in the first group, the thickness was found to be more in the second group and a well-formed adult-like muscular layer was found in the third group. The loose connective tiisue, the outer most layer was pronounced in the third group. Conclusion: The fetal gall bladder parameters show linear increase with GA and CRL. The location, size, and relation of the fundus with margin of gall bladder in fetus undergo changes with the development of the fetus. The fetal gall bladder undergoes marked histological changes during development.
背景:胎儿时期胆囊的发育是复杂的,早在妊娠第4周就开始了;胆囊的异常发育与多种先天性异常有关。本研究的目的是研究胎儿胆囊发育与胎龄(GA)的关系。方法:对29例胎儿进行横断面观察研究,对不同胎龄的胆囊参数和组织学变化进行评估。根据GA将胎儿分为<20周、21-30周、31周及以上三类。剖腹后,观察胆囊形态及位置。观察胆囊与肝脏的关系。测量胆囊长度(GBL)和胆囊宽度(GBW)。在所有胎儿中均观察到胆囊的组织发生和发育变化。结果:29例胎儿,男14例,女15例。第一组、第二组和第三组分别有5名、14名和10名胎儿。GA为13至35周。胎体平均冠臀长(CRL)为19.34±6.32 cm。平均GBL为2.06±0.83 cm,平均GBW为0.77±0.32 cm。GBL和GBW随CRL、GA和体重增加而增加。GBL、GBW与GA、CRL呈显著正相关。显微镜下,在第一组中,13周时的胎儿胆囊显示实心结构,管腔闭塞,早期有胆管形成。肌肉层最初非常薄,第一组只有少量随意排列的肌肉纤维,第二组的肌肉层厚度更大,第三组的肌肉层形成良好的成人肌肉层。第三组结缔组织疏松,最外层明显。结论:胎儿胆囊参数随GA和CRL的增加呈线性增加。胎儿胆囊底缘的位置、大小和关系随着胎儿的发育而发生变化。胎儿胆囊在发育过程中有明显的组织学变化。
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引用次数: 0
Sexual dimorphism and clinical importance of posterior condylar canal 髁突后管的两性异形及其临床意义
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/NJCA.NJCA_65_21
Suchismita Das
Background: The posterior condylar canal (PCC) and its associated emissary vein are important anatomical landmarks for juxta-condylar approach and extreme lateral approach for exposing lesions in the region lateral to the foramen magnum. The study aimed to provide a complete gender-based assessment of the morphological characteristics of PCC in an adult central Indian population. Methodology: The study was conducted on 130 dry adult central Indian human skulls of known sex (81 males, 49 females). The presence of PCC on both sides, their patency, variations, and site of internal opening in relation to important anatomical landmarks, i.e., sigmoid sulcus, jugular foramen, and foramen magnum were assessed. Results: The PCC and probe patency were statistically more common bilaterally than unilateral. Females showed statistically significant higher incidence of bilateral PCC and bilateral probe patency than males. Three morphological variations in PCC were found, i.e., double condylar canal, septation, and spur. They showed no significant gender differences. In both sexes, bilateral intrasinus was the most common type of internal opening of PCC. Internal opening into jugular foramen, foramen magnum, and retro sinus was significantly more unilaterally than bilateral. Significant gender differences in unilateral intrasinus and unilateral retro sinus type of internal opening were noted. Conclusion: This study gives knowledge about the comparison of various morphological variations of PCC in both sexes of an adult central Indian population, and its clinical impact on the surgeries of this region.
