The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.
Animals ; Brain ; Carotid Arteries ; Hemodynamics ; Humans ; Ischemia ; Male ; Models, Theoretical ; Rats ; Rats, Sprague-Dawley

The ideal sites of vascular access are on the forearm, however, where superficial vein are usually poor due to the chronicity of the disease. Limitation of microsurgical technique forces to use upper arm or synthetic grafts in spite of the presence of small vessels. In this prospective study, we evaluated the success-rate of microsurgical arteriovenous shunt (AVS) using a microscope (M group) and compared the results with those using a loupe ( 3.5, L group) on the 95 patients from October, 1996 to April, 1998. The magnifiers were selected according to the external diameter of the vein, microscope below 1.5 mm. The results of operation were evaluated immediately after operation and were classified by the strength of thrill : strong thrill (ST); week thrill (WT); pulsation (P); none (F). The mean external diameters(mm) of the radial arteries and cephalic veins in both groups were 2.5; 2.3 (L) and 2.0; 1.3 (M), respectively (p<0.05). The immediate results of operation was ST,38; WT,11; P,2; N,0 in L group and ST,34; WT,10; P,1; N,0 in M group, which revealed no significant differences between both groups. After two months of operation, the rates of failure for vascular access were 5.9% (3/51) in L group 6.7% (3/45) in M group. In conclusion, small superficial veins on the wrist below 1.5 mm in diameter can be used successfully for vascular access with microsurgical technique using a surgical microscope.
Arm ; Forearm ; Humans ; Kidney Failure, Chronic* ; Microsurgery ; Prospective Studies ; Radial Artery ; Transplants ; Veins ; Wrist*

No abstract available.
Lung Neoplasms* ; Lung*

No abstract available.
Coronary Artery Bypass* ; Saphenous Vein*

No abstract available.
Pulmonary Aspergillosis*

Purpose: To investigate the extent of bone ingrowth into the porous-coated acetabular cups as well as the factors that correlated with bone ingrowth in total hip arthroplasty. Materials and Methods: Thirty six Harris-Galante porous-coated acetabular cups that were retrieved through revision surgery were examined in this study. Acetabular cups retrieved due to infection or severely destroyed cups (ed note: severe what?) were excluded. The extent of bone ingrowth into the acetabular cups was grossly measured, and its correlation with the variables including age, gender, weight, height, the duration of fixation, size, number of screws, inclination and anteversion was statistically analyzed. Results: The mean proportion of bone ingrowth was 52.9 21.9%(2~90%) and less than 30% in three cups(8.3%). The pattern and the location of bone ingrowth were not consistent. There was no correlation between the extent of bone ingrowth and age, gender, weight, height, the duration of fixation, cup size, number of screws, size, inclination and anteversion. Conclusion: Harris-Galante porous-coated acetabular cups showed satisfactory bone ingrowth regardless of the variables associated with the demographic or surgical conditions. Surface treatments with a fiber-metal porouscoating appears to be suitable for cementless acetabular cups in terms of the long term results.
Acetabulum* ; Arthroplasty, Replacement, Hip

BACKGROUND: The rat is generally accepted as an ideal experimental animal. A limitation of rat surgery is the need for microsurgical techniques. Especially, the bile duct of a rat is so slender that it is almost impossible to perform primary microsuture anastomosis of the bile duct. The aim of the present study was to investigate the impact of various bile-duct surgical procedures after temporary ligation, a method which dilates the bile duct without permanent obstruction. METHODS: Temporary ligation of the bile duct with 6-0 chromic cat-gut sutures makes it constantly dilated. Twenty-five ligated rats were divided into three experimental groups: primary end-to-end anastomosis (PA), Roux-en-Y choledochoenterostomy in auxiliary liver transplantation (LT), and sham operation (C). RESULTS: After surgery, the serum levels of glutamate oxalacetic transferase (GOT) were normalized at 5 days in the PA and the C groups, and within 10 days in the LT group. Serum bilirubin and gamma-GTP were not elevated in the three groups. Morhologic examinations of the anastomotic sites in the PA and LT groups at two weeks after surgery showed them to be well healed with good anastomotic patency. CONCLUSIONS: A bile duct dilated by temporal ligation is of great use without high magnification in various bile-duct surgical procedures.
Animals ; Bile Ducts* ; Bile* ; Bilirubin ; Glutamic Acid ; Ligation* ; Liver Transplantation ; Rats* ; Sutures ; Transferases

Self emasculation, defined as autocastration, penile amputation, dr both, is the end result of an unusual psychiatric disorder that falls into the category of self-mutilation, A case of penile and bilateral testicular replantation is reported in which a 25-year-old man suffered a self-inflicted complete penile and bilateral testicular amputation. Replantation of the penis was successful; 2 months after surgery, a urethrogram demonstrated no evidence of urethral stricture, and color duplex ultrasonography showed good blood flow intoboth dorsal arteries and deep dorsal to the amputation site. Although complete erection has not been obtained, no other functional impairments have been encountered in the 4 months since replantation. It was hoped that the testicles would function as a true endocrine organ. Unfortunately, the tissue did not remain viable and was replaced by fibrous tissue. Therefore, he has been given supplementary testosterone.
Adult ; Amputation* ; Arteries ; Hope ; Humans ; Male ; Microsurgery ; Penis ; Replantation* ; Testis ; Testosterone ; Ultrasonography ; Urethral Stricture

Self emasculation, defined as autocastration, penile amputation, dr both, is the end result of an unusual psychiatric disorder that falls into the category of self-mutilation, A case of penile and bilateral testicular replantation is reported in which a 25-year-old man suffered a self-inflicted complete penile and bilateral testicular amputation. Replantation of the penis was successful; 2 months after surgery, a urethrogram demonstrated no evidence of urethral stricture, and color duplex ultrasonography showed good blood flow intoboth dorsal arteries and deep dorsal to the amputation site. Although complete erection has not been obtained, no other functional impairments have been encountered in the 4 months since replantation. It was hoped that the testicles would function as a true endocrine organ. Unfortunately, the tissue did not remain viable and was replaced by fibrous tissue. Therefore, he has been given supplementary testosterone.
Adult ; Amputation* ; Arteries ; Hope ; Humans ; Male ; Microsurgery ; Penis ; Replantation* ; Testis ; Testosterone ; Ultrasonography ; Urethral Stricture

No abstract available.