Left lobe splitting and full right-full left splitting: study of the portal anatomy on corrosion casts and on autopsy livers.
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Autopsy↗
Biomedical subjects
J Fasel
Publications and source records attributed to J Fasel.
In vivo human gastrocnemius architecture with changing joint angle at rest and during graded isometric contraction.
1. Human gastrocnemius medialis architecture was analysed in vivo, by ultrasonography, as a function of joint angle at rest and during voluntary isometric contractions up to the maximum force (MCV). maximum force (MVC). 2. At rest, as ankle joint angle increased from 90 to 150 deg, pennation increased from 15.8 to 27.7 deg, fibre length decreased from 57.0 to 34.0 mm and the physiological cross-sectional area (PCSA) increased from 42.1 to 63.5 cm2. 3. From rest to MVC, at a fixed ankle joint angle of 110 deg, pennation angle increased from 15.5 to 33.6 deg and fibre length decreased from 50.8 to 32.9 mm, with no significant change in the distance between the aponeuroses. As a result of these changes the PCSA increased by 34.8%. 4. Measurements of pennation angle, fibre length and distance between the aponeuroses of the gastrocnemius medialis were also performed by ultrasound on a cadaver leg and found to be in good agreement with direct anatomical measurements. 5. It is concluded that human gastrocnemius medialis architecture is significantly affected both by changes of joint angle at rest and by isometric contraction intensity. The remarkable shortening observed during isometric contraction suggests that, at rest, the gastrocnemius muscle and tendon are considerably slack. The extrapolation of muscle architectural data obtained from cadavers to in vivo conditions should be made only for matching muscle lengths.
Adult↗
[Development of a practice-oriented curriculum. 9. Arthrology].
The background problem this article addresses is the need to reduce the quantity of medical information to a standard core of knowledge relative to the overwhelming amount of scientific information to be learned in the limited amount of time students have available. The article is part of a study the aim of which is to define a core students, independent of their further medical specialization. The design of this study is a survey of a representative sample of Swiss general practitioners who were asked to identify in the list of Nomina Anatomica the most prevalent anatomical entities (terms) occurring in their practice. To assure the representativeness of the sample the identified terms were compared to prevalent diagnoses of all Swiss general practitioners and to the incidence of cases in German hospitals. From the list of International Anatomical Nomenclature (IANC) 280 anatomical terms could be identified with respect to arthrology. Of these, 250 were judged uniformly by the physicians: 52 terms were considered relevant, while it was not though necessary for 198 terms to be relevant, while it is was not thought necessary for 198 terms to be learned, i.e. general practitioners agreed on 89.3% of the terms. Only 29.7% of the terms in the IANC list belong to anatomical core knowledge in arthrology. There is evidence for the representativeness of these findings when compared to the prevalence of diagnoses made by general practitioners and to the incidence of cases in German hospitals. The method of using criteria of prevalence in a survey to identify a core of knowledge in medicine is suited for the definition of learning content necessary for professional purposes.
Curriculum↗
Three-dimensional reconstruction of a levator claviculae muscle.
During routine radiological examination of a 72 year-old woman a soft-tissue shadow in the left posterior triangle of the neck was observed. Three-dimensional reconstruction of this structure suggested that it might be a muscular variant: a levator claviculae muscle. In our case it took origin from the upper part of the cervical column and was inserted into the lateral third of the clavicle. With this example as a background, the general significance of anatomical muscular variants for modern imaging techniques is discussed.
Aged↗
[Extracorporeal shockwave lithotripsy of the gallbladder: importance of selection criteria].
In recent years, a number of alternatives to surgery for gallstones have been developed. Among them, extracorporeal shock-wave lithotripsy (ESWL) was promising, being non-invasive and risk-free. Nevertheless, its results vary according to the size, number and composition of the stones and according to the bile acids treatment used for fragment dissolution. To better evaluate the importance of these factors, we have widened the selection criteria currently used (1 to 3 non-calcified stones with a diameter below 30 mm) by including patients with large stones (up to 40 mm in diameter), multiple stones (up to 10 stones) and calcified stones. We also compared, for efficacy of fragment dissolution after ESWL, treatment by ursodeoxycholic acid alone as opposed to a mixture with chenodeoxycholic acid. Our results were (1) significant lessening of the fragmentation rate and of the number of gallbladders free of stones 1 year after ESWL when selection criteria are widened; (2) a mixture of ursodeoxycholic and chenodeoxycholic acids may favour fragment dissolution after ESWL compared to treatment by ursodeoxycholic acid alone.
