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Major Vessels (major + vessel)
Selected AbstractsCephalic vascular anatomy in flamingos (Phoenicopterus ruber) based on novel vascular injection and computed tomographic imaging analysesTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 10 2006Casey M. Holliday Abstract Head vascular anatomy of the greater (or Caribbean) flamingo (Phoenicopterus ruber) is investigated and illustrated through the use of a differential contrast, dual vascular injection technique, and high-resolution X-ray computed tomography (CT), allowing arteries and veins to be differentiated radiographically. Vessels were digitally isolated with segmentation tools and reconstructed in 3D to facilitate topographical visualization of the cephalic vascular tree. Major vessels of the temporal, orbital, pharyngeal, and encephalic regions are described and illustrated, which confirm that the general pattern of avian cephalic vasculature is evolutionarily conservative. In addition to numerous arteriovenous vascular devices, a previously undescribed, large, bilateral, paralingual cavernous sinus that excavates a large bony fossa on the medial surface of the mandible was identified. Despite the otherwise conservative vascular pattern, this paralingual sinus was found only in species of flamingo and is not known otherwise in birds. The paralingual sinus remains functionally enigmatic, but a mechanical role in association with the peculiar lingual-pumping mode of feeding in flamingos is perhaps the most likely hypothesis. Anat Rec Part A, 288A:1031,1041, 2006. © 2006 Wiley-Liss, Inc. [source] Toward an Implantable Wireless Cardiac Monitoring Platform Integrated with an FDA-Approved Cardiovascular StentJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2009ERIC Y. CHOW Ph.D. Continuous monitoring of blood pressure from a minimally invasive device in the pulmonary artery can serve as a diagnostic and early warning system for cardiac health. The foremost challenge in such a device is the wireless transfer of data and power from within the blood vessel to an external device while maintaining unrestricted flow through the artery. We present a miniaturized system, which is attached to the outer surface of a regular or drug-eluting FDA-approved stent. When expanded, the stent maintains a patent vessel lumen while allowing contact between the electronic sensors and the blood supply. The stent-based antenna can be used for both wireless telemetry and power transfer for the implanted electronics. Using the stent platform as both a radiating antenna and a structural support allows us to take advantage of an FDA-approved device whose safety and surgical procedure are well established. The electronics package has been reduced to an area of less than 1 mm2, with a thickness under 300 ,m. A minimally invasive implantation procedure allows the delivery of the stent-based implant in nearly any major vessel of the body. This article describes an initial prototype with two stents configured as a single dipole, a 2.4-GHz transmitter microchip, and a battery, and validates transcutaneous transmission through ex vivo and in vivo porcine studies. The results demonstrate the feasibility of a stent-based wireless platform for continuous monitoring of blood pressure. [source] Prevention of wound complications following salvage laryngectomy using free vascularized tissueHEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2007FRCS(C), Kevin Fung MD Abstract Background. Total laryngectomy following radiation therapy or concurrent chemoradiation therapy is associated with unacceptably high complication rates because of wound healing difficulties. With an ever increasing reliance on organ preservation protocols as primary treatment for advanced laryngeal cancer, the surgeon must develop techniques to minimize postoperative complications in salvage laryngectomy surgery. We have developed an approach using free tissue transfer in an effort to improve tissue vascularity, reinforce the pharyngeal suture line, and minimize complications in this difficult patient population. The purpose of this study was to outline our technique and determine the effectiveness of this new approach. Methods. We conducted a retrospective review of a prospective cohort and compared it with a historical group (surgical patients of Radiation Therapy Oncology Group (RTOG)-91-11 trial). Eligibility criteria for this study included patients undergoing salvage total laryngectomy following failed attempts at organ preservation with either high-dose radiotherapy or concurrent chemo/radiation therapy regimen. Patients were excluded if the surgical defect required a skin paddle for pharyngeal closure. The prospective cohort consisted of 14 consecutive patients (10 males, 4 females; mean age, 58 years) who underwent free tissue reinforcement of the pharyngeal suture line following total laryngectomy. The historical