Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 5.012
Rev. bras. ortop ; 58(2): 347-350, Mar.-Apr. 2023. graf
Article in English | LILACS | ID: biblio-1449797


Abstract Carpal tunnel syndrome is the most common compressive neuropathy of the upper limb, affecting ~ 4% of the general population. The clinical picture is characterized by pain and, mainly, paresthesia in the median nerve territory, of insidious onset and, in the most severe cases, loss of strength and atrophy of the thenar musculature is observed. It is an extremely common pathology in the daily practice of hand surgery, and in most cases, it can be treated with conservative methods. We present here an atypical case of carpal tunnel syndrome, of acute onset, triggered by persistent median artery (PMA) thrombosis, condition associated with distal embolization and hypoper-fusion of the limb.

Resumo A síndrome do túnel do carpo é a neuropatia compressiva mais comum do membro superior, afetando ~ 4% da população geral. O quadro clínico caracteriza-se por dor e, principalmente, parestesia no território do nervo mediano, de início insidioso e, nos casos mais graves, observa-se perda de força e atrofia da musculatura tenar. Trata-se de patologia extremamente comum na prática diária de cirurgia da mão, e na maior parte dos casos pode ser tratada com métodos conservadores. Apresentamos aqui um caso atípico de síndrome do túnel do carpo, de surgimento agudo, desencadeado pela trombose da artéria mediana persistente, quadro associado com embolização distal e hipoperfusão do membro.

Humans , Male , Middle Aged , Arteries , Thrombosis , Carpal Tunnel Syndrome , Compressive Strength
Int. j. morphol ; 41(1): 164-166, feb. 2023. ilus
Article in English | LILACS | ID: biblio-1430528


SUMMARY: Clear awareness of the vascular variations is critical in surgeries, which may cause massive hemorrhage during surgical procedures. During educational dissection of a male cadaver, we encountered a combined variation of the left obturator artery and ipsilateral aberrant inferior epigastric artery. The left obturator artery originated from the external iliac artery, then coursed inward, adherent to the superior pubic ramus. The left inferior epigastric artery originated from the femoral artery, and coursed behind the femoral vein. These anatomical variations shown in one person were extremely rare. This is particularly true with regard to these variations while performing pelvic and inguinal region surgeries.

El conocimiento claro de las variaciones vasculares es fundamental en las cirugías, ya que pueden causar una hemorragia masiva durante los procedimientos quirúrgicos. Durante la disección educativa de un cadáver de sexo masculino, encontramos una variación combinada de la arteria obturatriz izquierda y la arteria epigástrica inferior ipsilateral aberrante. La arteria obturatriz izquierda se originaba en la arteria ilíaca externa, luego discurrió hacia medial, adhiriéndose a la rama púbica superior. La arteria epigástrica inferior izquierda se originaba en la arteria femoral y discurría por detrás de la vena femoral. Estas variaciones anatómicas mostradas en una sola persona son extremadamente raras. Esto es importante de conocer estas variaciones cuando se realizan cirugías de las regiones pélvica e inguinal.

Humans , Male , Arteries/abnormalities , Groin/blood supply , Cadaver , Epigastric Arteries/abnormalities , Femoral Vein/abnormalities
Ann. afr. méd. (En ligne) ; 16(4): 5309-5319, 2023. figures, tables
Article in French | AIM | ID: biblio-1512334


Les artères digestives essentiellement le tronc cœliaque et l'artère mésentérique supérieure présentent plusieurs variantes anatomiques notamment au niveau de leur origine. L'objectif de cette étude était d'illustrer l'anatomie normale ainsi que les variantes anatomiques des artères digestives vues au scanner. Nous avons réalisé une étude transversale portant sur les scanners avec coupes abdominales sans et avec injection de produit de contraste iodé au temps artériel. Le tronc cœliaque et ses branches, l'artère mésentérique supérieure et l'artère mésentérique inférieure ont été étudiés. Nous avons collecté 155 patients. Plusieurs variantes anatomiques fréquentes et multiples ont été retrouvées, dont l'absence de tronc cœliaque (3 cas), le tronc hépato-splénique (12 cas), le tronc hépato-gastrique (2 cas), le tronc gastro-splénique (5 cas) et le tronc coeliacomésentérique (1 cas). Pour l'artère hépatique, il existait les types I (121 cas), II (13 cas), IV (1 cas), V (3 cas) et IX (3 cas) selon la classification de Michels, ainsi que d'autres variantes non classifiées (14 cas). Nous avons trouvé également une artère mésentérique moyenne reliant l'artère mésentérique supérieure de l'artère mésentérique inférieure. Cela justifie l'importance et la nécessité de la réalisation du scanner avant tout acte chirurgical impliquant les artères digestives

Humans , Surgical Procedures, Operative , Celiac Plexus , Digestive System , Arteries , Mesenteric Arteries
Article in Chinese | WPRIM | ID: wpr-986895


