7 research outputs found
Mode of insertion of the abductor hallucis muscle in human feet and its arterial supply
The abductor hallucis flap is commonly used as a pedicled flap (distally or proximally
based) in the management of ankle, heel, and mid-foot lesions, where it is
ideally used for closing defects. This study investigates the anatomical details of
this muscle regarding its various forms of insertion and its arterial supply in
15 cadaveric feet. Four types of insertion could be distinguished: type A, insertion
at the proximal phalanx of the big toe (46.7%); type B, insertion by two slips into
the base of the proximal phalanx and the sesamoid bone (33.3%); type C, insertion
at the sesamoid bone (6.7%); And type D, the insertion is divided into superficial
tendinous and deep fleshy parts which are attached to the base of the proximal
phalanx and to the metatarsophalangeal joint capsule of the big toe, respectively
(13.3%). As regards the arterial supply, three patterns were noticed: pattern A (40%)
where the medial plantar artery (MPA) is divided into superficial and deep branches
that supplied the muscle; pattern B (53.3%) where the MPA failed to produce
a deep branch but instead continued as the superficial branch supplying the two ends
of the muscle; and pattern C (6.6%) where the MPA continued as a deep branch
supplying the muscle. A superficial branch of MPA provided a branch to the abductor
hallucis muscle from its proximal part. In two specimens (13.3%), the lateral
plantar artery shared in the supply of the most proximal part of the muscle. These
results can be useful in determining the appropriate flap design based on the abductor
hallucis type of insertion and the pattern of its arterial supply in the patients.
Folia Morphol 2010; 69, 1: 54-6
An anatomical study of the arterial and nerve supply of the infrahyoid muscles
A precise knowledge of the sources of the arterial and neural supply of the
sternohyoid (SH), sternothyroid (STM), and superior belly of omohyoid (OM) is of
value to surgeons using the infrahyoid muscles in reconstruction procedures of
the head and neck. This study was designed to define the anatomical bases of
the variable sources of the arterial and neural supply of these muscles. Fourteen
cadavers were unilaterally dissected in the neck region, and the arterial pedicles
of these muscles were followed and accurate measurements were taken. For the
SH, two arterial pedicles (superior and inferior) originated from the superior thyroid
artery ST and supplied the muscle in 57.1% of cases. The inferior pedicle
was absent in 42.9% of cases. As regards the STM, one arterial pedicle from the
ST supplied its upper end by multiple branches in 57.1% of cases. In 14.3% of
cases, branches from the inferior thyroid artery (IT) supplied the STM in addition
to its supply from the ST. As regards the OM, two arterial pedicles originated
from the ST and supplied its upper and lower ends in 57.1% of cases. The main
artery from the ST to the superior belly of OM entered at its superior portion. The
ansa cervicalis (AC) innervated the infrahyoid muscles. SH usually had a double
nerve supply. In 57.1% of cases, its superior part was innervated by the nerve to
the superior belly of OM. Its inferior part received branches from the AC. In
35.7% of cases, its superior part received direct branches from the AC. As regards
the STM, in (71.4%) of cases, a common trunk arose from the loop and
supplied the inferior part of both the SH and STM. The nerve supply to the
superior belly of OM originated from the AC below the loop in 64.3% of cases.
These data will be useful for preserving the neuro-vascular supply of the infrahyoid
muscles during flap preparation
Prevalence of Congenital Heart Diseases in Children with Congenital Hypothyroidism
The aim of the work was to assess the prevalence of cardiac anomalies in primary congenital hypothyroidism (PCH) patients. Fifty patients with PCH recruited after diagnosis by ultrasonography or scintigraphy (64% Dysgenesis, 36% Dyshormonogenesis). The prevalence of cardiac anomalies was 18%, with renal anomalies being 8%. There was no significant difference in the longitudinal follow-up of growth and sexual maturation between a hypothyroid with and without anomalies. Statistically significant difference was found with replacement therapy of both groups. Hence, echocardiography should be done to screen this birth defect as soon as possible so as to prevent or delay the possible complications. [Arch Clin Exp Surg 2013; 2(2.000): 85-91
Corrosion Behaviour of 316L Stainless Steel in Hot Dilute Sulphuric Acid Solution with Sulphate and NaCl
Mortality from esophagectomy for esophageal cancer across low, middle, and high-income countries: An international cohort study.
BACKGROUND
No evidence currently exists characterising global outcomes following major cancer surgery, including esophageal cancer. Therefore, this study aimed to characterise impact of high income countries (HIC) versus low and middle income countries (LMIC) on the outcomes following esophagectomy for esophageal cancer.
METHOD
This international multi-center prospective study across 137 hospitals in 41 countries included patients who underwent an esophagectomy for esophageal cancer, with 90-day follow-up. The main explanatory variable was country income, defined according to the World Bank Data classification. The primary outcome was 90-day postoperative mortality, and secondary outcomes were composite leaks (anastomotic leak or conduit necrosis) and major complications (Clavien-Dindo Grade III - V). Multivariable generalized estimating equation models were used to produce adjusted odds ratios (ORs) and 95% confidence intervals (CI).
RESULTS
Between April 2018 to December 2018, 2247 patients were included. Patients from HIC were more significantly older, with higher ASA grade, and more advanced tumors. Patients from LMIC had almost three-fold increase in 90-day mortality, compared to HIC (9.4% vs 3.7%, p < 0.001). On adjusted analysis, LMIC were independently associated with higher 90-day mortality (OR: 2.31, CI: 1.17-4.55, p = 0.015). However, LMIC were not independently associated with higher rates of anastomotic leaks (OR: 1.06, CI: 0.57-1.99, p = 0.9) or major complications (OR: 0.85, CI: 0.54-1.32, p = 0.5), compared to HIC.
CONCLUSION
Resections in LMIC were independently associated with higher 90-day postoperative mortality, likely reflecting a failure to rescue of these patients following esophagectomy, despite similar composite anastomotic leaks and major complication rates to HIC. These findings warrant further research, to identify potential issues and solutions to improve global outcomes following esophagectomy for cancer