背景:髁后管及其相关的发射静脉是髁旁入路和极外侧入路暴露大孔外侧病变的重要解剖标志。该研究旨在对印度中部成年人群PCC的形态特征进行全面的基于性别的评估。方法:本研究对130个已知性别的干燥成年印度中部人类头骨(81个男性,49个女性)进行了研究。评估两侧PCC的存在、其通畅性、变异以及与重要解剖标志(即乙状结肠沟、颈静脉孔和大孔)相关的内部开口位置。结果:PCC和探针通畅性在统计学上双侧比单侧更常见。女性双侧PCC和双侧探针通畅率高于男性,具有统计学意义。PCC有三种形态变异,即双髁管、间隔和骨刺。他们没有表现出显著的性别差异。在两性中,双侧窦内是PCC最常见的内部开口类型。颈静脉孔、大孔和窦后的内口单侧明显多于双侧。单侧窦内型和单侧窦后型内开口存在显著的性别差异。结论:本研究对印度中部成年人群中PCC的各种形态变异进行了比较,并对该地区的手术产生了临床影响。
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引用次数: 0
Research in anatomy: Challenges and opportunities amid the COVID-19 pandemic 解剖学研究:新冠肺炎大流行中的挑战和机遇
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/NJCA.NJCA_5_22
N. Pushpa, S. Viveka, K. Ravi
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引用次数: 0
Attainment of Indian Medical Graduate (IMG) roles through the curriculum: The untold stakeholder perspective 印度医学研究生(IMG)在课程中扮演的角色:不为人知的利益相关者视角
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.4103/NJCA.NJCA_74_21
T. Gugapriya, Sithikantha Banarjee, M. Girish, Sachin Damke, Shital Bhattad
Background: Graduate Medical Education Regulations 1997 and “Vision 2015” documents were the steps toward training a skilled and competent Indian Medical Graduate (IMG). To implement the changes in the curriculum and to achieve the IMG goal, a nation-wide faculty development program was started by the Medical Council of India in 2009. Even before the introduction of Competency-Based Medical Education (CBME) in 2019, the Indian medical curriculum imbibed and trained the Graduates in competencies relevant for an IMG. This research was to attempt to understand the stakeholder perspective of the contribution of the curriculum in attaining the IMG roles prior to 2019. Methodology: The present multicentric study was carried out among 450 interns belonging to batch 2018 in the state of Maharashtra. A self-administrated, online, structured questionnaire containing 27 items based on IMG roles was used as the study instrument. Descriptive analysis was performed to arrive at the perception of stakeholders. Results: Analysis of self-rating of the competency for IMG roles showed a 30.7% for the “leader and as a team member role”. A detailed analysis noted that the majority of the participants lacked confidence in the role of the “medical expert.” Competency in the psychomotor domain gained maximum self-rating in comparison to the affective domain. The overall rating about their undergraduate training toward five IMG roles had an unsatisfactory score of 56.3% for the “lifelong learner” role. Conclusion: The study highlighted the stakeholder perspective about curriculum equipping them in developing “leader and a team member” while failing with “lifelong learner” IMG role. The study also emphasized that the attitudinal domain needs addressing by the CBME curriculum.
背景:《1997年研究生医学教育条例》和《2015年愿景》文件是培养一名技术娴熟、能力出众的印度医学研究生(IMG)的步骤。为了实施课程改革并实现IMG目标,印度医学委员会于2009年启动了一项全国教师发展计划。甚至在2019年引入基于能力的医学教育(CBME)之前,印度医学课程就吸收并培训了毕业生与IMG相关的能力。本研究旨在了解利益相关者对2019年之前课程在实现IMG角色方面的贡献的看法。方法:本多中心研究在马哈拉施特拉邦2018批次的450名实习生中进行。使用一份自我管理的、在线的、结构化的问卷,其中包含27个基于IMG角色的项目,作为研究工具。进行描述性分析以得出利益相关者的看法。结果:对IMG角色能力的自评分析显示,“领导者和团队成员角色”的自评率为30.7%。一项详细的分析指出,大多数参与者对“医学专家”的角色缺乏信心。与情感领域相比,心理运动领域的能力获得了最大的自我评价。对于“终身学习者”角色,他们对五个IMG角色的本科生培训的总体评分为56.3%,令人不满意。结论:该研究强调了利益相关者的观点,即课程使他们能够培养“领导者和团队成员”,而不能胜任“终身学习者”IMG角色。该研究还强调,态度领域需要通过CBME课程来解决。
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引用次数: 0
Learning human anatomy amid COVID-19 pandemic: A students' perspective 新冠肺炎大流行期间学习人体解剖学:学生的观点
Q4 Medicine Pub Date : 2021-10-01 DOI: 10.4103/njca.njca_85_21
Halima Albalushi, Mohamed Al Mushaiqri, Ruqaiya Al Jabri
