BACKGROUND The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.AIM To observe brachial artery sympathetic innervation.METHODS We developed a neuroph...BACKGROUND The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.AIM To observe brachial artery sympathetic innervation.METHODS We developed a neurophysiological autonomous test that measured the effects of peripheral sympathetic fibres on peripheral arteries.Our specific objective was to find the sympathetic innervation of the brachial artery.To accomplish this purpose,the brachial artery baseline diameter and flow rate were measured in the right arm of the patients.Afterwards,electrical stimulus was applied to the medial nerve for 5 s.Through electrical sympathetic activation,the vessel diameter and overall flow rate will decrease.After 7 d,a similar experiment was repeated using the ulnar nerve.RESULTS The differences in diameter and flow rate of the brachial artery in response to median and ulnar nerve activation were compared.In the total group,no significant difference in diameter was seen between medial and ulnar nerve stimulation(P=0.648).The difference in absolute slowdown of flow rate between median nerve stimulation and ulnar nerve stimulation was not statistically significant for the entire group(P=0.733).CONCLUSION As a target organ,the brachial artery receives an equal amount of sympathetic innervation from the median and the ulnar nerves.展开更多
Objective: Infra-pyloric artery (IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, ...Objective: Infra-pyloric artery (IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its anatomical variation is not thoroughly understood. Our study aimed to clarify the origination of the IPA. Methods: We did this prospective, multicenter, open-label, observational study at gastric surgery departments of 34 hospitals in China. Gastric cancer patients aged 18 years or older and scheduled to undergo elective total or distal gastrectomy were assigned. During the surgery, IPA dissecting and exposing the origination point with photographs or video clips were required. The primary outcome was the origination of the IPA. Analysis of variance, χ2 tests and Fisher's tests were used to analyze the differences between groups. The study is registered at Clinicaltrials.gov (No. NCT03071237). Results: Between May 8 and July 31, 2017, 429 patients were assigned for the study, and 419 (97.7%) patients had the IPA dissected and recorded through photograph or video and were included in the primary outcome analysis. The median age was 62 years old, and 73.7% were male. Among the patients, 78.5% received laparoscopic surgery. Single IPA origination was identified in 398 (95.0%) patients, including gastroduodenal artery (GDA) in 154 (36.8%) patients, anterior superior pancreaticoduodenal artery (ASPDA) in 130 (31.0%) patients, and right gastroepiploic artery (RGEA) in 114 (27.2%) patients. Fifteen (3.6%) patients were identified with multiple IPA and 6 (1.4%) patients were identified as IPA absence. The differences in the distribution of surgical approach (P=0.003) and geographic area (P=0.030) were statistically significant. No difference was shown in sex, age, gastrectomy type, tumor location, and clinical T, N and M stage. Conclusions: Our study found that the IPA originates from GDA, ASPDA and RGEA in similar proportions. Laparoscopic surgery may be more helpful in dissection of the IPA than open surgery.展开更多
Background: A special pillow was designed to redistribute mechanical stress during sleeping in order to slow down the formation of facial skin wrinkles. Objective: To investigate whether sleeping on a specially design...Background: A special pillow was designed to redistribute mechanical stress during sleeping in order to slow down the formation of facial skin wrinkles. Objective: To investigate whether sleeping on a specially designed pillow reduces facial skin wrinkles. Participants and Methods: A 28-day pilot study was carried out in which fifteen healthy female volunteers aged 23 - 55 years (mean age 35. 6 ± 8.5) slept on an antiwrinkle pillow. Evaluation of facial wrinkles was conducted before commencing the study (T0), following at 14 days (T14), and at 28 days (T28) when the study ended. Wrinkle density was assessed by computerized analysis of 2D images of participants’ faces. Results: A statistically significant decrease in wrinkle density was detected while smiling around both eyes, around the right eye in a relaxed facial expression, on average in all observed facial areas, around the left periorbital area in participants who predominantly slept on their left side of the body, but not on the frontal area. Limitations: A 3D camera could be used to better visualize and analyze wrinkle density. Conclusions: Sleeping on the specially designed pillow reduces facial wrinkles.展开更多
The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation.Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases.This can ...The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation.Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases.This can significantly improve transplantation success.A systematic literature review was performed according to the quality standards described in the AMSTAR measurement tool and the PRISMA guidelines.We valuated existing literature regarding the vascularization and blood perfusion patterns of the pancreas in terms of dominance and variability.The collected data was independently analyzed by two researchers.Variance of vascular anatomy was seen to be underreported in literature,though significant findings have been included and discussed in this study,providing valuable insight into the dynamics of pancreatic perfusion and feasibility of transplantation on several different supplying arteries.The splenic artery(SA)has a high percentage of consistency in all found studies(over 90%).High frequency of anastomoses between arterial pools supplying the pancreas can mediate sufficient blood supply through a dominant vessel,such as the SA,which is present in most cases.Pancreatic transplantation with isolated SA blood supply can provide sufficient arterial perfusion of the pancreas for stable transplant viability due to high anatomical consistency of the SA and vast communications with other arterial systems.展开更多
