OBJECTIVETo search for the morphological evidence of five-shu-point so as to explain the theory of the five-shu-point more reasonably.

METHODSCarefully study on Yellow Emperor's Internal Classic and compare with the modern anatomic knowledge.

CONCLUSIONThe theory of five-shu-point is closely related with the theory of blood vessels. The distributional pattern of the superficial vein on the remote parts of the limbs (below the elbow or the knee joints) is the morphological basis for the theory of five-shu-point.

Acupuncture Points ; Humans ; Lower Extremity ; blood supply ; Medicine, Chinese Traditional ; Upper Extremity ; blood supply ; Veins ; anatomy & histology

BACKGROUND: The curved sectional planes of the human body can provide a new approach of surface anatomy that the classical horizontal, coronal, and sagittal planes cannot do. The purpose of this study was to verify whether the curved sectional planes contribute to the morphological comprehension of anatomical structures. METHODS: By stacking the sectioned images of a male cadaver, a volume model of the right half body was produced (voxel size 1 mm). The sectioned images with the segmentation data were also used to build another volume model. The volume models were peeled and rotated to be screen captured. The captured images were loaded on user-friendly browsing software that had been made in the laboratory. RESULTS: The browsing software was downloadable from the authors' homepage (anatomy.co.kr). On the software, the volume model was peeled at 1 mm thicknesses and rotated at 30 degrees. Since the volume models were made from the cadaveric images, actual colors of the structures were displayed in high resolution. Thanks to the segmentation data, the structures on the volume model could be automatically annotated. Using the software, the sternocleidomastoid muscle and the internal jugular vein in the neck region, the cubital fossa in the upper limb region, and the femoral triangle in the lower limb region were observed to be described. CONCLUSION: For the students learning various medical procedures, the software presents the needed graphic information of the human body. The curved sectional planes are expected to be a tool for disciplinary convergence of the sectional anatomy and surface anatomy.
Anatomy, Cross-Sectional ; Cadaver* ; Comprehension ; Education ; Human Body ; Humans ; Imaging, Three-Dimensional ; Jugular Veins ; Learning ; Lower Extremity ; Male* ; Neck ; Upper Extremity ; Visible Human Projects

BACKGROUNDFor a child with osteosarcoma, prediction of the limb length discrepancy at maturity is important when planning for limb salvage surgery. The purpose of this study was to provide a reliable prediction method.

METHODSA retrospective review of Chinese children receiving chemotherapy for osteosarcoma before skeletal maturity was conducted. Standing full-length radiographs of the lower extremity were used for length measurements. Length-for-age curves were constructed using the LMS method. The lower limb multiplier for a specific age and gender was calculated using the formula M = Lm/L, where M was the gender- and age-specific multiplier, Lmwas the bone length at maturity, and L was the age-specific bone length. Prematurity and postmaturity radiographs were used to assess the accuracy of the prediction methods.

RESULTSA total of 513 radiographs of 131 boys and 314 radiographs of 86 girls were used to calculate the coefficients of the multiplier. The multipliers of 8-, 9-, 10-, 11-, 12-, 13-, 14-, 15-, 16-, 17-, and 18-year-old boys after chemotherapy for osteosarcoma were 1.394, 1.306, 1.231, 1.170, 1.119, 1.071, 1.032, 1.010, 1.004, 1.001, and 1.000, respectively; while for girls at the same ages, the multipliers were 1.311, 1.221, 1.146, 1.092, 1.049, 1.021, 1.006, 1.001, 1.000, 1.000, and 1.000, respectively. Prematurity and postmaturity femoral and tibial lengths of 21 patients were used to assess the prediction accuracy. The mean prediction error was 0 cm, 0.8 cm, and 1.6 cm for the multiplier method using our coefficients, Paley's coefficients, and Anderson's method, respectively.

CONCLUSIONSOur coefficients for the multiplier method are reliable in predicting lower limb length growth of Chinese children with osteosarcoma.

Adolescent ; Body Height ; physiology ; Bone Neoplasms ; surgery ; Child ; Female ; Femur ; anatomy & histology ; Humans ; Limb Salvage ; Lower Extremity ; anatomy & histology ; Male ; Models, Theoretical ; Osteosarcoma ; surgery ; Radiography ; Retrospective Studies ; Tibia ; anatomy & histology

OBJECTIVETo analyze the accuracy of three measurements of lower extremity length during total hip arthroplasty(THA),and explore the causes that influence the accuracy.

