Catheter-directed middle hemorrhoidal artery embolization for life-threatening rectal bleeding.

Over the past 10 years, arteriography has become a well-established technique for the diagnosis of acute lower gastrointestinal bleeding, but not particularly for rectal bleeding. However, to the authors' knowledge, the technique of middle hemorrhoidal artery embolization has rarely been reported in the literature. In the present report, three patients with life-threatening rectal bleeding are presented, which was controlled by superselective embolization of the middle hemorrhoidal artery or selective embolization of the internal iliac artery as a last resort.     

Anatomic study of a new axial skin flap based on the cutaneous branch of the medial plantar artery

A new axial skin flap based on the middle cutaneous branch of the medial plantar artery was evaluated in 33 fresh cadaver legs. The vascular pedicle of the skin flap is based on the middle cutaneous artery, its venae comitantes, and segments of the great saphenous vein, if necessary. The middle cutaneous artery is the largest cutaneous branch, arising from the medial plantar artery 2.5 cm distal to its origin. The diameter of its origin is 1.2 mm, and its pedicle is 2 cm long. The midline of the flap runs from the first web space to the heel tip. The upper and lower borders of the flap are 3 to 4 cm on either side of this line. The upper border is medial to the extensor hallucis tendon, and the lower border is medial to the abductor hallucis. Distally, the border begins 2 cm proximal to the metatarsalphalangeal joint; proximally, the border is at the middle of the medial malleolus. The flap diameter can be up to 8 × 12 cm. The middle cutaneous branch of the medial plantar artery was found in all cadaver specimens, except for one with a common trunk. The new flap design leaves the major blood supply to the foot and the plantar aponeurosis intact. It is easy to harvest and may be used either as an island flap or free flap. © 1995 Wiley-Liss, Inc.     

Hydatid cyst of gall bladder.

Gall bladder hydatid cyst is a rare entity. Concurrent occurrence of gall blader hydatid cysts along with liver cysts, especially with the biliary channels clear of cysts, is very rare. We report a 27-year-old man with a gall bladder hydatid cyst that was diagnosed only after opening the resected specimen of the gall bladder.     

腹部外科感染主要病原菌及药物敏感性的变化趋势

尽管越来越多强有力的新型抗生素应用于临床,感染依然是外科面临的重大难题之一.由于宿主、微生物和抗菌药物三方面各自力量的消长和相互间关系的变动,腹部外科感染性疾病常见细菌的构成比和药物敏感性均处于不断变化的过程中,只有及时掌握这种变化趋势,才能针对性地选用最有效的抗菌药物进行治疗,从而降低术后感染并发症、减少住院时间、减轻病人的经济负担和提高治愈率.     

准分子激光原位角膜磨镶术患者主客观因素与疗效的相关性分析

目的：通过对准分子激光原位角膜磨镶术(LASIK)患者主客观因素与疗效的相关性分析，了解临床影响术后视力的主观、客观因素。方法：对2002年间在我院行ASIK的164例患者325只眼(其中3例为单眼)进行连续性临床观察研究，分别进行术前、术后问卷式主客观因素调查，并对患者手术疗效进行相关性统计学分析。结果：患者术前对手术效果的期望值、手术中疼痛程度与手术后视力有显著相关性。结论：解除患者术前忧虑及避免术中疼痛对提高术后疗效有重要意义。     

全喉切除术中保留甲状软骨膜对手术进程和术后恢复影响的探讨

目的：探讨保留甲状软骨膜对全喉切除手术进程和病人术后恢复情况的影响。方法：在甲状软骨膜下游离甲状软骨并切断其上角。不结扎和切断舌骨下肌群和喉上动脉。保留之甲状软骨膜用以加强修复咽壁黏膜。结果：本组病例较经典全喉切除术手术时间缩短30min以上。手术中出血在100ml以下。患者术后第2d下床活动，第4d开始进食流质。手术创口均一期愈合。结论：全喉切除术中保留甲状软骨膜可有效地简化手术步骤，减少创伤和出血。利用甲状软骨膜加强咽壁黏膜缝合口，进一步减少了咽漏的发生.