Clinical analysis of risk factors of the patency of the descending branch of the lateral circumflex femoral artery

Abstract

Many studies have provided anatomical statistics of the descending branch of lateral circumflex femoral artery (LCFA) through its use as the pedicle of anterolateral thigh (ALT) flaps. However, most of the results from these studies were acquired during surgeries or from cadavers. Therefore, this study has studied the descending branch of LCFA in patients with underlying diseases or risk factors using lower extremity angiography, and how such risk factors and the degree of stenosis in other arteries affect the patency and stability of the descending branch. The subjects of retrospective study were 89 legs from 49 patients who had received lower extremity angiography. Risk factors included age, BMI, diabetes, hypertension, tobacco use, hyperlipidemia, cardiac status, carotid status, renal disease, pulmonary status, and history of lower limb amputation. Analysis of the degree of stenosis in the descending branch of LCFA in regard to each risk factor have shown that hypertension, pulmonary function, history of lower limb amputation, and the total score of 11 risk factors were statistically significant. Also, in the correlation study of lower limb arteries, there was a significant correlation with the degree of stenosis in the posterior tibial artery, but not so in others. Therefore, when planning a flap surgery using the descending branch of LCFA, one needs to run imaging tests such as angiography to check arterial patency in patients with hypertension, impaired pulmonary function, and history of lower limb amputation.     

Paralysis of the first dorsal interosseous muscle after external fixation of a distal radial fracture treated by transfer of the extensor indicis proprius tendon

We describe a patient in whom the motor branch to the first dorsal interosseous muscle was injured by the pins of an fixator used to treat an unstable fracture of the distal radius. She was successfully treated by extensor indicis proprius transfer to the base of the proximal phalanx of the index finger.     

Ulnar nerve lesion at the wrist related to pisotriquetral joint arthropathy

Introduction: Ulnar nerve lesions at the wrist (UNLW) are always difficult to localize clinically and sometimes electrophysiologically. Finding conduction block when studying ulnar motor nerve conduction (CB) across the wrist is sometimes the only way to demonstrate that the ulnar deep motor branch (UDMB) is entrapped. Methods: An elderly woman who had bilateral carpal tunnel syndrome (CTS) and thumb osteoarthritis for many years experienced worsening of left hand impairment recently. Results: Electrodiagnostic and ultrasound examinations revealed an acute and severe UDMB lesion related to pisotriquetral joint effusion. The patient received a local injection of a corticosteroid that provided rapid recovery. Conclusions: The diagnosis of UDMB lesion is especially difficult when CTS coexists, but CTS may allow for early diagnosis, if CB at the wrist is not overlooked. Chondrocalcinosis was responsible for the systemic inflammation, the CTS, the pisotriquetral joint effusion, and the UDBM compression, which has not been reported previously. Muscle Nerve, 2013     

Endovascular Treatment of Complex Aneurysms with the Use of Covera Stent Grafts

PurposeTo characterize the short-term results of a newly available self-expanding covered stent (Covera; CR Bard Peripheral Vascular Inc., Murray Hill, New Jersey) for the reconstruction of target vessels in complex aneurysms.Materials and MethodsFrom August 2017 to November 2018, this self-expanding covered stent was used in 17 patients (mean 72.6 ± 7.6 years of age) during endovascular aneurysm repair (EVAR) with hypogastric preservation (11.8%), branched EVAR (29.4%), fenestrated (F)-EVAR (17.6%), chimney + F-EVAR (11.8%), or chimney EVAR (29.4%). In more than 48 stented arteries (2.8 ± 1.1/patient), 25 were preserved using this self-expanding covered stent.ResultsAll target vessels were successfully preserved. There was no 30-day mortality and 1 in-hospital death. Intraoperative aneurysm exclusion was successful in 14 patients (82.4%) with a perioperative technical success rate of 82.4%. The actuarial survival rate was 93.8% at 6 months and 85.9% at 12 months. Aneurysm sac regression of >5 mm was observed in 4 cases (23.5%), and the sac remained stable in the remaining patients (13 cases [76.5%]). At 12 months, the primary clinical success rate was 76.5%, and assisted primary clinical success rate was 82.4%. No type 3 endoleak was related to a disruption of the reconstruction with the self-expanding covered stent.ConclusionsThis new self-expanding covered stent provides good short-term patency in chimneys, branches, or fenestrations. Larger series with long-term follow-up are required to determine if the stent can sustain the mechanical stress to which it will be submitted in these repairs.     

硬化大脑中动脉及豆纹支管壁弹性结构改变及意义

本文用光镜、电镜观察了正常和硬化大脑中动脉及其豆纹支管壁弹性结构的形态。结果显示，硬化大脑中动脉内弹力膜断裂，且以外层断裂明显，波纹状外观消失；而豆纹支内弹力膜结构完整，波纹状外观清晰可见。平滑肌萎缩、变性，胶原纤维增多。提示硬化大脑中动脉破裂出血是内弹力膜破坏，平滑肌萎缩，管壁脆性增加所致；而豆纹动脉是根部存在＂中膜缺损＂，此外受血流冲击引起破裂的可能性大。     

The injury of marginal mandibular branch unexpectedly promotes the repair of buccal branch of facial nerve in a rat model

Conclusions: The results indicate that the injury of the marginal mandibular branch improved the recovery of the buccal branch in a rat model.

Objective: The aim of this study was to investigate whether the injury or intactness of the marginal mandibular branch affects the regeneration of the facial nerve buccal branch in a rat model.

Methods: This experiment was conducted on 30 adult rats, which were randomly and equally divided into two groups. The buccal branch of the facial nerve was transected and reconstructed, with the marginal mandibular branch damaged (group A) or intact (group B). The vibrissae movement of rats was assessed since the 4th week after operation. At the 8th and 12th week, compound muscle action potentials (CMAPs) and morphological changes of injured buccal branches were evaluated.

Results: After the operation, vibrissae movement of rats was eliminated in group A, but it was similar to the health side in group B. CMAPs were recorded from regenerated buccal branches in group A since the 8th week, but no CMAPs could be recorded in group B at each time point. Additionally, the diameter of nerve fibers, the thickness of myelin sheath, and the density of regenerated fibers in group A were significantly larger than those in group B (p?相似文献   

Novel group VII histidine kinase HwHhk7B from the halophilic fungi <Emphasis Type="Italic">Hortaea werneckii</Emphasis> has a putative role in osmosensing

Histidine kinases (HKs) are abundant among prokaryotes and have been characterized in fungi and plants, although not yet in animals. These enzymes regulate diverse processes, including adaptation to osmotic stress and virulence of plant and animal pathogens. Here, we report the cloning, characterization and phylogenetic analysis of HwHHK7A and HwHHK7B, HK genes from the fungi Hortaea werneckii, a proposed model system for studying salt tolerance in eukaryotes. The two HwHhk7 isoforms are 96.7% identical in amino-acid sequence and have a typical eukaryotic hybrid HK domain composition. On the bases of the conserved sequence of the H box, they are classified into the group VII ascomycete HKs. For the HwHhk7B protein, the autokinase activity was demonstrated in vitro. The salt-responsive expression of the HwHHK7 genes and the increased osmotolerance of a wild-type Saccharomyces cerevisiae strain expressing the HwHHK7B gene lead us to speculate that these newly identified HKs have roles in osmosensing.