by Ho Wai-chun. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references. / Abstract also in Chinese. / Title / Dedication / Abstract --- p.i / Table of Contents --- p.iv / Glossary of abbreviation used in the thesis --- p.vi / List of figures --- p.viii / List of tables --- p.xvii / Acknowledgement --- p.xix / Statement of Originality --- p.xx / Chapter Chapter 1 ...... --- Introduction --- p.14 / Chapter Chapter 2...... --- Basic Principle / Chapter 2.1 --- The liver - a vital organ --- p.2-1 / Chapter 2.2 --- Blood supply to the liver --- p.2-7 / Chapter 2.3 --- Normal arterial anatomy of the coeliac axis --- p.2-11 / Chapter 2.4 --- Common anomalies of the coeliac axis --- p.2-17 / Chapter 2.5 --- Previous classification of coeliac anomaies --- p.2-24 / Chapter 2.6 --- Knowledge of arterial anomaly in relation to surgery --- p.2-31 / Chapter 2.7 --- Trans-catheter treatment of hepatocellular carcinoma --- p.2-33 / Chapter 2.8 --- Prevalence of hepatocellular carcinoma in H.K Chinese --- p.2-42 / Chapter 2.9 --- Management of hepatocellular carcinoma in Hong Kong --- p.2-43 / Chapter Chapter 3...... --- Definitions --- p.3-1 / Chapter Chapter 4...... --- Objectives of the study --- p.4-1 / Chapter Chapter 5...... --- "Materials, methods and subjects" / Chapter 5.1 --- Materials --- p.5-1 / Chapter 5.2 --- Methods --- p.5-3 / Chapter 5.3 --- Subjects --- p.5-10 / Chapter Chapter 6...... --- Results / Chapter 6.1 --- Coeliac axis --- p.6-5 / Chapter 6.2 --- Common hepatic artery --- p.6-9 / Chapter 6.3 --- Proper hepatic artery --- p.6-11 / Chapter 6.4 --- Right hepatic artery --- p.6-12 / Chapter 6.5 --- Middle hepatic artery --- p.6-20 / Chapter 6.6 --- Left hepatic artery --- p.6-28 / Chapter 6.7 --- Gastroduodenal artery --- p.6-33 / Chapter 6.8 --- Right gastric artery --- p.6-37 / Chapter 6.9 --- Left gastric artery --- p.5-45 / Chapter 6.10 --- Splenic artery --- p.6-49 / Chapter 6.11 --- Summary of results --- p.6-51 / Chapter Chapter 7...... --- Discussion / Chapter 7.1 --- Introduction --- p.74 / Chapter 7.2 --- Selective Internal Radiation --- p.7-3 / Chapter 7.3 --- Coeliac axis --- p.7-10 / Chapter 7.4 --- Common hepatic & proper hepatic artery --- p.7-7 / Chapter 7.5 --- Right hepatic artery --- p.7-14 / Chapter 7.6 --- Middle hepatic artery --- p.7-18 / Chapter 7.7 --- Left hepatic artery --- p.7-25 / Chapter 7.8 --- Gastroduodenal artery --- p.7-30 / Chapter 7.9 --- Right gastric artery --- p.7-35 / Chapter 7.10 --- Left gastric artery --- p.7-43 / Chapter 7.11 --- Splenic artery --- p.7-45 / Chapter 7.12 --- Comparison with the golden classics --- p.7-47 / Chapter 7.13 --- Comparison of subjects with HCC & without HCC --- p.7-50 / Chapter 7.14 --- Comparison of the male group and the female group --- p.7-51 / Chapter Chapter 8...... --- Conclusions / References --- p.B-1 / Bibliography --- p.B-1 / Appendix I Schematic diagram of histological anatomy of the liver --- p.A-l / Appendix II Embryology --- p.A-2 / "Appendix III Percentages of occurrence of the different types of coeliac axis, by Michels' study" --- p.A-3 / "Appendix IV Percentages of occurrence of the different types of the hepatic arterial blood supply, by Michels' study" --- p.A-4 / Appendix V No. of deaths from malignant liver cancer in Hong Kong froml984 to1993 --- p.A-5 / Appendix VI Flow chart for HCC management in PWH of Hong Kong --- p.A-6 / Appendix VII Comparison with Michels' study --- p.A-7 / Appendix VIII Comparison of the group with HCC and the group without HCC --- p.A-8 / Appendix IX Comparison of the male and female group --- p.A-9