Objective: To investigate the efficacies of different forms of free radial collateral artery perforator flaps in repairing the defects after oral tumor surgeries. Methods: From May 2016 to March 2021, 28 patients (22 males, 6 females, aged 35-62 years) with oral tumors admitted by Hunan Cancer Hospital received the reconstructive surgeries with the free radial collateral artery perforator flaps after removal of oral tumors, including 24 cases of tongue cancer (11 cases of tongue marginal cancer, 9 cases of tongue belly cancer and 4 cases of tongue cancer involved in the floor of the mouth) and 4 cases of buccal and oral cancer. Four forms of radial collateral artery perforator flaps were used: single perforator flaps for 6 cases, double perforators flaps for 7 cases, flaps without perforator visualization for 10 cases and chimeric perforator myocutaneous flaps for 5 cases. The recipient vessels were the superior thyroid artery and superior thyroid vein, and if second concomitant vein available, it was anastomosed with internal jugular vein in end-to-side fashion. SPSS 20.0 statistical software was used to analyze the data. Results: The mean length of flaps was (9.7±0.4) cm, mean width (4.4±0.3) cm and mean thickness (1.1±0.4) cm. The mean length of the vascular pedicles was (7.1±0.6)cm (6.0-8.0 cm), the mean diameter of the radial accessory arteries was (1.1±0.3)mm (0.8-1.3 mm). Eleven cases(39.3%) had respectively one accompanying vein and 17 cases(60.7%) had respectively two accompanying veins, with the mean diameter of (1.1±0.3) mm (0.8-1.3 mm). All the 28 flaps survived, the donor and recipient wounds healed in one stage, the appearances of the flaps were satisfactory, only linear scars remained in the donor sites, and the upper arm functions were not significantly affected. Follow up for 12-43 months showed that the flaps were soft with partially mucosalization, the reconstructed tongue and buccal cavity were in good shape, and the swallowing and language functions were satisfactory. The swallowing and language functions were retained to the greatest extent in 3 cases with near total tongue resection, although the functions were still significantly affected. There was no local recurrence of the tumor during follow-up. One case had regional lymph node metastasis, and further lymph node dissection and comprehensive treatment were performed, with satisfactory outcomes. Conclusions: The vascular pedicle of the radial collateral artery perforator flap has a constant anatomy, which can be prepared in different forms to improve the safety of the operation and minimize the donor site damage. It is an ideal choice for the repair of small and medium-sized defects after oral tumor surgery.

Male , Female , Humans , Perforator Flap/transplantation , Plastic Surgery Procedures , Tongue Neoplasms/surgery , Arm/surgery , Mouth Neoplasms/surgery , Arteries , Skin Transplantation , Treatment Outcome
Chinese Critical Care Medicine ; (12): 358-361, 2023.
Article in Chinese | WPRIM | ID: wpr-982593


OBJECTIVE@#To investigate the effect of different fraction of inspired oxygen (FiO2) baseline levels before endotracheal intubation on the time of expiratory oxygen concentration (EtO2) reaching the standard in emergency patients with the EtO2 as the monitoring index.@*METHODS@#A retrospective observational study was conducted. The clinical data of patients receiving endotracheal intubation in the emergency department of Peking Union Medical College Hospital from January 1 to November 1 in 2021 were enrolled. In order to avoid interference with the final result due to inadequate ventilation caused by non-standard operation or air leakage, the process of the continuous mechanical ventilation after FiO2 was adjusted to pure oxygen in patients who had been intubated was selected to simulate the process of mask ventilation under pure oxygen before intubation. Combined with the electronic medical record and the ventilator record, the changes of the time required to reach 0.90 of EtO2 (that was, the time required to reach the standard of EtO2) and the respiratory cycle required to reach the standard after adjusting FiO2 to pure oxygen under different baseline levels of FiO2 were analyzed.@*RESULTS@#113 EtO2 assay records were collected from 42 patients. Among them, 2 patients had only one EtO2 record due to the FiO2 baseline level of 0.80, while the rest had two or more records of EtO2 reaching time and respiratory cycle corresponding to different FiO2 baseline level. Among the 42 patients, most of them were male (59.5%), elderly [median age was 62 (40, 70) years old] patients with respiratory diseases (40.5%). There were significant differences in lung function among different patients, but the majority of patients with normal function [oxygenation index (PaO2/FiO2) > 300 mmHg (1 mmHg ≈ 0.133 kPa), 38.0%]. In the setting of ventilator parameters, combined with the slightly lower arterial partial pressure of carbon dioxide of patients [33 (28, 37) mmHg], mild hyperventilation phenomenon was considered to be widespread. With the increased in FiO2 baseline level, the time of EtO2 reaching standard and the number of respiratory cycles showed a gradually decreasing trend. When the FiO2 baseline level was 0.35, the time of EtO2 reaching the standard was the longest [79 (52, 87) s], and the corresponding median respiratory cycle was 22 (16, 26) cycles. When the FiO2 baseline level was increased from 0.35 to 0.80, the median time of EtO2 reaching the standard was shortened from 79 (52, 78) s to 30 (21, 44) s, and the median respiratory cycle was also reduced from 22 (16, 26) cycles to 10 (8, 13) cycles, with statistically significant differences (both P < 0.05).@*CONCLUSIONS@#The higher the FiO2 baseline level of the mask ventilation in front of the endotracheal intubation in emergency patients, the shorter the time for EtO2 reaching the standard, and the shorter the mask ventilation time.

