Anatomic Foundations Research Articles

Anterior pedicle lateral nasal wall flap: A novel technique for the reconstruction of anterior skull base defects

Expansion of the clinical indications for ablative endoscopic endonasal approaches has behooved us to search for new reconstruction alternatives. We present the anatomic foundations of a novel anterior pedicled lateral wall flap (Hadad-Bassagaisteguy 2 or HB2 flap) for the vascularized reconstruction of anterior skull base defects. Anatomic description. Feasibility study. Technical report Using a cadaveric model, we investigated the feasibility of harvesting an anteriorly based mucoperiosteal flap from the lateral nasal wall. We then applied the techniques developed in the anatomical laboratory to reconstruct two patients with defects resulting from the endoscopic endonasal resection of esthesioneuroblastomas and one patient with an extensive meningoencephalocoele of the anterior cranial fossa. HB2 flaps were harvested and transposed to reconstruct anterior skull base defects in cadaveric specimens, and subsequently, in three patients. The HB2 flap provided adequate coverage in the cadaveric model, as well as clinically in our three patients. Their postoperative healing was uneventful. The HB2 flap is a feasible alternative for the reconstruction of anterior skull base defects in select patients.

Second Prize: Pelvic Neuroanatomy and Innovative Approaches to Minimize Nerve Damage and Maximize Cancer Control in Patients Undergoing Robot-Assisted Radical Prostatectomy

Robot-assisted radical prostatectomy is an option for surgical management of clinically localized prostate cancer. There have been theoretical concerns, however, regarding lack of anatomic data with specific relevance to robot-assisted prostatectomy, use of thermal or electrical energy during nerve sparing, and lack of tactile feedback. To address these concerns, we have revisited anatomic foundations and have incorporated a few modifications and strategies in the technique of robot-assisted prostatectomy to maximize cancer control, preserve neurovascular tissue, and emulate time-tested steps of anatomic radical prostatectomy. We present our findings about neural anatomy, modified technique, and oncologic and functional outcomes from patients who have undergone this procedure at our institution.

Intercerebellar Coupling Contributes to Bimanual Coordination

Compared to unimanual task execution, simultaneous bimanual tapping tasks are associated with a significantly reduced intertap variability. It has been suggested that this bimanual advantage is based on the integration of timing signals which otherwise control each hand independently. Although its functional and anatomic foundations are poorly understood, functional coupling between cerebellar hemispheres might be behind this process. Because the execution of fast alternating fingertaps increases intertap variability, it is hypothesized that intercerebellar coupling is reduced in such tasks. To shed light on the functional significance of intercerebellar coupling, 14 right-handed subjects performed unimanual right, bimanual simultaneous, and bimanual alternating synchronization tasks with respect to a regular auditory pacing signal. In all conditions, within-hand intertap interval was 500 msec. Continuous neuromagnetic activity, using a 122-channel wholehead neuromagnetometer and surface electromyograms of the first dorsal interosseus muscle of both hands, were recorded. For data analysis, we used the analysis tool Dynamic Imaging of Coherent Sources, which provides a tomographic map of cerebromuscular and cerebrocerebral coherence. Analysis revealed a bilateral cerebello-thalamo-cortical network oscillating at alpha (8-12 Hz) and beta (13-24 Hz) frequencies associated with bimanual synchronization. In line with our hypothesis, coupling between cerebellar hemispheres was restricted to simultaneous task execution. This result implies that intercerebellar coupling is key for the execution of simultaneous bimanual movements. Although the criticality of a specific magneto-encephalography pattern for behavioral changes should be interpreted with caution, data suggest that intercerebellar coupling possibly represents the functional foundation of the bimanual advantage.

1709: Anatomic Foundations of Nerve Sparing During Robotic Prostatectomy: A Study Involving 14 Cadavers

You have accessJournal of UrologyDiscussed Poster,Wednesday, May 12, 2004,8:00 am - 12:00 pm1 Apr 20041709: Anatomic Foundations of Nerve Sparing During Robotic Prostatectomy: A Study Involving 14 Cadavers Ashutosh Tewari, Ashok K. Hemal, Mazen Hasan, James O. Peabody, Aditya Bansal, Richard Sarle, and Mani Menon Ashutosh TewariAshutosh Tewari More articles by this author , Ashok K. HemalAshok K. Hemal More articles by this author , Mazen HasanMazen Hasan More articles by this author , James O. PeabodyJames O. Peabody More articles by this author , Aditya BansalAditya Bansal More articles by this author , Richard SarleRichard Sarle More articles by this author , and Mani MenonMani Menon More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(18)38901-8AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "1709: Anatomic Foundations of Nerve Sparing During Robotic Prostatectomy: A Study Involving 14 Cadavers." The Journal of Urology, 171(4S), p. 452 © 2016 by American Urological AssociationFiguresReferencesRelatedDetails Volume 171Issue 4SApril 2004Page: 452 Advertisement Copyright & Permissions© 2016 by American Urological AssociationMetricsAuthor Information Ashutosh Tewari More articles by this author Ashok K. Hemal More articles by this author Mazen Hasan More articles by this author James O. Peabody More articles by this author Aditya Bansal More articles by this author Richard Sarle More articles by this author Mani Menon More articles by this author Expand All Advertisement PDF DownloadLoading ...