comparison group consisted of 27 patients in the concomitant chemoradiotherapy arm of the RTOG-91-11 trial who met the same eligibility criteria (26 males, 1 female; mean age, 57 years) but did not undergo free tissue transfer or other form of suture line reinforcement. Minimum follow-up in both groups was 12 months. Results. The overall pharyngocutaneous fistula rate was similar between groups,4/14 (29%) in the flap group, compared with 8/27 (30%) in the RTOG-91-11 group. There were no major wound complications in the flap group, compared with 4 (4/27, 14.8%) in the RTOG-91-11 group. There were no major fistulas in the flap group, compared with 3/27 (11.1%) in the RTOG-91-11 group. The rate of pharyngeal stricture requiring dilation was 6/14 (42%) in the flap group, compared with 7/27 (25.9%) in the RTOG-91-11 group. In our patients, the rate of tracheoesophageal speech was 14/14 (100%), and complete oral intake was achieved in 13/14 (93%) patients. Voice-Related Quality of Life Measure (V-RQOL) and Performance Status Scale for Head and Neck Cancer Patients (PSS-HN) scores suggest that speech and swallowing functions are reasonable following free flap reinforcement. Conclusions. Free vascularized tissue reinforcement of primary pharyngeal closure in salvage laryngectomy following failed organ preservation is effective in preventing major wound complications but did not reduce the overall fistula rate. Fistulas that developed following this technique were relatively small, did not result in exposed major vessels, and were effectively treated with outpatient wound care rather than readmission to the hospital or return to operating room. Speech and swallowing results following this technique were comparable to those following total laryngectomy alone. © 2007 Wiley Periodicals, Inc. Head Neck 2007 [source] Impact of intraoperative sonography on resection and cryoablation of liver tumorsJOURNAL OF CLINICAL ULTRASOUND, Issue 5 2001Diana Gaitini MD Abstract Purpose We retrospectively analyzed the impact of intraoperative sonography (IOUS) on the management of patients referred for resection of liver tumors. Methods Forty patients underwent IOUS with a 7-MHz curved-array sector transducer; in selected cases, a 5-MHz linear-array transducer attached to a color Doppler unit was also used. The number, size, and location of tumors on IOUS, including tumor proximity to or invasion of major vessels or invasion of the diaphragm, were compared to findings on preoperative imaging studies. The effect of these findings on surgical management was assessed. Unresectable lesions were treated by cryoablation under ultrasound guidance. Results IOUS detected preoperatively unsuspected lesions in 7 patients (18%). Metastases suspected on CT arterial portography were ruled out in 2 patients (5%), and indeterminate lesions were diagnosed as cysts by IOUS in 2 other patients (5%). Vascular proximity or vascular or diaphragmatic invasion detected by IOUS rendered lesions unresectable in 4 patients (10%). Cryoablation under IOUS guidance and monitoring was attempted in 11 patients (28%) and performed successfully in 10. Conclusions IOUS changed the management in 38% of patients and guided cryoablation in 28% of patients. IOUS performed by an experienced sonologist is invaluable for the accurate assessment of liver tumor resectability; the detection of additional, preoperatively unknown lesions; and the guidance of cryoablation of unresectable tumors. © 2001 John Wiley & Sons, Inc. J Clin Ultrasound 29:265,272, 2001. [source] Peroneal artery perforator-based propeller flap reconstruction of the lateral distal lower extremity after tumor extirpation: Case report and literature reviewMICROSURGERY, Issue 8 2008Ariel N. Rad M.D. Background: Soft tissue defects in the distal lower extremity present a formidable challenge due to the lack of reliable local flap options. Pedicled adipofasciocutaneous flaps provide the closest match to local tissues, but random pattern flaps are limited in reliability, size, reach, and arc-of-rotation. One hundred and eighty degree perforator-based propeller flaps are an innovative option because they provide robust axial perfusion to flaps with significantly greater surface area and ease of transposition versus that provided by their random pattern counterparts in these anatomic regions traditionally addressed with free tissue transfer. Case: We present a rare case of aggressive digital papillary carcinoma of the posteriolateral ankle and Achilles region. Wide local excision resulted in a defect with Achilles tendon exposure and denudation. A fasciocutaneous propeller flap based on a dominant peroneal artery perforator was raised and rotated 180° to resurface the wound, providing a gliding surface for Achilles tendon function. The reconstruction was successful with no complications, excellent contour, and esthetic appearance. Conclusions: Peroneal perforator-based propeller flaps in the ankle region are useful local options providing unparalleled form and function, with excellent surface area and mobility, for dynamic areas of the lower extremity, without sacrificing any major vessels or nerves. This technique adds to the reconstructive microsurgeon's armamentarium for complex coverage of the ankle region. