We reviewed 12 cases of infarcts in the territory of the anterior choroidal artery (AChA) on CT and/or MRI. In each case vascular occlusion in the region was verified angiographically. Although the extent of the lesion on CT/MR images was variable, all were located on the axial images within an arcuate zone between the striatium anterolaterally and the thalamus posteromedially. The distribution of the lesions on mutiplanar MRI conformed well to the territory of the AChA demonstrated microangiographically. The variability of the extent of the infarcts may be explained by variations in the degree of occlusive changes in the AChA or the development of collateral circulation through anastomoses between the AChA and the posterior communicating and posterior cerebral arteries. The extent of the lesion appeared to be closely related to the degree of neurological deficit. 相似文献
Background: Between 1991 and November 1994, 18 patients with large, solitary, nonparasitic liver cysts underwent laparoscopic deroofing;
the last 13 of them also received an omental transposition flap in addition.
Methods: Using three to four trocars, the cystic contents were first aspirated, and the cyst derooted widely using diathermia. An
omental transposition flap was fashioned and stapled into the cyst cavity itself.
Results: Postoperative complications included one case of pulmonary atelectasis. Another patient developed a subhepatic bile collection
which was aspirated percutaneously. On average, patients were discharged on the 4th (2–14) postoperative day. Follow-up was
performed with abdominal ultrasound for 2–43 months (mean 19 months). There were two early cyst recurrences, both in cases
without an omental transposition flap (overall recurrence rate, 11%; in patients with omental flap, 0).
Conclusions: Deroofing in combination with an omental transposition flap is a safe and effective therapy for symptomatic solitary liver
cysts and can be performed using minimal-access surgical techniques.
Received: 19 January 1996/Accepted: 26 August 1996 相似文献
Although the conventional outside-in technique is especially useful for repairing tears in the anterior portion of the meniscus,
it has a disadvantage of making an additional 1–2 cm sized skin incision and tying knots subcutaneously over the capsule.
Therefore we devised two all-inside repair techniques of lateral meniscus anterior horn tear according to the site of meniscal
tear, meniscosynovial junction or red–red zone. Because these techniques are modified methods of the outside-in meniscal repair
using a spinal needle, they are as simple as conventional outside-in technique. In addition they have advantages of vertical
mattress suture, which is an important characteristic of the all-inside repair, and no additional incision. We recommend these
techniques as an alternative method for repairing an anterior horn tear of the lateral meniscus. 相似文献
Background. Partial harvesting of the left internal mammary artery (LIMA) is a widespread technique used during minimally invasive coronary operations performed through a left anterior small thoracotomy. The influence of persisting LIMA branches was investigated to evaluate their effect on the blood flow of the left anterior descending artery.
Methods. Thirty patients, 15 with totally (group A) and 15 with partially (group B) harvested LIMAs, were evaluated. All the patients underwent postoperative angiography, during which a flow map of the LIMA was performed. The average peak velocity and the diastolic-to-systolic peak velocity ratio were recorded. The LIMA graft flow pattern was recorded in the proximal and distal thirds of the artery. Intramammary adenosine (12 to 14 μg) was injected and the average peak velocities before and after injection were calculated.
Results. The average peak velocity was similar in both groups in the proximal and distal thirds of the LIMA (25 ± 7 and 26 ± 5 cm/sec, respectively, in group A versus 27 ± 5 and 25 ± 5 cm/sec, respectively in group B; p = NS). The diastolic-to-systolic peak velocity ratio was similar proximally (0.78 ± 0.3 in group A versus 0.69 ± 0.3 cm/s in group B; p = NS), but not distally (1.72 ± 0.1 in group A versus 0.97 ± 0.3 in group B; p < 0.0005). The LIMA graft flow reserve was similar both proximally and distally (2.6 ± 0.6 and 2.5 ± 0.3 cm/s, respectively, in group A versus 2.6 ± 0.5 and 2.6 ± 0.3 cm/s, respectively, in group B; p = NS).
Conclusions. The persistence of LIMA branches does not influence the blood flow of the left anterior descending artery after acute adenosine-induced myocardial hyperemia. If a left anterior small thoracotomy is used in left anterior descending artery direct revascularization, complete LIMA harvesting is not mandatory and depends on the personal preference of the surgeon. 相似文献
Summary The serratus anterior muscle in the rat is supplied by the serratus division of thoracodorsal vessels, in a pattern similar to man [2]. The serratus anterior muscles were transferred to the groin area as a free muscle flap in 17 rats and as a free muscle graft in 13 rats. In the free muscle flap group, the serratus anterior muscles of 8 of 10 rats survived; histological examination showed them to be viable and the vascular anastomoses were patent at the 30th day. In the free muscle graft group, all of the muscle grafts became necrotic. As a result, it is concluded that the microvascular transfer of serratus anterior muscles in rats is a useful small animal model for microsurgical laboratory training of clinical free flap transfers and also for performing pharmacological and biochemical studies in transplanted muscle. 相似文献
At the Indiana University Medical Center, 99 patients with medically intractable complex partial seizures (MI-CPS) had presurgical evaluation with subsequent anterior temporal lobectomy. The majority of the patients had single photon emission tomography (SPECT) performed interictally as well as during an actual epileptic seizure (ictal scan). Decreased regional cerebral perfusion (rCP) was seen in 54/94 (57%) of the interictal scans corresponding to the eventual site of the surgery. However, ictal scans provided a higher yield; increased rCP in the temporal lobe during an actual seizure was observed in 60/82 (73%) concordant to the side of surgery. SPECT is a useful, noninvasive method of localizing the epilepti-form focus in patients with MI-CPS considered for resective surgery. Both interictal and ictal SPECT need to be performed; combined interictal hypo-perfusion and ictal hyperperfusion in the same focal area are unique to epileptogenic lesions. Ictal SPECT studies can be performed in the majority of patients during the period of continuous video/EEG monitoring with only a little additional effort. Combining the results of functional brain imaging (interictal and ictal SPECT, PET) with clinical semiology of seizures, surface and sphenoidal EEG, magnetic resonance imaging and other non-invasive tests, anterior temporal lobectomy can be recommended in approximately two-thirds of the patients without resorting to potentially dangerous intracranial EEG monitoring. 相似文献