The macro-micro-anatomy of the lingual artery of 25 adult cadavers wasstudied.The origin of the artery is rather concentrated and the greater cornu of thehyoid bone can be used as the indicator.The entrance of the art...The macro-micro-anatomy of the lingual artery of 25 adult cadavers wasstudied.The origin of the artery is rather concentrated and the greater cornu of thehyoid bone can be used as the indicator.The entrance of the artery into the hyoglossusmuscle is almost constantly along the posterior border of the muscle,where the artery issuperficially located and easily to be exposed,and has a constant relationship with thevein and hypoglossal nerve.Thus the lingual artery can be used as the artery of a recipientarea in case of tongue reconstruction.The deep lingual artery has two types ofbranches;the short ones mainly supply the muscles of tongue while the long ones mainlysupply the mucosa by forming a submucosal network.In the muscles of tongue,minutearterioles run tortuously along the muscular fibers with abundant anastomoses betweeneach other,but no anastomosis is found to cross over the rnidline of the tongue.Be-neath the mucosa,there is an arterial network spreading all over the whole tongue notlimited to one side.The relationship of the arterial architecture to the structure and thefunctions of the tongue and its clinical significance were discussed.展开更多
Objectives: The purpose of this work was to determine the dimensions of CFA before the birth of the deep thigh artery, describe the mode of termination of the CFA, search for CFA collaterals, and describe the anatomic...Objectives: The purpose of this work was to determine the dimensions of CFA before the birth of the deep thigh artery, describe the mode of termination of the CFA, search for CFA collaterals, and describe the anatomical variations of the CFA. Methodology: This was a prospective study conducted at the Anatomy Laboratory of the Faculty of Medicine and Odonto-Stomatology of Bamako. CFA arteries of 12 fresh corpses of adults include 9 men and 3 women. A total of 24 CFA arteries were dissected and photographed. Results: The mean length of CFA was 50.9 ± 12.55 mm (range: 31 and 93 mm). Its average diameter was 9.12 ± 1.17 mm (range: 7 and 12 mm). In 70.83%, the CFA artery ended without any particularity. There was 29.17% anatomic variation in the CFA termination mode. The CFA divided into 3 branches (trifurcation) in 25%. The 3 branches were in 20.83%, the FS and a common core to LFCA and AQ;in 4.17%, they were the SFA, the DFA and the MFCA. In 4.17%, it divided into 4 branches which are: the SFA, the DFA, the MFCA and a common core to QA and LFCA. The CFA gave as collateral: circumflex superficial iliac artery in 22 cases (91.67%), superficial epigastric artery in 19 cases (79.17%), upper external pudendal artery in 20 cases (83.33%), and lower external pudendal artery in 14 cases (58.33%). We noted in our series 9 anatomical variations at the collateral level of the CFA or 37.5%. The CFA gave birth to the following branches: the MFCA in 4 cases or 16.67%, the LFCA in 1 case or 4.17%, the QA in 1 case or 4.17%, and a common core to the QA and LFCA in 3 cases or 12.5%. Conclusion: The length of CFA is important. The variations of CFA are frequent and important to know in clinical and surgical practice.展开更多
Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realiz...Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.展开更多
BACKGROUND The diagnosis and therapy during surgery depend largely on a full account of anatomic characteristics.Apart from regular structures,the common,less common or even uncommon anatomic variations are critical f...BACKGROUND The diagnosis and therapy during surgery depend largely on a full account of anatomic characteristics.Apart from regular structures,the common,less common or even uncommon anatomic variations are critical for procedural planning.This is especially true during craniocerebral microsurgery,where small vascular variations can affect the final surgical results and patient prognosis.CASE SUMMARY Herein,two rare variations concerning the A1(horizontal)segment of anterior cerebral artery(ACA1)were introduced.One enabled the communication between perforating branch of ACA1 and dural artery of anterior skull base,which was discovered during autopsy.The other was ophthalmic artery(OA)originating from ACA1,shown on digital angiography.CONCLUSION In this study,we found two rare anatomical variations.One was an abnormal OA originated from the anterior communicating artery.The other was a perforating branch of the A1 segment of the anterior cerebral artery,which communicated with meningeal vessels in the anterior skull base.This finding is of great significance for the treatment of anterior communicating artery aneurysm or in other anterior skull base surgery.展开更多
Objective To investigate anterior tragal perforating aftery( ATPA) and provide anatomic basis for flap derived from preauricular area. Methods Twenty ( 40 sides) cadaver heads fixed in 10% formalin solution and perfus...Objective To investigate anterior tragal perforating aftery( ATPA) and provide anatomic basis for flap derived from preauricular area. Methods Twenty ( 40 sides) cadaver heads fixed in 10% formalin solution and perfused with red - colored latex were used to perform gross anatomy study. Two heads of fresh cadaver展开更多
