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  • 1
    Electronic Resource
    Electronic Resource
    Anatomic bases of the vascularized hepatic teres ligament flap (1997)
    Springer
    Surgical and radiologic anatomy 19 (1997), S. 293-294 
    Details
    ISSN: 1279-8517
    Keywords: Artery ; Flap ; Bile duct ; Ligament
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Le ligament rond du foie (ligament teres hepatis) a été étudié chez 30 sujets adultes. Ce ligament représente un reliquat fibreux de la veine ombilicale et une petite lumière irrégulière y persiste à l'état adulte. Il est vascularisé par une artère indépendante et des veines paraombilicales. A partir de son segment proximal, le ligament rond peut être aisément mobilisé, ainsi que l'artère du ligament rond née de l'artère hépatique droite près du hile, réalisant un lambeau pédiculisé. Une intervention chirurgicale pour réparer la voie biliaire extra-hépatique à partir de ce lambeau du ligament rond a été effectuée avec succès chez douze patients.
    Notes: Summary The hepatic ligamentum teres was investigated in 30 adult specimens. The ligament represents a fibrous remnant of the umbilical v. and a small irregular lumen still exists in the ligament in adult life. The ligament is supplied by one set of independent round ligament a. and paraumbilical vv. Since the proximal segment of the ligament is easily mobilised and since the ligamentous a. originates from the right hepatic a. near the hilum, a proximal vascularized pedicle flap of the ligamentum teres has been recommended. Surgical repair of the extrahepatic bile duct using a vascularized pedicle flap of the ligamentum teres has been carried out successfully in 12 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01637594
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  • 2
    Electronic Resource
    Electronic Resource
    Anatomic bases of the vascularized hepatic teres ligament flap (1998)
    Springer
    Surgical and radiologic anatomy 19 (1998), S. 293-294 
    Details
    ISSN: 1279-8517
    Keywords: Artery ; Flap ; Bile duct ; Ligament
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The hepatic ligamentum teres was investigated in 30 adult specimens. The ligament represents a fibrous remnant of the umbilical v. and a small irregular lumen still exists in the ligament in adult life. The ligament is supplied by one set of independent round ligament a. and paraumbilical vv. Since the proximal segment of the ligament is easily mobilised and since the ligamentous a. originates from the right hepatic a. near the hilum, a proximal vascularized pedicle flap of the ligamentum teres has been recommended. Surgical repair of the extrahepatic bile duct using a vascularized pedicle flap of the ligamentum teres has been carried out successfully in 12 patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s00276-997-0293-2
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Basic vascular anatomy and the reimplantation of the amputated hand through the palm (1990)
    Springer
    Surgical and radiologic anatomy 12 (1990), S. 241-246 
    Details
    ISSN: 1279-8517
    Keywords: Palm of the hand ; Blood supply ; Blood vessels ; Reimplantation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Trente membres supérieurs de sujets adultes ont été étudiés. Les vaisseaux sanguins de la main ont été analysés sur des angiographies, des coupes anatomiques et des dissections sous microscope. Les artères de la paume sont disposées en trois plans dans la partie moyenne, alors que dans les segments sous-jacents, elles sont disposées en deux plans seulement. La disposition des territoires dépendant des aa. radiale et ulnaire n'est pas la même dans chaque plan. Il existe trois voies anastomotiques entre les aa. radiale et ulnaire dans le sens paume-dos de la main. Les possibilités de réimplantation après amputation transpalmaire ont été envisagées grâce à l'étude dynamique de la circulation, à des coupes et à l'analyse des anastomoses artérielles entre ces trois plans.
