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At least 1,261 records · Page 70Linked to original sources
PubMed1990

[The effect of the vertical bracket position on the orthodontic finish].

As during orthodontic treatment and in particular during the phase of the precise adjustment of occlusion by applying the "straight-wire technique" problems arise as far as the vertical dimensions are concerned, the usual distances between the bracket slots and the edges of the incisors respectively the top of the cusps have been verified. Measurements were done on models at the end of treatment of ten patients treated with fixed attachments who may represent ideal occlusion as far as profile radiographs and gnathology were concerned. After regulation of the plane of occlusion the vertical distances between the slot base plane (parallel to the plane of occlusion) and the edge of the incisors respectively tops of cusps were measured by means of a modified parallelometer in connection with a special slot and tube support as well as a specially developed dial test indicator, while a maximum fit between bracket base and buccal crown surface was given. In case of the upper front brackets (torque + 22 degrees) large vertical measurement to the edge of the incisors were recorded, 8.25 respectively 8.33 mm). This may be attributable to excessive torque of the applied brackets. Only approximate figures for the vertical positioning for other teeth could be given, as anatomical variations have to be considered.

Adolescent↗
PubMed1992

Computed tomography in the initial management of acute left-sided diverticulitis.

Computed tomography (CT) was used in place of contrast enemas as the initial imaging study to evaluate patients with the clinical diagnosis of acute sigmoid diverticulitis. This report attempts to clarify the role of CT in the management of acute sigmoid diverticulitis by reviewing its usefulness in the diagnosis and treatment of 59 patients. CT established that three patients (5 percent) were hospitalized with an incorrect clinical diagnosis. Thirty-seven patients (62.7 percent) were identified as having uncomplicated acute diverticulitis. These patients were all treated successfully with nonsurgical therapies and were discharged in an average of 6.8 days. In the remaining 19 patients (32.2 percent), CT revealed complicated acute diverticulitis by identifying abscess, fistula, peritonitis, or obstruction. Eleven of these 19 patients required urgent surgery or CT-guided percutaneous drainage of an abscess. The four patients whose abscesses were drained percutaneously responded favorably and underwent an elective single-stage resection. The average hospital stay for patients with complicated diverticulitis was 13.6 days. Computed tomography is a useful aid in the initial management of patients with acute diverticulitis. It is a noninvasive test that recognizes and stratifies patients according to the severity of their disease. It has the further advantage of providing information about extracolonic pathology and anatomic variation useful for surgical planning. Additionally, early CT-guided needle drainage allowed downstaging of complicated diverticulitis, avoided emergent surgery, and permitted single-stage elective surgical resection.

Abscess↗
PubMed1989

Anatomical basis of whole pancreas transplantation.

Combined liver and whole pancreas procurement is feasible provided that anatomical variations of the hepatic a. are kept in mind and recognised. In case of a single middle hepatic a., the pancreas can be procured with the celiac axis and the superior mesenteric a. The liver is harvested with all its artery. In case of a left hepatic a., the liver should have the celiac axis, the left and the middle hepatic a. The pancreas is harvested with the superior mesenteric a. on which the splenic a. will be implanted, provided that the dorsal pancreatic a. is really coming from the splenic a. In case of a right hepatic a., the liver is procured with the middle hepatic a., the right hepatic a. and the superior mesenteric a. The pancreas will have the celiac axis, the common hepatic a. with the gastroduodenal branch and the splenic a.

Humans↗
PubMed2004

Single-trabecula building block for large-scale finite element models of cancellous bone.

Recent development of high-resolution imaging of cancellous bone allows finite element (FE) analysis of bone tissue stresses and strains in individual trabeculae. However, specimen-specific stress/strain analyses can include effects of anatomical variations and local damage that can bias the interpretation of the results from individual specimens with respect to large populations. This study developed a standard (generic) 'building-block' of a trabecula for large-scale FE models. Being parametric and based on statistics of dimensions of ovine trabeculae, this building block can be scaled for trabecular thickness and length and be used in commercial or custom-made FE codes to construct generic, large-scale FE models of bone, using less computer power than that currently required to reproduce the accurate micro-architecture of trabecular bone. Orthogonal lattices constructed with this building block, after it was scaled to trabeculae of the human proximal femur, provided apparent elastic moduli of approximately 150 MPa, in good agreement with experimental data for the stiffness of cancellous bone from this site. Likewise, lattices with thinner, osteoporotic-like trabeculae could predict a reduction of approximately 30% in the apparent elastic modulus, as reported in experimental studies of osteoporotic femora. Based on these comparisons, it is concluded that the single-trabecula element developed in the present study is well-suited for representing cancellous bone in large-scale generic FE simulations.

