ABSTRACT
To investigate the variations of the renal segments in Korean adults. the findings of selective renal arteriograms from l3O kidneys were analyzed. The boundary on the lateral surface of the kidney between the areas supplied by anterior and posterior branches of the renal artery was investigated by analysis of the findings of 100 renal arteriograms. In 75% of the cases the boundary was observed to be posterior to the lateral borderline of the kidney and the configuration of it was variable. Under the definition of the segmental artery as the eecorrd branch of the renal artery that could be tied outside the hilum, the distribution of the renal segments was observed. The number of the renal segments in a kidney ranged from 3 to 7 and the frequency was 1.6%. 24.2%. 50.8%. 22.6% and 0.8% in the order of increment. The 5-segment-kidney, the most common form described in many textbooks, was observed in 50.8% of the cases and also was the most common form in this study. In most of the cases(90%) superior and inferior segments were observed. The level of each boundary of the superior and inferior segments was observed on the ventral and dorsal surface of the kidney and compared. The level was identical on both surfaces in 56.1% and 31.8 5t of the superior and inferior segments respectively. The variations in the origin and the number of arteries supplying the superior and inferior segments was compared and the result revealed more complex variations in the former. From the viewpoint of clinical application these results may provide useful information and important suggestions for renal conservative surgery. Considering that the distribution of the renal segments is variable and the number and origin of the arteries supplying the superior and inferior segments, which are frequently indicated for partial nephrectomy. are variable. it may contribute to better surgical results if surgeons observe and decide the resection margin preoperatively by taking the selective renal arteriography from several directions.
Subject(s)
Adult , Humans , Angiography , Arteries , Kidney , Nephrectomy , Renal ArteryABSTRACT
The cavernous sinus is a extradural venous pathway enclosed by leaves of dura and periosteum located on either side of the sella turcica, and has connections with cerebrum, cerebellum, brain stem and orbit. It contains the internal carotid artery, the abducens nerve, and the sympathetic nerves, and its lateral wall contains the third and fourth cranial nerves as well as the first and sometimes the second division of the fifth cranial nerve. These connections and the relationships make the sinus of special interest to neurosurgeons. However, the descriptions of the cavernous sinus and its contents show great variation in books and journals. To better define this anatomy, in this report, eighty cavernous sinuses from fresh cadavers were studied in detail using surgical microscope with special attention to the relationships imprortant in surgical approaches on the intracavernous structures, and twenty cavernous sinuses were studied, based on serial sections in the coronal planes for the study of the microanatomical structures. The results of this study were summarized as follows : 1) The average distance between the posterior clinoid process and the entrance of the 3rd, 4th, 5th, 6th cranial nerve into the cavernous sinus were 5.99+/-1.69, 12.00+/-2.83, 15.44+/-2.38, 17.85+/-3.12mm. 2) The lateral wall of the sinus was composed of two layers : a deep layer is formed by the sheathes of nerve III, IV, and VI with a reticular membrane and some dural fold, and the deep layer was less defined and more irregular and imcomplete. 3) The average length of the Parkinson's striangle was 14.76+/-3.40mm(superior), 18.54+/-3.96mm(inferior), 6.33+/-2.14mm(posterior). 4) There were many variations in the origin and course of the sixth nerve. Among these, calssic pattern which originated and run all its course to the orbit as a single trunk is 67.5%.
Subject(s)
Abducens Nerve , Brain Stem , Cadaver , Carotid Artery, Internal , Cavernous Sinus , Cerebellum , Cerebrum , Cranial Nerves , Membranes , Orbit , Periosteum , Sella Turcica , Trigeminal Nerve , Trochlear NerveABSTRACT
The description of the carotid artery and venous structure in the cavernous sinus, because of their size and location, was very short or even absent in the most anatomical textbooks. But, since the report of a direct surgical approach to the cavernous sinus by Parkinson in 1965, there has been an increasing number of reports of successful direct surgical approaches to the cavernous sinus. With the introduction of microsurgery and the developement of new techinques and surgical approach, a more accurate knowledge of vascular anatomy of the cavernous sinus is not only of theoretical academic interest, but may also have implications. To better study this vascular anatomy, eighty cavernous sinuses from fresh cadavers of adult subjects were dissected under the operating surgical microscope. A red solution of resin was injected to facilitate the dissection, and twenty cavernous sinuses were studied, based on serial sections in the coronal planes for the study of the venous structure of the cavernous sinus. The results of this study were summarized as follows. 1) The most common branch of internal carotid artery in the cavernous sinus was the meningohypophyseal trunk, the largest intracavernous branch, which was presented in 100% of our specimens, the inferior cavernous artery, in 96.3%, and capsular artery, in 13.8%. 2) The ophthalmic artery arised within the paraclinoid portion of the internal carotid artery in 33.8%. In 3.8%, it entered the floor of the optic canal through a foramen in the bone. But there was no intracavernous origin of the ophthalmic artery. 3) The cavernous sinus seemed to be a venous pathway, an irregualr network of venous channel, not a trabeculated sinus.