anatomical study of the relation between the descending branch of the inferior gluteal artery and the posterior cutaneous nerve of the thigh

The gluteal thigh flap is a myofascio-cutaneous flap receiving its blood supply from a descending branch of the inferior gluteal artery. The superior and inferior myocutaneous gluteal free flaps have been considered as valuable alternatives to the latissimus dorsi or TRAM flap since 1975. The purpose of this study was to gain a better understanding of the anatomical relationship between the posterior cutaneous nerve of the thigh, and the descending branch of the inferior gluteal artery. Twenty four posterior thigh specimens of adult human cadavers were dissected after latex injection of the internal iliac artery. The inferior gluteal artery and the posterior cutaneous nerve of the thigh were carefully dissected. The relation between the descending branch of inferior gluteal artery and the posterior cutaneous nerve of the thigh was studied and photographed. The external diameter and the length of the descending branch of the inferior gluteal artery were measured. The inferior gluteal artery gave off a descending branch that is accompanied by the posterior cutaneous nerve of the thigh. The descending branch was observing in all cadavers dissected. Its average external diameter was 0.3 +/- 0.07mm and it was arising about 7.15 +/- 0.68cm away from the tip of the greater trochanter of the femur. In 5 lower limbs [20.8%] the descending branch was passing medial to the posterior cutaneous nerve of the thigh. In the remaining cadavers the descending branch of the inferior gluteal artery was passing lateral to the posterior cutaneous nerve of the thigh in 19 out of 24 specimens [79.2% of lower limbs]. It was descending below the gluteal fold with the posterior cutaneous nerve of the thigh in a common connective tissue sheath in 21 out of 24 specimens. In all dissected lower limbs, one or two cutaneous branches of the descending branch of inferior gluteal artery and one or two cutaneous nerves were supplying the infragluteal perforator flap. Loop of nerves was found surrounding the inferior gluteal artery and its descending branch in 3 out of 24 lower limbs [12.5%]. Knowledge of the vascular anatomy extends the clinical applicability of the posterior thigh fasciocutaneous flap to patients who might otherwise be excluded because of prior injury or operative procedure

TT virus among blood donors in Alexandria

TTV is a non enveloped, single-stranded, circular- DNA virus that has been assigned to the Family Circiniviridae. The primary mode of TTV transmission was proposed to be transfusion [and hence its name]. Little is known about the clinical significance and the natural history of TTV infection. Hence, responsibility of the virus for specific liver disease is still debated. In our study, we tested ninety five blood donors attending Kom El-Decka regional blood bank in Alexandria for the presence of TTV DNA in their sera by PCR technique. The same samples were tested for ALT and AST levels by colorimetric technique and for HBsAg and anti-HCV by the ELISA technique. Out of the 95 blood donors, 46 [48.4%] had TTV DNA in their sera. None of the 95 blood donors included in this study was positive for HBsAg, while 22 [23.2%] were anti-HCV positive. Out of the 22 anti-HCV positive blood donors, 13 [59.1%] were TTV DNA positive, while out of the 73 anti-HCV negative blood donors, 33 [45.2%] had TTV DNA in their sera. There was no statistically significant difference between the prevalence of TTV DNA and anti-HCV in blood donors. No biochemical evidence of liver disease potentially linked to the TTV infection was observed in our blood donors who were TTV DNA positive. Furthermore, the occurrence of elevated serum AST and ALT was most often linked to HCV rather than TTV

Re-appraisal of surgical anatomy of arterial supply of the right colon

Hemorrhagic complications can be a major cause of conversion and/or morbidity during laparoscopic intestinal surgery. The limited exposure currently provided in laparoscopic intestinal resection demands a precise knowledge of mesenteric vascular anatomy to avoid such complications and to expedite the procedure. Most surgical texts depict a "normal pattern" of arterial supply to the right colon consisting of three arterial branches [middle colic artery, right colic artery and ileocolic atery] arising independently from the superior mesenteric artery [SMA]. We performed detailed dissection of the SMA in thirty adult cadavers. We found the ileocolic artery in all of our cases and the middle colic artery in 29 of 30 cadavers but only three cases of a right colic artery arising directly from SMA. Our data, combined with review of published anatomic studies, lead us to conclude that in the vast majority of cases there are only two independent branches arising from SMA that supply the large intestine, the ileocolic and the middle colic arteries. The right colic artery directly arising from SMA is unusual [10%]. This knowledge may help lower the risk of vascular complications during laparoscopic intestinal surgery