OBJECTIVE: To explore the kidney anatomic structure of banna minipig inbred-lines, and to provide data for kidney xenotransplantation. METHODS: The fresh and infused kidneys of banna minipig (including the vessel and the ureter) were checked by anatomic microscope and vernier caliper in original location and away body. The tissue structure was observed by HE stain. RESULTS: The structure of kidney of banna minipig inbred-lines (including the vessel and the ureter) are similar to that of human being. The fascia propria of kidney is divided into three layers including capsula fibrosa, capsula adipose and fascia renalis. The thickness of cortex renalis is (20.0 +/- 2.4) mm. The average diameter of renal artery is 5.1 mm and is similar to that of human being. All the kidneys of banna minipig inbred-lines have a single branch renal artery. The diameters of left and right ureters are 5.1 mm and 4.7 mm, respectively. CONCLUSION: The kidney of banna minipig inbred-lines is an ideal replacement of human kidney for xenotransplantation.
OBJECTIVE To introduce a skin flap containing the middle cutaneous branch of the medial plantar artery. METHODS Microanatomic study was performed on 8 fresh cadaveric feet, the arteries were dissected and infused with methylene blue to observe their vascular distribution and the skin area supplied by the middle cutaneous branch. Furthermore, the clinical application was reported. A local pedicled flap containing the middle cutaneous branch was used to repair the soft tissue defects of the foot in 7 patients, and free cutaneous graft was used to repair the skin defects of the fingers in 6 patients. RESULTS The results showed that the medical plantar artery gave off 3 cutaneous branches to supply the medial aspect of the foot, among which the middle branch was the largest one and anastomosed with the other two branches. The skin flaps used clinically were all survived completely. CONCLUSION Medial plantar cutaneous graft had a reliable blood supply, and it’s one of the best choice in repairing small to middle sized skin defects of the foot and the fingers.
Objective To reveal the fibrillar network in vitreous and the effect of plasmin on this network.Methods 20 vitreous gels of freshly slaughtered pigs were divided into 2 groups, the gels in first group were digested by 3 Uplasmin (3 U/ml) at 37c for 24 hours respectively, the second group received the same PBS as control. After digestion, gels were fixed in neutral buffered formalin solution. Samples from vitreous base, cortex and the central region were observed by the technique of freeze etching electron microscopy.Results In vitreous collagen fibril network was in a three-dimensional array, collagen fibril density showed marked differences, central vitreous had the sparse fibril density, the cortex denser and the basal vitreous densest. After digestion by plasmin, the collagen fibrillar network was destructed.Conclusion Collagen fibrils in vitreous present spatial arrangement regularly, plasmin can lead to destruction of the fibrillar network.(Chin J Ocul Fundus Dis，2003，19：179-181)
In 10 adult specimens, we observed the distribution of the temporal branches of the facial nerve and its relation with the superficial temporal artery. The 6.3±0.9 temporal branches (5-8 branches, mean 6.3+0.9) went across the lateral margin of the M. frontalis and 10.3±2.2 branches entered the muscle. Their in-let, points were 2.86±5.35 mm upwardand outward of the outer canthus, and all points were about in one line. In conclusion, it was safe for surgeons, to operate in the "safe area" of the temporal region, medial to thevertical line to the outer canthus, without the risk to damage the branches of the facial nervc .
Objective To review the vascular anatomy of the donor and the reci pient for the l iving kidney transplantation. Methods The recent l iterature about the vessels of donor and reci pient in cl inical appl ications was extensively reviewed. Results The pertinent vascular anatomy of the donor and recipient was essential for the screening of the proper candidates, surgical planning and long-term outcome. Early branching and accessory renal artery of the donor were particularly important to deciding the side of nephrectomy, surgical technique and anastomosing pattern, and their injuries were the most frequent factor of the conversion from laparoscopic to open surgery. With increase of laparoscopic nephrectomy indonors, accurate venous anatomy was paid more and more attention to because venous bleeding could also lead to conversion to open nephrectomy. Multidetector CT (MDCT) could supplant the conventional excretory urography and renal catheter angiography and could accurately depict the donors’ vessels, vascular variations. In addition, MDCT can excellently evaluate the status of donor kidney, collecting system and other pertinent anatomy details. Conclusion Accurate master of related vascular anatomy can facil iate operation plan and success of operation and can contribute to the rapid development of living donor kidney transplantation. MDCT has become the choice of preoperative one-stop image assessment for living renal donors.