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source] Limb salvage of infected diabetic foot ulcers with free deep inferior epigastric perforator flaps ,MICROSURGERY, Issue 2 2006Masayoshi Ohta M.D. Soft-tissue reconstruction of the feet in diabetic patients with angiopathy, sensorial neuropathy, and immunopathy is a complicated problem. Until the mid-1980s, chronic foot ulcers in diabetic patients were treated conservatively, because flap surgery was regarded as too risky. However, in recent years, early debridement and flap coverage have become popular reconstructive methods for diabetic foot wounds. Several flap donor sites are available, depending on the nature of the defect. The deep inferior epigastric artery perforator (DIEP) flap is a relatively new flap that developed as a modification of the transverse rectus abdominis muscle (TRAM) flap. It provides a large amount of skin and subcutaneous tissue, without the donor-site morbidity of the ordinary TRAM flap. Furthermore, using the DIEP flap avoids the loss of major vessels. In this study, we report on the successful use of the DIEP flap in four cases of diabetic foot ulceration. © 2006 Wiley-Liss, Inc. Microsurgery 26: 87,92, 2006. [source] Anatomy of Complications Workshop: An educational strategy to improve performance in obstetricians and gynaecologistsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 2 2003Ian Hammond Abstract Many specialist obstetricians and gynaecologists feel inadequately trained to deal with certain situations such as injury to bowel, bladder, ureter and major vessels, and value further training to prevent and manage these problems. We present the structure, objectives and rationale for a surgical skills workshop, which is an intensive practical learning experience aimed to improve the performance of obstetricians and gynaecologists. The overall objective of the workshop is improvement in the prevention and management of complications in obstetric and gynaecological surgery. Over 100 participants have completed the workshop so far. Pre-workshop preparation includes anatomical illustrations to guide reading and a training video describing surgical skills, ewe anatomy and hysterectomy in the ewe. There are four modules: anatomy includes an interactive lecture, cadaveric dissection and examination of prosections with specific learning tasks. Surgical skills involves the demonstration, practice and learning of techniques needed to deal with unexpected operative injury to bowel, bladder, ureter and major blood vessels. Live animal surgery on a ewe allows further supervised practice of the previously learned skills plus the repair of serious vascular injury. Case presentations allow each participant to present a complicated case in a facilitated group session with discussion and feedback from their peers. This session is controlled, non-threatening and a valuable interactive learning experience. Participant feedback suggests that this workshop format is useful and appears to improve the confidence, competence and performance of the participants. This workshop is presented as a template on which other educational activities can be developed. [source] Elective sirolimus-eluting stent implantation for multivessel disease involving significant LAD stenosis: One-year clinical outcomes of 99 consecutive patients,the Rotterdam experienceCATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 1 2004Chourmouzios A. Arampatzis MD Abstract The aim of this study was to evaluate the effectiveness of sirolimus-eluting stent (SES) implantation for patients with multivessel disease, which included left anterior descending artery (LAD) treatment. Since April 2002, SES has been utilized as the device of choice for all interventions in our institution as part of the Rapamycin-Eluting Stent Evaluated at Rotterdam Hospital (RESEARCH) registry. In the first 6 months of enrolment, 99 consecutive patients (17.6% of the total population) were treated for multivessel disease involving the LAD. The impact of SES implantation on major adverse cardiac events (MACE) was evaluated. All the patients received SES in the LAD. Additional stent implantation in the right coronary artery, the left circumflex, or in all three major vessels was attempted successfully in 32 (32%), 51 (52%), and 16 (16%) of the treated patients respectively. During a mean follow-up of 360 ± 59 days (range, 297,472 days), we had one death, one non-Q-wave myocardial infarction, and eight patients required subsequent intervention. The event-free survival of MACE at 1 year was 85.6%. SES implantation for