The role of the anterolateral thigh flap (ALTF) in reconstructive microsurgery grows systematically from mid-eighties of the twenty century until now. Significant anatomic variability of the perforators supplying the ALTF was described in literature. the aim of the study was ultrasonographic assessment of the ALTF perforators in terms of localization, symmetry, diameter and flow velocity. material and methods. The study was performed using ultrasound machine with 12 MHz linear transducer. Both thighs of 30 healthy volunteers (15 men and 15 women) aged from 18 to 60 (mean 37.9) were examined. The line from anterior superior iliac spine (ASIS) to lateral border of the patella was traced, and divided into 10 equal segments. Point where perforator pierces the deep fascia was marked and its diameter was measured and recorded. Maximal flow velocity was measured and recorded. Symmetry of perforator location was confirmed as positive if difference in position of two perforators on both thighs was less than 1.5 cm in diameter. Results. Total number of 119 perforators supplying skin of 60 thighs was found (mean 1.98 perforator per thigh). No perforators were found in 4 thighs (6.6%). Perforators were most abundant in segments from 5 to 7 (74.6%). Perforators with largest diameters and maximal flow velocity reaching 30-47 cm/s were localized in segments 5 and 6. Perforators in segments 4 and 5 were more abundant in men (50.9%) than in women (36.7%). Septal perforators make up to 26.9% of the total. Eighty percent of the septal perforators were localized in segments 5 and 6. Perforator distribution was elicited in the middle of the ASIS -patella line. In the range of ±1.5 cm from the midpoint of the line 33.6% of the perforators were found. conclusions. 1. Most of perforators with large diameter and big flow velocity are located in segments 5 and 6. 2. Perforators are more common in men in segments 4 and 5 than in women. 3. No perforators found in 4 thighs suggests that preoperative perforator mapping should become a preoperative routine, which can spare intraoperative dilemmas. key words: anterolateral thigh flap, color Doppler assessment, preoperative planning * Study performed within the framework of statutory work of

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A case of liposarcoma of the mediastinum in reported and a review of the literature is given. To our knowledge 53 cases have been described in the literature. The most common symptoms are dyspnea, chest-pain, a cough and loss of weight. There is no relation between operability, the duration of clinical symptoms and the size of the tumor. The final diagnosis was made by histological examination in all cases. A clinical classification of the tumor is not possible, because there are no characteristic clinical findings. The prognosis in general depends on the histological type of the malignant. Although recurrence of the tumor appears in more than 40% of cases, radical surgical resection is the only method of successful treatment. The significance of the five-year survival rate is doubtful, because recurrent tumors were reported up to 14 years after the initial surgical procedure.

Replantation of a totally avulsed scalp is a demanding microsurgical procedure with no good alternatives. Here, we present a case of successful scalp replantation after 11 hours of cold ischemia in a 24-year-old woman. The steps of the procedure, the outcomes, and a review of the literature are presented. Adhering to the steps outlined in this report during replantation is vital for success, and allows the serious complications and pitfalls associated with this procedure to be avoided. Following basic plastic surgery principles leads to better aesthetic outcomes. We observed good, even hair growth, and the return of sensation to the skin and frontal muscle function. Replantation of an avulsed scalp is an effective treatment that allows the patient to return to normal life after severe physical and psychological trauma.

Preliminary results of sonographically controlled alcohol injection into the region of the coeliacal ganglion for treatment of medically intractable pain in inoperable pancreas carcinoma (6 patients) are compared with results of a similar treatment using a surgical approach (10 patients). Both procedures resulted in up to total pain relief and marked reduction of consumption of analgetics. Neurolysis of the coeliacal ganglion by means of sonographically guided alcohol injection seems to be a useful treatment to reduce pain in inoperable pancreas carcinoma.