To provide anatomic basis for transposition of vascularized radial midforearm flap.Methods On 40 adult cadaveric upper limb specimens injected with red dye,the origin,course,branchs,diameters and anastomosis of interm...To provide anatomic basis for transposition of vascularized radial midforearm flap.Methods On 40 adult cadaveric upper limb specimens injected with red dye,the origin,course,branchs,diameters and anastomosis of intermuscular branch of radial artery and its cutaneous branch were observed.Results Originating from radial artery,intermuscular branch of radial artery descended along periosteum closely between pronator teres and supinator,the main stem was (4.8±1.0)cm in length and (1.2±0.2)mm in diameter.After its periosteal branches were sent off to distribute over middle and inferior shaft of radius,its cutaneous branch perforated from intermuscle and deep fascia and anastomosed with some other cutaneous branches in the forearm.Perforating point of the cutaneous branch was located (11.1±1.3)cm beneath lateral epicondyle of humerus,its diameter was about (0.6±0.1)mm.Conclusion Radial midforrarm flap pedicled with intermuscular branch of radial artery can be transferred to repair soft tissue defect of elbow,forearm or hand.7 refs.展开更多
Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The...Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The rapid advancement of imaging techniques, including computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography, have provided us with a wealth of new information on the subject. Anomalous origin of a coronary artery from the contralateral sinus is the anomaly most frequently associated with sudden cardiac death, in particular if the anomalous coronary artery has a course between the aorta and the pulmonary artery. However, other coronary anomalies, like anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae, have also been implicated in cases of sudden cardiac death. Patients are usually asymptomatic, and in most of the cases, coronary anomalies are discovered incidentally during coronary angiography or on autopsy following sudden cardiac death. However, in some cases, symptoms like angina, syncope, heart failure and myocardial infarction may occur. The aims of this article are to present a brief overview of the diverse coronary variants and anomalies, focusing especially on anatomical features, clinical manifestations, risk of sudden cardiac death and pathophysiologic mechanism of symptoms, as well as to provide valuable information regarding diagnostic workup, follow-up, therapeutic choices and timing of surgical treatment.展开更多
The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery...The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy. Extensive iconography supports the text, with particular attention to images obtained in vivo using non-invasive imaging. We have divided this article into three groups, according to their frequency in the general population: Normal, normal variant and anomaly. Although congenital coronary artery anomalies are relatively uncommon, they are the second most common cause of sudden cardiac death among young athletes and therefore warrant detailed review. Based on the functional relevance of each abnormality, coronary artery anomalies can be classified as anomalies with obligatory ischemia, without ischemia or with exceptional ischemia. The clinical symptoms may include chest pain, dyspnea, palpitations, syncope, cardiomyopathy, arrhythmia, myocardial infarction and sudden cardiac death. Moreover, it is important to also identify variants and anomalies without clinical relevance in their own right as complications during surgery or angioplasty can occur.展开更多
Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of cases.It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid i...Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of cases.It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid injuries that might compromise the liver function.In the present case the liver donor had the vascular anatomy of Michels typeⅦ,e.g.a hepatic artery originating from the celiac trunk and going to the left lobe,an accessory left hepatic artery coming from the left gastric artery,and a replaced right hepatic artery coming from the superior mesenteric artery.This pattern of vascular supply is uncommon,representing less than 5%of cases.The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery,and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.展开更多
The shortage of organs and the increasing median age of deceased donors for orthotropic liver transplantation stimulate transplant centres to accept grafts that otherwise would have been discarded due to severe vascul...The shortage of organs and the increasing median age of deceased donors for orthotropic liver transplantation stimulate transplant centres to accept grafts that otherwise would have been discarded due to severe vascular abnormali- ties. We encountered a donor with two arterial aneurysms and a left accessory hepatic artery: an arterial aneurysm of the common hepatic artery and a left accessory hepatic artery arising from a second aneurysm of the left gastric artery (Mi- chels type V). A complex reconstruction was created to trans- plant the liver. Multiple arterial anastomosis was made and the hepatic inflow of the transplanted liver restored. Although the procedure increased the risk of hepatic artery thrombosis, one more organ supposed to be discarded was saved.展开更多