multivessel disease in a consecutive series of patients is associated with low incidence of adverse events. The reported results are related predominantly to the reduction in repeat revascularization. Catheter Cardiovasc Interv 2004;63:57,60. © 2004 Wiley-Liss, Inc. [source] 4413: Analysis of gene expression in acute ischemic neuroretinas : a genome-wide screen discriminating occlusion (BRVO) versus laser effects in ratsACTA OPHTHALMOLOGICA, Issue 2010C OROPESA Purpose Identification of genes differentially regulated in rat neuroretinas submitted to an experimental acute branch retinal vein occlusion (BRVO), to a laser treatment, or to no treatment at all. Methods We have developed an in vivo experimental model of venous occlusion by photodynamic thrombosis in rat retinas. After anaesthesia, a sodium fluorescein solution was injected in rat tail 15 minutes before laser treatments. To induce ischemia in tested retina, venous sites adjacent to the optic nerve head were photocoagulated with an argon laser. In one group of tested animals, the retina was exposed to laser treatment at sites located between major vessels. As this treatment may have an effect upon choroidal blood flow, control eyes were not subjected to laser treatment. RNAs were isolated from the neuroretina 30 minutes post treatments, and processed for Affymetrix gene-chip analysis. Results Genome-wide screen enabled us to identify 308 and 348 genes which were up- or down-regulated, respectively, by BRVO and laser treatment only. When we compared the transcriptomes of retinas subjected to vessel occlusion or laser treatment to the control one, we found that the expression profiles of, respectively, 116 and 126 genes were specifically modified. The majority of the up- and down-regulated genes encode proteins involved in different aspects of early stress response, neuroprotection, inflammation and apoptosis. Conclusion Our microarray analysis revealed changes in gene expression bearing similarities to gene expression results from other ischemia models. Furthermore, it revealed that laser treatment may have an unreported impact on retina's metabolism. [source] Cardiac computed tomography: Diagnostic utility and integration in clinical practiceCLINICAL CARDIOLOGY, Issue S1 2006Matthew J. Budoff M.D. Abstract Cardiac applications of computed tomography (CT) is a rapidly growing diagnostic area because of the ability to visualize plaque burden (coronary artery calcification [CAC]) and luminal obstruction (computed tomographic angiography [CTA]) noninvasively. Coronary artery calcification has been validated in over 1,000 studies over the last 20 years, primarily with electron beam tomography. Studies demonstrate several indications that could aid physicians in the management of symptomatic and asymptomatic patients. Determining that a symptomatic patient has no CAC is associated with both a lower risk of an abnormal nuclear study and angiographic obstruction. The ability to detect subclinical atherosclerosis (CAC) with minimal radiation and no contrast makes this an attractive method for risk stratification. New studies demonstrate a 10-fold risk of cardiovascular events with increasing amounts of coronary calcification. The invasive nature, expense, and risk resulting from invasive angiography have been instrumental in encouraging the development of new diagnostic methods that allow the coronary arteries to be visualized noninvasively. Multislice CT, with its advanced spatial and temporal resolution, has opened up new possibilities in the imaging of the heart and major vessels of the chest, including the coronary arteries. The last decade has seen great strides in the field of cardiac imaging, particularly in the ability to visualize the coronary lumen with sufficient diagnostic accuracy. Possessing that qualification, CTA is now being used increasingly in clinical practice. As a result of having high spatial and improved temporal resolutions, this imaging modality not only allows branches of the coronary artery to be evaluated, but also allows simultaneous analysis of other cardiac structures, making it extremely useful for other cardiac applications. This paper reviews the diagnostic utility and limitations of cardiac CT and how it could be integrated into clinical practice. [source] Incision design in implant dentistry based on vascularization of the mucosaCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2005Johannes Kleinheinz Abstract Objectives: The delivery of an adequate amount of blood to the tissue capillaries for normal functioning of the organ is the primary purpose of the vascular system. Preserving the viability of the soft tissue segment depends on the soft tissue incision being properly designed in order to prevent impairment of the circulation. A knowledge of the course of the vessels as well as of their supply area are crucial to the decision of the incision. The aim of this study was to visualize