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J H Fasel

Publications and source records attributed to J H Fasel.

29 records · Page 2Linked to original sources
PubMed1996

Segmental anatomy of the liver: a review and a proposal for an international working nomenclature.

The segmental anatomy of the human liver has become a field of increasing interest to radiologists during the past few years. The number of different terminologies which have been used since the topic has been systemically investigated is, however, a source of serious confusion. The present paper describes the reasons why the authors plead for an international working nomenclature which distinguishes a right hemiliver consisting of a right posterior and a right anterior segment, formed by subsegments 6 and 7, and 5 and 8, respectively, and a left hemiliver consisting of a left medial and a left lateral segment, the former corresponding to segment 4, and the latter to subsegments 2 and 3. This basic concept, however, must be carefully tailored to the highly variable individual anatomy of each patient. Furthermore, some aspects of hepatic segmentation are not yet understood and require additional anatomical investigation.

Humans↗
PubMed1996

General medical practice as a guideline for preclinical anatomy teaching? The veins.

The amount of time assigned for teaching anatomy to medical undergraduates has been drastically reduced in all countries of the world during the sixties. This restriction has intensified the debate about the contents to be taught. The present study is intended to be a contribution to defining, against this background, a "tronc commun", a basic stock of anatomical knowledge that should be required from every medical student, whatever clinical speciality he may eventually engage in. The criterion proposed is the need of anatomical knowledge in general medical practice. With regard to the veins, the following conclusions have emerged from a questionnaire directed to general practitioners: 1) 92.8% of the vessels were agreed upon by the physicians asked. 2) General medical relevance was granted to 9.6% of the vessels mentioned in the international anatomical nomenclature. These results, which are in accordance with those recorded for the other chapters investigated so far, suggest that an adaptation of the amount of information taught to the time disponible in our days is possible, without endangering the basic knowledge necessary for general clinical practice. But the results also show that any reduction beneath the time necessary for teaching these notions jeopardizes the fundamental education indispensable to every physician. Thus, they clearly contradict tendencies considering that anatomy has become a branch that can be neglected in modern medical curricula.

Anatomy↗
PubMed1996

Relationship between intrahepatic vessels and computer-generated hepatic scissurae: an in vitro assay.

Liver segmentation is a matter of increasing importance for radiologists, in particular with respect to accurate preoperative localisation of focal hepatic lesions. Procedures for delineating the segmental anatomy from CT or MR images are therefore much in demand. In this context, a convenient technique for generating the intersegmental scissurae by computer has recently been proposed [9]. The procedure, however, seemed questionable from an anatomical point of view. We therefore checked its relevance using anatomical vascular casts of post mortem livers and comparing the computer-generated scissurae with the actual course of the intrahepatic vessels. The results presented in this paper confirm that a rigid application of flat scissural planes is not able to render the real intrahepatic compartmentation. Only techniques considering the effective individual vascular anatomy can provide a correct determination of the hepatic segments.

Aged↗
PubMed1996

Duplicated hepatic artery: radiologic and surgical implications.

Preoperative angiography of the coeliac trunk and superior mesenteric artery is routinely performed before liver resections and transplantations. For this purpose, it is usual to inject each branch of the coeliac trunk separately. Selective angiographic studies, however, may lead to overlooking surgically essential anatomic variations of the hepatic blood supply, as demonstrated by the present report. A case of a duplicated hepatic artery is presented, its radiologic and surgical implications discussed, and the relevant literature reviewed. This uncommon and particularly evocative feature illustrates the clinical importance of a sound knowledge of anatomical variants.

Adult↗
PubMed1994

[Anatomy for the future general physician: a guiding thread in undergraduate education].

In all countries of the world the amount of time allotted to teaching anatomy has been drastically reduced during the 'sixties. This restriction has intensified the discussion about the contents to be taught. Between the contradictory opinions concerning the problem, this study is intended to indicate a middle way, insofar as it advocates a basic anatomical knowledge orientated towards general medical practice. More detailed anatomy would then be studied during the postgraduate curriculum, according to the specific needs of the clinical specialty chosen. This paper presents the results concerning the respiratory system.

Anatomy↗
PubMed1994

[Basic anatomy of the future for the general physician].

