Rare anastomosis between the ascending pharyngeal and vertebral arteries via the hypoglossal canal: A cadaveric case report / 대한해부학회지

We present a rare case of external carotid artery-vertebral artery anastomosis via the ascending pharyngeal artery, diagnosed upon cadaveric dissection. The ascending pharyngeal artery gave rise to a branch to the hypoglossal canal, which is a variation of a true persistent fetal hypoglossal artery. Knowledge of persistent carotid-vertebrobasilar anastomoses is important as these fetal vessels can contribute significantly to the posterior cerebral circulation. Only 10 cases of external carotid artery-vertebrobasilar artery anastomoses have been reported to our knowledge, and our case presents the first cadaveric dissection of this rare variation.

Review of the external carotid plexus: anatomy, function, and clinical manifestations / 대한해부학회지

The external carotid plexus is a combination of postganglionic sympathetic fibers derived from the superior cervical ganglion. This plexus travels along the external carotid artery and continues onto the artery’s branches. The external carotid plexus plays an important role in innervating the mid and lower face. Therefore, implications to the plexus may result in facial abnormalities. Herein, we review the anatomy, function, and review its clinical applications.

Iliofemoral Vein Stenting in a Patient with Pelvic Metastasis

We report a case of an 81-year-old woman with extensive pelvic lymphadenopathy that caused severe stenosis and occlusion of the right common and external iliac veins and proximal common femoral vein. Pelvic lymphadenopathy resulted from the recurrence of a previous right ovarian epithelial tumor. The patient had severe right lower extremity edema, consistent with severe venous insufficiency.She was treated with high-pressure balloon angioplasty (12-14 mm in diameter) and four self-expanding stents (14-10 mm diameter, 80-40 mm length). The postoperative response was dramatic to a near-complete resolution of the edema. The venous clinical severity scores were 10 and 2 at presentation and 6 months after the follow-up, respectively. Balloon angioplasty and stenting are safe and effective methods for providing symptomatic relief for lower extremity venous insufficiency in patients with extensive and unresectable pelvic masses.

Rare anastomosis between the ascending pharyngeal and vertebral arteries via the hypoglossal canal: A cadaveric case report / 대한해부학회지

We present a rare case of external carotid artery-vertebral artery anastomosis via the ascending pharyngeal artery, diagnosed upon cadaveric dissection. The ascending pharyngeal artery gave rise to a branch to the hypoglossal canal, which is a variation of a true persistent fetal hypoglossal artery. Knowledge of persistent carotid-vertebrobasilar anastomoses is important as these fetal vessels can contribute significantly to the posterior cerebral circulation. Only 10 cases of external carotid artery-vertebrobasilar artery anastomoses have been reported to our knowledge, and our case presents the first cadaveric dissection of this rare variation.

Review of the external carotid plexus: anatomy, function, and clinical manifestations / 대한해부학회지

The external carotid plexus is a combination of postganglionic sympathetic fibers derived from the superior cervical ganglion. This plexus travels along the external carotid artery and continues onto the artery’s branches. The external carotid plexus plays an important role in innervating the mid and lower face. Therefore, implications to the plexus may result in facial abnormalities. Herein, we review the anatomy, function, and review its clinical applications.

Iliofemoral Vein Stenting in a Patient with Pelvic Metastasis

We report a case of an 81-year-old woman with extensive pelvic lymphadenopathy that caused severe stenosis and occlusion of the right common and external iliac veins and proximal common femoral vein. Pelvic lymphadenopathy resulted from the recurrence of a previous right ovarian epithelial tumor. The patient had severe right lower extremity edema, consistent with severe venous insufficiency.She was treated with high-pressure balloon angioplasty (12-14 mm in diameter) and four self-expanding stents (14-10 mm diameter, 80-40 mm length). The postoperative response was dramatic to a near-complete resolution of the edema. The venous clinical severity scores were 10 and 2 at presentation and 6 months after the follow-up, respectively. Balloon angioplasty and stenting are safe and effective methods for providing symptomatic relief for lower extremity venous insufficiency in patients with extensive and unresectable pelvic masses.