Aged , Humans , Male , Middle Aged , Female , Intubation, Intratracheal , Respiration , Ventilators, Mechanical , Arteries , Blood Gas Analysis
Article in Chinese | WPRIM | ID: wpr-981617


OBJECTIVE@#To summarize the effectiveness of the temporal island flap pedicled with the perforating branch of zygomatic orbital artery for repairing defects after periocular malignant tumor resection.@*METHODS@#Between January 2015 and December 2020, 15 patients with periocular malignant tumors were treated. There were 5 males and 10 females with an average age of 62 years (range, 40-75 years). There were 12 cases of basal cell carcinoma and 3 cases of squamous carcinoma. The disease duration ranged from 5 months to 10 years (median, 2 years). The size of tumors ranged from 1.0 cm×0.8 cm to 2.5 cm×1.5 cm, without tarsal plate invasion. After extensive resection of the tumors, the left defects in size of 2.0 cm×1.5 cm to 3.5 cm×2.0 cm were repaired with the temporal island flap pedicled with the perforating branch of zygomatic orbital artery via subcutaneous tunnel. The size of the flaps ranged from 3.0 cm×1.5 cm to 5.0 cm×2.0 cm. The donor sites were separated subcutaneously and sutured directly.@*RESULTS@#All flaps survived after operation and the wounds healed by first intention. The incisions at donor sites healed by first intention. All patients were followed up 6-24 months (median, 11 months). The flaps were not obviously bloated, the texture and color were basically the same as the surrounding normal skin, and the scars at recipient sites were not obviously. There was no complication such as ptosis, ectropion, or incomplete closure of the eyelids and recurrence of tumor during follow-up.@*CONCLUSION@#The temporal island flap pedicled with the perforating branch of zygomatic orbital artery can repair the defects after periorbital malignant tumors resection and has the advantages of reliable blood supply, flexible design, and good morphology and function.

Male , Female , Humans , Middle Aged , Plastic Surgery Procedures , Skin Transplantation , Soft Tissue Injuries/surgery , Treatment Outcome , Surgical Flaps , Arteries/surgery , Carcinoma, Squamous Cell/surgery , Skin Neoplasms/surgery , Perforator Flap/blood supply
An. Fac. Cienc. Méd. (Asunción) ; 55(3): 122-125, 20221115.
Article in Spanish | LILACS | ID: biblio-1401565


El tálamo posee una irrigación vascular compleja, llena de variantes anatómicas de relevancia para los estudiantes de la medicina. La presencia y el infarto producido por la oclusión de la arteria de Percherón es caracterizado por un cuadro clínico raro, poco conocido por los médicos del Servicio de Urgencias. Generalmente está asociado a la triada de alteración de la consciencia, parálisis de la mirada vertical y alteraciones de la memoria. Presentamos el caso de un varón de 54 años que se presenta con alteración del sensorio, somnolencia y alteraciones de la memoria, en el que no se pudo realizar terapia adecuada debido al desconocimiento de dicha entidad.

The thalamus has a complex vascular supply, full of anatomical variants of relevance to medical students. The presence of the Percheron artery is one of these anatomical variants, and the infarction produced by its occlusion is characterized by a rare clinical picture, little known by doctors in the Emergency Department. It is generally associated with the triad of impaired consciousness, vertical gaze palsy, and memory disturbance. We present the case of a 54-year-old man who presented with altered sensorium, drowsiness and memory alterations, in whom adequate therapy could not be carried out due to ignorance of this entity.

Stroke , Arteries
Rev. méd. hondur ; 90(1): 53-56, ene.-jun. 2022. ilus.
Article in Spanish | LILACS, BIMENA | ID: biblio-1393246


Antecedentes: Los infartos cerebelosos suponen una entidad rara con una incidencia baja del total de ictus isquémicos. El territorio más prevalente de los infartos cerebelosos son los de la arteria cerebelosa posterior inferior (PICA). Cuando los infartos se limitan al cerebelo, los pacientes típicamente experimentan síntomas no específicos, esto hace considerar otros diagnósticos de forma errónea. Descripción del caso clínico: paciente femenina de 54 años, con antecedente de hipertensión arterial, quien presentaba cefalea insidiosa y progresiva acompañado de vértigo, alteración en la marcha y deterioro progresivo del estado de conciencia. Se realizó imagen de Resonancia Magnética Cerebral (IRM), la cual reveló zonas hiper intensas bilaterales en región cerebelosa que delimitaban territorio vascular de la arteria cerebelosa posterior inferior además dilatación moderada del sistema ventricular. Fue intervenida quirúrgicamente, realizándose craniectomía suboccipital descompresiva; posterior a la cirugía presentó mejoría clínica. Conclusiones: El ictus isquémico cerebeloso bilateral es una forma infrecuente de ictus y su presentación clínica es muy diversa. El desarrollo de las neuroimágenes, juegan un papel importante para ayudar a los médicos a seleccionar el tratamiento adecuado. Alrededor de la mitad de los pacientes con infartos cerebelosos que presentan deterioro neurológico progresivo y son tratados con craniectomía suboccipital descompresiva tienen buenos resultados. El pilar fundamental de este caso fue el hacer un diagnóstico temprano de esta entidad, ya que permitió prevenir las posibles complicaciones graves asociadas al infarto cerebeloso, las cuales ocurren durante la primera semana del ictus y, por lo tanto, asegurar un pronóstico favorable para el paciente...(AU)