the course of the arteries using different techniques, to perform macroscopic- and microscopic analyses, and to develop recommendations for incisions in implant dentistry. Material and methods: The vascular systems of seven edentulous human cadavers were flushed out and filled with either red-colored rubber bond or Indian ink and formalin mixture. After fixation a macroscopic preparation was performed to reveal the course, distribution and supply area of the major vessels. In the area of the edentulous alveolar ridge specimens of the mucosa were taken and analyzed microscopically. Results: The analyses revealed the major features of mucosal vascularization. The main course of the supplying arteries is from posterior to anterior, main vessels run parallel to the alveolar ridge in the vestibulum and the crestal area of the edentulous alveolar ridge is covered by a avascular zone with no anastomoses crossing the alveolar ridge. Conclusion: The results suggest midline incisions on the alveolar ridge, marginal incisions in dentated areas, releasing incisions only at the anterior border of the entire incision line, and avoidance of incisions crossing the alveolar ridge. Résumé Fournir une quantité adéquate de sang aux capillaires pour un fonctionnement normal de l'organe est le but premier du système vasculaire. Préserver la viabilité du segment de tissu mou dépend de l'incision du tissu mou qui doit être effectuée de manière précise pour prévenir la détérioration de la circulation. Une connaissance de géographie des vaisseaux ainsi que de leurs aires de réserve sont essentiels pour la décision de l'incision. Le but de cette étude a été de visualiser les artères en utilisant différentes techniques afin d'effectuer des analyses tant macro- que microscopiques et pour developper des recommandations pour les incisions lors de la pose d'implants dentaires. Les systèmes vasculaires de sept cadavres humains édentés ont été vidés et remplis avec soit de l'encre de Chine ou une solution rouge et du formol. Après fixation une préparation macroscopique a été effectuée pour mettre en évidence le cours, la distribution et l'aire de réserve des principaux vaisseaux. Dans la zone du rebord alvéoaire édenté des spécimens des muqueuses ont été prélevés et analysés microscopiquement. Les analyses ont mis en évidence les principaux caractères de la vascularisation de la muqueuse. Le cours principal des artères converge de l'arrière vers l'avant, les vaisseaux principaux courent parallèlement au rebord alvéolaire dans le vestibule et l'aire crestale des rebords alvéolaires édentés et sont couverts par une zone non-vascularisée sans anastomose traversant le rebord alvéolaire. Ces résultats suggèrent donc des incisions au milieu de la ligne du rebord alvéolaire, des incisions marginales dans les zones dentées, des incisions d'accès seulement dans la frontière antérieure de la ligne d'incision générale et l'abstention d'incision traversant la crête alvéolaire. Zusammenfassung Ziele: Das erste Ziel des Gefässsystems ist es, eine adäquate Menge Blut zu den Kapillaren zu führen, um eine normale Funktion des Organs zu gewährleisten. Der Erhalt der Lebensfähigkeit des Weichteilsegments hängt von der Weichgewebsinzision ab, welche sauber gestaltet sein sollte, um die Zirkulation nicht zu beeinträchtigen. Die Kenntnis des Verlaufs und der Versorgungsgebiete der Gefässe ist für die Wahl der Inzision entscheidend. Das Ziel dieser Studie war, den Verlauf der Arterien mittels verschiedener Techniken sichtbar zu machen, um makroskopische und mikroskopische Analysen durchführen zu können und um Empfehlungen für Inzisionen in der oralen Implantatchirurgie zu entwickeln. Material und Methoden: Das Gefässsystem von 7 zahnlosen menschlichen Kadavern wurde ausgespült und entweder mit rot gefärbter Gummiflüssigkeit oder mit indischer Tinte und einer Formalinmixtur aufgefüllt. Nach der Fixierung wurde eine makroskopische Präparation durchgeführt, um den Verlauf, die Verteilung und die Versorgungsgebiete der grossen Gefässe aufzuzeigen. Im Bereich des zahnlosen Alveolarkammes wurden Proben der Mukosa entnommen und mikroskopisch analysiert. Resultate: Die Analysen zeigten die generellen Eigenschaften der Vaskularisation von Schleimhäuten. Die Hauptrichtung der versorgenden Gefässe verläuft von posterior nach anterior, die Hauptgefässe liegen parallel zum Alveolarkamm im Vestibulum und die Kammregion des zahnlosen Alveolarkammes wird durch eine avaskuläre Zone ohne den Alveolarkamm überkreuzende Anastomosen bedeckt. Schlussfolgerung: Aufgrund der Resultate werden Inzisionen im Bereich der Kammmitte des zahnlosen Alveolarkammes und marginale Inzisionen im bezahnten Bereich vorgeschlagen. Entlastungsschnitte sollten nur an der anterioren Grenze der gesamten Inzisionslinie gelegt werden. Inzisionen, welche den Alveolarkamm überkreuzen, sollten vermieden werden. Resumen Objetivos: El suministro de una cantidad adecuada