摘要:

AbstractOur objective was to describe the boundaries and sites of communication of the posterior peritoneal compartments in order to explain extensions of pathological processes in retroperitoneal areas. To this end we examined these distinct bilateral compartments [anterior (AP) and posterior (PP) pararenal and perirenal (P) spaces] in four bodies by CT scans, dissections, crosssections, latex injections, and light microscopy. Perirenal areas bilaterally were closed spaces which extended from the inferior surface of the diaphragm to the superior pelvic aperture (pelvic inlet) tapering superiorly and inferiorly in the shape of two cones with a common base at the midrenal area where they communicated across the median plane. The AP is a potential space on the right but contains the pancreas on the left. Each has shorter superior and inferior extensions than the corresponding PP space. Tough, often multilaminar, fasciae surrounded these spaces and limited the spread of injected latex except where vascular pathways permitted inter‐compartmental spread. Computer‐assisted 3‐D reconstructions showed that these spaces extended potentially from the diaphragm into the pelvis. These compartments and their fasciae help explain the predictable yet restricted clinical extensions of pancreatitis, renal infections, and aortic aneurysms in the posterior ab

ISSN:0897-3806    

DOI:10.1002/ca.980030102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractPrevious studies involving the mapping of antral G‐cells have had little significance because the techniques involved have been tedious, inaccurate, and have concentrated on pathological material, without establishing normal antral anatomy or physiology. We describe a new, reproducible technique for the accurate mapping of antral G‐cells, which shows their relationship to the parietal cell mass and the macroscopic antrum‐corpus boundary.The antrum of 20 normal, “fresh,” postmortem human stomachs was examined by cutting 4–8 longitudinal strips. The macroscopic antrum‐corpus boundary (nerve of Latarjet) was identified. Serial section were stained for parietal and G‐cells to define the microscopic antrum‐corpus boundary.In 4 stomachs, the parietal cells extended to the pylorus. In these, the G‐cells were sparse and the antrum as defined by the G‐cells was significantly smaller (P<0.01). The G‐cell boundary correlated better with the macroscopic boundary than did the parietal cell boundary.This study provides a basis for future quantitative studies on parietal and G‐cells in the antrum which should be defined according to both G‐cells and parietal cells. Patients with “acid antra” appear to have reduced number of antral G‐cells and this may have practical significance for patients

ISSN:0897-3806    

DOI:10.1002/ca.980030103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

Abstract“Highly selective” or “proximal gastric” vagotomy seeks to denervate the pariental cell mass of the stomach while preserving the innervation of the pyloric antrum, and is now frequently used in the surgical treatment of duodenal ulceration. However, a high incidence of recurrent ulceration after highly selective vagotomy has been reported, suggesting inadequate denervation of the parietal cell mass. This study aims to examine the innervation of the distal parietal cell mass by antral nerves and their possible role in recurrent ulceration after highly selective vagotomy.The distribution of the nerves supplying the pyloric antrum, distal to the termination of the nerve of Latarjet, was compared to the pariental cell boundary in 20 stomachs.Parietal cells extended all the way to the distal pylorus in 35% of stomachs and could potentially have been innervated by antral branches in 55%. Branches from the anterior vagal trunk terminated on the posterior antral surface in 25% of stomachs and from the posterior trunk on the anterior surface in 20%.These findings suggest that there may be an anatomical limitation to complete denervation of the distal pariental cells mass during a standard highly selective vagotomy where the nerve of Latarjet and all the branches distal to it are

ISSN:0897-3806    

DOI:10.1002/ca.980030104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractPercutaneous femoral artery cannulation can cause pseudoaneurysms. When this occurs, the puncture site is frequently in the profunda femoris artery (PFA) or femoral artery (FA) distal to the PFA origin, where anatomic relationships make hemostasis difficult to achieve. Two such complications prompted a study of the relations of this arterial complex to palpable landmarks. Four measurements were made on 101 cadaver extremities (61 males, 40 females; 45 left, 56 right). The measurements and results (mean ± S.D.) are: (1) horizontal distance from pubic tubercle (PT) to perpendicular extending inferiorly from anterior superior iliac spine (ASIS), 9.44 ± 1.34 cm; (2) horizontal distance from PT to middle of FA, 5.15 ± 0.87 cm; (3) distance from inguinal ligament to origin of PFA, 5.31 ± 1.46 cm; (4) distance from level of PT to origin of PFA, 2.37 ± 1.40 cm. When males and females were compared, significant differences were found between means of measurements 3 and 4; likewise, the means for measurement 1 were significantly different between left and right sides. The PFA originated superior to the level of PT in only three extremities, but the distance was never more than 0.5 cm. These data indicate that (1) the FA is typically located about 5 cm lateral to PT, (2) the origin of PFA is usually inferior to the level of PT, and (3) the frequency of complications of percutaneous FA cannulation can be diminished by insertion of the needle or cannula 1 cm or more superior to the level o

ISSN:0897-3806    

DOI:10.1002/ca.980030105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractAn erroneous view of early nerve development in human limbs is presented in many medical embryology and neuroanatomy textbooks. The early limb bud is described as having segmental dermatome stripes running across it, which later reorganize to form the adult pattern. In fact, the nerves grow first into a plexus, which they later leave to supply fields very similar to those in the adult. Since this error may have clinical consequences, in that it gives a false view of how anomalies are likely to arise, its source is identified and its propagation through the literature is traced. A brief review of the most recent findings concerning the mechanisms by which nerve patterns are established in vertebrate limbs is also given.

ISSN:0897-3806    

DOI:10.1002/ca.980030106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

摘要:

AbstractThe arteries leaving the intermuscular fissures of the lower leg form six constant rows. Two further vascular groups emerge from the lateral and the medial heads of the gastrocnemius muscle. The vessels form a fine epifascial network, the radial and longitudinal meshes of which anastomose together. The epifascial network is complemented by a weaker, subfascial one. The arteries can be subdivided into cutaneous, musculocutaneous, and cutaneomuscular groups, corresponding to their supplying areas. A significant difference in vessel pattern could not be found between the left and the right lower leg of the same person. The different areas of supply are constant in the middle one‐third of the lower leg, but vary considerably in the upper one‐third and moderately in the lower one‐third. The borders of the different areas show interlocking pat

ISSN:0897-3806    

DOI:10.1002/ca.980030107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980030108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980030109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980030110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY

ISSN:0897-3806    

DOI:10.1002/ca.980030111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1990

数据来源: WILEY