scholarly journals New Possible Surgical Approaches for the Submammary Adipofascial Flap Based on Its Arterial Supply

2016 ◽  
Vol 2016 ◽  
pp. 1-10
Author(s):  
Ehab M. Elzawawy ◽  
Melad N. Kelada ◽  
Ahmed F. Al Karmouty
Keyword(s):  
Breast Implants ◽  
Partial Mastectomy ◽  
Surgical Approaches ◽  
Lateral Part ◽  
Medial Part ◽  
Fat Necrosis ◽  
Adipofascial Flap ◽  
Multiple Origins ◽  
Inferior Portion ◽  
Perforator Vessels

Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not well defined, and the harvest of the flap may be compromised due to its uncertain vascularity. The aim of the work was to identify perforator vessels supplying SMAF and define their origin, site, diameter, and length. Materials and Methods. The flap was designed and dissected on both sides in 10 female cadavers. SMAF outline was 10 cm in length and 7 cm in width. The flap was raised carefully from below upwards to identify the perforator vessels supplying it from all directions. These vessels were counted and the following measurements were taken using Vernier caliper: diameter, total length, length inside the flap, and distance below the submammary skin crease. Conclusions. The perforators at the lateral part of the flap took origin from the lateral thoracic, thoracodorsal, and intercostal vessels. They were significantly larger, longer, and of multiple origins than those on the medial part of the flap and this suggests that laterally based flaps will have better blood supply, better viability, and more promising prognosis. Both approaches, medially based and laterally based SMAF, carry a better prognosis and lesser chance for future fat necrosis than the classical cranially based flap.

scholarly journals A Case of Contiguous Primary Hepatic Marginal Zone B-Cell Lymphoma and Hemangioma Ultimately Diagnosed Using Contrast-Enhanced Ultrasonography

2015 ◽  
Vol 8 (1) ◽  
pp. 50-57 ◽  
Author(s):  
Kazue Shiozawa ◽  
Manabu Watanabe ◽  
Takashi Ikehara ◽  
Yasushi Matsukiyo ◽  
Yoshinori Kikuchi ◽  
...  
Keyword(s):  
B Cell ◽  
Malt Lymphoma ◽  
Marginal Zone ◽  
B Cell Lymphoma ◽  
Lateral Part ◽  
Medial Part ◽  
Contrast Enhanced ◽  
Contrast Enhanced Ultrasonography ◽  
Equilibrium Phases ◽  
Low Density Area

Primary hepatic marginal zone B-cell malignant lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma) is extremely rare. We present a case in which a lesion was diagnosed as 2 contiguous tumors (MALT lymphoma and hemangioma) using contrast-enhanced ultrasonography (US) with sonazoid. There has been no previous case of contiguous hepatic MALT lymphoma and hemangioma. The present case was a female with no medical history. We detected a snowman-like appearance, which was a tumor of 15 mm in diameter with hypo- and hyper-echogenicities in the lateral and medial parts, respectively, in the Couinaud's segment (S6) of the liver on US. The tumor appeared as a single lesion with a low-density area in the unenhanced phase and prolonged enhancement in the equilibrium phases on dynamic CT. On MRI, the whole lesion showed a low-intensity signal on T1-weighted imaging, but isointensity in the lateral part and high intensity in the medial part were seen on T2-weighted imaging. On contrast-enhanced US, the lateral hypoechoic region was homogenously hyperenhanced in the early vascular phase, and the contrast medium was washed out after about 30 s; in contrast, the medial hyperechoic region was gradually stained from the margin toward the central region. The tumor showed a defect in both hypo- and hyperechoic regions in the postvascular phase. Hemangioma was suspected for the medial part based on the typical image findings, but the lateral part was not given a diagnosis. Thus, surgical resection was performed. The medial part was a hemangioma, and the lateral part was a MALT lymphoma by histopathological findings.

