Origin Of Veins Research Articles

Right Hepatic Vein Injury and Control during Laparoscopic Surgery

Background: Laparoscopic liver resection (LLR) has now been widely performed in experienced centers. One of the worse complications during this surgery, is the hepatic vein injury, because it may cause conversion, air embolization, fatal hemorrhaging, or even death. Methods: We present the video of a 70 Years old male, with a previous history of Colon Cancer, who develops Liver Metastases in the right lobe, one of the lesions is situated close to the origin of the right hepatic vein. The patient is proposed to surgery, he Underwent Laparoscopic Right Hepatectomy. Results: During the surgery the Right hepatic vein is injured, which cause important bleeding, in the video we can observe how to achieve temporary control of the bleeding and proceed to a definitive management, the surgery is ended and the patient recovers successfully. Conclusion: Laparoscopic liver resection is an advanced procedure that requires skillful surgeons trained in this techniques, Hepatic Vein Injuries is one of the worst complications of this surgery. The Backflow bleeding can be minimized with fluid restriction, muscular relaxation and the effect of pneumoperitoneum, but, the experience of the surgeon permits the initial temporary control through laparoscopic, and then, proceed to the definitive management of the complication via laparoscopy or laparotomy.

The origin and nature of hydraulic fractures and veins within the Burren, County Clare, Ireland

The origin and nature of hydraulic fractures and veins within the Burren, County Clare, Ireland

The origin and nature of hydraulic fractures and veins within the Burren, County Clare, Ireland

The origin and nature of hydraulic fractures and veins within the Burren, County Clare, Ireland

Percutaneous portal vein recanalization using self-expandable nitinol stents in patients with non-cirrhotic non-tumoral portal vein occlusion.

The purpose of this study was to evaluate the feasibility, safety, and efficacy of portal vein recanalization (PVR) and propose a new classification for better selecting candidates with portal vein occlusion (PVO) in whom PVR could be feasible. The charts of 15 non-cirrhotic patients in whom stent placement using a trans-hepatic approach was attempted for the treatment of PVO with cavernous transformation were reviewed. There were 12 men and 3 women with a mean age of 47 ± 12 years (range: 22–60 years) [corrected]. Intrahepatic involvement was classified into 3 groups according to the intrahepatic extent of PVO: type 1 included occlusions limited to the origin of the main portal vein and/or the right or left portal branches, type 2 included type 1 plus extension to the origin of segmental branches, type 3 included type 2 plus extension to distal branches. There were 6 patients with PVO type 1, 7 patients with PVO type 2, and 2 patients with PVO type 3. Indications for PVR were gastrointestinal bleeding (n=6), portal biliopathy (n=2), reduce portal pressure before surgery (n=4), or other (n=3). PVR was successful in 13 patients (87%) with no severe side effects. Failure of PVR or early stent thrombosis occurred in 100% of type 3 vs. 8% of type 1 and 2 patients (P=0.03). During a mean follow-up of 42±28 months (range: 6-112 months), patients with a permeable stent had resolution of portal hypertension-related manifestations. In 13 patients in whom PVR was feasible, stent permeability was 77% at 2 years (87% vs. 60% in patients who received anticoagulation or not, respectively; P=0.3). PVR is feasible in most patients with non-cirrhotic, non-tumoral portal vein occlusion when there is no extension of the occlusion to distal branches.

The Origin of Carbonate Veins Within the Sedimentary Cover and Igneous Rocks of the Cocos Ridge: Results From IODP Hole U1414A.