    Notes: Summary Thirty adult upper extremities were used to study the blood vessels of the hand by angiography, cross-sectional measurement and operative microscopic dissection. The arteries in the middle segment of the palm are arranged in three planes, while in the upper or lower segment there are two planes only. The division of the territories of the radial and ulnar arteries are not same in the three different layers. There are three main anastomotic pathways between the radial and ulnar arteries in the radial-ulnar direction, while in the palmar-dorsal direction there are three anastomotic zones between the palmar and dorsal planes. According to the rate of appearance, sources, cross-sectional area, irrigation territories and anastomoses of the arteries in the three segments, the clinical significance in the reimplantation of the amputated hand through the palm has been discussed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623697
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Blood supply of the flexor digital tendon in the hand and its clinical significance (1990)
    Springer
    Surgical and radiologic anatomy 12 (1990), S. 113-117 
    Details
    ISSN: 1279-8517
    Keywords: Vascularity ; Flexor digital tendon
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Résumé Une étude anatomique des pédicules et de la vascularisation des tendons fléchisseurs des doigts a été réalisée sur cadavres frais, au moyen d'injections artérielles d'encre de chine, et d'une dissection méticuleuse sous microscope du tendon diaphanisé. Selon que la membrane synoviale entoure ou non le tendon, ce dernier peut être divisé en deux parties: partie non synoviale et partie synoviale. La vascularisation intrinsèque du tendon fléchisseur digital est essentiellement constituée par des éléments vasculaires longitudinaux, tandis que les anastomoses transversales sont courtes et éparses. La partie non synoviale du tendon est enveloppée par le paratendon et la distribution vasculaire dans cette région est uniforme; dans la gaine synoviale les vaisseaux sanguins se distribuent seulement du côté dorsal, tandis que le côté palmaire est dépourvu de vaisseaux. Les tendons fléchisseurs superficiels et profonds présentent une zone avasculaire au niveau des articulations interphalangienne et métacarpophalangienne. On peut penser que la différence d'architecture vasculaire peut être en relation avec les forces mécaniques auxquelles le tendon est soumis. Le mode de nutrition du tendon est discuté et le choix d'une greffe tendineuse en per-opératoire est suggéré.
    Notes: Summary An anatomical study on the blood sources and vascularity of the flexor digital tendon was conducted in the upper extremities of fresh cadavers by means of arterial injection and meticulous dissection of the transparent tendon under the microscope. According to whether or not synovial membrane surrounded the tendon, the flexor digital tendon can be divided into 2 regions: non-synovial and synovial. The major intrinsic blood supply of the digital tendon was in the form of longitudinal vascular bundles, while the transverse anastomotic branches were short and sparse. The non-synovial region of the tendon was covered by paratenon and the vascular distribution of this region was uniform. In the synovial sheath, the blood vessels distributed only on the dorsal side, while the volar side was devoid of vessels. The profundus and superficialis tendons had an avascular zone at the proximal interphalangeal and metacarpophalangeal joints respectively. It was considered that the difference of the vascular architecture might be related to the mechanical force to which the tendon was subjected. The nutrition of tendon was discussed and the selection of tendon graft at operation was suggested.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01623335
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  • 5
    Electronic Resource
    Electronic Resource
    Predicting the outcome of severe ulcerative colitis: development of a novel risk score to aid early selection of patients for second-line medical therapy or surgery (2004)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 19 (2004), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : The failure rate of medical therapy in severe ulcerative colitis is high. A risk index, to aid the identification of patients of not responding at an early stage to intravenous corticosteroid therapy, would be useful to facilitate second-line treatment or surgery.Methods : We recruited 167 consecutive patients with severe ulcerative colitis between January 1995 and March 2002; and employed multiple logistic regression to analyse parameters within the first 3 days of medical therapy. We applied statistical modelling to formulate a risk score according to the likelihood of medical failure.Results : Sixty-seven (40%) patients failed to respond to medical therapy. Multiple logistic regression analysis identified mean stool frequency and colonic dilatation within the first 3 days and hypoalbuminaemia as independent predictors of outcome (P 〈 0.001, 0.001 and 0.002 respectively). A numerical risk score was formulated based on these variables. Patients with scores of 0–1, 2–3 and ≥4 had a medical therapy failure rate of 11%, 43% and 85% respectively. Receiver–operator characteristic analysis of this score yielded area under curve of 0.88, with a sensitivity of 85% and specificity of 75% using score ≥4 in predicting non-response.Conclusion : This risk score allows the early identification of patients with severe ulcerative colitis who would be suitable for second-line medical therapy or surgery.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2036.2004.01945.x
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