Humans , Female , Middle Aged , Cerebellum/blood supply , Infarction, Posterior Cerebral Artery/diagnosis , Arteries , Magnetic Resonance Imaging , Infarction, Posterior Cerebral Artery/complications , Early Diagnosis
Int. j. morphol ; 40(3): 601-607, jun. 2022. ilus
Article in English | LILACS | ID: biblio-1385641


SUMMARY: Background and Objectives: The palatine nerves and vessels cross the pterygopalatine fossa, the palatine canals, the palatine foramina and the submucosal space, at the level of the hard palate and the palatine recess of the maxillary sinus. Their trajectory is long, complicated and difficult to highlight on a single dissection piece. In the literature that we studied, we did not find clear images that fully highlight the real configuration of the pterygopalatine ganglion and nerves and of the palatine vessels. Our aim was to provide a clear and representative dissection of the pterygopalatine ganglion and of the palatine neurovascular bundle throughout its pathway in a simple, coherent and useful presentation for the practitioners interested in the regional pathology. We resected the posterior and inferomedial osseous walls of the maxillary sinus and highlighted the neurovascular structures in the pterygopalatine fossa and the wall of the maxillary sinus. We photographed the dissection fields and detailed the important relations. The images that we obtained are clear, simple and easy to interpret and use. We successfully highlighted the aspect and the main relations of the pterygopalatine ganglion and the pathway and distribution of the palatine nerves and vessels, from their origin to the terminal plexuses. There is a broad spectrum of clinical procedures or situations that require a proper knowledge and understanding of the anatomical pathway and relations of the palatine neurovascular elements. This includes the various types of regional anesthesia, tumor resection surgery, flaps of the palatine mucosa, the LeFort osteotomy etc. Demonstration of the pterygopalatine ganglion and its relations is useful in endoscopic interventions at the level of the pterygopalatine fossa.

RESUMEN: Los nervios y vasos palatinos atraviesan la fosa pterigopalatina, además de los canales palatinos, los forámenes palatinos y el espacio submucoso a nivel del paladar duro y el receso palatino del seno maxilar. Su trayectoria es larga, complicada y difícil de destacar en una sola pieza de disección. En la literatura que estudiamos, no encontramos imágenes claras que resalten completamente la configuración real del ganglio y los nervios pterigopalatinos y de los vasos palatinos. Nuestro objetivo fue proporcionar una disección clara y representativa del ganglio pterigopalatino y del haz neurovascular palatino a lo largo de su trayecto en una presentación simple, coherente y útil para los médicos interesados en la patología regional. Resecamos las paredes óseas posterior e inferomedial del seno maxilar y resaltamos las estructuras neurovasculares en la fosa pterigopalatina y la pared del seno maxilar. Fotografiamos los campos de disección y detallamos las relaciones importantes. Las imágenes que obtuvimos son claras, sencillas y de fácil interpretación. Resaltamos con éxito el aspecto y las principales relaciones del ganglio pterigopalatino y el trayecto y distribución de los nervios y vasos palatinos, desde su origen hasta los plexos terminales. En conclusion, existe un amplio espectro de procedimientos o situaciones clínicas que requieren un adecuado conocimiento y comprensión del trayecto anatómico y las relaciones de los elementos neurovasculares palatinos. Esto incluye los distintos tipos de anestesia regional, cirugía de resección tumoral, colgajos de mucosa palatina, osteotomía de LeFort, etc. La demostración del ganglio pterigopalatino y sus relaciones es útil en intervenciones endoscópicas a nivel de la fosa pterigopalatina.

Humans , Male , Ganglia, Parasympathetic/anatomy & histology , Maxillary Sinus/anatomy & histology , Arteries/anatomy & histology , Cadaver , Ganglia, Parasympathetic/blood supply
Int. j. morphol ; 40(3): 595-600, jun. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1385686


SUMMARY: The superior laryngeal artery is the primary vessel providing the blood supply to the larynx. Commonly, it is derived from the superior thyroid artery. Different variations in the origin have been described in the current literature; knowledge of such variations is crucial for various surgical interventions of the larynx and surgical procedures in the lateral region of the neck regarding the carotid triangle. It should be noted that radiological studies, such as selective angiography of the thyroid gland, can also be misleading in cases of variations. Herein, we describe a case of bilateral superior laryngeal artery originating directly from the external carotid artery of the neck. The arteries at first have a transverse course and then pierce through the thyrohyoid membrane alongside internal laryngeal nerves. Moreover, we also review the known variations in the origin of the superior laryngeal artery and propose a new classification of all known variations.

RESUMEN: La arteria laríngea superior es el vaso principal que proporciona el suministro de sangre a la laringe. Comúnmente, se deriva de la arteria tiroidea superior. Han sido descritas diferentes variaciones en su origen y el conocimiento de éstas resulta crucial para las intervenciones quirúrgicas realizadas en la laringe, como también en los procedimientos quirúrgicos que se llevan a cabo en la región lateral del cuello, respecto al triángulo carotídeo. Cabe señalar que los estudios radiológicos, como la angiografía selectiva de la glándula tiroides, también pueden ser engañosos en casos de variaciones anatómicas. Aquí, describimos un caso de arteria laríngea superior bilateral que se originaba directamente de la arteria carótida externa. Las arterias al inicio tenían un curso transversal y luego atravezaban la membrana tirohioidea junto con los nervios laríngeos internos. Revisamos también las variaciones conocidas en el origen de la arteria laríngea superior y proponemos una nueva clasificación de todas las variaciones conocidas.