Adolescent↗
Healing of the transected anterior cruciate ligament in the rabbit.
Healing of the anterior cruciate ligament was studied in 170 male rabbits. One group included immature animals that had open epiphyses, and a second group consisted of only mature animals. In one knee of each animal, the anterior cruciate ligament was transected either completely or partially, and in the contralateral knee a sham operation was carried out. Mechanical testing and histological studies of the ligaments were done immediately postoperatively and at two weeks, six weeks, three months, and one year. As we expected, there was no regeneration after complete transection of the anterior cruciate ligament, and all of the animals in which this procedure was done had severe osteoarthrosis of the joint at three months. Postoperatively, the partially sectioned ligaments exhibited one-third of the strength of the ligaments on the side on which the sham operation had been done in the immature animals and one-fourth of the strength of the ligaments on the side on which the sham operation had been done in the mature animals. Subsequently, there was secondary complete rupture of 20 per cent of the partially sectioned ligaments. The remaining 80 per cent of the partially sectioned ligaments were clearly weaker two weeks after the operation than immediately postoperatively, but this was also true on the side on which the sham operation had been done. At six weeks, the initial postoperative strength of the partially sectioned ligaments had been regained. At one year, the ligaments of the immature animals were two-thirds as strong as those on the contralateral side, and those of the mature animals were three-fourths as strong as those on the contralateral side. The ligaments were markedly elongated, especially in the mature animals. At three months, stiffness of the ligaments returned to normal. Histologically, the defect was filled with tissue that was still somewhat different from normal ligamentous tissue.
Aging↗
Mastocytosis and atopy: a study of 33 patients with urticaria pigmentosa.
Thirty-three patients with histologically verified urticaria pigmentosa were studied for coexisting atopic disease by means of history, skin prick testing with five common inhalants and serological investigation for total IgE and specific IgE antibodies to five common inhalants. The prevalence of atopy in urticaria pigmentosa was similar to that observed in the normal Swiss population, both on the basis of history (7/33 = 21%) and of positive skin prick tests to common inhalants (12/33 = 36%). However, total serum IgE levels were significantly lower (geometric mean value 16.8 kU/l) than in a control group of 52 Swiss blood donors of comparable age and sex distribution (geometric mean value 43.0 kU/l, t = 2.93, P less than 0.005). Specific IgE antibodies to common inhalants were also observed less frequently in urticaria pigmentosa patients than in controls, although this difference was not statistically significant. Low total and specific IgE values in patients with urticaria pigmentosa may be explained by increased absorption of circulating IgE to abundant tissue mast cells.
Adolescent↗
[Sports medicine at Swiss universities: Freiburg].
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Curriculum↗
[The intraosseous course of the chorda tympani].
Subsequently to a gross anatomy study the present report covers the intraosseous course of the chorda tympani by histological methods. After having passed the middle ear, the nerve enters the petrotympanic fissure (of Glaser), moves medially deep in it, never appearing in the mandibular fossa. It leaves the external surface of the base of the skull medial to the spined sphenoid, through the sphenopetrosal fissure.
Chorda Tympani Nerve↗
[Savary's ulcer: a new complication of gastroesophageal reflux? Apropos of 32 endoscopically observed cases].
Savary's ulcer is a rare and little known peptic ulcer situated just above Barrett's esophagus. It is predominant in elderly women, bleeds less than Barrett's ulcer and is almost always associated with peptic stenosis. It is, like Barrett's and Wolf's ulcers, a complication of gastroesophageal reflux and not of Barrett's esophagus.
Adolescent↗
[Ulcers and hiatal hernia. Apropos of 19 endoscopic case reports].
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Adult↗
A contribution to the anatomic basis of the transoral approach to the atlas and axis.
