Virtual reality technology has been increasingly used in the field of anatomy education, particularly in response to the COVID-19 pandemic. Virtual reality in anatomy (VRA) allows the creation of ...immersive, three-dimensional environments or experiences that can interact in a seemingly real or physical way. A comprehensive search of electronic databases was conducted to identify relevant studies. The search included studies published between 2020 and June 2023. The use of VRA education has been shown to be effective in improving students' understanding and retention of knowledge, as well as developing practical skills such as surgical techniques. VRA can allow students to visualize and interact with complex structures and systems in a way that is not possible with traditional methods. It can also provide a safe and ethical alternative to cadavers, which may be in short supply or have access restrictions. Additionally, VRA can be used to create customized learning experiences, allowing students to focus on specific areas of anatomy or to repeat certain exercises as needed. However, there are also limitations to the use of VRA education, including cost and the need for specialized equipment and training, as well as concerns about the realism and accuracy of VRA models. To fully utilize the potential of VRA education, it is important for educators to carefully consider the appropriate use of VR and to continuously evaluate its effectiveness. It is important for educators to carefully consider the appropriate use of VRA and to continuously evaluate its effectiveness to fully utilize its potential.
Objective
This review article summarises the latest evidence for preventive central lymph node dissection in patients with papillary thyroid cancer taking into account the possible complications and ...risk of recurrence.
Background
Papillary thyroid cancer is the most frequent histological variant of malignant neoplasms of the thyroid gland. It accounts for about 80-85% of all cases of thyroid cancer. Despite good postoperative results and an excellent survival rate in comparison with many other malignant diseases, tumor metastases to the cervical lymph nodes are frequent. Most researchers agree that the presence of obvious metastases in the lymph nodes requires careful lymph node dissection. It was suggested to perform preventive routine lymphadenectomy in all patients with malignant thyroid diseases referred to surgery.
Methods
It was performed the literature review using the “papillary thyroid cancer”, “central lymph node dissection”, “hypocalcemia”, “recurrent laryngeal nerve paresis”, “metastasis”, “cancer recurrence” along with the MESH terms. The reference list of the articles was carefully reviewed as a potential source of information. The search was based on Medline, Scopus, Google Scholar, eLibrary engines. Selected publications were analyzed and their synthesis was used to write the review and analyse the role of preventive central lymph node dissection in patients with papillary thyroid cancer.
Conclusions
The necessity of preventive central lymph node dissection in patients with differentiated papillary thyroid carcinoma is still controversial. There is much evidence that it increases the frequency of transient hypocalcemia. Due to the fact that this complication is temporary, its significance in clinical practice is debatable. It can also be assumed that an extant of surgery in the neck area is associated with an increased risk of recurrent laryngeal nerve injury. However, most studies indicate that this injury is associated more with thyroidectomy itself than with lymph node dissection. Recurrent laryngeal nerve dysfunction is also a temporary complication in the vast majority of cases. At the same time, a large amount of data shows that central lymph node dissection reduces the risk of thyroid cancer recurrence in two times.
Introduction: Renal lobulation (also known as fetal or embryonic lobulation) is a rare variation during development in which renal lobules have a visible anatomical space between them, and this can ...be seen in 0.5–4% of adults. Material and methods: this study was conducted on 54 human kidneys from patients who died due to causes unrelated to renal pathology which were fixed in a 10% formaldehyde solution and then carefully dissected. Results: The group with fetal lobulation (n = 16) was associated with a length M = 9.89 (SD = 0.6, p = 0.15). By comparison, the kidneys without lobulation (n = 38) were associated with a numerically longer length M = 10.29 (SD = 0.607, p = 0.098). To test the hypothesis that lobulation is associated with a statistically significant different length a Mann–Whitney test was performed, which indicated that the length of the kidneys is smaller in scase of lobulation U = 198, Z = −2.04, p = 0.04. Cross-tabulation also demonstrated that kidney lobulation may be influenced by the presence of polar arteries with r = 0.41 (p < 0.02). The likelihood ratio was 7.28, df 1, p = 0.003, with an odds ratio of 6.857 (CI 95% = 1.84–25.61). Logistic regression analysis demonstrated that kidneys with lobulation were 6.85 times more likely to have polar arteries than kidneys without lobulation. Conclusions: the data from our research indicate that even though no pathological conditions have been linked with lobulated kidneys, the incidence of vascular variations (specifically polar arteries) is higher when there is persistent fetal lobulation.