Humans , Male , Aged , Arteries/anatomy & histology , Anatomic Variation , Larynx/blood supply
Int. j. morphol ; 40(1): 18-23, feb. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1385567


SUMMARY: The posterior superior alveolar artery (PSAA) and the infra-orbital artery (IOA) present intraosseous and extraosseous rami which form an anastomosis in the lateral wall of the maxillary sinus. This anastomosis is always present, however it has not yet been included in anatomical terminology (AT), and different terms are used in scientific communication to refer to it. The aim of this study was to carry out a review of the different terms used to name this vascular structure. A literature review was carried out on the terms used to name the anastomosis between the PSAA and IOA in imaging studies and human cadavers that assessed the presence/frequency of this anatomical structure. The search was carried out in the Medline, EMBASE and LILACS databases, in Portuguese, Spanish and English, with no date restrictions. Qualitative analysis was applied to the studies selected, analysing the terminology used to refer to the anastomosis between the PSAA and IOA. Of the 2108 original articles found, 60 were selected as potentially relevant and 54 studies were finally included for qualitative analysis. Sixteen terms were found to refer to the anastomosis between the PSAA and IOA, the most frequent being Posterior Superior Alveolar Artery (PSAA), followed by Alveolar Antral Artery (AAA). Many terms are used in the medical literature to designate the anastomosis between the PSAA and IOA, the most frequent being PSAA and AAA. There is a need to unify the terms used to designate this vascular structure, and to incorporate the selected term into anatomical terminology, in order to avoid confusion in scientific communication.

RESUMEN: La arteria alveolar superior posterior (AASP) y la arteria infra-orbital (AIO) tienen ramas intra y extra óseas que forman una anastomosis en la pared lateral del seno maxilar. Esta anastomosis está siempre presente, sin embargo, aún no ha sido incluida en la terminología anatómica (TA), por lo que en la comunicación científica se utilizan diferentes términos para referirse a ella. El objetivo de este estudio fue realizar una revisión sobre los diferentes términos utilizados para nombrar esta estructura vascular. Se realizó una revisión de la literatura sobre los términos utilizados para nombrar la anastomosis entre AASP y AIO en estudios imagenológicos y en cadáveres humanos que evaluaron la presencia/frecuencia de esta estructura anatómica. La búsqueda fue realizada en las bases de datosMedline, EMBASE y LILACS, en los idiomas portugués, español e inglés, sin restricción de fecha. Los estudios seleccionados fueron evaluados de forma cualitativa, analizando la terminología empleada para referirse a la anastomosis entre AASP y AIO. Fueron encontrados 2108 artículos originales, siendo seleccionados 60 artículos potencialmente relevantes y finalmente fueron incluidos 54 estudios para análisis cualitativo. Fueron encontrados 16 términos para referirse a la anastomosis entre AASP y AIO, siendo AASP el más frecuente seguido de arteria alveolo-antral (AAA). Son muchos los términos utilizados en la literatura médica para designar la anastomosis entre AASP y AIO, siendo AASP y AAA los más usados. La unificación de los términos utilizados para designar esta estructura vascular y su incorporación en la Terminología Anatómica contribuiría a evitar equívocos en la comunicación científica.

Humans , Orbit/blood supply , Arteries/diagnostic imaging , Alveolar Process/blood supply , Maxillary Sinus/diagnostic imaging , Arteriovenous Anastomosis , Cadaver , Cone-Beam Computed Tomography , Terminology as Topic
Int. j. morphol ; 40(1): 137-142, feb. 2022. ilus, tab
Article in English | LILACS | ID: biblio-1385576


SUMMARY: The dorsalis pedis artery (DPA) is a vital artery that supplies the foot and ankle area which is clinically important for palpating when taking the pulse. This research was performed on fresh cadaveric dissection of 40 legs by injecting paint into popliteal artery for tracking the dorsalis pedis artery and its branches. The present research revealed that the Thai population has an anatomical variation and different location of the DPA and exact location of DPA for estimating the location of the DPA and may have clinical implications. The statistically descriptive analysis elucidated the distances of the DPA to the lateral malleolus and medial malleolus which were 51.48 ± 7.27 mm and 42.62 ± 11.40 mm, respectively. The distance of the extensor hallucis longus (EHL) to the DPA was 14.29 ± 4.11 mm. The length of the dorsalis pedis artery which measured from artery on intermalleolar line to its dipping in 1st intermetatarsal space to be 122.03 ± 21.07 mm. The arcuate loop which is anastomosis U-loop of lateral tarsal arteries of the DPA was found 55 % in Thais population. There were no statistically significant differences of all parameters between the side and sex in DPA consideration. An understanding of the variations of the anatomical vasculature of DPA is essential for precise clinical assessment because exact anatomical knowledge and location can contribute to the pulse taking and be applied in surgical procedure.