Introduction: Many countries adopted remote teaching upon the declaration of COVID-19 pandemic. Like many universities around the world, Sultan Qaboos University in the Sultanate of Oman shifted to emergency remote teaching (ERT) to contain the spread of the virus. In addition, anatomy classes were shifted to be taught online completely. This study aimed to explore students' perspective about the impact of COVID-19 pandemic on anatomy learning. Methodology: Students enrolled in anatomy courses during spring 2020 semester were asked to fill a questionnaire within 4 weeks of the end of online classes. The questionnaire included questions about students' perceptions and preferences about learning anatomy during ERT. Results: Findings indicated that coronavirus pandemic was disruptive to students' anatomy learning. Fulfilling courses requirements, home environment, internet connection, the anatomy knowledge without exposure to cadavers, and other resources in the lab were their main concerns. The reliability of internet connection was a major factor affecting their way of studying anatomy and selecting learning resources. Social media platforms were helpful in assisting students in their study and communication between themselves and their instructors. However, assessment and practical part teaching were not satisfactory to the students and they urge improvement. Conclusion: COVID-19 pandemic was disruptive to anatomy education. Internet connection was the major obstacles for the students, while the social media platforms were helpful tools in study and communication. Students urged improvement in the practical part teaching and assessment of the anatomy courses.
简介:新冠肺炎疫情宣布后,许多国家采用了远程教学。与世界各地的许多大学一样,阿曼苏丹国的苏丹卡布斯大学转向了紧急远程教学(ERT),以遏制病毒的传播。此外,解剖学课程完全改为在线教学。本研究旨在探讨学生对新冠肺炎大流行对解剖学学习影响的看法。方法:要求2020年春季学期参加解剖学课程的学生在网课结束后4周内填写问卷。该问卷包括关于学生在ERT期间对学习解剖学的看法和偏好的问题。结果:研究结果表明,冠状病毒大流行对学生的解剖学学习造成了干扰。满足课程要求、家庭环境、互联网连接、不接触尸体的解剖学知识以及实验室中的其他资源是他们主要关心的问题。网络连接的可靠性是影响他们学习解剖学和选择学习资源的主要因素。社交媒体平台有助于帮助学生进行学习以及与导师之间的交流。然而,评估和实践部分教学并不令人满意,他们敦促改进。结论:新冠肺炎疫情对解剖学教育具有破坏性。互联网连接是学生的主要障碍,而社交媒体平台是学习和交流的有用工具。学生们敦促在解剖学课程的实践部分教学和评估方面有所改进。
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引用次数: 1
Acute lymphoblastic leukemia in Indian children at a tertiary care center: A multiparametric study with prognostic implications 三级护理中心印度儿童急性淋巴细胞白血病:一项具有预后意义的多参数研究
Q4 Medicine Pub Date : 2021-10-01 DOI: 10.4103/njca.njca_49_21
S. Jha, Dinesh Kumar
Background: Leukemia is a varied group of hematological malignancies due to uncontrolled proliferation of blast cells. Among childhood leukemias, acute lymphoblastic leukemia (ALL) comprise 70%–80% of all childhood leukemias in India. The current study aims to report the various prognostic markers of disease severity. Methodology: Bone marrow and peripheral blood samples from 20 patients of ALL were subjected to cytogenetic and flow cytometric analysis after recording clinical history and laboratory findings. Patients were classified according to immunophenotyping markers.: For risk stratification, patients were divided into two subgroups B ALL and T ALL. The age group of majority of patients was 1–9 years (90%) with 5% each belonging to <1 and >9 years. Male: female ratio was 1.1:1. Results: Hepatosplenomegaly, lymphadenopathy, and mediastinal involvement was found in 45%, 40%, and 5% of patients, respectively. Hemoglobin levels <5 g/dl and >5 g/dl were seen in 50% of patients in each range. White blood cell counts >50,000 were seen in 3 (15%) of patients. Cytogenetic analysis revealed hypodiploid karyotype for majority (64%) of cases, normal karyotype in 28% and hyperdiploidy in rest (7%). Structural aberrations like t (21;4), del (5p), dic (5) were found all in B ALL subgroup. Patients were stratified into high and standard risk groups based on good and prognostic factors. Conclusions: This study reinforces the significance of immunophenotyping cytogenetics, clinical presentation as a prognostic tool, and their significance in risk stratification.