Carbonate veins in the igneous basement and in the lithified sedimentary cover of the Cocos Ridge at International Ocean Discovery Program (IODP) Hole 344‐U1414A reveal the hydrologic system and fluid‐rock interactions. IODP Hole 344‐U1414A was drilled on the northern flank of the Cocos Ridge and is situated 1 km seaward from the Middle America Trench offshore Costa Rica. Isotopic and elemental compositions were analyzed to constrain the fluid source of the carbonate veins and to reveal the thermal history of Hole 344‐U1414A. The formation temperatures (oxygen isotope thermometer) of the carbonate veins in the lithified sedimentary rocks range from 70 to 92 °C and in the basalt from 32 to 82 °C. 87Sr/86Sr ratios of the veins in the altered Cocos Ridge basalt range between 0.707307 and 0.708729. The higher ratios are similar to seawater strontium ratios in the Neogene. 87Sr/86Sr ratios lower 0.7084 indicate exchange of Sr with the igneous host rock. The calcite veins hosted by the sedimentary rocks are showing more primitive 87Sr/86Sr ratios <0.706396. The isotopic compositions indicate seawater, modified into a hydrothermal fluid by subsequent heating, as the main fluid source. Low‐temperature alteration and the presence of a high‐temperature fluid resulted in different carbonate precipitates forming up to several cm thick veins. The geochemical data combined with age data of the sedimentary rocks suggest intraplate seamount volcanism in the area between the Galapagos hot spot and the Cocos Island as an additional heating source, after the formation of the Cocos Ridge at the Galapagos hot spot.

РЕДКИЕ МЕТАЛЛЫ В МИНЕРАЛАХ ОЛОВОНОСНЫХ МЕТАСОМАТИТОВ ВЕРХНЕУРМИЙСКОГО РУДНОГО УЗЛА (ДАЛЬНИЙ ВОСТОК РОССИИ)

Исследована редкометалльная минерализация оловоносных метасоматитов Верхнеурмийского рудного узла на Дальнем Востоке России. Изучен минеральный состав метасоматитов пяти стадий формирования цвиттер-турмалинитового оловоносного комплекса: биотит-серицитовой, мусковит-кварцевой, сидерофиллит-топазовой, кварц-турмалиновой и хлорит-серицитовой. Выделены минералы, содержащие редкие металлы, и оценены концентрации редких металлов.Определена рудно-геохимическая специализация метасоматитов Верхнеурмийского рудного узла. Показано наличие в составе оловоносных метасоматитов района множества минералов редких металлов, имеющих стратегическое значение для развития минерально-сырьевой базы России: Nb, Ta, W, Y, REE (весь спектр от La до Lu), Be, Li, Zr, Hf, In, Sc, Se, Cd. Минералы-концентраторы редких металлов разделены на собственно редкометалльные и минералы (жильные и рудные) с изоморфными примесями редких металлов.Изучена последовательность образования минералов-концентраторов редких металлов района и прослежена эволюция их видового состава. Минералы редких металлов образуются в течение всей истории формирования цвиттер-турмалинитовой формации – от предрудной стадии биотитовых фельдшпатолитов до пострудной стадии хлорититов, включая рудную стадию цвиттеров. Выявлено постадийное снижение интенсивности редкометалльного минералообразования и эволюция состава минерализации от литофильных редких металлов к халькофильным: (LREE, Zr, Hf) → (W, Nb, Ta, Y, HREE, Sc) → (Sn, In, Cd, Se).Выявлены магматический, метасоматический и кристаллохимический факторы образования минералов-концентраторов редких металлов Верхнеурмийского рудного узла. Перспективы узла связаны с наличием литий-фтористых гранитов правоурмийского комплекса, контролирующих размещение вольфрамово-оловорудных цвиттеров и турмалинитов с попутной редкометалльной минерализацией.

Age and Geochemistry of the Cape Burks Gabbroids (Russkaya Station Area, West Antarctica)

The paper reports first geological, chemical, mineralogical, Sr–Nd chemical–isotope, and geochronological data on the gabbroid massif discovered on the Hobbs coast in the Cape Burks area, West Antarctica. The area is made up of compositionally diverse gabbroids that are intersected by thin vein and dike bodies of mafic, intermediate, and fesic composition. The gabbroids are represented by olivine and olivinefree gabbros and gabbronorites, with sharply subordinate troctolites, gabbro–anorthosites, and anorthosites. The U–Pb SHRIMP–II zircon age of the gabbroids and vein rocks was estimated at 100 ± 1 Ma. The gabbroids were supposedly emplaced in the upper crust in tectonically active conditions. The thickness of the pluton is no less than 2.5–3 km. The rocks were crystallized from a highly fractionated melt. Their composition was mainly determined by accumulation and fractional crystallization. The origin of vein felsic rocks was likely related to an evolved residual liquid. The igneous complex was formed in a within–plate geodynamic setting, and its primary melts were derived from a weakly LILE enriched lithospheric mantle.