The precise anatomy of the facial nerve branches innervating rat whisker pad and the distribution of their corresponding motor neurons in facial nucleus area were investigated.The extratemporal facial nerves of 6 rats...The precise anatomy of the facial nerve branches innervating rat whisker pad and the distribution of their corresponding motor neurons in facial nucleus area were investigated.The extratemporal facial nerves of 6 rats were anatomically observed under a surgical microscope,and then the nerve specimens of facial nerve branches at 7 anatomical sites were taken and examined for the axons and myelin sheath using Luxol fast blue staining.The distribution of facial motor neurons innervating the facial branches was observed in 12 rats by retrograde labelling.The distal pes,a fusing architecture of the buccal and marginal mandibular branches,was found to furcate into superior,middle and inferior branches to innervate whisker pad.Histologically,the myelin sheath of each branch was morphologically consistent,and the nerve fiber bundles of facial nerve branches became increasingly thinner and scattered,particularly after crossing the distal pes site and innervating the whisker pad.The facial motor neurons innervating the buccal and marginal mandibular branches were clearly distributed in similar regions in facial nucleus.This study confirmed the highly spatial synergy between the buccal and marginal mandibular branches innervating the whisker pad from extratemporal anatomy and distribution of facial motor neurons.展开更多
BACKGROUND AND OBJECTIVE: To avoid recurrent laryngeal nerve (RLN) injury during thyroid surgery, it is important to identify the nerve and to follow its projection carefully to discriminate it from the inferior th...BACKGROUND AND OBJECTIVE: To avoid recurrent laryngeal nerve (RLN) injury during thyroid surgery, it is important to identify the nerve and to follow its projection carefully to discriminate it from the inferior thyroid artery. DESIGN, TIME AND SETTING: All studies were performed at the Anatomy Division of Shaoyang Medical College from May 2003 to May 2004 with repeated measurement design. MATERIALS: Fifty embalmed adult corpses, comprising 20 females and 30 males, were obtained by donation. METHODS AND MAIN OUTCOME MEASURES: The projection, branches, and the relationship of the RLN to the inferior thyroid artery were observed. RESULTS: The RLN in all cases ascended through the tracheoesophageal groove at the isthmus superior levels of the thyroid gland. However, the RLN in 14 cases were situated inferior to the isthmus of the thyroid gland; 11 cases were to the right side and 2 cases to the left side, projected in the tracheoesophageal groove, and ascended away from the groove after 4.5-6.5 mm. The RLN typically ramified at the thyroid isthmus plane (44 cases, 44% of all cases). The RLN branches were variable. Type 2 rami were most common in the RLN, accounting for 55%; the second most common was RLN branches with no rami. RLN braches with type 3 rami, 4 rami, and 5 rami were less common. Approximately 54% of nerves were situated behind the main branch artery. The nerves located adjacent to the arteries, and between the arterial branches, were similar; the former applied to 19 cases, accounting for 19%, whereas the latter applied to 18 cases, accounting for 18%. Left nerves behind the artery, and right nerves before the artery, were more common. There were significant differences between the left and right nerves (P 〈 0.01). CONCLUSION: There was not a significant difference in the projection of the RLN, while a significant difference in the number of RLN branches existed. In addition, the anatomical relationship of the RLN and the inferior thyroid artery exhibited side differences.展开更多
Objective:To investigate the anatomical basis of Rubens'flap based on the deep circumflex iliac artery,and to apply more donor site tissue amount for big chest wall defect.Methods:Gross anatomical study was carrie...Objective:To investigate the anatomical basis of Rubens'flap based on the deep circumflex iliac artery,and to apply more donor site tissue amount for big chest wall defect.Methods:Gross anatomical study was carried on 8 sides of fresh specimens of 4 cases and data was measured by mean of the Vernier caliper.Besides,the surgical simulation was carried on 1 specimen(2 sides).Results:At the inguinal segment,the via artery gave off(9.16±6.22)branches;the diameter of the origin was(3.97±0.86)mm;the distance from starting point to the first branch was(15.87±9.24)mm;amount of osteomusculocutaneous branch was 3.12±1.34;the biggest diameter of perforator was(1.48±1.02)mm;pedicle length was(132.51±48.24)mm.In the surgical simulation,the layers of Ruben's flap from up to down ranged in skin,subcutaneous tissue,obliquus externus abdominis,oblique internal abdominis and transversus abdominis.Conclusion:Rubens'flap,with large tissue amount,based on the deep circumflex iliac artery,near to traditional abdominal flap,has a good clinical application prospect in breast reconstruction and repair of big chest wall defect,for its thin waist effect and slight donor site defect.展开更多
文摘BACKGROUND The sympathetic nervous system makes medium and large peripheral arteries smaller to slow the blood flowing through them.AIM To observe brachial artery sympathetic innervation.METHODS We developed a neurophysiological autonomous test that measured the effects of peripheral sympathetic fibres on peripheral arteries.Our specific objective was to find the sympathetic innervation of the brachial artery.To accomplish this purpose,the brachial artery baseline diameter and flow rate were measured in the right arm of the patients.Afterwards,electrical stimulus was applied to the medial nerve for 5 s.Through electrical sympathetic activation,the vessel diameter and overall flow rate will decrease.After 7 d,a similar experiment was repeated using the ulnar nerve.RESULTS The differences in diameter and flow rate of the brachial artery in response to median and ulnar nerve activation were compared.In the total group,no significant difference in diameter was seen between medial and ulnar nerve stimulation(P=0.648).The difference in absolute slowdown of flow rate between median nerve stimulation and ulnar nerve stimulation was not statistically significant for the entire group(P=0.733).CONCLUSION As a target organ,the brachial artery receives an equal amount of sympathetic innervation from the median and the ulnar nerves.