de sangre a los capilares tisulares para el funcionamiento normal de un órgano es el propósito primario del sistema vascular. La preservación de la viabilidad del segmento de tejido blando depende en la incisión del tejido blando que debe estar debidamente diseñada en orden a prevenir mermas en la circulación. Un conocimiento del curso de los vasos al igual que del área de suministro es crucial para la decisión de la incisión. La intención de este estudio fue visualizar el curso de las arterias usando diferentes técnicas, para realizar análisis macro- y microscópicos, y desarrollar recomendaciones para incisiones en odontología de implantes. Material y métodos: Se vaciaron los sistemas vasculares de 7 cadáveres humanos edéntulos y rellenados con pegamento de goma de color rojo o con una mezcla de tinta india y formalina. Tras la fijación se llevó a cabo una preparación macroscópica para revelar el curso, distribución y área de suministro de los vasos principales. En el área de la cresta alveolar edéntula se tomaron especímenes y se analizaron microscópicamente. Resultados: Los análisis revelaron las principales características de la vascularización mucosa. El curso principal de las arterias de suministro as desde posterior a anterior, los vasos principales corren paralelos a la cresta alveolar en el vestíbulo y el área crestal de la cresta alveolar esta cubierta por una zona avascular sin anastomosis que crucen la cresta alveolar. Conclusión: Los resultados sugieren incisiones en la cresta alveolar, incisiones marginales en áreas dentadas, incisiones liberadoras solo en el borde anterior de la línea completa de incisión, y evitar las incisiones que crucen la cresta alveolar. [source] Bone morphology and vascularization of untreated and guided bone augmentation-treated rabbit calvaria: evaluation of an augmentation modelCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005Christer Slotte Abstract Objectives: Cranial vault is widely used in experimental models on membranous bone healing in general, guided bone augmentation (GBA) studies being one example. To our knowledge, however, few studies on the characteristics of the untreated calvaria regarding bone density, vessel topography, and their intra/interindividual variations and associations are available. The aims of this investigation were to (1) map the large vessel topography of the skull vault, (2) describe the parietal bones of the adult rabbit histologically and morphometrically, and (3) histologically compare untreated parietal bone with parietal bone that had been treated with a GBA device. Material and methods: Ten adult untreated rabbits were microangiographed. General anesthesia was induced and the mediastinum was opened. Heparin and lidocaine were injected in the aorta followed by perfusion with India ink. After death, en bloc biopsies of the skull vault including the overlying soft tissues and dura mater were taken. The specimens were cleared with the Spalteholtz technique, microscopically examined, and digitally imaged. Thereafter, circular biopsies were harvested to obtain decalcified sections. In addition, sections from 14 GBA-treated rabbit skulls (of the same race, sex and age as the untreated animals) served as reference specimens for comparison. Histomorphometric examinations were carried out. Results: In the cleared specimens, all parietal bones were found to be supplied by one major branch of the meningeal artery. From each of these, separate branches supplied the dura wherein a fine vessel network covered the bone. No major vessels were found in the supracalvarial soft tissue. Numerous fine vessels were found within the periosteum and dura entering the cortical plates. The decalcified sections of the parietal bones revealed an outer and inner cortical plate enveloping a diploic space containing bone trabeculae, marrow tissue and larger sinusoids. Hollow connections were frequently found in both the outer and inner cortical plates in both the untreated and the GBA-treated specimens. These connections contained marrow tissue that extended to the periosteum and the dura. The morphometric measurements revealed similar proportions of cortical, trabecular, and marrow areas in the right and left untreated bones. The area of the outer cortical plate was significantly larger than the area of the inner cortical plate. Bone density was similar in the right and left untreated and GBA-treated specimens, as was the frequency and width of hollow connections through the cortical bone plates. Conclusions: The symmetry between the left and right parietal bones concerning the large vessel topography and the histomorphometric parameters assessed was high. Hollow connections in the cortical plates were frequently found. The bilateral use of the parietal bones is suggested to be reliable in experimental GBA models regarding the blood supply and bone quality. Résumé La voûte crânienne est souvent utilisée dans les