Submitted by Sandra Pereira (srpereira@ufrrj.br) on 2017-05-30T16:11:15Z No. of bitstreams: 1 2010 - B?rbara Xavier Silva.pdf: 1788178 bytes, checksum: 96ff6d70aeb442564d90879a261fb5f6 (MD5) / Made available in DSpace on 2017-05-30T16:11:15Z (GMT). No. of bitstreams: 1 2010 - B?rbara Xavier Silva.pdf: 1788178 bytes, checksum: 96ff6d70aeb442564d90879a261fb5f6 (MD5) Previous issue date: 2010-08-27 / The knowledge of anatomical variations is important for radiological and surgical procedures and has a theoretical and practical significance for experimental research and surgical practice in domestic animals. The aim of this study was to describe the origin and measures of the main branches of celiac artery in domestic cats of both sexes. The anatomical dissections were performed on 30 cadavers of adult cats, 15 male and 15 female, with a rostrum-sacral length of 47.9 cm and 46.6 cm respectively. Cats were positioned in right lateral decubit and a thoracic incision was made to remove the 6th to 10th ribs to cannulate the thoracic portion of aorta. The vascular system was fixated with 10% formaldehyde solution and then filled with coloured Petrolatex S-65. After five days emerged in 10% formaldehyde solution, all the animals were washed in current water. The celiac artery and its proximal branches were ?in situ? dissected, lengthen and measured with a pachymeter. No organs were removed. The average length and standard deviation of the celiac, lienal, left gastric and hepatic artery were calculated and compared in both sexes by unpaired t test. To verify if the frequency distributions observed for the 30 examined animals is in accordance with the literature, we performed the Qui-square test, with a 5% level of significance, to test if the nullity hypothesis is true for the origin of the celiac artery, number of gastric arteries, and the number of lienal artery main ramifications. The relationship between the celiac, lienal, left gastric and hepatic artery length, with rostrum-sacral length was calculated by the correlation coefficient ?r? varying between -1 r +1. The celiac artery arose as a single artery in 15 (100%) females. In males the celiac artery arose as a single artery in 12 (80%) cats; in three (20%) cats we observed the presence of celiac-mesenteric trunk. The average length of the celiac artery in females was 1.32 cm, and originated at the level of the 13th thoracic vertebra in two (13.3%) animals, between the 13th and the 1st lumbar vertebra in one (6.7%) animal, at the level of 1st lumbar vertebra in six (40%) cats, and between the 1st and 2nd lumbar vertebra in six (40%) cats. The average length of the celiac artery in males was 1.27 cm, and originated at the level of 13th thoracic vertebra in three (20%) animals, between 13th thoracic vertebra and 1st lumbar vertebra in three (20%) animals, at the level of 1st lumbar vertebra in four (26.7%) animals, between 1st and 2nd lumbar vertebra in one (6.7%) and at the level of the 2nd lumbar vertebra in four (26.7%) animals. In female the gastrolienal trunk was the predominant morphological arrangement (53.3%) with medium length of 0.31 cm. In males, the classic celiac trifurcation was the predominant morphological arrangement (53.3%). No relation was observed between the celiac, lienal, left gastric and hepatic artery length and the rostrum-sacral length in cats. The origin of the celiac artery, number of gastric arteries, and the number of lienal artery main ramifications are not gender dependent. / O conhecimento das varia??es anat?micas ? importante para procedimentos cir?rgicos e radiol?gicos e tem um significado pr?tico e te?rico para a pesquisa experimental e a pr?tica cir?rgica em animais dom?sticos. O objetivo deste estudo foi descrever a origem e medidas da art?ria cel?aca e de suas ramifica??es em gatos de ambos sexos correlacionando seus valores com o comprimento do animal. As dissec??es foram realizadas em 30 cad?veres de gatos adultos, 15 machos e 15 f?meas, com m?dia do comprimento rostro-sacral de 47,9cm e 46,6 cm respectivamente. Os gatos foram posicionados em dec?bito lateral direito e feita uma incis?o tor?cica para remo??o da 6? a 