In all countries of the world the amount of time allotted to teaching anatomy has been drastically reduced during the 'sixties'. This restriction has intensified the discussion about the contents to be taught. Between the contradictory opinions concerning the problem, this study is intended to indicate a middle way, insofar as it advocates a basic anatomical knowledge orientated towards general medical practice. More detailed anatomy would then be studied during the postgraduate curriculum, according to the specific needs of the clinical specialty chosen. This paper presents the results concerning the reproductive organs of the female.

Anatomy↗
PubMed1993

Elementary anatomy for the future general practitioner: the arteries.

In all countries of the world the amount of time allotted to teaching anatomy has been drastically reduced. This study is intended to be a contribution to defining, against such a background, a basic stock of macroscopic anatomy that should be required from every medical student, whatever branch of the profession he may eventually engage in. More advanced knowledge, specific to a particular specialty, will be integrated into the resident's curriculum. In this way free time will be made available so that the gifted student can be given an effective introduction into contemporary morphological research. In the chapter on the arteries, general medical relevance is granted to only 13.2% of the vessels mentioned in the International Nomenclature. Marked reduction in the amount of teaching of macroscopic anatomy seems therefore to be possible, without surrendering a full, clinically-orientated education.

Anatomy↗
PubMed1993

[The differential diagnosis of prescalene soft tissue shadows. A clinical-anatomical contribution].

In CT examination of a female patient of 72 years of age, a prescalenic soft tissue shadow situated unilaterally on the left side was seen. 3D reconstruction revealed a course of the relevant structure that would correspond to a variation of the muscle of the neck. This is presented briefly in the following article and discussed within the framework of soft tissue shadows due to muscular variations.

Aged↗
PubMed1990

[Cricothyreotomy using the Quicktrach coniotomy instrument set].

Percutaneous cricothyroidotomy may be a lifesaving procedure for airway obstruction, which cannot be relieved by endotracheal intubation and can be performed with specially designed instruments. A new device, the "Quicktrach", was evaluated by an anatomical preparation, flow and resistance measurements, and puncture of the cricothyroid membrane in 55 corpses. The size of the parts of the instrument (needle, plastic cannula, depth gauge) in relation to the size of the larynx is adequate, thus there is little likelihood of perforation of the posterior wall of the larynx. Resistance of the plastic cannula is sufficiently low to allow for adequate ventilation. The duration of time until the cannula is positioned properly in the trachea is significantly shorter, when an incision prior to the puncture is done (83 +/- 88 seconds without incision versus 35 +/- 41 seconds with incision; mean +/- SD). The "Quicktrach" is easy to apply even by inexperienced persons. The incidence of damage to the larynx (lesions including fractures of the thyroid, cricoid and 1. tracheal cartilage in 18%; soft tissue injury in 9%) is relatively high, however considering the live saving character of the procedure these numbers appear to be acceptable. Technical problems which occur with the use of the device are discussed and suggestions for improvement are made.

Airway Obstruction↗
PubMedDate not supplied

Angiographic anatomy of the laterocavernous sinus.

BACKGROUND AND PURPOSE: The laterocavernous sinus (LCS) has recently been recognized as one of the major drainage pathways of the superficial middle cerebral vein (SMCV). Our purpose was to investigate the drainage pattern of the SMCV, with special emphasis on the angiographic anatomy of the LCS. METHODS: The drainage pathways of the SMCV were evaluated prospectively on 100 selective carotid angiograms obtained in 65 consecutive patients. RESULTS: The SMCV was absent in 19% of cases. A classic termination into the cavernous sinus (CS) was found in 20%, a paracavernous sinus in 39%, and an LCS in 22%. The LCS drained toward the pterygoid plexus (27%), the superior petrosal sinus (18%), the posterior aspect of the CS (32%), or a combination of these pathways (23%). A complete absence of connection between the LCS and CS was observed in 63.5% of the patients. CONCLUSION: The LCS is a laterosellar venous space that is anatomically and angiographically distinct from the CS. Secondary small anastomoses between the LCS and CS may make it difficult to differentiate the two structures. Appreciation of the course and connection pattern of the LCS is important, particularly when planning an endovascular approach to treatment of lesions in the region of the CS.

Adolescent↗