Target neurons of floccular caudal zone inhibition in Y-group nucleus of vestibular nuclear complex

1987 ◽  
Vol 57 (2) ◽  
pp. 460-480 ◽  
Author(s):  
Y. Sato ◽  
T. Kawasaki
Keyword(s):  
Brain Stem ◽  
Red Nucleus ◽  
Contralateral Side ◽  
Medial Longitudinal Fasciculus ◽  
Lateral Part ◽  
Medial Part ◽  
Single Neurons ◽  
Eighth Nerve ◽  
Observing Responses ◽  
Stimulation Of

Extracellular unit spikes were recorded in and around the Y-group nucleus in the anesthetized cat. Target (T) neurons of floccular caudal zone inhibition were identified by observing cessation of their spontaneous discharges following stimulation of the floccular caudal zone. The axonal trajectories of the T neurons to the rostral brain stem were studied by observing the antidromic responses of single neurons during systematic tracking with a stimulating microelectrode in the brain stem. The axons of the T neurons pass through a region closely ventral to the lateral part of the brachium conjunctivum (BC), continue rostrally in a region between the BC and the lateral lemniscus, arch medially around the rostral part of the nucleus reticularis tegmenti pontis, cross the midline, continue to the contralateral side by about 1.5 mm lateral from the midline, arch rostrally, run in the central tegmental field on the contralateral side, arch dorsomedially around the caudal pole of the red nucleus, and enter the contralateral oculomotor nucleus (OMN) from the ventrolateral side. In the caudal half of the contralateral OMN, the axons of the T neurons branch out and terminate. The T neurons were exclusively located in the dorsal subdivision of the Y-group nucleus (DY), whereas some were in the medial part of the subnucleus lateralis parvocellularis (SLP, Ref. 12) of the lateral cerebellar nucleus. T neurons were not found in the ventral subdivision of the Y-group nucleus (VY). Differences in neuronal connections between the DY and VY neurons were investigated by observing responses of single neurons to stimulation of the contralateral OMN, the ipsilateral floccular caudal zone, the ipsilateral eighth nerve (i8N), and the contralateral eighth nerve (c8N). Most neurons in the DY and the adjacent medial part of the SLP, receiving inhibitory inputs from the ipsilateral flocculus (exclusively from the caudal zone), project to the contralateral OMN, and about one-half of these neurons receive polysynaptic inputs from the i8N and the c8N. On the other hand, most neurons in the VY receive monosynaptic inputs from the i8N, and some of these neurons project to the ipsilateral flocculus. The neuronal tract via the ventral part of the pontine tegmentum demonstrated in the present experiments is distinct from the classically established vestibulooculomotor tracts via the BC, the medial longitudinal fasciculus, or the ascending tract of Deiters. We call this tract the 'crossing ventral tegmental tract'. Previously, we reported that electrical stimulation of the caudal zone elicited conjugate downward eye movement.(ABSTRACT TRUNCATED AT 400 WORDS)

scholarly journals Immediate reconstruction using a modified inframammary adipofascial flap after partial mastectomy

Surgery Today ◽  
2012 ◽  
Vol 43 (4) ◽  
pp. 456-460 ◽  
Author(s):  
Yuko Kijima ◽  
Heiji Yoshinaka ◽  
Munetsugu Hirata ◽  
Tadao Mizoguchi ◽  
Sumiya Ishigami ◽  
...  
Keyword(s):  
Partial Mastectomy ◽  
Immediate Reconstruction ◽  
Adipofascial Flap

Incidental T2 hyperintensities in the medial part of the bilateral globus pallidus are possibly an age-related physiological finding

2021 ◽  
pp. 197140092110141
Author(s):  
Jun Oyama ◽  
Kota Yokoyama ◽  
Tomoyuki Fujioka ◽  
Tadashi Nariai ◽  
Jun Karakama ◽  
...  
Keyword(s):  
Globus Pallidus ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Lateral Part ◽  
Medial Part ◽  
Available N ◽  
Computed Tomography Images ◽  
Age Related ◽  
History Of ◽  
Lifestyle Diseases