背景:白血病是一种由原始细胞不受控制的增殖引起的多种血液系统恶性肿瘤。在儿童白血病中,急性淋巴细胞白血病(ALL)占印度所有儿童白血病的70%-80%。目前的研究旨在报告疾病严重程度的各种预后标志物。方法:对20例ALL患者的骨髓和外周血进行细胞遗传学和流式细胞术分析,记录临床病史和实验室结果。根据免疫表型标记物对患者进行分类。对于风险分层,将患者分为B ALL和T ALL两个亚组。患者年龄以1-9岁为主(90%),9岁各占5%。男女比例为1.1:1。结果:肝脾肿大、淋巴结病变和纵隔受累分别占45%、40%和5%。在每个范围内,50%的患者血红蛋白水平为5 g/dl。3例(15%)患者白细胞计数达50万。细胞遗传学分析显示,大多数病例(64%)为次二倍体核型,28%为正常核型,其余为超二倍体(7%)。t(21.4)、del (5p)、dic(5)等结构畸变均出现在B all亚组。根据良好和预后因素将患者分为高危组和标准高危组。结论:本研究强调了免疫表型细胞遗传学、临床表现作为预后工具的重要性,以及它们在风险分层中的重要性。
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引用次数: 1
Histomorphometric study of renal corpuscles of human and goat 人和山羊肾小体的组织形态计量学研究
Q4 Medicine Pub Date : 2021-10-01 DOI: 10.4103/njca.njca_72_21
G. Rasool, Pratima Jaiswal, Aarushi Jain, Shiv K. Sharma
Background: The nephron is the functional and structural unit of the kidney and greatly varies in its structure among different vertebrates; also the formation of nephron shows a variable degree of differences among species. This study was done to compare the size of the renal corpuscle, glomerulus, and urinary space between human and goat kidneys. Methodology: This observational descriptive type of the study was done in the Department of Anatomy, Government Medical College, Kota from December 2019 to January 2021, after seeking proper approval from the Institutional Review Board and Ethical Committee for the study. Seventy human and 70 goat kidney tissues were taken for this study. The stained sections were studied under light microscopy for the diameter of renal corpuscles and glomeruli were measured in ×400 by MICAPS camera and software attached on microscope. The observed data were analyzed, and calculated by MedCalc software version 20.0.3. Data were subjected to independent sample t-test and results were compared and were considered significant at P < 0.05. Results: The renal corpuscles had the mean greatest and least diameter of 131.57 μ and 131.49 μ in humans. While respective values were 157.95 μ and 142.61 μ in goats. The glomeruli had mean maximum and minimum diameter of 112.80 μ and 111.60 μ in humans and 128.20 μ and 119.59 μ in goats. Mean urinary space distance that was 9.66 μ and 13.19 μ in humans and goats, respectively. Conclusions: The present is useful for anatomists and veterinary doctors, comparative anatomists, anthropologists, and histologists.