Radical resection of a giant retroperitoneal calcifying fibrous tumor combined with right hepatectomy and reconstruction of the inferior vena cava and bilateral renal veins

BackgroundWe report a case of a giant retroperitoneal calcifying fibrous tumor (CFT) treated by radical tumor resection combined with right hepatectomy and reconstruction of the inferior vena cava (IVC) and bilateral renal veins. Only three case reports of CFT arising in the retroperitoneum have been reported until today.Case presentationIn a 19-year-old female patient, computed tomography (CT) images showed a well-demarcated expansile lesion around the IVC accompanied by focal calcification, whereas the IVC that was circumferentially surrounded by the lesion was dilated due to the desmoplastic reaction. On magnetic resonance imaging (MRI), the lesion demonstrated heterogeneous hypointensity on T2-weighted images. Delayed enhancement was observed on dynamic contrast-enhanced CT and MRI. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images showed increased FDG uptake [maximum standardized uptake values (SUVmax), early image 7.28; delayed image 7.40]. On operative examination, because the tumor adhered to the liver parenchyma, the right Glisson capsule, and the origin of bilateral renal veins, radical tumor resection combined with right hepatectomy and reconstruction of the IVC and bilateral renal veins was performed.ConclusionsRadical tumor resection was successfully and appropriately performed for a young patient with a giant retroperitoneal CFT with a view to achieving complete venous reconstruction and safe surgical margins for a potentially malignant tumor.

Pure Laparoscopic Transhepatic Enucleation of a Mucinous Cystic Neoplasm Abutting the Major Hepatic Veins at the Hepatocaval Confluence (with Video)

BackgroundA mucinous cystic neoplasm (MCN) of the liver is a rare disease entity, occurring predominantly in the left hemiliver as reported by Simo et al.1 Thomas et al.2 and Vogt et al.3 Surgical resection of tumors at the hepatocaval confluence is a technically demanding procedure. Enucleation procedures have been performed for the management of benign or premalignant lesions such as cystic tumors as previously described by Thomas et al.2 and Vogt et al.3. We present a patient who underwent pure laparoscopic transhepatic enucleation to treat a MCN abutting the major hepatic veins at the hepatocaval confluence. MethodsWe treated a 77-year-old man who presented with a 5-cm-sized cystic mass at the hepatocaval confluence. Using the Pringle maneuver, we performed liver parenchymal transection along the junction between the origin of the middle hepatic vein (MHV) and the inferior vena cava (IVC) as reported by Kim4. The MHV formed the left-sided boundary of the cystic mass. After dissection of the left boundary of the cystic wall, the dorsal side of the cystic mass was carefully dissected. Liver parenchymal transection was continued up to the right hepatic vein (RHV). Laparoscopic enucleation was performed to expose the RHV and MHV, as well as the IVC. ResultsThe operation time was 270 min, the estimated blood loss was 80 mL, and no transfusion was necessary in this patient. The final histopathological diagnosis of the mass was MCN. Postoperatively, the patient recovered uneventfully, and he was discharged on postoperative day 5. ConclusionsLaparoscopic transhepatic enucleation for MCNs at the hepatocaval confluence is technically feasible and offers the benefits of a parenchyma-sparing resection. However, this procedure requires a high level of technical skills and shows a steep learning curve.

Bilateral “quadriceps gastrocnemius” and termination of small saphenous vein outside the popliteal fossa in a cadaver

The gastrocnemius muscle located on the posterior compartment of the leg, has two heads. Muscular variations presumably seriously compromise parts of the muscular, vascular, nervous, and skeletal and/or organ systems. The main causes of gastrocnemius muscle variation may be due to an error of embryologic developmental timing or persistence of an embryologic condition. On the other hand, variations in the origin, course, and termination of the superficial veins of the lower limb are common. However, variations of the short saphenous are rarely reported. Knowledge on the anatomical variations of structures has clinical significance to surgeons, radiologists who interpret plain and computerized imaging.