Background and purpose Bilateral T2 hyperintensities in the medial part of the globus pallidus (GP) are sometimes incidentally observed in patients without a known history of diseases that present with such lesions. The purpose of this study was to evaluate the frequency of this finding and the association between this finding and age, lifestyle diseases and GP calcification. Methods We retrospectively investigated the brain magnetic resonance imaging (MRI) of 742 patients, which included between 104 and 108 consecutive patients from each decade of life between the 20s and 80s. The signal intensity ratio of the medial part to the lateral part of the GP in T2-weighted images (T2 medial/lateral ratio) was evaluated. For cases in which brain computed tomography images were available ( N=437), GP calcifications were also evaluated. The associations between the T2 medial/lateral ratio and age, sex, history of lifestyle diseases and GP calcification were investigated. Results Bilateral T2 medial/lateral ratios >1.10, 1.30 and 1.50 were observed in 29.8%, 7.1% and 1.8% of all cases, respectively. A high bilateral T2 medial/lateral ratio was observed less frequently in young patients ( p<0.01), more frequently in elderly patients and those with hypertension or dyslipidaemia ( p<0.05) and more frequently in patients with a calcified GP ( p<0.01). Conclusion Incidental bilateral T2 hyperintensities in the medial part of the GP on brain MRI are most likely an age-related physiological finding.

Traumatic Intraconal Foreign Body: Report of an Injury Corrected With Combined Surgical and Endoscopic Treatment

2015 ◽  
Vol 12 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Daniele Marchioni ◽  
Dario Bertossi ◽  
Davide Soloperto ◽  
Luca Bianconi ◽  
Pasquale Procacci ◽  
...  
Keyword(s):  
Foreign Body ◽  
Multidisciplinary Approach ◽  
Lateral Part ◽  
Medial Part ◽  
Combined Approach ◽  
Foreign Body Removal ◽  
Present Technique ◽  
Retrobulbar Space ◽  
Therapeutic Problem ◽  
Anatomic Region

Abstract BACKGROUND Management of penetrating ocular splinter injuries is very controversial. Penetrating wounds of the orbit represent a complex therapeutic problem that requires a multidisciplinary approach. Endoscopic approaches to the orbit are currently performed through the lamina papyracea to access the medial part, or through large orbitotomies to access the lateral part. OBJECTIVE To describe a novel combined approach to the lateral part of the orbit. METHODS Clinical and surgical findings of intraorbital foreign body removal are presented. A minimal supraorbital osteotomy was performed, combined with endoscopic intraorbital dissection. RESULTS The foreign body was removed, no postoperative complications were reported, and visual acuity increased from 2/10 preoperatively, to 8/10 one month after surgery. CONCLUSION The present technique can be considered a safe and novel surgical approach to access the retrobulbar space and to treat the pathology of this anatomic region.

Standardised method of selecting surgical approaches to benign parapharyngeal space tumours, based on pre-operative images

2007 ◽  
Vol 122 (6) ◽  
pp. 628-634 ◽  
Author(s):  
S Kanzaki ◽  
H Nameki
Keyword(s):  
Surgical Approach ◽  
Parapharyngeal Space ◽  
Surgical Approaches ◽  
Anatomical Landmarks ◽  
Resonance Imaging ◽  
Large Tumour ◽  
Transcervical Approach ◽  
Skull Base Approach ◽  
Inferior Portion ◽  
Superior Portion

AbstractMany approaches to the parapharyngeal space have been reported. However, few reports describe parapharyngeal space tumours and the best surgical approach to these tumours. We retrospectively examined the surgical approaches we used to resect 22 parapharyngeal space tumours. In order to determine the best surgical approach for each tumour, we first subdivided the parapharyngeal space into six compartments, based on anatomical landmarks seen on computed tomography and/or magnetic resonance imaging scans. We then determined the location of each tumour relative to these six parapharyngeal space compartments. In our series of cases, we found that large tumours spanning the superior portion of the parapharyngeal space could be completely removed through a skull base approach. To remove a large tumour in the middle and inferior portion of the parapharyngeal space, a transparotid approach was the most suitable. Finally, a tumour in the inferior portion of the parapharyngeal space was best accessed through a transcervical approach.