Objective To provide the anatomic bases for clinical application of the second dorsal metacarpal artery(SDMA) island flap with double pivot points. Methods The origin,branches and distribution of the recurrent cutaneous branch of the SDMA were observed in 30 adult fresh cadaver specimens, which were illustrated with special dye.Eighteen cases of skin defets of the thumb were repaired with the SDMA island flap. The defect locations were the dorsal part in 11 cases and palmar part in 7 cases, including 3 cases of defect in association with long pollical extensor defect and 2 cases of defect in association with dorsal skin defect of proximal finger. The flap area ranged from 2 cm×3 cmto 3 cm×5 cm. Results The appearance of therecurrent cutaneous branch of the SDMA was observed in all cases(100%), which originated 0.5±0.2 cm distant from the distal intersectiones between the SDMA and the index extensor and disappeared 1.2±0.5 cm distant from the proximal metacarpophalangeal joint. The branches of 1.7±0.7 were seen with a longitudinal fan-like distributionforward proximal part on the deep surface of the dorsal superficial vein. The exradius and the length of the recurrent cutaneous branch of the SDMA were 0.3±0.1 mm and 6.5±0.8 mm, respectively. The transplanted flaps survived in all cases and 16 cases were followed up for 8-14 months. The colour and appearance of the skin were satisfactory. The two-point discriminations were 0.9 mm in 3 cases by bridging digital nerve and 1.1 mm in 9 cases by anastomosing dorsal digital nerve; while the two-point discrimination was 13-15 mm in 4 cases without anastomosing nerve. Conclusion The origin,branches and distribution of the recurrent cutaneous branch of the SDMA is constant, which provide a potentially longer pedicle and increase the possibility to rotate the flap and also avoid the donor skin defect of rotation of the flap.
Objective To explore the arterial origin and the distribution of the extracranial branches of the facial nerve. Methods Red latex or red chlorinated polyvinyl chloride was injected into the arteries of 15 fresh adult head specimens by both common carotid artery catheterization. The arterial origin and distribution of the extracranial branches of the facial nerve were observed. Results The nutrient arteries of the extracranial branches of the facial nerve originated from stylomastoid artery of the posterior auricular artery, the facial nervous branch of superficial temporal artery, transverse facial artery, superior and inferior facial nervous branches of external carotid artery and the posteriorand anterior facial nervous branches of external carotid artery. The outer diameters of them were (0.8±0.2) mm, (0.9±0.4) mm, (1.9±0.3) mm, (1.0±0.2) mm, (1.1±0.4) mm, (1.0±0.2) mm and (1.1±0.6) mm respectively. The sub-branches ofthe attendant artery of the facial nerve anastomosed each other in addition to supplying their own nerve, and a rich vascular network was formed between the facial nerve and adjacent tissue. Conclusion The study on blood supply of the extracranial segment of the facial nerve can provide anatomic basis for avoiding injury of the nutrient arteries of the facial nerve during operation of the parotidean and masseteric region clinically.