背景:肾单位是肾脏的功能和结构单位,不同脊椎动物的结构差异很大;肾单位的形成也显示出不同物种之间不同程度的差异。这项研究是为了比较人和山羊肾脏的肾小体、肾小球和尿路间隙的大小。方法:这项观察性描述性研究于2019年12月至2021年1月在科塔政府医学院解剖系进行,此前该研究已获得机构审查委员会和伦理委员会的适当批准。本研究采集了70个人体和70个山羊肾组织。染色切片在光学显微镜下进行研究,用MICAPS相机和显微镜上的软件测量肾小体和肾小球的直径,单位为×400。通过MedCalc软件20.0.3版对观测数据进行分析和计算。对数据进行独立样本t检验,并对结果进行比较,认为其具有显著性(P<0.05)。结果:人类肾小体的平均最大和最小直径分别为131.57μ和131.49μ。山羊分别为157.95μ和142.61μ。人类肾小球的平均最大和最小直径分别为112.80μ和111.60μ,山羊肾小球的平均直径分别为128.20μ和119.59μ。人类和山羊的平均尿路间隔分别为9.66μ和13.19μ。结论:本书对解剖学家和兽医、比较解剖学家、人类学家和组织学家都很有用。
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引用次数: 1
The memory storing synthetic brain cells 储存合成脑细胞的记忆
Q4 Medicine Pub Date : 2021-10-01 DOI: 10.4103/njca.njca_128_21
N. Pushpa, K. Ravi
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引用次数: 0
Uterine parameters of clinical importance in North Indian females of reproductive age – An ultrasonographic evaluation 北印度育龄妇女子宫参数的临床重要性超声评价
Q4 Medicine Pub Date : 2021-10-01 DOI: 10.4103/njca.njca_93_20
A. Arya, Sushma Tomar, R. Diwan, A. Pandey, P. Manik
Introduction: The uterine size is important during planning of assisted reproductive techniques and hysterectomy and there is no established normative data from the women of northern India, this study was undertaken with the objective to report the normal length, width and anteroposterior lengths of non-gravid uterus. Methodology: In a prospective observational study, conducted in Department of Anatomy in collaboration with Departments of Radiology, Obstetrics and Gynecology of King George's Medical University, Lucknow, the ultrasonographic measurements of non-gravid uterus were noted. The ultrasonography was performed on females in dorsal decubitus position having full urinary bladder. Uterine position was identified by placing the probe on suprapubic area Length and anteroposterior diameter of uterus were measured by placing the probe in longitudinal direction (sagittal plane). Length was measured from fundus to external os. The anteroposterior diameter is maximum measurement in mid sagittal plane of body of uterus. The transducer was rotated up to 90 degree to measure the transverse diameter. Transverse diameter is the maximum measurement in transverse plane across the fundus. The volume of uterus was calculated. Results: The study included transabdominal ultrasonographic measurements of 100 females of age range 19-49 years (mean age 34.06 ± 0.35 years). Mean length, transverse diameter, anteroposterior diameters and volume noted were 7.71 (±0.47) cm, 4.63 (±0.33) cm, 3.75 (±0.31) cm and 70.54 (± 9.68) cm3. Conclusion: Normative values of uterine length, width and anteroposterior diameters of one-hundred non-pregnant women of northern India reported. Accurate measurement of uterine parameters is useful in timely management of various pathologies associated with abnormal size of uterus, infertility related procedures; such as in-vitro fertilization (IVF), embryo transfer (ET) and intrauterine device insertion.