Animals↗
PubMed1986

Radio-anatomic study of the carotid axis with regard to the implantation of microsurgical vascular anastomoses.

The authors report a radio-anatomic study of the carotid axis in the context of the implantation of microsurgical vascular anastomoses. The information derived from 36 dissections and 50 arteriographic studies suggests the preferential use of the superior thyroid, facial and lingual branches. Section and turning-down of the external carotid and direct end-to-side implantation on the common carotid could provide fall-back solutions when the collaterals are slender. Because of anatomic variations and frequent atheromatous lesions, arteriographic study before implantation appears essential.

Adult↗
PubMed1980

[Case of cystic adventitial degeneration of the brachial artery].

Cystic degenerative disease of the brachial artery, which caused acute and total occlusion of the artery was encountered in a 51 years old male patient. At the exploration of the brachial artery at the lower border of the axilla, an anatomical variation, high division of the superficial brachial artery, was observed. At the bifurcation of the artery, a cystic degenerative change was detected and was judged to be the cause of the arterial occlusion. He was treated successfully with partial resection of the arterial wall containing the cyst, followed by autologous vein patch plasty.

Arm↗
PubMedDate not supplied

Differences between surgical colorectal conditions seen in the temperate and tropical regions.

Geographic location of a population plays a significant role in the interpretation of symptoms of some diseases of the colon. Because diverticular disease of the colon is very rare in the tropics, frank rectal bleeding, which may be suggestive of bleeding diverticulosis when it occurs in a temperate region, is suggestive of a bleeding ileal typhoid ulcer eroding terminal branches of the superior mesenteric artery. Similarly, symptoms suggestive of ulcerative colitis in a temperate region are suggestive of amebic colitis in the tropics. Anatomic variation also plays a part in the nature of some disease processes. The high incidence of freely mobile cecum and ascending colon and the freely mobile redundant sigmoid colon, seen in a tropical population, play a part in the frequent occurrence of nontumid intussusception, relatively high incidence of sigmoid volvulus, and relatively high incidence of rectal prolapse seen in the area.

Climate↗
PubMedDate not supplied

Diagnosis of an accessory portal vein and its clinical implications for portosystemic shunts.

PURPOSE: To present a peculiar anatomic portal veins variant and evaluate its clinical implications. METHODS: Among 118 consecutive patients undergoing transjugular intrahepatic portosystemic shunting (TIPS), six male patients were found to have an accessory portal vein, which was seen during direct portography.R ESULTS: In all six patients, portograms showed an accessory small-caliber vein parallel to the trunk of the main portal vein ending in the right lobe of the liver. Two of the six accessory portal veins drained blood from coronary veins, precluding access to coronary vein embolization during TIPS. CONCLUSION: An accessory portal vein is a rare anatomical variation with clinical significance for both surgical shunt placement and TIPS, as well as for transportal embolization of coronary veins.

Humans↗
PubMed1975

Urologic complications after operations for anorectal cancer, with an evaluation of preoperative intravenous pyelography.

Urologic complications arose in 23.7 per cent of 569 patients who underwent abdominoperineal or low anterior resection for anorectal cancer. No radomization of the two operations was attempted, low anterior resection being performed whenever resection 5 cm below the tumor was possible. Complications were more frequent after abdominoperineal resection and in men. Preoperative intravenous pyelography was performed in the cases of 541 of the patients, including 60 who underwent palliative colostomy. The pyelograms of 30 per cent of these patients were abnormal. The abnormalities were anatomic variations of the urinary tract in 25 per cent and urologic diseases in 75 per cent. None of the postoperative urologic complications was related to an abnormal preoperative pyelogram. No relation was found between the radicality of abdominoperineal and low anterior resection and the pyelographic signs of tumor involvement.

Anus Neoplasms↗
PubMedDate not supplied

Upper airway disease.

More than 40% of children admitted to hospitals have respiratory disorders. Acute respiratory emergencies are either upper or lower airway obstructive diseases due to various etiological factors. A comprehensive knowledge and understanding of the anatomical variation of the upper airway in children is essential in the management of the critically ill.

Child↗
PubMed1993

A case report of celiac axis compression and implications in regional chemotherapy for liver metastasis.