PROLAPSO GENITAL SEVERO: CONSIDERACIONES CLÍNICAS, FISIOPATOLÓGICAS Y DE TÉCNICA QUIRÚRGICA AL MOMENTO DE SU CORRECCIÓN

SUMMARY Current surgical treatment of severe genital prolapse is consequence of a better knowledge and understanding of the pelvic floor. An extensive review of the anatomic and physiopathological foundations that determine the apparition of prolapse is presented.

ANATOMIC BASIS OF HEPATIC SURGERY

Modern hepatic surgery is based on precise anatomic foundations. The importance of this information applies to all levels of the diagnostic and therapeutic chain. Modern methods of imaging--CT scanning, MR imaging, and preoperative sonography--help physicians to detect variations and plan surgical excision.

Developments in Cardiovascular Medicine

An astonishingly satisfying instant book, Developments in Cardiovascular Medicine was printed within only four months after its content, a special symposium, was presented by the Royal College of Physicians to celebrate the 400th anniversary of the birth of William Harvey. Linking today's cardiology with its historical foundations, including not only William Harvey's epochal revelation but also the crucial new principles added during the fruitful four centuries since his time, 30 internationally distinguished scientists show the physical, chemical, anatomic, physiological, and metabolic foundations for the complicated, and expensive but rewarding modern cardiovascular diagnosis and therapy. The book provides a broad overview without belaboring working details but unfortunately penetrates current cardiology somewhat unevenly as some have come to expect from multiauthored texts. Up-to-the-minute data are presented on the atrial receptors that promote urine flow, including information not yet in print elsewhere. On the other hand, the gross anatomy of the muscle bundles

The Autonomic Nervous System: Morphological, Comparative, Clinical and Surgical Aspects

According to the publisher, this book represents the culmination of 25 years of study and original investigation by the author; indeed, it contains an enormous amount of varied, well-annotated data which undoubtedly will serve as a standard reference for many years to come. Unfortunately, there is little reference to newer physiologic and pharmacologic concepts which are of such great significance and importance to the modern clinician, for the book is constructed upon strong anatomic foundations and will appeal primarily to the student of autonomic anatomy and to the surgeon. A relatively current bibliography, following each of the 28 chapters, and the numerous, superb illustrations, many in color, stand as the outstanding features of the book. The chapters are grouped into four major subdivisions which begin with a splendid historical section, followed by a discussion of the principles of autonomic function based primarily upon older anatomic concepts of classification. Of particular

VESTIBULO-OCULAR REFLEX ARC

THE PROBLEM The actual anatomic foundations of the concept of the reflex arc were laid by Ramon y Cajal between 1887 and 1892, when he carried out a systematic study of the spinal cord with the method of Golgi. Cajal's findings were soon confirmed by the best neuro-anatomists (van Gehuchten, von Lenhossek, Held, Retzius, von Kolliker and others).1A short time later, when Cajal and van Gehuchten developed the concept of axonal polarization, the elementary reflex arc acquired a more general significance; it became the expression of the fundamental plan of structure and function of the nervous system. Figure 1 reproduces the original diagram of Cajal, showing the reflex arc composed of the afferent sensory neuron, the efferent motoneuron and a connecting link that may either be only a collateral from the posterior root or also include one or more intercalated (internuncial) neurons. When the internuncial neurons lie outside

STAMMERING AS A DISORDER OF SPEECH DEPENDENT ON CONDITIONS OF CHILD DEVELOPMENT

As the facts concerned with child development become collaborated into a more exact and unified body of scientific knowledge, it will become easier to understand tendencies to perversion from the normal that may appear at any point in the child's developmental progress. The ultimate attainment of normality in the adult depends on two great factors: (1) Hereditary and congenital anatomic and physiologic foundations; and the persistence of the normality of these congenital foundations during the period of (2) the physiologic processes of development. The foundations concern matters of physical structure and organization of all organs, including brain and nervous system, and concern the sexual organization, whether male or female. But also the physiologic processes of development must take hold of these anatomic and physiologic foundations and modify and advance them safely to final matured conditions and processes according to developmental laws. In the course of this upward road, however, lie