子宫大小在辅助生殖技术和子宫切除术的规划中很重要,并且没有来自印度北部妇女的既定规范数据,本研究旨在报告非妊娠子宫的正常长度,宽度和前后长度。方法:在一项前瞻性观察研究中,解剖系与勒克瑙乔治国王医科大学放射学、产科和妇科合作进行,记录了非妊娠子宫的超声测量。超声检查的对象为膀胱满尿的女性,采用背卧位。将探头置于耻骨上区确定子宫位置,在纵向(矢状面)放置探头,测量子宫长度和前后径。测量从眼底到外眼的长度。子宫前后径是子宫体正中矢状面最大测量值。传感器旋转90度以测量横向直径。横径是眼底横切面上的最大测量值。计算子宫体积。结果:对100例女性进行了经腹超声检查,年龄19 ~ 49岁,平均年龄34.06±0.35岁。平均长度、横径、前后径和体积分别为7.71(±0.47)cm、4.63(±0.33)cm、3.75(±0.31)cm和70.54(±9.68)cm3。结论:报告了100例印度北部非孕妇子宫长度、宽度和前后径的正常值。子宫参数的准确测量有助于及时处理与子宫异常大小、不孕相关的各种病理;如体外受精(IVF),胚胎移植(ET)和宫内节育器插入。
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引用次数: 0
Morphological variations of pulmonary veins draining into left atrium: A detailed cadaveric study 左心房肺静脉引流的形态学变化:一项详细的尸体研究
Q4 Medicine Pub Date : 2021-10-01 DOI: 10.4103/njca.njca_65_20
Prasenjit Bose, U. Choudhary, Pooja Singh, Barkha Singh, Royana Singh
Introduction: During pulmonary vein isolation ablation procedure, the knowledge of number and position of pulmonary veins with thickness of posterior wall of left atrium (LA) is of invaluable significance. The objective of the study was to determine the left atrial wall thickness (LAWT) and its relationship with number and variations of right pulmonary veins (RPVs) and left pulmonary veins (LPVs). Methodology: In an observational study, carried out in the Department of Anatomy, All India Institute of Medical Sciences, Raipur (Chhattisgarh), morphological variations of pulmonary veins among 75 formalin-fixed hearts were noted. The thickness of posterior wall of LA was measured in each specimen studied. The number of RPVs and LPVs was counted. Any sexual differences in these numbers were noted. Results: Normal anatomical description of two RPVs and two LPVs opening the LA was observed in 63 out of 75 heart specimens (84%). The posterior LAWT is ranged 1.28–1.48 mm where two RPVs and two LPVs enter LA. The remaining 12 specimens (16%) showed variation in the number of veins opening into LA ranging between 1 and 5 veins of either side. The posterior LAWT ranged between 1.01 and 2.53 mm in these 12 specimens. The mean posterior LAWT thickness with 3, 4, and 5 RPVs was 1.47, 1.94, and 2.43 mm, respectively. Conclusion: The thickness of posterior wall of LA increases as the number of RPVs increases. Twelve specimens (16%) showed variation in the number of veins opening into LA ranging between 1 and 5 veins of either side.
在肺静脉隔离消融术中,了解肺静脉的数量和位置与左心房后壁(LA)厚度的关系是非常重要的。本研究的目的是确定左房壁厚度(LAWT)及其与右肺静脉(rpv)和左肺静脉(lpv)数量和变化的关系。方法:在拉伊普尔(恰蒂斯加尔邦)全印度医学科学研究所解剖学系进行的一项观察性研究中,注意到75颗福尔玛固定心脏的肺静脉形态学变化。在每个研究标本中测量LA后壁的厚度。日志含义统计rpv和lpv的个数。注意到这些数字中的任何性别差异。结果:75例心脏标本中有63例(84%)观察到两条rpv和两条lpv打开LA的正常解剖描述。后部LAWT范围为1.28-1.48 mm,其中两个rpv和两个lpv进入LA。其余12个标本(16%)的静脉数量在两侧1 - 5条静脉之间变化。在这12个标本中,后侧LAWT在1.01 - 2.53 mm之间。rpv为3,4,5时,后侧LAWT平均厚度分别为1.47,1.94和2.43 mm。结论:后壁厚度随rpv数的增加而增加。12例(16%)的标本显示,每侧有1 - 5条静脉进入LA。
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引用次数: 0
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National Journal of Clinical Anatomy
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