Are textbook lungs really normal? A cadaveric study on the anatomical and clinical importance of variations in the major lung fissures, and the incomplete right horizontal fissure.

INTRODUCTION: The lungs have three main fissures: the right oblique fissure (ROF), right horizontal fissure (RHF), and left oblique fissure (LOF). These can be complete, incomplete or absent; quantifying the degree of completeness of these fissures is novel. Standard textbooks often refer to the fissures as complete, but awareness of variation is essential in thoracic surgery. MATERIALS AND METHODS: Fissures in 81 pairs of cadaveric lungs were classified. Oblique fissures were measured from lung hila posteriorly to the lung hila anteriorly; and the RHF measured from the ROF to the anteromedial lung edge. The degree of completeness of fissures was expressed as a percentage of the total projected length were they to be complete. The frequency and location of accessory fissures was noted. RESULTS: LOF were complete in 66/81 (81.5%), incomplete in 13/81 (16.0%) and absent in 2/81 (2.47%); ROF were complete in 52/81 (64.2%), incomplete in 29/81 (35.8%) and never absent; RHF were more variable, complete in 18/81 (22.2%), incomplete in 54/81 (66.7%) and absent in 9/81 (11.1%). LOF and ROF were on average 97.1% and 91.6% complete, respectively, being deficient posteriorly at the lung hila. The RHF on average 69.4% complete, being deficient anteromedially. There were accessory fissures in 10 left and 19 right lungs. CONCLUSIONS: This study provides a projection of the anatomy thoracic surgeons may encounter at operation, in particular the variable RHF. This knowledge is essential for optimal outcomes in both benign and oncological procedures influenced by the fissures

Unmet need for family planning in Uttar Pradesh

For more about the East-West Center, see http://www.eastwestcenter.org/In Uttar Pradesh, 30 percent of currently married women of reproductive age have an unmet need for family planning. The percentage of total need that is unmet is especially high among women who are Muslim, who live in rural areas, who are illiterate, whose husbands are illiterate, who belong to scheduled tribes, and who are not exposed to media messages on family planning. The NFHS Subject Reports is a series summarizing secondary analysis of data from the 1992-93 National Family Health Survey (NFHS) in India. The NFHS collected information from nearly 90,000 Indian women on a range of demographic and health topics. Conducted under the auspices of the Indian Ministry of Health and Family Welfare, the survey provides national and state-level estimates of fertility, infant and child mortality, family planning practice, maternal and child health, and the utilization of services available to mothers and children. IIPS conducted the survey in cooperation with consulting organizations and 18 population research centers throughout India. The East-West Center and a U.S.-based consulting firm, Macro International, provided technical assistance, and the United States Agency for International Development (USAID) provided financial support