ObjectiveTo exclusively compare the short-and long-term outcomes of hepatic resection (HR) patients with multifocal tumors meeting the Milan criteria between locating in same and different sections. MethodsA total of 219 consecutive HR patients with multifocal tumors meeting the Milan criteria were divided into group SS (n=97, same section) and group DS (n=122, different sections) according to their anatomical location (Couinaud's segmentation). ResultsThe 1-, 3-, and 5-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly higher in the group SS than those in the group DS (P < 0.05). The subgroup analysis showed that patients with 2 tumors and those undergoing en bloc resection were associated with better OS and RFS (P < 0.05). ConclusionsFor HCC patients with multifocal tumors meeting the Milan criteria, those with tumors locating in same hepatic section may have better longterm survival and lower HCC recurrence rates than those locating in different sections after HR.
【Abstract】ObjectiveTo investigate the anatomic feature and special clinical manifestations of variant right intrahepatic bile duct draining into left hepatic bile duct near the umbilical portion. MethodsVariant right intrahepatic bile ducts joining into left hepatic bile ducts near the umbilical portions were identified through cholangiograms in 52 patients, who were included in this study. Their history, clinical process and operations were reviewed. ResultsThere were total 38 cases of intrahepatic gallstone in this group. High incidence of intrahepatic calculi was found in variant right intrahepatic bile ducts （23/38 cases, 60.52%） and left hepatic ducts （33/38 cases, 86.84%）. Most of these cases were accompanied with dilatation and stricture of bile ducts in these area. The gallstones in the variant right intrahepatic bile ducts were not detected in 8 cases (8/23) and the rate of residual gallstone was as high as 86.95%(20/23). Injury of variant right intrahepatic bile duct took place when left hepatectomy was performed in one case. ConclusionGallstone is very likely to be formed in the variant right intrahepatic bile duct due to derangement of bile hydrokinetics and compression of blood vessel. Special attention should be paid to the diagnosis and operation of this abnormity.
ObjectiveTo observe the macular choroidal and retinal pigment epithelium (RPE) thickness in tilted disc syndrome (TDS). MethodsThis is a descriptive study. Thirty eyes of 22 TDS patients (TDS group) and 30 eyes of 15 normal subjects (control group) were analyzed. Among TDS group, there were 8 males (11 eyes) and 14 females (19 eyes), the average age was (9.00±2.78) years old. The best corrected visual acuity (BCVA) was 0.3-1.0, and the average spherical equivalent degree was (-3.44±2.22) DS. Among the control group, there were 8 males (16 eyes) and 7 females (14 eyes), the average age was (9.33±1.11) years old. The best corrected visual acuity (BCVA)≥1.0, and the average spherical equivalent degree was (-3.18±1.13)DS. The difference of the spherical equivalent degree between two groups was not statistically significant (t=-1.648, P=0.110). Enhanced depth imaging techniques of frequency-domain optical coherence tomography was used to measure the thickness of choroid and RPE at totally 17 sites. There sites included subfoveal, 4 sites each (500, 1000, 1500 and 2000 μm from the fovea) at the horizontal (nasal/temple) and vertical (superior/inferior) directions. ResultsThe subfoveal choroidal thickness was (235.53±51.77) μm and (273.45±60.3) μm in TDS patients and control respectively, the difference was significant(t=-2.612,P=0.011). The difference of the choroidal thickness of the other 8 horizontal sites (F=24.180) and 8 vertical sites (F=23.390) in TDS group was statistically significant (P=0.000). The TDS choroidal thickness of all horizontal sites except nasal 1000 μm site was thinner than corresponding sites of the control group (P<0.05). The TDS choroidal thickness of the subfoveal site and 4 inferior vertical sites was thinner than corresponding sites of the control group (P<0.05). The subfoveal RPE thickness was (32.56±5.00) μm and (36.58±3.60) μm in TDS patients and control respectively, the difference was significant(t=-3.567,P=0.001). The subfoveal RPE thickness was the thickest among other 16 sites in both groups, and the TDS RPE thickness of all sites was thinner than control group, the difference was statistically significant (P<0.05). ConclusionThe choroidal and RPE thickness of TDS patient was thinner than normal subjects.
OBJECTIVE: To investigate the feasibility of segmentation of latissimus dorsi on the basis of anatomy and electrophysiology. METHODS: Ten cadaveric latissimus dorsi was dissected according to the blood supply, nerve innervation. Electromyelogram (EMG) of latissimus dorsi of 13 healthy persons was recorded with superficial electrode plate in the motion of shoulder joint. The results of record were managed with statistic methods. Ten patients(including reconstruction of breast and repair of scar on elbow joint and on chest wall) were treated with the lateral inferior myocutaneous island flap. RESULTS: According to the medial and lateral vasculonervous branches, latissimus dorsi can be divided into the medial superior and lateral inferior segments. The clinical application of the segment achieved good results in reconstructing breast and in repairing scars on elbow and on chest wall. CONCLUSION: Latissimus dorsi can be divided into two segments and applied separately. The lateral inferior segment is more useful in shoulder motion.
Objective To make further exploration of the structure characteristics of anterolateral ligament (ALL) and provide clinical reference for diagnosis and treatment of ALL injury, especially for ALL reconstruction through anatomical study of ALL in a Chinese population. Methods Sixteen cadaveric knees, including 8 left knees and 8 right knees with sex ratio of 1∶1 and a mean age of 73.5 years (range, 57-84 years), were dissected to reveal the ALL through a standard approach. A qualitative and a quantitative characterizations of the ALL were performed. Results ALL was seen in 75.0% of the specimens, originating on the lateral femoral epicondyle, proximal and posterior to the lateral collateral ligament (LCL). It coursed on LCL or was parallel to LCL, anterodistally to its anterolateral tibial attachment approximately midway between the center of the Gerdy’s tubercle and the lateral margin of the fibular head. A strong connection was observed between the middle part of the ALL and the periphery of the meniscal body of the lateral meniscus. The distance between the center of the insertion and Gerdy’s tubercle was (23.9±3.3) mm; and the distance between the center of the insertion and the lateral margin of the fibular head was (23.8±4.0) mm. The ALL length at 0° and 60° flexion and neutral knee rotation were (44.8±5.1) mm and (47.8±5.5) mm respectively (t=14.071, P=0.000), and the ligament had its great extend at 60° of knee flexion and internal rotation. Furthermore, the ALL length at 0° and 60° flexion of males were both significantly higher than those of females (t=2.920, P=0.015; t=2.806, P=0.019), while other measurements differences were significant between males and females (P>0.05). Conclusion ALL is an independent and a non-isometric ligament located in the anterolateral area to the knee, of which the length is different between males and females. ALL plays a role in rotational stability of the knee, and should be put much emphasis in clinical practice.
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)
The purpose of this study was to investigate the arterial supply of the pisiform bone. Fifty upper extremities from adult human cadavers of both sexes were studied. The observations showed that there was a small branch(named the main artery of pisiform) arising from the lower part of the ulnar artery in each cases. The mean value of the length of the main artery of the pisiform was 23.89±8.68mm, the diameter of the artery was 0.79±0.21mm. The length, width and thickness of the pisiform were 11. 61±1.98mm, 11.40±1.87mm and 10.30±1.26mm, respectively. The length and width of the space accupied by the lunate on the X-ray films were measured, they were 16.38±1.96mm and 12.03±1.17mm, respectively.