modèles expérimentaux de guérison osseuse membranaire en général, l'augmentation osseuse guidée (GBA) étant un exemple. Peu d'études sur les crânes non-traités sont disponibles en ce qui concerne la densité osseuse, la topographie des vaisseaux et leurs variations intra/interindividuelles et leurs associations. Les buts de cette étude ont été 1) de cartographier la topographie des vaisseaux larges sur la voute crânienne, 2) de décrire les os pariétaux du lapin adulte histologiquement et morphométriquement et 3) de comparer histologiquement l'os pariétal non-traité avec celui traité par GBA. Dix lapins adultes non-traités ont subi une micro-angiographie. L'anesthésie générale a été effectuée et la partie médiane a été ouverte. De l'héparine et de la lidocaïne ont été injectées dans l'aorte suivies d'une perfusion avec de l'encre noire. Après la mort, des biopsies en blocs de la voûte crânienne comportant la dura mater et les tissus mous la recouvrant ont été prélevées. Les spécimens ont été estimés par la technique de Spalteholtz, examinés microscopiquement et des images digitales ont été réalisées. Des biopsies circulaires ont été prélevées pour obtenir des sections décalcifiées. Des sections de 14 crânes de lapins traités GBA (de même race, sexe et âge que les non-traités) ont servi de spécimens de référence pour comparaison. Des examens histomorphométriques ont été effectués. Dans les spécimens non-traités, tous les os pariétaux étaient irrigués par une branche majeure de l'artère méningée. De chacune de ces dernières, différentes branches abreuvaient la dura dans laquelle un réseau de vaisseau fins recouvrait l'os. Aucun vaisseau majeur n'a été trouvé dans le tissu mou ou sus-voûte. De nombreux vaisseaux fins ont été trouvés à l'intérieur du périoste et de la dura pénétrant qu'entre les bords corticaux. Les sections décalcifiées des os pariétaux ont révélé des bords corticaux interne et externe enveloppant un espace diploïque contenant de l'os trabéculaire, de la moelle osseuse et de larges sinusoïdes. Des connexions creuses étaient fréquemment trouvées tant dans les plaques corticales interne qu'externe et tant dans les spécimens non-traités que traités GBA. Ces connexions contenaient de la moelle qui allait jusqu'au périoste et la dura. Les mesures morphométriques ont révélé des proportions semblables de cortical, trabécules et moelle dans les les os non-traités. L'aire du bord cortical externe était significativement plus importante que l'aire du bord cortical interne. La densité osseuse était semblable dans les spécimens non-traités et traités GBA gauches et droits ainsi que la fréquence et la largeur des connexions creuses à travers les bords osseux corticaux. La symétrie entre les os pariétaux gauches et droits concernant la topographie des vaisseux larges et des paramètres histomorphométriques étaient importante. Les connexions creuses dans les bords corticaux était souvent trouvées. L'utilisation bilatérale des os pariétaux est proposée pour sa fiabilité dans les modèles GBA expérimentaux concernant l'apport sanguin et la qualité osseuse. Zusammenfassung Ziele:,Die Schädeldecke wird oft bei experimentellen Modellen zur bindegewebigen Knochenheilung verwendet. Ein Beispiel dafür sind Studien zur gesteuerten Knochenaugmentation (GBA). Soviel wir wissen, existieren jedoch nur wenige Studien über die Charakteristiken der unbehandelten Kalvaria bezüglich Knochendichte, Gefässtopographie und deren intra-/interindividuelle Variationen und Assoziationen. Die Ziele dieser Untersuchung waren (1) die Topographie der grossen Gefässe der Schädeldecke aufzuzeichnen, (2) die parietalen Knochen des ausgewachsenen Kaninchens histologisch und histomorphometrisch zu beschreiben, und (3) histologisch den unbehandelten parietalen Knochen mit parietalem Knochen, der mit einer GBA Einrichtung behandelt worden war, zu vergleichen. Material und Methoden:,Zehn ausgewachsene Kaninchen wurden mikroangiographisch untersucht. In Narkose wurde das Mediastinum eröffnet. Es wurde Heparin und Lidocain in die Aorta injiziert, darauf folgte die Perfusion mit India Tinte. Nach dem Tod wurden Blockbiopsien der Schädeldecke inklusive bedeckende Weichgewebe und Dura mater entnommen. Die Präparate wurden mittels der Spaltenholztechink gereinigt, mikroskopisch untersucht und digital aufgezeichnet. Danach wurden zirkuläre Biopsien gewonnen, um entkalkte Schnitte herzustellen. Zusätzlich dienten Schnitte von 14 GBA-behandelten Kaninchenschädeln (gleiche Rasse, Geschlecht und Alter wie die unbehandelten Tiere) als Referenzpräparate zum Vergleich. Es wurden histomorphometrische Untersuchungen durchgeführt. Resultate:,In den gereinigten Präparaten konnte gesehen werden, dass alle parietalen Knochen durch einen grossen Ast der Meningalarterie versorgt wurden. Separate Aeste dieser Arterie versorgten die Dura, wobei ein feines Gefässnetz den Knochen bedeckte. In den Weichgeweben auf der Kalvaria konnten