METHODSFrom January 2010 to January 2013,145 patients underwent THA were retrospectively analyzed. There were 66 males and 79 females,ranging in age from 48 to 89 years with an average of 66.7 years. Their lower extremities were measured by three methods during operation,among them,31 cases with reference method of contralaterallegs (A method) ,63 cases with measurement method of Kirschner wire location (B method), and other 51 cases with measurement method of anatomical landmark (C method). The accuracy of the three measurements and the incidence rate of length inequality of lower extremity were analyzed.

RESULTSAll patients were followed up,there was no significant differences in the operation time and the intraoperative blood loss among three groups. The difference of lower extremity length with A,B,C method were respectively (8.7+/-5.7),(3.1+/-2.6), (5.6+/-5.3) mm after operation; there were significant difference between any two groups. The accuracy of three methods from high to low were respectively B,C,A method. The incidence rate of length inequality of lower extremity with A, B, C method were respectively 32.3%, 1.6%, 11.8%, the incidence rate with A method was higher than that other two methods ; and there was no significant difference between B method and C method.

CONCLUSIONThe measurement method of Kirschner wire location has the best accuracy in the three methods and the measurement method of anatomical landmark is the second. The measurement method of Kirschner wire location is recommended in all THA except for the patients with femoral neck fracture. And the measurement method of anatomical landmark can be used in the patients with femoral neck fracture.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Female ; Humans ; Leg Length Inequality ; epidemiology ; Lower Extremity ; anatomy & histology ; Male ; Middle Aged ; Retrospective Studies

A new method to reconstruct comparatively complete muscle model of human lower limb from CT and MRI data is presented. Topological structure of more than fourteen muscles is built and the coordinates of origin and insertion points are given. Based on this model, straight-line model and centroid-line muscle model are acquired. Muscle force prediction is discussed according to the model reconstructed, and a multi-objective optimization method is put forward for evaluating muscle forces of human lower extremity.
Humans ; Image Processing, Computer-Assisted ; Lower Extremity ; Magnetic Resonance Imaging ; Models, Biological ; Muscle Contraction ; physiology ; Muscle, Skeletal ; anatomy & histology ; physiology ; Tomography, X-Ray Computed

OBJECTIVETo analyze anatomy data of popliteal veins (PV), with the purpose of selection of popliteal venous valves construction segment via venography, and to evaluate the surgical results.

METHODSFrom February 1998 to November 2010, after analyzing the popliteal vessel anatomy data of 39 limbs and related phlebography research of 862 cases, 102 patients (69 male and 33 female patients, aged from 48 to 71 years, mean 59 years) with severe deep venous insufficiency were selected for popliteal venous valve construction procedures. Doppler ultrasound, continuous dynamic venography, and intraoperative venous pressure measurements were used to assess the hemodynamic changes pre- and postoperatively. Venous clinical severity score (VCSS) were used to evaluate long-term results of deep venous valve construction procedures.

RESULTIn the 102 patients, 93.7% patients had one pair of valves in popliteal vein (PV), locating in the distal 1/3 segment of PV, with gastrocnemius veins (GV) joining with PV above PV valves. Postoperative blood flow volume of the PV was significantly higher than the preoperative volume (732.3 ml/min vs. 150.2 ml/min, t = 8.979, P < 0.001). The proximal pressure was significantly lower than the distal pressure ((12 ± 3) cm H(2)O vs. (15 ± 3) cm H(2)O, 1 cm H(2)O = 0.098 kPa, t = 8.049, P < 0.001). VCSS score was significantly lower after the surgery ((34 ± 15) cm H(2)O vs. (41 ± 14) cm H(2)O, t = 59.780, P < 0.001). Pre- and postoperative hemodynamic changes and VCSS scores were statistically significant (9.3 ± 1.9 vs. 1.8 ± 1.0, t = 59.780, P < 0.001). Mean follow-up were 8.9 years with an ulcer recovery rate of 96.3%, and a 3.7% ulcer recurrent rate.

CONCLUSIONSPopliteal vessel anatomy study and venography research provide critical information for the PV valve construction part selection, which stayed proximal to the communications of GV and PV. Restoration of gastrocnemius pump function and satisfactory long-term efficacy are received after valve construction.

Aged ; Female ; Hemodynamics ; Humans ; Lower Extremity ; blood supply ; Male ; Middle Aged ; Popliteal Vein ; anatomy & histology ; surgery ; Vascular Surgical Procedures ; methods ; Venous Insufficiency ; surgery ; Venous Valves ; surgery

OBJECTIVETo explore the feasibility and therapeutic effect of thinned posterior tibial artery free perforator flap for the reconstruction of soft tissue defects at dorsum of hands.

