ABSTRACT
To observe the topographic localization of the brachial artery termination. This study was conducted at the Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from December 2011 to February 2013. The bifurcation level of the brachial artery was determined in relation to the neck of the radius. Normal and abnormal terminations of the brachial artery were recorded. In 13 cases [21.7%], the bifurcation of brachial artery was normal. In 33 cases [6%], the bifurcation level was a few centimeters below the neck of the radius. In 7 cases [11.7%], the bifurcation level was above the radial neck in the area of cubital fossa. In 6 cases [10%], the termination of the brachial artery was found to be above the middle of the front of the arm. In one of the previous cases, the radial artery arose from the brachial artery on the medial side of the ulnar artery. In one case [1.7%], the radial and the ulnar arteries originated directly from the axillary artery, the brachial artery was absent. Morphological variations of the brachial artery are common findings and should be considered by surgeons when performing procedures in the brachial artery area
ABSTRACT
Objectives: To compare the efficacy, cost effectiveness and safety of both extracorporeal shock-wave lithotripsy [ESWL] and Holmium: YAG laser lithotripsy for the management of upper ureteric stones
Patients and Methods: One hundred and eight patients of various age groups and of both sexes who had primary or recurrent unilateral or bilateral upper ureteric stones underwent 108 primary procedures and 19 ancillary procedures [total: 127] including in-situ ESWL [60 patients] using the Dornier MPL 9000 machine and ureterorenoscopy [URS] combined with Holmium: YAG laser lithotripsy [46 patients]
Results: The overall stone-free rate was 93.75% for the patients subjected to URS ir] combination with laser lithotripsy and 91. 7% for the patients subjected to ESWL. For stones < 1 cm, the success rate was 100% in the laser and 95.65% in the ESWL group. For stones > 1 cm, the success rate was 90% in the laser and 78.6% in the ESWL group. For impacted stones, the success rate was 92.85% in the laser and 72.7% in the ESWL group. The efficiency quotient [EQ] for the laser and ESWL groups was 0.86 and 0.73, respectively. The complication rate was 12.53% in the laser and 11. 7% in the ESWL group. The average cost [in Egyptian pounds] was 1618.1 pounds E for Holmium: YAG laser treatment and 1069.1 pounds E for ESWL treatment
Conclusion: Apart from the treatment of impacted stones and stones larger than 1 cm, ESWL is the first choice as treatment modality for upper ureteric stones. However ESWL and URS combined with holmium: YAG laser lithotripsy may be complementary to each other in treating upper ureteric stones