基金funded by the Gastric Cancer Diagnose and Treatment Project(D171100006517004,D17110700650000)of Beijing Municipal Science&Technology Commissionsupported by Beijing Municipal Administration of Hospital Clinical Medicine Development of Special Funding Support(ZYLX201701)
文摘Objective: Infra-pyloric artery (IPA) is an important anatomical landmark in treatment of gastric cancer and is the key vessel for pylorus-preserving gastrectomy and subgroup of infra-pyloric lymph nodes. However, its anatomical variation is not thoroughly understood. Our study aimed to clarify the origination of the IPA. Methods: We did this prospective, multicenter, open-label, observational study at gastric surgery departments of 34 hospitals in China. Gastric cancer patients aged 18 years or older and scheduled to undergo elective total or distal gastrectomy were assigned. During the surgery, IPA dissecting and exposing the origination point with photographs or video clips were required. The primary outcome was the origination of the IPA. Analysis of variance, χ2 tests and Fisher's tests were used to analyze the differences between groups. The study is registered at Clinicaltrials.gov (No. NCT03071237). Results: Between May 8 and July 31, 2017, 429 patients were assigned for the study, and 419 (97.7%) patients had the IPA dissected and recorded through photograph or video and were included in the primary outcome analysis. The median age was 62 years old, and 73.7% were male. Among the patients, 78.5% received laparoscopic surgery. Single IPA origination was identified in 398 (95.0%) patients, including gastroduodenal artery (GDA) in 154 (36.8%) patients, anterior superior pancreaticoduodenal artery (ASPDA) in 130 (31.0%) patients, and right gastroepiploic artery (RGEA) in 114 (27.2%) patients. Fifteen (3.6%) patients were identified with multiple IPA and 6 (1.4%) patients were identified as IPA absence. The differences in the distribution of surgical approach (P=0.003) and geographic area (P=0.030) were statistically significant. No difference was shown in sex, age, gastrectomy type, tumor location, and clinical T, N and M stage. Conclusions: Our study found that the IPA originates from GDA, ASPDA and RGEA in similar proportions. Laparoscopic surgery may be more helpful in dissection of the IPA than open surgery.
文摘Background: A special pillow was designed to redistribute mechanical stress during sleeping in order to slow down the formation of facial skin wrinkles. Objective: To investigate whether sleeping on a specially designed pillow reduces facial skin wrinkles. Participants and Methods: A 28-day pilot study was carried out in which fifteen healthy female volunteers aged 23 - 55 years (mean age 35. 6 ± 8.5) slept on an antiwrinkle pillow. Evaluation of facial wrinkles was conducted before commencing the study (T0), following at 14 days (T14), and at 28 days (T28) when the study ended. Wrinkle density was assessed by computerized analysis of 2D images of participants’ faces. Results: A statistically significant decrease in wrinkle density was detected while smiling around both eyes, around the right eye in a relaxed facial expression, on average in all observed facial areas, around the left periorbital area in participants who predominantly slept on their left side of the body, but not on the frontal area. Limitations: A 3D camera could be used to better visualize and analyze wrinkle density. Conclusions: Sleeping on the specially designed pillow reduces facial wrinkles.
文摘The variability of vascular anatomy of the pancreas underlines the difficulty of its transplantation.Research regarding the consistency of anatomical variations shows splenic arterial dominance in most cases.This can significantly improve transplantation success.A systematic literature review was performed according to the quality standards described in the AMSTAR measurement tool and the PRISMA guidelines.We valuated existing literature regarding the vascularization and blood perfusion patterns of the pancreas in terms of dominance and variability.The collected data was independently analyzed by two researchers.Variance of vascular anatomy was seen to be underreported in literature,though significant findings have been included and discussed in this study,providing valuable insight into the dynamics of pancreatic perfusion and feasibility of transplantation on several different supplying arteries.The splenic artery(SA)has a high percentage of consistency in all found studies(over 90%).High frequency of anastomoses between arterial pools supplying the pancreas can mediate sufficient blood supply through a dominant vessel,such as the SA,which is present in most cases.Pancreatic transplantation with isolated SA blood supply can provide sufficient arterial perfusion of the pancreas for stable transplant viability due to high anatomical consistency of the SA and vast communications with other arterial systems.