Regional chemotherapy through a catheter placed in the hepatic artery is routinely used for treatment of unresectable liver metastasis from colon carcinoma. With some frequency, anatomical variations of the hepatic artery, including compression of the celiac axis, are found, and must be recognized preoperatively for appropriate management and placement of the catheter. We report a case of a colon cancer patient with multiple liver metastases and compression of the celiac axis, who received decompression of the celiac axis and catheterization of the hepatic artery.

Adenocarcinoma↗
PubMed2000

Long-term results of root reconstruction using the Carrel patch.

OBJECTIVE: The treatment of annuloaortic ectasia in patients, including those with Marfan syndrome, ascending aortic dissection, and other disorders of the ascending aorta and aortic valve presents a surgical challenge that has, unfortunately, shown high hospital mortality up to now. Improvements in graft materials and advanced surgical techniques have, however, begun to reduce hospital mortality. SUBJECTS AND METHODS: We retrospectively analyzed the records of 47 consecutive patients who undergoing aortic root reconstruction using the Carrel patch between January 1991 and March 1999. RESULTS: Postoperative complications included myonephrotic metabolic syndrome caused by femoral artery cannulation in 2 patients. Reexploration was done to halt bleeding in 2 patients. In 1 of 4 acute dissection patients, retrograde filling of the false lumen was demonstrated postoperatively. Overall surgical mortality in this series was 2.1% (1 of 47). The cardiac-event free rate was 98% at 5 years and 88% at 8 years. Actual survival is 97.8% at 8 years. No anastomosis complications were seen during follow-up (average: 32.7 months) (about 2.73 years). CONCLUSION: Surgery is considered feasible in any anatomic variation of aortic root disease, even in coronary ostial minimal dislocation, and the Carrel patch holds hope in preventing of anastomotic pseudaneurysm and ensuring long-term survival. Our experience suggests that modified Bentall operation, or aortic root remodeling using the Carrel patch, has few late-term complications, even in Marfan patients.

Adult↗
PubMed2004

Increased abnormal pituitary findings on magnetic resonance in patients with male idiopathic hypogonadotrophic hypogonadism.

Idiopathic hypogonadotropic hypogonadism (IHH) is a well-known disorder apart from its pathogenesis, which is still mostly unclear, even though a diverse subgroup of patients with hypogonadotropic hypogonadism and hyposmia/anosmia--the Kallman syndrome--have been partly linked to a mutated gene, known as kal-1 gene. In this study, we aimed to evaluate the sellar region of patients with IHH on magnetic resonance (MR). Pituitary MR of 120 male patients with IHH, diagnosed by a thorough endocrinologic assessment, were compared with pituitary MR of 49 healthy cases selected randomly who underwent detailed endocrinologic and neurologic evaluation and were assessed as healthy. Patients with IHH were diagnosed with microadenomas and irregularly contrasting pituitary (ICP), 18.2 and 10.7%, respectively. Although some anatomic variations were seen in healthy controls, microadenomas and ICP had solely been observed in patients with IHH and none in controls. Intact appearence of hypophysis in patients with IHH was significantly lower than in randomly selected healthy male subjects (p = 0.021). Mean infundibulum width of hypophysis and transverse diameter of posterior hypophysis were significantly broader in patients with IHH than in controls (both having p < 0.001), while mean hypophysis height and volume did not differ between groups. Results showed unusual incidence of pituitary abnormalities on pituitary MR in male patients with IHH. In conclusion, MR imaging is particularly useful in defining the morphological aspects of the hypothalamo - pituitary region in some endocrine disorders and other researchers might want to bear our findings in mind when performing MR evaluation of similar patient subgroups.

Adenoma↗
PubMed1999

Laparoscopic visualization of the cystic artery anatomy.

Uncontrolled bleeding from the cystic artery and its branches is a serious problem that may increase the risk of intraoperative lesions to vital vascular and biliary structures. On laparoscopic visualization anatomic relations are seen differently than during conventional surgery, so proper knowledge of the hepatobiliary triangle anatomic structures under the conditions of laparoscopic visualization is required. We present an original classification of the anatomic variations of the cystic artery into two main groups based on our experience with 200 laparoscopic cholecystectomies, with due consideration of the known anatomicotopographic relations. Group I designates a cystic artery situated within the hepatobiliary triangle on laparoscopic visualization. This group included three types: (1) normally lying cystic artery, found in 147 (73.5%) patients; (2) most common cystic artery variation, manifesting as its doubling, present in 31 (15.5%) patients; and (3) the cystic artery originating from the aberrant right hepatic artery, observed in 11 (5.5%) patients. Group II designates a cystic artery that could not be found within the hepatobiliary triangle on laparoscopic dissection. This group included two types of variation: (1) cystic artery originating from the gastroduodenal artery, found in nine (4. 5%) patients; and (2) cystic artery originating from the left hepatic artery, recorded in two (1%) patients.