The transoral approach (Fang and Ong 1962) allows direct free exposure of the atlas and axis. However, a morphologic description of certain structures at risk corresponding to the views at operation has so far been lacking. The present study is intended to fill this gap by giving the surgeon a transoral view of the peripharyngeal structures. This is a further instance of how classical gross anatomy needs to be continuously rediscovered in the light of clinical activities.
Axis, Cervical Vertebra↗
[A partially duplicated vena cava inferior: clinical, macroscopic and embryologic anatomy].
Anomalies of the inferior vena cava (IVC) can become unexpected obstacles during anterior surgery exposures of the lumbar spine. Starting from a recently observed case of a partially bilateral IVC, the literature, both clinical and anatomical, was reviewed with particular respect to the requirements of spine surgery. Based on extensive radiological (especially phlebographic), surgical, and anatomical investigations, the frequency of left sided or bilateral IVC can be figured out at about 2%. The embryogenesis of the variation is contested. Our observations comprising 45 human embryos confirm the conception according to which the infrarenal segment of IVC originates from the sacrocardinal (and not from the supracardinal) vein.
Humans↗
Light and electron microscopic changes in the kidney of Wistar rats following treatment with cyclosporine A.
The morphological changes found in kidneys of patients undergoing chronic Cyclosporine A (CSA) treatment could, despite of numerous attempts, not yet be reproduced in reliable experimental models. The purpose of the present investigation was to systematically scan the in vivo fixed kidneys in CSA treated Wistar rats at the light and electron microscopic level. The study revealed changes in the proximal tubules, i.e., inclusion bodies, vacuolization, microcalcifications and regeneration. Some glomeruli displayed a thickening of the parietal sheet of Bowman's capsule. At the electron microscopic level, individual necroses of myocytes in the tunica media of afferent arterioles were observed. Thus, at the ultrastructural level, the kidneys of CSA treated normotensive Wistar rats do reveal morphological changes similar to those occurring in man.
Animals↗
[Barrett's ulcer: myths and realities].
Barrett's ulcer, a rare disease of elderly patients, is not a precancerous condition. It has a marked tendency to bleed but not to perforate. It seems to develop in the squamous epithelium of the lower esophagus and not in the columnar epithelium of the endobrachy esophagus.
Aged↗
Comparison of two assays for the determination of specific IgE in serum of atopic and nonatopic subjects: the Allergenetics FAST and the Phadezym RAST.
The FAST assay (Allergenetics) for the determination of specific IgE has recently been introduced. The results of this test, graded in classes 0 (negative), 1 (equivocal) and 2 to 6 (positive) were compared with those of another commercially available test (Phadezym RAST, Pharmacia), graded from class 0 (negative) and classes 1 to 4 (positive). In 52 adults suffering from rhinitis/asthma, a total of 114 positive skin prick tests (SPT) were obtained for common respiratory allergens. In 67% of these tests the Phadezym RAST was positive and in 63% the FAST was positive (classes 2 to 6). In these patients there were 151 negative SPT: 6% corresponded to a positive Phadezym RAST (all class 1) and 34% to a positive FAST (classes 2 to 6). The serum of nine nonatopic volunteers who had negative SPT for 12 common allergens were tested. In none did the Phadezym RAST give any positive results; the FAST was positive in all nine sera, detecting between five and 11 allergens. When both assays were performed on 14 unselected cord blood samples, the Phadezym RAST was positive in three samples (with class 1 results to a maximum of two allergens), and the FAST was positive in 12 samples, detecting between one and seven allergens. Thus, in our hands, the FAST gave an abnormally high number of positive results in patients with negative SPT, in nonatopic volunteers, and in cord blood.
Adolescent↗
Laservision-disk and computer-assisted medical learning.
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Audiovisual Aids↗
[The exit of the chorda tympani nerve through the external surface of the base of the skull].
Current textbooks of anatomy consider the chorda tympani to leave the external surface of the base of the skull through the petrotympanic fissure (of Glaser). In contrast to this view, Krause in 1905 described the sphenopetrosal fissure as outlet structure. The present reexamination of the extracranial course of 33 chordae tympani confirms the latter conception. Thus, the prevailing opinion has to be revised. Clinical impacts are discussed.
Chorda Tympani Nerve↗