METHODSSix fresh adult lower limbs specimens were injected with red latex via arterial cannula and dissected. The number, distribution, branches, and outer diameter of posterior tibia artery perforators were observed. Based on the anatomic study, the perforator flaps were designed to reconstruct soft tissue defects at dorsum of hands and wrists. The redundant fat on the flaps was removed, but preserving the nutrient vascular system. 11 flaps were used with the size ranging from 2 cm x 5 cm to 10 cm x 14 cm.

RESULTS43 skin perforators of posterior tibial artery were observed in six lower limbs, 29 perforators with the outer diameter is greater than 0.5 mm when they threading over the deep fascia plane, on average every 4.8 bundles of sides. The mean outside diameter of perforating artery is (1.8 +/- 0.5) mm, and the length is (44 +/- 15) mm. 6 perforators were founded both in the second and fifth zone which could be used for anastomosis for its better diameters. All flaps survived completely without any complication at donor sites. 7 cases were followed up for 3-12 months. Both satisfactory functional and cosmetic results were achieved with a soft and thinned appearance.

CONCLUSIONSThe thinned posterior tibial artery free perforator flap has a reliable blood supply and good appearance. It is very suitable for the reconstruction of small or medium-sized defects at the dorsum of hands and wrists.

Adolescent ; Adult ; Female ; Hand Injuries ; surgery ; Humans ; Lower Extremity ; anatomy & histology ; blood supply ; Male ; Middle Aged ; Perforator Flap ; blood supply ; Reconstructive Surgical Procedures ; methods ; Tibial Arteries ; anatomy & histology ; transplantation ; Young Adult

OBJECTIVE: The aim of this prospective study was to determine whether the additional use of the single photon emission computed tomography/CT (SPECT/CT) technique improves the diagnostic value of planar lymphoscintigraphy in patients presenting with primary lymph edema of the lower limb. MATERIALS AND METHODS: For a defined period of three years (April 2011-April 2014) a total of 34 consecutive patients (28 females; age range, 27-83 years) presenting with swelling of the leg(s) suspicious of (uni- or bilateral, proximal or distal) primary lymphedema were prospectively examined by planar lymphoscintigraphy (lower limbs, n = 67) and the tomographic SPECT/CT technique (anatomical sides, n = 65). RESULTS: In comparison to pathological planar scintigraphic findings, the addition of SPECT/CT provided relevant additional information regarding the presence of dermal backflow (86%), the anatomical extent of lymphatic disorders (64%), the presence or absence of lymph nodes (46%), and the visualization of lymph vessels (4%). CONCLUSION: As an adjunct to planar lymphoscintigraphy, SPECT/CT specifies the anatomical correlation of lymphatic disorders and thus improves assessment of the extent of pathology due to the particular advantages of tomographic separation of overlapping sources. The interpretation of scintigraphic data benefits not only in baseline diagnosis, but also in physiotherapeutical and microsurgical treatments of primary lymphedema.
Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lower Extremity/anatomy & histology/*radiography ; Lymphatic Vessels/radiography ; Lymphedema/*diagnosis/radiography ; Lymphoscintigraphy ; Middle Aged ; Radiopharmaceuticals/diagnostic use ; Retrospective Studies ; Tomography, Emission-Computed, Single-Photon ; Tomography, X-Ray Computed

MR imaging appearances of different types of reconstructive muscle flaps following reconstructive surgery of the lower extremity with associated post-surgical changes due to altered anatomy, radiation, and potential complications, can be challenging. A multidisciplinary therapeutic approach to tumors allows for limb salvage therapy in a majority of the patients. Decision-making for specific types of soft tissue reconstruction is based on the body region affected, as well as the size and complexity of the defect. Hematomas and infections are early complications that can jeopardize flap viability. The local recurrence of a tumor within six months after a complete resection with confirmed tumor-free margins and adjuvant radiation therapy is rare. Identification of a new lesion similar to the initial tumor favors a finding of tumor recurrence.
Adult ; Female ; Hematoma/etiology ; Humans ; Limb Salvage ; Lower Extremity/anatomy & histology/radiography/*surgery ; *Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Reconstructive Surgical Procedures ; Sarcoma/radiotherapy/*surgery ; Soft Tissue Infections/radiography/*surgery ; Soft Tissue Injuries/radiography/*surgery ; Soft Tissue Neoplasms/radiotherapy/*surgery ; Surgical Flaps/adverse effects