文摘The macro-micro-anatomy of the lingual artery of 25 adult cadavers wasstudied.The origin of the artery is rather concentrated and the greater cornu of thehyoid bone can be used as the indicator.The entrance of the artery into the hyoglossusmuscle is almost constantly along the posterior border of the muscle,where the artery issuperficially located and easily to be exposed,and has a constant relationship with thevein and hypoglossal nerve.Thus the lingual artery can be used as the artery of a recipientarea in case of tongue reconstruction.The deep lingual artery has two types ofbranches;the short ones mainly supply the muscles of tongue while the long ones mainlysupply the mucosa by forming a submucosal network.In the muscles of tongue,minutearterioles run tortuously along the muscular fibers with abundant anastomoses betweeneach other,but no anastomosis is found to cross over the rnidline of the tongue.Be-neath the mucosa,there is an arterial network spreading all over the whole tongue notlimited to one side.The relationship of the arterial architecture to the structure and thefunctions of the tongue and its clinical significance were discussed.
基金Professor Seydou Doumbia for his financial support for the article
文摘Objectives: The purpose of this work was to determine the dimensions of CFA before the birth of the deep thigh artery, describe the mode of termination of the CFA, search for CFA collaterals, and describe the anatomical variations of the CFA. Methodology: This was a prospective study conducted at the Anatomy Laboratory of the Faculty of Medicine and Odonto-Stomatology of Bamako. CFA arteries of 12 fresh corpses of adults include 9 men and 3 women. A total of 24 CFA arteries were dissected and photographed. Results: The mean length of CFA was 50.9 ± 12.55 mm (range: 31 and 93 mm). Its average diameter was 9.12 ± 1.17 mm (range: 7 and 12 mm). In 70.83%, the CFA artery ended without any particularity. There was 29.17% anatomic variation in the CFA termination mode. The CFA divided into 3 branches (trifurcation) in 25%. The 3 branches were in 20.83%, the FS and a common core to LFCA and AQ;in 4.17%, they were the SFA, the DFA and the MFCA. In 4.17%, it divided into 4 branches which are: the SFA, the DFA, the MFCA and a common core to QA and LFCA. The CFA gave as collateral: circumflex superficial iliac artery in 22 cases (91.67%), superficial epigastric artery in 19 cases (79.17%), upper external pudendal artery in 20 cases (83.33%), and lower external pudendal artery in 14 cases (58.33%). We noted in our series 9 anatomical variations at the collateral level of the CFA or 37.5%. The CFA gave birth to the following branches: the MFCA in 4 cases or 16.67%, the LFCA in 1 case or 4.17%, the QA in 1 case or 4.17%, and a common core to the QA and LFCA in 3 cases or 12.5%. Conclusion: The length of CFA is important. The variations of CFA are frequent and important to know in clinical and surgical practice.
文摘Aim: This study aimed at describing the anatomical variations of the external branch of the superior laryngeal nerve and at estimating the frequency of nerves at risk during the thyroid surgery. Methodology: We realized a forward-looking study from September, 2016 in May 31st, 2018 in the laboratory of anatomy of the Faculty of Medicine and Odontostomatology of Bamako in Mali. All the fresh anatomical subjects not carrying trauma and or a scar at the level of the previous region of the neck were held. The anatomical subjects were not included presenting a traumatic lesion and\or a scar of the previous region of the neck. Results: We realized 34 dissections of the external branch of the superior laryngeal nerve to 17 deathly subjects (11 men and 6 women with a sex-ratio of 1.8). The average age of the subjects was of 42 years (extremes: 18 and 70 years). Our study allowed highlighting in 100% of the cases, the external branch of the superior laryngeal nerve and the superior thyroid artery so to the right as to the left. On 34 dissected external branch of the superior laryngeal nerve, none had a previous route. However we found 28 nerves (82.4%) having a later route, stuck to the external face of the lower constrictor of the pharynx. These were not mixed with the superior thyroid artery and its branch of division and were situated outside the thyroid capsule. In 17.6% of the cases (6 cases), the nerve had a route mixed in the branch of the superior thyroid artery. These were found inside of the capsule (11.8% adhered to the artery and 5.8% crossed its branch of division). Conclusion: The risk of injury of the external laryngeal nerve during thyroid surgery procedure is never zero. It is more important on the left side.
文摘BACKGROUND The diagnosis and therapy during surgery depend largely on a full account of anatomic characteristics.Apart from regular structures,the common,less common or even uncommon anatomic variations are critical for procedural planning.This is especially true during craniocerebral microsurgery,where small vascular variations can affect the final surgical results and patient prognosis.CASE SUMMARY Herein,two rare variations concerning the A1(horizontal)segment of anterior cerebral artery(ACA1)were introduced.One enabled the communication between perforating branch of ACA1 and dural artery of anterior skull base,which was discovered during autopsy.The other was ophthalmic artery(OA)originating from ACA1,shown on digital angiography.CONCLUSION In this study,we found two rare anatomical variations.One was an abnormal OA originated from the anterior communicating artery.The other was a perforating branch of the A1 segment of the anterior cerebral artery,which communicated with meningeal vessels in the anterior skull base.This finding is of great significance for the treatment of anterior communicating artery aneurysm or in other anterior skull base surgery.