Abdominal Muscles↗
PubMed2004

[Preoperative colonoscopy before esophagectomy and reconstruction with gastric interposition].

INTRODUCTION: The standard treatment of esophageal carcinoma is esophagectomy and reconstruction with gastric interposition. In many centers, preoperative colonoscopy is routinely performed in order to exclude any significant colonic pathology. This is important in case of the intraoperative necessity to use a colon interposition due to gastric pathology, anatomical variation, or injury of gastric vascularization. PATIENTS AND METHODS: Two hundred twenty-eight consecutive patients with esophageal carcinoma (adenocarcinoma 102, squamous cell carcinoma 126) who underwent esophagectomy were included in this study. Of them, 171 (75%) had preoperative colonoscopy. Reconstruction was done by gastric tube in 219 and colon interposition in nine. RESULTS: Intraoperative conversion to colon interposition was necessary in none of the 219 patients with intended reconstruction by a gastric conduit. In two of 171 patients (1.2%), preoperative colonoscopy revealed pT1 adenocarcinomas of the colon which were completely removed by endoscopy, and a total of 62 adenomas were histopathologically diagnosed. Fifty-three patients (31%) had endoscopic evidence of asymptomatic diverticulosis. No complications were observed after colonoscopy. CONCLUSION: Preoperative colonoscopy prior to esophagectomy and intended gastric tube formation appears unnecessary from the surgical point of view, as intraoperative conversion to a colon interposition is rare. The rate of colon adenomas or carcinomas was not increased in patients with adeno- or squamous cell carcinoma of the esophagus than in an age-matched, normal population.

Adenocarcinoma↗
PubMed2006

[The transverse rectus abdominis muscle (TRAM) flap. A "second defensive line" in microvascular reconstructions of defects in the head and neck area].

BACKGROUND: The microvascular anastomosed transverse rectus abdominis muscle (TRAM) island flap has been successfully used in plastic surgery for more than 10 years. In reconstructive head and neck surgery, however, it is not yet established. METHOD: We analysed the preparation and anatomical variation in TRAM flaps in an examination of eight cadavers. In a clinical case with complete reconstruction of the nose after nasal ablation and complete loss of a radial lower forearm flap that had been transplanted previously due to a recurrent tumor, the possibility of forming and modeling a TRAM flap is demonstrated. RESULTS: The flap vessels of the TRAM are comparable to the radial forearm flap, and the donor site may be primarily closed. The TRAM proved to be a suitable alternative to close lesions of the head and neck area in selected cases. The myocutaneous TRAM is bulkier than the fascio-cutaneous radial forearm flap. The subcutaneous abdominal fat of the TRAM can be reduced in relation to the vascular distribution of the perforator vessels. If the subcutaneous fat of the flap is reduced, the flap can be shaped and formed well. In the described case, it was used to close the lesion after ablation of the nose and middle face. CONCLUSION: The risk of an iatrogenic lesion of the peritoneal fascia or postsurgical herniation of the abdominal wall is low if several surgical prerequisites are taken into consideration. The myocutaneous TRAM will not replace the fascio-cutaneous radial forearm flap in microvascular head and neck surgery, but the large diameter of the donor vessels and the highly vascularized flap tissue makes it an alternative as a second line procedure in cases of unfavorable wound conditions.

Cadaver↗
PubMed1998

[Ciaglia percutaneous dilatation tracheotomy with endoscopic control. Analysis of complication-fraught steps].

Since the first description by Ciaglia in 1985, percutaneous dilatational tracheostomy (PDT) has emerged worldwide to be a favored and frequently used technique for airway control. Advantages are the rapidity, simplicity and independence of the physician. These characteristics tempt clinicians to perform the procedure uncritically and thus produce complications. Based on our experiences with the technique and on a critical analysis of the literature the indications and optimal operative technique are discussed. Operative steps are illustrated and potential pitfalls (anatomic variations, injury to vital structures and bleeding) are defined. In our experience endoscopic control plays a crucial role in preventing intraoperative complications. ENT colleagues should know the technique because of their experience with tracheotomized patients and should offer their services to other disciplines.

Bronchoscopes↗