10? costelas para canula??o da por??o tor?cica da aorta. Em seguida, o sistema vascular foi fixado com solu??o de formaldeido a 10% e preenchidos com solu??o de Petrolatex S-65 corado. Ap?s cinco dias imersos em solu??o de formaldeido a 10%, todos os animais foram lavados em ?gua corrente. A art?ria cel?aca e seus ramos proximais foram dissecados "in situ" e medidos com um paqu?metro. O comprimento m?dio e desvio padr?o da art?ria cel?aca, lienal, g?strica esquerda e hep?tica foram calculados e comparados em ambos os sexos atrav?s do teste t n?o pareado. Com o intuito de verificar se a distribui??o de freq??ncias observadas para os 30 animais examinados est? de acordo com a literatura, aplicou-se o teste do X2 (qui-quadrado) considerando o n?vel de signific?ncia 5% para testar se a hip?tese de nulidade ? verdadeira, no que diz respeito a origem da art?ria cel?aca, n?mero de art?rias g?strica, e n?mero de ramifica??es principais da art?ria lienal. Em rela??o ao comportamento conjunto do comprimento da art?ria cel?aca, lienal, g?strica esquerda e hep?tica em fun??o do comprimento rostro-sacral, optou-se por calcular o coeficiente de correla??o ?r?, que pode variar entre -1 r +1. A art?ria cel?aca surgiu como uma art?ria ?nica em 15 (100%) f?meas examinadas. Nos machos a art?ria cel?aca surgiu como uma art?ria ?nica em 12 (80%) gatos e em tr?s (20%) gatos foi observada a presen?a do tronco cel?aco-mesent?rico. O comprimento m?dio da art?ria cel?aca nas f?meas foi de 1,32 cm, emergindo em n?vel da 13? v?rtebra tor?cica em dois (13,3%) animais, entre a 13? v?rtebra tor?cica e a 1? v?rtebra lombar em um (6,7%) animal, em n?vel da 1? v?rtebra lombar em seis (40%) animais, e entre a 1? e 2? v?rtebra lombar em seis (40%) animais. O comprimento m?dio da art?ria cel?aca no sexo masculino foi de 1,27 cm, emergindo em n?vel da 13? v?rtebra tor?cica em tr?s (20%) animais, entre 13? v?rtebra tor?cica e 1? v?rtebra lombar em tr?s (20%) animais, em n?vel da 1? v?rtebra lombar em quatro (26,7%) animais, entre a 1? e 2? v?rtebra lombar em um (6,7%) e em n?vel da 2? v?rtebra lombar em quatro (26,7%) animais. Nas f?meas o tronco gastro-lienal foi o arranjo morfol?gico predominante (53,3%) com um comprimento m?dio de 0,31 cm. Nos machos, a trifurca??o cl?ssica da art?ria cel?aca foi o arranjo morfol?gico predominante (53,3%). N?o foi observada rela??o entre o comprimento da art?ria cel?aca, lienal, g?strica esquerda e hep?tica em fun??o do comprimento rostro-sacral. A origem da art?ria cel?aca, n?mero de art?rias g?stricas e n?mero de ramifica??es principais da art?ria lienal independem do sexo.

Hyperspectral imaging (HSI) in abdominal surgery is a new non-invasive tool for the assessment of the perfusion and oxygenation of various tissues and organs. Its benefit in pancreatic surgery is still unknown. The aim of this study was to evaluate the key impact of using HSI during pancreatoduodenectomy (PD). In total, 20 consecutive patients were included. HSI was recorded during surgery as part of a pilot study approved by the local Ethics Committee. Data were collected prospectively with the TIVITA® Tissue System. Intraoperative HS images were recorded before and after gastroduodenal artery (GDA) clamping. We detected four patients with celiac artery stenosis (CAS) caused by a median arcuate ligament (MAL). In two of these patients, a reduction in liver oxygenation (StO2) was discovered 15 and 30 min after GDA clamping. The MAL was divided in these patients. HSI showed an improvement of liver StO2 after MAL division (from 61% to 73%) in one of these two patients. There was no obvious decrease in liver StO2 in the other two patients with CAS. HSI, as a non-invasive procedure, could be helpful in evaluating liver and gastric perfusion during PD, which might assist surgeons in choosing the best surgical approach and in improving patients’ outcomes.