文摘Objective To investigate anterior tragal perforating aftery( ATPA) and provide anatomic basis for flap derived from preauricular area. Methods Twenty ( 40 sides) cadaver heads fixed in 10% formalin solution and perfused with red - colored latex were used to perform gross anatomy study. Two heads of fresh cadaver
文摘To provide anatomic basis for transposition of vascularized radial midforearm flap.Methods On 40 adult cadaveric upper limb specimens injected with red dye,the origin,course,branchs,diameters and anastomosis of intermuscular branch of radial artery and its cutaneous branch were observed.Results Originating from radial artery,intermuscular branch of radial artery descended along periosteum closely between pronator teres and supinator,the main stem was (4.8±1.0)cm in length and (1.2±0.2)mm in diameter.After its periosteal branches were sent off to distribute over middle and inferior shaft of radius,its cutaneous branch perforated from intermuscle and deep fascia and anastomosed with some other cutaneous branches in the forearm.Perforating point of the cutaneous branch was located (11.1±1.3)cm beneath lateral epicondyle of humerus,its diameter was about (0.6±0.1)mm.Conclusion Radial midforrarm flap pedicled with intermuscular branch of radial artery can be transferred to repair soft tissue defect of elbow,forearm or hand.7 refs.
文摘Coronary artery anomalies and variants are relatively uncommon congenital disorders of the coronary artery anatomy and constitute the second most common cause of sudden cardiac death in young competitive athletes. The rapid advancement of imaging techniques, including computed tomography, magnetic resonance imaging, intravascular ultrasound and optical coherence tomography, have provided us with a wealth of new information on the subject. Anomalous origin of a coronary artery from the contralateral sinus is the anomaly most frequently associated with sudden cardiac death, in particular if the anomalous coronary artery has a course between the aorta and the pulmonary artery. However, other coronary anomalies, like anomalous origin of the left coronary artery from the pulmonary artery, atresia of the left main stem and coronary fistulae, have also been implicated in cases of sudden cardiac death. Patients are usually asymptomatic, and in most of the cases, coronary anomalies are discovered incidentally during coronary angiography or on autopsy following sudden cardiac death. However, in some cases, symptoms like angina, syncope, heart failure and myocardial infarction may occur. The aims of this article are to present a brief overview of the diverse coronary variants and anomalies, focusing especially on anatomical features, clinical manifestations, risk of sudden cardiac death and pathophysiologic mechanism of symptoms, as well as to provide valuable information regarding diagnostic workup, follow-up, therapeutic choices and timing of surgical treatment.
基金financial support from the Department of Health via the National Institute for Health Research comprehensive Biomedical Research Centre award to Guy’s and St Thomas’ NHS Foundation Trust in partnership with King's College London and King’s College Hospital NHS Foundation TrustThe Centre of Excellence in Medical Engineering funded by the Wellcome Trust and EPSRC under grant number WT 088641/Z/09/Z+2 种基金King’s College London and UCL Comprehensive Cancer Imaging CentreFunded by the CRUK and EPSRC in association with the MRC and Do H (England)Funded by the British Heart Foundation award RE/08/003
文摘The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy. Extensive iconography supports the text, with particular attention to images obtained in vivo using non-invasive imaging. We have divided this article into three groups, according to their frequency in the general population: Normal, normal variant and anomaly. Although congenital coronary artery anomalies are relatively uncommon, they are the second most common cause of sudden cardiac death among young athletes and therefore warrant detailed review. Based on the functional relevance of each abnormality, coronary artery anomalies can be classified as anomalies with obligatory ischemia, without ischemia or with exceptional ischemia. The clinical symptoms may include chest pain, dyspnea, palpitations, syncope, cardiomyopathy, arrhythmia, myocardial infarction and sudden cardiac death. Moreover, it is important to also identify variants and anomalies without clinical relevance in their own right as complications during surgery or angioplasty can occur.
文摘Vascular anatomy of the liver is varied,and the 'standard'anatomy is seen in 55%-80%of cases.It is very important that extrahepatic arteries are identified precisely at the time of graft procurement to avoid injuries that might compromise the liver function.In the present case the liver donor had the vascular anatomy of Michels typeⅦ,e.g.a hepatic artery originating from the celiac trunk and going to the left lobe,an accessory left hepatic artery coming from the left gastric artery,and a replaced right hepatic artery coming from the superior mesenteric artery.This pattern of vascular supply is uncommon,representing less than 5%of cases.The replaced hepatic artery was reconstructed in the back-table with polypropylene suture 7.0 by connecting it to the stump of the splenic artery,and the celiac trunk of the graft was anastomosed to the recipient common hepatic artery.