Surgical management of calcified liver hydatid cyst complicated with thoracobiliary fistula: a case series and literature review

Thoracobiliary fistula is a rare complication of hydatid cyst of the liver especially in the calcified form. Surgery is the only medical option. The treatment consists of radical surgical procedures in the majority of the patients. Conservative surgical treatments are performed with high mortality rate. Herein, we will describe two patients of calcified hydatid cysts of the liver whose condition becomes complicated with Thoracobiliary fistula. The first patient was treated with right thoracotomy and resection of pleural hydatid cysts. Then, were evacuated the ruptured laminated membrane and daughter cysts of infected hepatic hydatid cysts through diaphragmatic opening and sub diaphragmatic drainage of the calcified liver hydatid cyst. The second patient was also treated with right thoracotomy, resection of pulmonary hydatid cysts, evacuation of ruptured bile stained laminated membrane and daughter cysts of hepatic hydatid cysts through diaphragmatic opening and sub diaphragmatic drainage of the calcified cyst cavity. Our patients underwent conservative surgery which posed a severe risk. Both cases are discussed together with review of the literature

role of pyloromyotomy on gastric drainage in esophagectomy and gastric pull-up procedures: a randomized clinical trial study

Introduction: Gastric drainage disorder is one of the complications of gastric pull-up and esophagectomy after surgery which might lead to esophageal cancer and benign strictures. The aim of this study was to determine the role of pyloromyotomy on gastric drainage

Materials and Methods: In this prospective randomized controlled clinical trial study, we studied 51 patients in two matched groups from July 2008 to August 2010 in Imam Reza Hospital, Tabriz,Iran. Twenty-seven patients in group one had no pyloromyotomy and 24 patients in group two had pyloromyotomy after transhiatal esophagectomy and gastric pull-up procedure. The outcomes were measured as the incidence of gastric outlet compromise which was diagnosed 12 months after esophagectomy and gastric pull-up. Regurgitation, fullness, respiratory distress, coughing and, clinical delayed gastric emptying were observed and compared in two groups by radioisotope gastric emptying scanning

Results: A total number of 51 patients, 19 [37.25%] male and 32 [62.75%] female were studied in this research. The overall incidence of delayed gastric emptying was 19 /51 [37.25%]. Pyloromyotomy did not reduce the incidence of delayed gastric emptying. There was no statistically significant difference in the length of hospital stay in study groups [group 1= 11 days versus 12 days in group 2, P=0.41]. There was no statistical difference in anastomotic leak or anastomotic stricture [P= 0.72]. Mortality was two [one patient, 3.7%, in group 1 and one patient, 4.2%, in group 2]. The incidences of regurgitation and increased gastric emptying were not statistically different in two groups

Conclusion: Pyloromyotomy could not reduce the incidence of delayed gastric emptying after transhiatal esophagectomy, and vagotomy

Electrodiagnostic Evaluation of Peripheral Nervous System Changes in Patients with Multiple Sclerosis

Background: There is supportive evidence that multiple sclerosis (MS) could potentially affect the peripheral nervous system. We assessed peripheral sensory and motor nerve involvement in patients with MS by a nerve conduction velocity test. Methods: We studied 75 patients who had a relapsing-remitting or secondary progressive pattern. We measured amplitude, latency, conduction velocity, Hoffmann reflex (H-Reflex), and F-Waves. Results: The amplitude of the right tibial, right proneal, left tibial, left proneal, and left median motor nerves was less than the mean for the normal population. Right ulnar sensory conduction in the patients showed an amplitude that was less than that of the normal population; there was no significant change in the amplitude of other sensory nerves. Latencies of the right and left median and right proneal motor nerves and left ulnar sensory nerves were statistically less than that of the normal population. Mean motor conduction velocity and F-wave conduction did not differ significantly from the normal population. H-reflex latencies of the right and left lower limbs were significantly more prolonged than those of the normal population. Conclusion: Our results suggest possible peripheral motor nerve abnormalities in MS patients, especially with the amplitude of the motor nerves; however, our results do not demonstrate any significant difference among the nerve conduction velocity parameters of sensory nerves between MS patients and the normal population.

Evaluation of caudal anesthesia performed in conscius infants for lower abdominal surgeries

To assess the tolerance and efficiency of caudal anesthesia in infants undergoing lower abdominal surgery. Thirty-five infants aged 2-13 weeks with a median gestational age of 35 weeks, were given single dose caudal epidural anesthesia [with bupivacaine] without sedation. This group of babies was treated at the Tabriz Children General Hospital between December 2006 and March 2007. We evaluated patients> analgesia [Beclere pain scale], blood pressure, heart rate changes, and apnea during the 24-hour postoperative period. Each patient was self-compared by Run test. Three patients had pain requiring induction of general anesthesia. Out of 35 cases, 23 patients had non-significant changes in heart rate, 20 patients had non-significant changes in systolic blood pressure, and 17 patients had non-significant changes in diastolic blood pressure. None of the patients experienced apnea. Four patients required postoperative analgesic support for 2 hours, 2 patients for 3.5 hours, and 9 patients for 4 hours. The present study shows that single dose caudal block can be used successfully in conscious babies for minor lower abdominal surgery, and may also facilitate postoperative pain management