Precise knowledge of the topographic features of the splenic artery and its branches in the hilum region is of practical interest due to the various interventions on the vessels of the spleen.
The ...anatomy of the spleen was studied by means of macroscopic dissection on 330 organ complexes, which were carefully documented and analyzed statistically.
The analysis of the splenic artery trajectory led to identification of four types: straight (43.03%), sinusoidal (27.58%), serpentine (20.91%) and alternating (8.48%). To assess the relation between the trajectory of the splenic artery and its branches we performed a chi square test. Sinuous or serpentine trajectory was associated with the presence of long splenic artery branches (dorsal pancreatic artery or the great pancreatic artery), X2 (2,
= 330) = 12.85,
= 0.001. The artery was located suprapancreatic in 70.30% of cases, anteropancreatic in 4.55%, the vessel had an intrapancreatic course in 14.85% and in 10.00% of cases the artery was located retropancreatic. The presence of inferior polar arteries was associated with a longer pancreas (Spearman's correlation; r = 0.37;
= 0.037). In a multiple regression analysis, inferior polar arteries predicted the length of the pancreas although only a small number of cases could be explained by this model (R2 = 0.127, Adjusted R2 = 0.098; Betta = 0.357; t(330) = 2.091;
= 0.045). There were 30 (9.09%) cases of accessory spleens.
The arterial supply of the spleen is highly variable in its trajectory, terminal branches, and relation to other organs. The splenic artery tends to be sinuous or serpentine in zones when a large artery branches off (e.g., the dorsal pancreatic or greater pancreatic artery). Multiple short branches tend to stabilize the trajectory of the splenic artery. Inferior polar arteries and accessory spleens contribute to the length of the pancreas, most likely due to increased vascular supply to the tail of the gland.
Developmental Variations of the Renal Excretory System Serghei Covantsev; Natalia Pichugina; Malikat Magomedova ...
Online journal of health & allied sciences : OJHAS,
07/2023, Letnik:
22, Številka:
2
Journal Article
Recenzirano
Odprti dostop
Introduction: There are multiple studies about the developmental variations of the arterial and venous system of the kidneys. However, the description of developmental variations of the excretory ...system are not abundantly present in the literature. Material and Methods: The structure of the renal excretory system was studied by means of macroscopic dissection on 90 kidneys. Results: Intrarenal pelvis (type I) when the pelvis is completely located inside the sinus, closed by the parenchyma was encountered in 45 specimens, which corresponds to 50% of cases. The extrarenal pelvis that is located outside the sinus and is not covered by the renal parenchyma was encountered in 9 specimens (10% of cases). Extrarenal type of pelvis with an open posterior surface, when, the posterior surface of the pelvis is free from the parenchyma and the anterior one is covered by the groove of the kidney was encountered in 18 specimens (20% of cases). The mixed type, in which the pelvis is located partly inside the sinus, partly outside of it, was encountered in 16 specimens (17.78% of cases). A special type of pelvis, when the pelvis as such is anatomically absent, and two elongated large calyces, connect and form the ureter was found in 2 cases (2.22%). Pearson correlation analysis demonstrated that calyces’ lengths correlated best when there were two calyces (r=0.51; p<0.001). When the number of calyces increases, this correlation decreased and when there were four of them – disappeared. At the same time, the length of the calyces decreased with an increase in their number (r=0.37; p=0.012). Conclusions: Developmental variations of the renal excretory system are frequent. There are multiple classifications that can be used in clinical practice depending on the surgical or endoscopic procedure. Most of the available classifications aim at assessment of the drainage area of the calyces and anatomical structure of the pelvis.