文摘The shortage of organs and the increasing median age of deceased donors for orthotropic liver transplantation stimulate transplant centres to accept grafts that otherwise would have been discarded due to severe vascular abnormali- ties. We encountered a donor with two arterial aneurysms and a left accessory hepatic artery: an arterial aneurysm of the common hepatic artery and a left accessory hepatic artery arising from a second aneurysm of the left gastric artery (Mi- chels type V). A complex reconstruction was created to trans- plant the liver. Multiple arterial anastomosis was made and the hepatic inflow of the transplanted liver restored. Although the procedure increased the risk of hepatic artery thrombosis, one more organ supposed to be discarded was saved.
文摘The precise anatomy of the facial nerve branches innervating rat whisker pad and the distribution of their corresponding motor neurons in facial nucleus area were investigated.The extratemporal facial nerves of 6 rats were anatomically observed under a surgical microscope,and then the nerve specimens of facial nerve branches at 7 anatomical sites were taken and examined for the axons and myelin sheath using Luxol fast blue staining.The distribution of facial motor neurons innervating the facial branches was observed in 12 rats by retrograde labelling.The distal pes,a fusing architecture of the buccal and marginal mandibular branches,was found to furcate into superior,middle and inferior branches to innervate whisker pad.Histologically,the myelin sheath of each branch was morphologically consistent,and the nerve fiber bundles of facial nerve branches became increasingly thinner and scattered,particularly after crossing the distal pes site and innervating the whisker pad.The facial motor neurons innervating the buccal and marginal mandibular branches were clearly distributed in similar regions in facial nucleus.This study confirmed the highly spatial synergy between the buccal and marginal mandibular branches innervating the whisker pad from extratemporal anatomy and distribution of facial motor neurons.
文摘BACKGROUND AND OBJECTIVE: To avoid recurrent laryngeal nerve (RLN) injury during thyroid surgery, it is important to identify the nerve and to follow its projection carefully to discriminate it from the inferior thyroid artery. DESIGN, TIME AND SETTING: All studies were performed at the Anatomy Division of Shaoyang Medical College from May 2003 to May 2004 with repeated measurement design. MATERIALS: Fifty embalmed adult corpses, comprising 20 females and 30 males, were obtained by donation. METHODS AND MAIN OUTCOME MEASURES: The projection, branches, and the relationship of the RLN to the inferior thyroid artery were observed. RESULTS: The RLN in all cases ascended through the tracheoesophageal groove at the isthmus superior levels of the thyroid gland. However, the RLN in 14 cases were situated inferior to the isthmus of the thyroid gland; 11 cases were to the right side and 2 cases to the left side, projected in the tracheoesophageal groove, and ascended away from the groove after 4.5-6.5 mm. The RLN typically ramified at the thyroid isthmus plane (44 cases, 44% of all cases). The RLN branches were variable. Type 2 rami were most common in the RLN, accounting for 55%; the second most common was RLN branches with no rami. RLN braches with type 3 rami, 4 rami, and 5 rami were less common. Approximately 54% of nerves were situated behind the main branch artery. The nerves located adjacent to the arteries, and between the arterial branches, were similar; the former applied to 19 cases, accounting for 19%, whereas the latter applied to 18 cases, accounting for 18%. Left nerves behind the artery, and right nerves before the artery, were more common. There were significant differences between the left and right nerves (P 〈 0.01). CONCLUSION: There was not a significant difference in the projection of the RLN, while a significant difference in the number of RLN branches existed. In addition, the anatomical relationship of the RLN and the inferior thyroid artery exhibited side differences.
基金This study was supported by Capital Development Fund(Grant No.20093010)Clinical Characteristic Application of Capital City(Grant No.Z111107058811097)+2 种基金Research and Development Fund of Peking University People's Hospital(Grant No.RDC2014-27)Research and Development Fund of Peking University People's Hospital(Discipline Cultivation Project)(Grant No.RDD2016-05)Youth Fund Project of Natural Science Foundation of Hainan Province(2018)(Grant No.818QN313).
文摘Objective:To investigate the anatomical basis of Rubens'flap based on the deep circumflex iliac artery,and to apply more donor site tissue amount for big chest wall defect.Methods:Gross anatomical study was carried on 8 sides of fresh specimens of 4 cases and data was measured by mean of the Vernier caliper.Besides,the surgical simulation was carried on 1 specimen(2 sides).Results:At the inguinal segment,the via artery gave off(9.16±6.22)branches;the diameter of the origin was(3.97±0.86)mm;the distance from starting point to the first branch was(15.87±9.24)mm;amount of osteomusculocutaneous branch was 3.12±1.34;the biggest diameter of perforator was(1.48±1.02)mm;pedicle length was(132.51±48.24)mm.In the surgical simulation,the layers of Ruben's flap from up to down ranged in skin,subcutaneous tissue,obliquus externus abdominis,oblique internal abdominis and transversus abdominis.Conclusion:Rubens'flap,with large tissue amount,based on the deep circumflex iliac artery,near to traditional abdominal flap,has a good clinical application prospect in breast reconstruction and repair of big chest wall defect,for its thin waist effect and slight donor site defect.