RESUMEN: La arteria dorsal del pie (ADP) es una arteria vital que irriga eldorso del pie y el tobillo, y es clínicamente importante para la toma del pulso. Esta investigación se realizó en disección cadavérica de 40 piernas inyectando látex coloreado en la arteria poplítea para rastrear la ADP y sus ramas. La presente investigación reveló que en la población tailandesa la ADP tiene una variación anatómica y una ubicación diferente. Por tanto, determinar la ubicación exacta del ADP será útil para las implicaciones clínicas. El análisis estadísticamente descriptivo determinó que las distancias del ADP al maléolo lateral y al maléolo medial eran 51,48 ± 7,27 mm y 42,62 ± 11,40 mm, respectivamente. La distancia del tendón del músculo extensor largo del halux (ELH) al ADP era de 14,29 ± 4,11 mm. La longitud de la ADP, desde la línea intermaleolar hasta su entrada al primer espacio intermetatarsiano, era de 122,03 ± 21,07 mm. El asa arqueada, que es una anastomosis U-loop de las arterias tarsales laterales de la ADP, se encontró en un 55 % de la población tailandesa. No hubo diferencias estadísticamente significativas en todos los parámetros de la ADP entre el lado y el sexo. La comprensión de las variaciones de la variaciones anatómicas de la ADP es esencial para una evaluación clínica precisa. El conocimiento anatómico exacto y la ubicación pueden contribuir a la toma del pulso y ser útil en el procedimiento quirúrgico.

Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Arteries/anatomy & histology , Anatomic Variation , Foot/blood supply , Thailand , Cross-Sectional Studies
An. bras. dermatol ; 97(1): 99-101, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1360095


Abstract The caliber-persistent labial artery is a vascular anomaly in which a primary arterial branch penetrates into the submucosal tissue without reduction in diameter. Most lesions are benign and do not require treatment, except for complications and/or on patient demands. In this way, noninvasive diagnostic tools are preferred such as high-resolution and color Doppler ultrasonography which allow direct observation of the lesion, assessing its exact location and diameter at every axis, as well as the blood flow velocity. An excisional biopsy of these lesions or even their surgical extirpation could have a fatal outcome with profuse bleeding.

Humans , Vascular Malformations/diagnosis , Lip Diseases/diagnosis , Musculoskeletal Abnormalities , Arteries/diagnostic imaging , Ultrasonography, Doppler, Color
Int. braz. j. urol ; 48(1): 8-17, Jan.-Feb. 2022. graf
Article in English | LILACS | ID: biblio-1356298


ABSTRACT Objectives: In this review we will describe the testicular vessels anatomy and the implications of these vessels in surgical treatment of high undescended testis. Material and Methods: We performed a narrative review of the literature about the role of the testicular arteries anatomy in the treatment of high undescended testis. We also studied two human testes to illustrate the testicular vascularization. Results: Each testis is irrigated by three arteries: testicular artery (internal spermatic artery), a branch of the right aorta; deferential artery (vasal artery), a branch of the inferior vesicle artery that originates from the anterior trunk of internal iliac artery and cremasteric artery (external spermatic artery), a branch of the inferior epigastric artery. There are important communications among the three arteries with visible anastomotic channels between the testicular and deferential arteries. Conclusions: Laparoscopic transection of the testicular vessels by dividing the spermatic vessels (Fowler-Stephens surgery) is safe in patients with high abdominal testis due to the great collateral vascular supply between testicular, vasal and cremasteric arteries; also, two-stage Fowler-Stephens orchiopexy appears to carry a higher rate of success than the single stage approach.

Humans , Male , Spermatic Cord/surgery , Laparoscopy , Cryptorchidism/surgery , Arteries/surgery , Testis/surgery , Orchiopexy
Chinese Journal of Burns ; (6): 328-334, 2022.
Article in Chinese | WPRIM | ID: wpr-936014


Objective: To explore the clinical effects of free transplantation of expanded thoracodorsal artery perforator flaps in reconstructing cervical cicatrix contracture deformity after burns. Methods: A retrospective observational study was conducted. From May 2018 to April 2021, 11 patients with cervical cicatrix contracture deformity after burns who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 3 males and 8 females, aged 5 to 46 years, with a course of cervical cicatrix contracture deformity of 5 months to 8 years. The degree of cervical cicatrix contracture deformity was degree Ⅰ in one patient, degree Ⅱ in nine patients, and degree Ⅲ in one patient. In the first stage, according to the sizes of neck scars, one rectangular skin and soft tissue expander (hereinafter referred to as expander) with rated capacity of 200 to 600 mL was placed in the back. The expansion time was 4 to 12 months with the total normal saline injection volume being 3.0 to 3.5 times of the rated capacity of expander. In the second stage, free expanded thoracodorsal artery perforator flaps with areas of 10 cm×7 cm to 24 cm×13 cm were cut out to repair the wounds with areas of 9 cm×6 cm to 23 cm×12 cm which was formed after cervical cicatectomy. The main trunk of thoracodorsal artery and vein were selected for end-to-end anastomosis with facial artery and vein, and the donor sites were directly closed. The survival of flaps and healing of flap donor sites were observed on the 14th day post surgery. The appearances and cicatrix contracture deformity of the flaps, recovery of cervical function, and scar hyperplasia of donor sites were followed up. Results: On the 14th day post surgery, the flaps of ten patients survived, while ecchymosis and epidermal necrosis occurred in the center of flap of one patient and healed 2 weeks after dressing change. On the 14th day post surgery, the flap donor sites of 11 patients all healed well. During the follow-up of 6-12 months post surgery, the flaps of ten patients were similar to the skin around the recipient site in texture and color, while the flap of one patient was slightly swollen. All of the 11 patients had good recovery of cervical function and no obvious scar hyperplasia nor contracture in the flaps or at the donor sites. Conclusions: Application of expanded thoracodorsal artery perforator flaps can restore the appearance and function of the neck, and cause little damage to the donor site in reconstructing the cervical cicatrix contracture deformity after burns, which is worthy of clinical reference and application.