keine grossen Gefässe gefunden werden. Im Periost und in der Dura waren zahlreiche feine Gefässe zu sehen, welche in die kortikalen Platten eintraten. Die entkalkten Schnitte der parietalen Knochen zeigten eine äussere und innere kortikale Platte, welche einen abgeschlossenen Raum mit Knochentrabekeln, Markgewebe und grossen Hohlräumen umschlossen. In der inneren und in der äusseren kortikalen Platte konnten oft sowohl bei den unbehandelten als auch bei den GBA-behandelten Präparaten hohle Verbindungen gefunden werden. Diese Verbindungen enthielten Markgewebe, dass sich bis zum Periost und der Dura erstreckte. Die morphometrischen Messungen zeigten sowohl in den rechten als auch in den linken unbehandelten Knochen ähnliche Proportionen zwischen kortikalem Knochen, trabekulärem Knochen und den Markarealen. Die Fläche der äusseren kortikalen Platte war signifikant grösser als die Fläche der inneren kortikalen Platte. Die Knochendichte war in den rechten und linken unbehandelten und in den GBA-behandelten Präparaten ähnlich, ebenso die Häufigkeit und die Breite der hohlen Verbindungen durch die kortikalen Platten. Schlussfolgerungen:,Die Symmetrie zwischen den rechten und linken parietalen Knochen bezüglich Topographie der grossen Gefässe und der untersuchten histomorphometrischen Parameter war gross. In den kortikalen Platten konnten häufig hohle Verbindungen gefunden werden. Es wird vorgeschlagen, dass die bilaterale Verwendung von parietalen Knochen bei experimentellen GBA-Modellen zuverlässig ist bezüglich Blutversorgung und Knochenqualität. Resumen Objetivos:,La bóveda craneal es ampliamente usada en modelos experimentales en cicatrización de hueso membranoso en general, siendo un ejemplo los estudios de regeneración ósea guiada (GBA). Que sepamos, sin embargo, se dispone de pocos estudios sobre las características del calvario no tratado con respecto a la densidad ósea, la topografía vascular, y sus variaciones intra/interindividuo y sus asociaciones. Las intenciones de esta investigación fueron (1) cartografiar la topografía de grandes vasos de la bóveda craneal, (2) describir histológica y morfométricamente los huesos parietales del conejo adulto, y (3) comparar histológicamente el hueso parietal no tratado con el hueso parietal tratado con un dispositivo de GBA. Material y Métodos:,Se llevaron a cabo microangiografías a diez conejos adultos sin tratar. Se indujo anestesia general y se abrió el mediastino Se inyectaron heparina y lidocaina en la aorta seguida por infusión de tinta de India. Tras la muerte, se tomaron biopsias en bloque de la bóveda craneal incluyendo los tejidos blandos superpuestos y de la duramadre. Los especimenes se aclararon con la técnica de Spalteholtz, se examinaron microscópicamente, y se tomaron imágenes digitales. Más adelante, se recogieron biopsias circulares para obtener secciones descalcificadas. Además, secciones de los cráneos de los conejos tratados con 14secciones descalcificadas. Además, secciones de los cráneos de los conejos tratados con 14 GBA (de la misma raza, sexo y edad que los animales no tratados) sirvieron como especimenes de referencia para la comparación. Se llevaron a cabo exámenes histomorfométricos. Resultados:,En los especimenes aclarados, todos los huesos parietales se encontró que estaban irrigados por una rama principal de la arteria meníngea. De cada una de estas, ramas separadas irrigaron la dura en donde una fina red de vasos cubrió el hueso. No se encontraron vasos mayores en el tejido blando supracalvario. Se encontraron numerosos vasos dentro del periostio y la dura entrando en las placas corticales. Las secciones descalcificadas de los huesos parietales revelaron una placa cortical interna y externa envolviendo un espacio diploico conteniendo trabéculas óseas, tejido medular y grandes sinusoides. Frecuentemente se encontraron conexiones huecas en las placas corticales internas y externas tanto en los especimenes sin tratar como en los tratados con GBA. Estas conexiones contenían tejido medular que se extendió hasta el periostio y la dura. Las medidas morfogenéticas revelaron proporciones similares de áreas corticales trabeculares y medulares en los huesos derecho e izquierdo no tratados. El área de la placa cortical externa fue significativamente mayor que el área de placa cortical interna. La densidad ósea fue similar en el lado derecho e izquierdo no tratados y en los especimenes tratados con GBA, así como la frecuencia y la anchura de las conexiones huecas a lo largo de las placas óseas corticales. Conclusiones:,La simetría entre los huesos parietales izquierdos y derechos concernientes a la topografía vascular y los parámetros histomorfométricos valorados fue alta. Las conexiones huecas en las placas corticales se encontraron con frecuencia. Se sugiere que el uso bilateral de huesos parietales es fiable como modelo experimental GBA respecto al suministro de sangre y calidad ósea. [source] | ||||||||||