Silicone Gel-Filled Breast Implants: Is Local Inflammation Associated With Fat Necrosis?

1995 ◽  
Vol 1 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Frederick H. Silver ◽  
George D. Pins ◽  
Azam Rizvi ◽  
Robert M. Olson ◽  
Anthony D'Aguillo
Keyword(s):  
Breast Implants ◽  
Fat Necrosis ◽  
Local Inflammation ◽  
Silicone Gel

scholarly journals Tomodensitometric Bone Anatomy of The Intervertebral Foramen of The Lower Cervical Spine: Measurements and Comparison of Foraminal Volume in Healthy Individuals and Patients Suffering from Cervicobrachial Neuralgia Due to Foraminal Stenosis.

2022 ◽  
Author(s):  
Pierre COUDERT ◽  
Gaetan LAINE ◽  
Vincent POINTILLART ◽  
Camille DAMADE ◽  
Louis BOISSIERE ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Current Knowledge ◽  
Intervertebral Discs ◽  
Lateral Part ◽  
Foraminal Stenosis ◽  
Medial Part ◽  
Lower Cervical Spine ◽  
Intervertebral Foramen ◽  
Asymptomatic Group ◽  
Symptomatic Group

Abstract Purpose Degenerative foraminal stenosis of the cervical spine can lead to cervicobrachial neuralgias. Computed tomography (CT)-scan assists in the diagnosis and evaluation of foraminal stenosis. The main objective of this study is to determine the bony dimensions of the cervical intervertebral foramen and to identify which foraminal measurements are most affected by degenerative disorders of the cervical spine. These data could be applied to the surgical treatment of this pathology, helping surgeons to focus on specific areas during decompression procedures. Methods A descriptive study was conducted between two groups: an asymptomatic one (young people with no evidence of degenerative cervical spine disorders) and a symptomatic one (experiencing cervicobrachial neuralgia due to degenerative foraminal stenosis). Using CT scans, we determined a method allowing measurements of the following foraminal dimensions: foraminal height (FH), foraminal length (FL), foraminal width in its lateral part ((UWPP, MWPP and IWPP (respectively Upper, Medial and Inferior Width of Pedicle Part)) and medial part (UWMP, MWMP and IWMP (respectively Upper, Medial and Inferior Width of Medial Part)), and disk height (DH). Foraminal volume (FV) was calculated considering the above data. Mean volumes were measured in the asymptomatic group and compared to the values obtained in the symptomatic group. Results Both groups were made up of 10 patients, and a total of 50 intervertebral discs (100 intervertebral foramina) were analyzed in each group. Comparison of C4C5, C5C6 and C6C7 levels between both groups showed several significant decreases in foraminal dimensions (p< 0,05) as well as in foraminal volume (p <0.001) in the symptomatic group. The most affected dimensions were UWPP, MWPP, UWMP, MWMP and FV. The most stenotic foraminal areas were the top of the uncus and the posterior edge of the lower plate of the overlying vertebra. Conclusion Using a new protocol for measuring foraminal volume, the present study refines the current knowledge of the normal and pathological anatomy of the lower cervical spine and allows us to understand the foraminal sites most affected by degenerative stenosis. Those findings can be applied to foraminal stenosis surgeries. According to our results, decompression of the foramen in regard of both uncus osteophytic spurs and inferior plate of the overlying vertebra might be an important step for nerve roots release.

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