Objective To provide the anatomic basis for thelag screw placement in the anterior column of the acetabulum. Methods Twenty-two pelvis specimens with 44 acetabula of the native adult cadavers were studied. The anthropometric measurement was performed on 44 acetabula to determine the shape of the transverse section of the anterior column of the acetabulum, the optimal entry point for the lag screw on the outer table of the ilium, the direction of the screw, and the distance from the entry point to the obturator groove. Results The transverse section of the anterior column of the acetabulum was almost triangle-shaped. The path for the lag screw placement was 10.5±0.8 mm in diameter. The optimal entry point on the posterolateral ilium for the screw fixation was found toexist 9.2±2.4 mm superior to the line between the anterior superior iliac spine and the greater sciatic notch and 38.5±3.8 mm superior to the greater sciatic notch. The distance from the entry point to the obturator groove was 84.1±6.2 mm. The inclination of the lag screw was 54.2±5.5° at the caudal direction in the sagittal plane and 40.7±3.8° in the horizontal plane. The device for the safe screw placement in the anterior column was designed. Conclusion The above datacan facilitate an insertion of one 6.5 mm lag screw into the anterior acetabular column and minimize the risk of articular violation or cortical penetration, which has a narrow margin of safety. The safe length of the lag screw should be 70 mm.The optimal entry point on the posterolateral ilium for the screw fixationis determined to be 10 mm superior to the line between the anterior superior iliac spine and the greater sciatic notch and 40 mm superior to the greater sciatic notch. The inclination of the lag screw should be 55° at the caudal direction in the sagittal plane and 40° in the horizontal plane. It is safe to place thelag screw in the anterior column with the help of the targeting device.
Objective To study the human optic canal and its inner structures, and provide anatomic knowledge of this area for optic nerve decompression and further study in pathologic mechanisms of indirect optic nerve injury. Methods Serial sections of the 18 optic canals of adults were made at orbital, middle and cranial parts. Quantitative measurements of the canal wall thickness, canal transverse area, dural sheath transverse area, optic nerve transverse area, and subarachnoid space transverse area were done by means of IMAGEPRO morphometric analysis system. Subarachnoid space transverse area to canal transverse area ratio (SSTA/CTA) and subarachnoid space transverse area to dural sheath transverse area ratio (SSTA/DSTA) were calculated. Results The middle portion of medial wall is the thinnest part of the canal (0.35plusmn;0.48)mm. The middle part of the optic canal was the narrowest part and the transverse area was (17.54plusmn;2.12)mm2. From cranial end to orbital end, SSTA/CTA, SSTA/DSTA and the subarachnoid space transverse area became smaller and smaller. Conclusion Since the potential space is limited, even a tiny amount of blood or sweling of the nerve may cause optic compression. Due to the potential space gradually decreases from cranial end to orbital end and the narrowest portion of the canal is in the middle part, the middle part and the anterior part of the optic canal are critical in optic narve decompression. (Chin J Ocul Fundus Dis,1999,15:24-26)
ObjectivesTo evaluate the reproducibility of Heidelberg retina tomograph (HRT) macular edema module(MEM) measuring the macular retinal thickness.MethodsSixty-two healthy volunteers (9-68 years old) were examined by HRT-II procedure. The retinal signal width (SW) at macula and fovea and macular edema index (E) were recorded for t-test, Pearson linear-correlation analysis. Intra-subject variation repeatedly measured was analyzed with coefficient of variation, 95% tolerance limits of change (TC), and intraclass coefficient of correlation (ICC). ResultsIn healthy individuals, retinal SW was (0.734±0.236) mm at macula，and (0.781±0.243) mm at fovea; macular E was (1.169±0.619). The coefficient of variation repeatedly measured: retinal SW was (8.7±68)%，retinal SW at the fovea was (8.5±6.7)%, and the average was (15.6±13.9)%; 95%TC of intra-subject sequential repeated measurement was 0.131 (8.9%) of retinal SW, 0.137 (10.5%)of fovea SW，and 0.198 (7.4%) of average E. ICC of one individual repeatedly measured by one operator was 0.950 of macular SW, 0.949 of fovea SW, and 0.898 of average edema index.ConclusionsHRT-II MEM is noninvasive, fast and highly reproducible, which provides a new technique to monitor the objective quantification of macular diseases related to retinal thickness. ( Chin J Ocul Fundus Dis, 2005,21:103-105)