Типы нарушения проведения в легочных венах

Recently, the notion that in 60-80 % of cases the origin of the pulmonary veins (PV) is the place of origin of atrial fibrillation (AF) has become widespread. It has been shown that in this area, under the action of norepinephrine (HA), in the absence of stimulation, an intrinsic rhythm appears. Using two-channel microelectrode leads (from the mouth and distal part of the PV) in rats weighing 350-450 grams, it was found that: 1) in the distal part of PV there are cells with depolarized resting potential (RP) up to -50 mV, which under normal conditions are not excitable; 2) in 17 experiments out of 23, various blocks of excitation conduction along PV were revealed; 3) in 8 experiments out of 23, a reflected excitation wave - echo from PV - was recorded. Myocardium of PV is an extremely heterogeneous medium with a strong variance in the duration of the action potential and variable rate of conduction, which contributes to the occurrence of different types of conduction blocks and causes echoes and other rhythm disturbances.

Cystic vein: a guide for safer laparoscopic cholecystectomy

Background: Major complications of laparoscopic cholecystectomy are bleeding and bile duct injury, and it is necessary to clearly identify structures endoscopically to keep bleeding and injury from occurring. The aim of this study was to depict the anatomic landmark in the Calots triangle, a vein (cystic vein), a constant feature which can help Laparoscopic surgeons to conduct a safe LC along with other precautions to be adopted. Methods: A total of 100 patients (58 male, 42 female) who underwent cholecystectomy were examined preoperatively by clinically. The origin and number of cystic veins and their relationship with the Calot triangle was evaluated. Results: The cystic veins were delineated intraoperatively in 80 of the 93 patients. The relationship between the cystic vein and the Calot triangle was identified in 80 (86.02%) of the 93 patients. One cystic vein was found in 53 (66.25%) patients, while multiple cystic veins were found in 27 (33.75%) patients. All these veins are above the cystic common bile duct junction. Conclusion: The configuration of the cystic veins and their relationship in the Calot triangle with cystic artery and cystic duct can be identified intraoperatively and used as a guideline for safe laparoscopic cholecystectomy.

Geochemistry and origin of organic-rich sediment veins in fractured granitic basement, Helmsdale, Sutherlandshire, UK

Black sediment veins up to 2 cm width penetrate the Caledonian Helmsdale Granite in the vicinity of the Helmsdale Fault, onshore Moray Firth. The black colour and geochemistry of the veins reflect a high content of organic carbon. Both Devonian and Jurassic shales are conceivable available sources, but sterane compositions relate the organic matter to the Jurassic shales. A content of extractable organic matter higher than in the shales suggests that the carbon in the veins represents oil rather than mechanically mobilized shale. The oil was present during sediment vein emplacement. The veins were emplaced forcefully, which may reflect high fluid pressure associated with post-Jurassic movement on the Helmsdale Fault.

The sapheno femoral junction involvement in the treatment of varicose veins disease

Sapheno femoral junction (SFJ) incompetence has been considered the most important cause of chronic venous insufficiency in a high percent of cases since the beginning of history varicose veins treatment. As a consequence SFJ dissection, ligation and section has been practiced all along the last century, generally associated to great saphenous vein stripping, with the porpoise of stopping the effect of hydrostatic pressure considered the origin of varicose veins. Recurrence prevalence at the site of SFJ, even in correctly performed dissection suggests that this attitude may not be the ideal one. Moreover, with the introduction of catheter-based systems of endovenous heating of the great saphenous vein with radiofrequency or endovenous laser ablation, it was shown that venous ablation could be achieved without high ligation of the SFJ. Also foam sclerotherapy demonstrated good results, even if less effective, always leaving the SFJ untouched. Following this trend several methods have been suggested that spare the SFJ, so that this site have lost its strategical importance. In this review history of the SFJ involvement in the varicose vein strategy is analyzed with particular attention to the new generation methods, technology assisted, launched on the market.