Female , Humans , Male , Arteries , Burns/surgery , Cicatrix/surgery , Contracture/surgery , Hyperplasia , Perforator Flap , Plastic Surgery Procedures , Skin Transplantation , Soft Tissue Injuries/surgery , Treatment Outcome
Chinese Journal of Burns ; (6): 165-169, 2022.
Article in Chinese | WPRIM | ID: wpr-935991


Objective: To explore the clinical application value of two longitudes three transverses method in the location of the perforator of thoracodorsal artery perforator and deep wound repair. Methods: The retrospectively observational study was conducted. From December 2018 to June 2020, 17 patients with deep wounds who were admitted to the Affiliated Hospital of Zunyi Medical University met the inclusion criteria and were included in this study, including 7 males and 10 females, aged 12 to 72 years. The wound areas of patients after debridement were 7 cm×3 cm to 11 cm×7 cm. Two longitudinal lines were located through the midpoint of the armpit, the posterior superior iliac spine, and the protruding point of the sacroiliac joint, and three transverse lines were located 5, 10, and 15 cm below the midpoint of the armpit between the two longitudinal lines, i.e. two longitudes three transverses method, resulting in two trapezoidal areas. And then the thoracodorsal artery perforators in two trapezoidal areas were explored by the portable Doppler blood flow detector. On this account, a single or lobulated free thoracodorsal artery perforator flap or flap that carrying partial latissimus dorsi muscle, with an area of 7 cm×4 cm to 12 cm×8 cm was designed and harvested to repair the wound. The donor sites were all closed by suturing directly. The number and location of thoracodorsal artery perforators, and the distance from the position where the first perforator (the perforator closest to the axillary apex) exits the muscle to the lateral border of the latissimus dorsi in preoperative localization and intraoperative exploration, the diameter of thoracodorsal artery perforator measured during operation, and the flap types were recorded. The survivals of flaps and appearances of donor sites were followed up. Results: The number and location of thoracodorsal artery perforators located before operation in each patient were consistent with the results of intraoperative exploration. A total of 42 perforators were found in two trapezoidal areas, with 2 or 3 perforators each patient. The perforators were all located in two trapezoid areas, and a stable perforator (the first perforator) was located and detected in the first trapezoidal area. There were averagely 1.47 perforators in the second trapezoidal area. The position where the first perforator exits the muscle was 2.1-3.1 cm away from the lateral border of the latissimus dorsi. The diameters of thoracodorsal artery perforators were 0.4-0.6 mm. In this group, 12 cases were repaired with single thoracodorsal artery perforator flap, 3 cases with lobulated thoracodorsal artery perforator flap, and 2 cases with thoracodorsal artery perforator flap carrying partial latissimus dorsi muscle. The patients were followed up for 6 to 16 months. All the 17 flaps survived with good elasticity, blood circulation, and soft texture. Only linear scar was left in the donor area. Conclusions: The two longitudes three transverses method is helpful to locate the perforator of thoracodorsal artery perforator flap. The method is simple and reliable. The thoracodorsal artery perforator flap designed and harvested based on this method has good clinical effects in repairing deep wound, with minimal donor site damage.

Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Arteries , Perforator Flap , Plastic Surgery Procedures/methods , Retrospective Studies , Skin Transplantation , Soft Tissue Injuries/surgery , Treatment Outcome
Chinese Medical Journal ; (24): 591-597, 2022.
Article in English | WPRIM | ID: wpr-927512


BACKGROUND@#Insufficient cerebral perfusion is suggested to play a role in the development of Alzheimer disease (AD). However, there is a lack of direct evidence indicating whether hypoperfusion causes or aggravates AD pathology. We investigated the effect of chronic cerebral hypoperfusion on AD-related pathology in humans.@*METHODS@#We enrolled a group of cognitively normal patients (median age: 64 years) with unilateral chronic cerebral hypoperfusion. Regions of interest with the most pronounced hypoperfusion changes were chosen in the hypoperfused region and were then mirrored in the contralateral hemisphere to create a control region with normal perfusion. 11C-Pittsburgh compound-positron emission tomography standard uptake ratios and brain atrophy indices were calculated from the computed tomography images of each patient.@*RESULTS@#The median age of the 10 participants, consisting of 4 males and 6 females, was 64 years (47-76 years). We found that there were no differences in standard uptake ratios of the cortex (volume of interest [VOI]: P = 0.721, region of interest [ROI]: P = 0.241) and grey/white ratio (VOI: P = 0.333, ROI: P = 0.445) and brain atrophy indices (Bicaudate, Bifrontal, Evans, Cella, Cella media, and Ventricular index, P > 0.05) between the hypoperfused regions and contralateral normally perfused regions in patients with unilateral chronic cerebral hypoperfusion.@*CONCLUSION@#Our findings suggest that chronic hypoperfusion due to large vessel stenosis may not directly induce cerebral β-amyloid deposition and neurodegeneration in humans.