Surgical Resection of Malignancies Invading Inferior Vena Cava Level I and II. Issues Still Need to Be Discussed.

Abdominal malignancies invading inferior vena cava present high postoperative morbidity and poor prognosis that has been decreasing in the last years. Our aim was to present and discuss a series of resected tumors invading the inferior vena cava from the origin of the hepatic vein to the common iliac veins (Level I and II). We retrospectively evaluated from 2005 to 2015 short- and long-term results of 20 consecutive surgical resections of tumors with associated inferior vena cava resection at Levels I and II performed at the Sanchinarro Hospital, Madrid, Spain. The series included 4 leiomyosarcomas, 3 pancreatic cancers, 2 germinal cancers, 5 renal cancers, 4 liver cancers and 2 adrenal cancers. There were 7 circular cava resections, all of them replaced by polytetrafluoroethylene (PTFE) graft and 13 primary repairs. Sapheno-femoral arterio-venous fistulas have been performed in 6 cases. Early postoperative complications occurred in 11 cases (57.9%) and mortality in one case. Graft thrombosis occurred in one case at 14 months from surgery (1/7, 14.2%). Surgical resection with combined inferior vena cava resection can be performed in selected patients with acceptable morbidity and mortality in light of the recent advancement in surgical technique.

Origin of the pegmatite veins within the skarn body at Vevčice near Znojmo (Gf&amp;ouml;hl Unit, Moldanubian Zone)

Origin of the pegmatite veins within the skarn body at Vevčice near Znojmo (Gf&amp;ouml;hl Unit, Moldanubian Zone)

VOLUME-RENDERED ANGIOGRAPHIC AND STRUCTURAL OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY OF MACULAR TELANGIECTASIA TYPE 2.

To evaluate multimodal imaging including volume-rendered angiographic and structural optical coherence tomography of macular telangiectasia Type 2 (MacTel2) for right-angle vein complexes, macular cavitations, and signs of deeper retinal vascular invasion. Retrospective review of imaging performed in a community-based retinal referral center. The eyes were scanned using optical coherence tomography using split-spectrum amplitude-decorrelation techniques to derive flow information. These data were extracted and used to create volume-rendered images of the retinal vasculature with integrated structural information derived from the component optical coherence tomographic images. There were 24 eyes of 16 patients who had a mean age of 61.8 years. Right-angle veins seemed in association with vascular proliferation external to the deep vascular plexus. The origin of a right-angle vein was surrounded by a stellate arrangement of radiating retinal vessels apparently caused by contraction of surrounding tissue in the temporal macula. Cavitations were found in the fovea and varied in size and configuration from one examination to the next. Many smaller cavitations, called microcavitations, were seen in the surrounding macula. Vascular invasion occurred into the subretinal space. There are contractile features of the tissue in the temporal macula and the number, size, and temporal variations in the cavitations have not been in not mentioned in previous published descriptions of MacTel2. Vascular invasion of deeper layers occurred in the temporal macula through the outer nuclear layer. Volume-rendered angiographic and structural optical coherence tomography offers unprecedented ability to examine the vascular interrelationships their associations with cavitations in the macula.

First records of syn-diagenetic non-tectonic folding in quaternary thermogene travertines caused by hydrothermal incremental veining