Aged , Female , Humans , Male , Middle Aged , Alzheimer Disease/pathology , Amyloid beta-Peptides/metabolism , Arteries , Atrophy , Brain/metabolism , Cerebral Cortex/metabolism , Cerebrovascular Circulation , Constriction, Pathologic/pathology , Magnetic Resonance Imaging/methods , Positron-Emission Tomography/methods
Journal of Biomedical Engineering ; (6): 1127-1132, 2022.
Article in Chinese | WPRIM | ID: wpr-970650


The radial artery pulse wave contains a wealth of physiological and pathological information about the human body, and non-invasive studies of the radial artery pulse wave can assess arterial vascular elasticity in different age groups.The piezoelectric pulse wave transducers were used to non-invasively acquire radial artery pulse waves at different contact pressures in young and middle-aged and elderly populations. The radial artery waveforms were decomposed using a triangular blood flow model fitting method to obtain forward and reflected waves and calculate reflection parameters. Finally a correlation analysis and regression analysis of the contact pressure Psensor with the reflection parameters was carried out. The results showed that the reflection parameters RM, RI and Rd had a strong negative correlation with Psensor in both types of subjects, and the correlation coefficients and slopes of the regression curves were significantly different between the two types of subjects (P<0.05). Based on the results of this study, excessive contact pressure on the transducer should be avoided when detecting radial artery reflection waves in clinical practice. The results also show that the magnitude of the slope of the regression curve between the reflection parameters and the transducer contact pressure may be a potentially useful indicator for quantifying the elastic properties of the vessel.

Middle Aged , Aged , Humans , Blood Pressure/physiology , Arteries , Blood Flow Velocity/physiology , Elasticity , Pulse Wave Analysis , Radial Artery/physiology
Chinese Journal of Burns ; (6): 661-666, 2022.
Article in Chinese | WPRIM | ID: wpr-940972


Objective: To investigate the clinical effects of free peroneal artery perforator flaps in repairing forefoot skin and soft tissue defect wounds assisted with three-dimensional computed tomography angiography (3D-CTA). Methods: A retrospective observational study was conducted. From March 2017 to September 2019, 15 patients with skin and soft tissue defect wounds in the forefoot were treated in the Department of Burn and Plastic Surgery of Yidu Central Hospital of Weifang, including 12 males and 3 females, with age of 18-60 years. The wound area on admission was 3.0 cm×3.0 cm-9.0 cm×8.0 cm. The 3D-CTA examination before operation was performed to select the peroneal artery perforating vessels with appropriate length of vascular pedicle and good blood perfusion. According to the wound area and the perforating vessels of the peroneal artery located by 3D-CTA, the peroneal artery perforator flaps of 3.5 cm×3.5 cm-9.5 cm×8.5 cm carried with lateral sural cutaneous nerve was designed and cut, and the nerve was anastomosed with the nerve of the wound. The wound in the donor site of the flap was directly sutured or covered with medium-thickness skin graft from the thigh. The consistencies of type, diameter, and perforating position of perforating vessel of the peroneal artery detected by 3D-CTA before the operation with those of the actual measurement during operation were observed. The length of time for flap cutting and the survival of the flap after operation were recorded. During follow-up of 12 months after the operation, the patients were instructed to evaluate the foot function according to the Maryland foot function score standard, and the wound healing in the donor area and the occurrence of complications affecting the motor function of limb were observed. Data were statistically analyzed with paired sample t test. Results: The types of peroneal artery perforating vessels in patients measured during the operation were septocutaneous perforator of 12 cases, musculocutaneous perforator of 2 cases, and musculomuscular septal perforator of 1 case, which were consistent with those measured by preoperative 3D-CTA. The diameter of the peroneal artery perforating vessel measured by preoperative 3D-CTA was (1.38±0.17) mm, which was close to (1.40±0.19) mm measured during the operation (t=0.30, P>0.05). The horizontal distance from the starting point of the perforating vessel to the outer edge of the shank was (42±6) mm, and the vertical distance from the starting point of the perforating vessel to the level of the lateral ankle tip was (219±14) mm measured by preoperative 3D-CTA, which were respectively close to (43±6) and (221±15) mm of intraoperative measurement (with t values of 0.46 and 0.38, respectively, P>0.05). The length of time for cutting flap was (31±6) min. All flaps survived post operation without vascular crisis. During follow-up of 12 months after the operation, the foot function was evaluated as excellent in 11 cases, good in 3 cases, and fair in 1 case, the donor site wound healed well, the scar was not noticeable with no contracture, and the motor function of joints was not affected. Conclusions: Free peroneal artery perforator flap is one of the effective methods to reconstruct skin and soft tissue defect wounds in the forefoot, and the risk of surgery can be reduced when the anatomical location of the perforating vessels is confirmed by 3D-CTA.

Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Arteries , Computed Tomography Angiography , Perforator Flap/blood supply , Plastic Surgery Procedures/methods , Skin Transplantation , Soft Tissue Injuries/surgery , Treatment Outcome