This study is the first documentation of syn-diagenetic non-tectonic contractional deformations observed in two Pleistocene thermogene travertine deposits from the late Miocene-Pleistocene Tuscan extensional-hydrothermal province (Italy). The deposits consist of primary porous beds hosting secondary bed-parallel carbonate veins. The porous beds are generally flat-lying, particularly in the upper section of the deposits, whereas the veined beds frequently form undulated structures. These structures are up to a few meters in wavelength, are mostly confined within the lower-middle section of the deposits, and are here mostly interpreted as folds. Field observations, U-Th geochronology, and stable isotope analyses are used to characterize the origin of veins and folds. Radiometrically-determined age inversions, structure overprinting relationships, downward growth of vein crystals, deformation of primary sedimentary structures, and downward increasing frequency of veins and folds show that the undulated travertine beds can be mainly interpreted as the product of syn-diagenetic hydrothermal rejuvenation causing non-tectonic veining and folding. The non-tectonic hypothesis is also supported by the absence of contractional deformation in the travertine-hosting sediments. The folds were generated by complex mechanisms including bending and buckling caused by laterally-confined volume expansion during syn-diagenetic circulation of mineralizing fluids and related incremental veining. Modeling some folds with the Biot-Ramberg's buckling equation shows a vein-to-host travertine viscosity ratio between 1.5 and 4, confirming the syn-diagenetic origin of folds. Veining and folding changed some original properties of travertines including rheology, fabric, porosity, and chronological sequence. The identification of these structures and related changes of rock properties (e.g., age rejuvenation) is relevant for the proper interpretation of thermogene travertines as recorders of many geological processes including paleoclimate oscillations, earthquake occurrences, hydrothermal circulations, and uplift or incision rates. Synthesizing, the studied thermogene travertines appear more like sedimentary-hydrothermal-hybrid zoned deposits rather than pure sedimentary systems uniquely responding to the superposition law.

Characteristics of intrahepatic cholangiocarcinoma according to tumor location.

406 Background: Recently, the perihilar cholangiocarcinoma was defined as a tumor existing perihilar region between the right side of the umbilical portion of the left portal vein and the left side of the origin of the right posterior portal vein, in the General Rules for Clinical and Pathological Studies on Cancer of the Biliary Tract (The 6th edition). The study was aimed to investigate characteristics of intrahepatic cholangiocarcinoma (IHCC) according to tumor location. Methods: Study 1: Sixty-two IHCC patients who underwent hepatic resection were divided into the following 3 groups; peripheral type (n=41), perihilar type (n=10) and unclassified type (peripheral type with perihilar invasion: n=11). Clinicopathological data including CA19-9 and immnohistochemical staining of Ki67 and hypoxia inducible factor-1 (HIF-1) were compared. Study 2: The effect of 2 cycles of adjuvant gemcitabine combined with 5-FU and cisplatin (GFP) (Morine and Shimada. Hepatogastroenterology 2009) was retrospectively investigated, in advanced IHCC with one of 3 prognostic factors of LN metastasis, intrahepatic metastasis and R2 resection. Results: Study 1: There was no difference in background variables except for more frequent hilar biliary invasion in perihilar and unclassified types, and the largest tumor size in unclassified-type. The 5-year survival rate in the peripheral, perihilar and unclassified-types were 44%, 20% and 0%, respectively. In addition, CA19-9 level, Ki67 labelling index and positive rate of HIF-1 expression in the unclassified type were higher than those in other 2 types. Multivariate analysis revealed the unclassified type as an independent prognostic factor. Study 2: In 29 patients (47%) having one of the 3 prognostic factors, 9 patients including 4 unclassified-type IHCCs received the adjuvant GFP. The prognosis in GFP group tended to be better than that in non-GFP group (3-year survival rate: 38% vs. 6%, p = 0.07). Two patients with unclassified-type IHCC in non-GFP group died within 1 year after surgery. Conclusions: The unclassified-type IHCC indicated the most aggressive tumor biology, and the adjuvant GFP may be a useful strategy for such a highly malignant tumor with poor prognostic factors.

Left Atrial Myxoma with an Unusual Origin near Right Pulmonary Vein

ABSTRACT Atrial myxoma is the most frequent intracardiac tumor, accounting for nearly 50% of benign cardiac tumours in adults. We present here a rare case report of a solitary left atrial myxoma attached to the left atrial wall near the origin of the right pulmonary vein. The stalk of tumor was not attached to the interatrial septum, which is the most common site of attachment. Instead, it was attached on the wall of left atrium adjacent to the interatrial septum. Surgical exploration confirmed its attachment in the left atrium near the origin of right upper pulmonary vein. How to cite this article Bhardwaj V, Makhija N, Bhoje A, Chitara KK. Left Atrial Myxoma with an Unusual Origin near Right Pulmonary Vein. J Perioper Echocardiogr 2017;5(1):31-33.