Levator alae nasi muscle V-Y island flap for nasal tip reconstruction.

PubMed

La Padula, Simone; Abbate, Vincenzo; Di Monta, Gianluca; Schonauer, Fabrizio

2017-03-01

Nasal tip reconstruction can be very challenging. It requires close attention to skin texture, colour and thickness matching, with the respect of the nasal aesthetic units and symmetry. Flaps are usually preferred to skin grafts where possible. Based on different donor areas, various flaps have been described for reconstruction of this region. Here we present a new V-Y myocutaneous island flap based on the levator alae nasi muscle (LAN muscle) blood supply. This flap may represent an alternative to the nasalis myocutaneous sliding V-Y flap previously described by Rybka. As its pivot point it is located more cranially than the nasalis flap, and it can advance more medially than the Rybka flap, with the possibility of covering larger defects of the nasal tip area, up to 1.8 cm in diameter. Over the past 5 years, 24 patients received nasal tip reconstruction with this flap following the resection of basal cell carcinomas. Good tip projection was maintained, and the aesthetic outcome was satisfactory, with well healed scars. We recommend this technique as an alternative to other flaps for nasal tip defects, especially if paramedian. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Early adaption to the antarctic environment at dome C: consequences on stress-sensitive innate immune functions.

PubMed

Feuerecker, Matthias; Crucian, Brian; Salam, Alex P; Rybka, Ales; Kaufmann, Ines; Moreels, Marjan; Quintens, Roel; Schelling, Gustav; Thiel, Manfred; Baatout, Sarah; Sams, Clarence; Choukèr, Alexander

2014-09-01

Abstract Feuerecker, Matthias, Brian Crucian, Alex P. Salam, Ales Rybka, Ines Kaufmann, Marjan Moreels, Roel Quintens, Gustav Schelling, Manfred Thiel, Sarah Baatout, Clarence Sams, and Alexander Choukèr. Early adaption in the Antarctic environment at Dome C: Consequences on stress-sensitive innate immune functions. High Alt Med Biol 15:341-348, 2014.-Purpose/Aims: Medical reports of Antarctic expeditions indicate that health is affected under these extreme conditions. The present study at CONCORDIA-Station (Dome C, 3233 m) seeks to investigate the early consequences of confinement and hypobaric hypoxia on the human organism. Nine healthy male participants were included in this study. Data collection occurred before traveling to Antarctica (baseline), and at 1 week and 1 month upon arrival. Investigated parameters included basic physiological variables, psychological stress tests, cell blood count, stress hormones, and markers of innate immune functions in resting and stimulated immune cells. By testing for the hydrogen peroxide (H2O2) production of stimulated polymorphonuclear leukocytes (PMNs), the effects of the hypoxia-adenosine-sensitive immune modulatory pathways were examined. As compared to baseline data, reduced oxygen saturation, hemoconcentration, and an increase of secreted catecholamines was observed, whereas no psychological stress was seen. Upon stimulation, the activity of PMNs and L-selectin shedding was mitigated after 1 week. Endogenous adenosine concentration was elevated during the early phase. In summary, living conditions at high altitude influence the innate immune system's response. After 1 month, some of the early effects on the human organism were restored. As this early adaptation is not related to psychological stress, the changes observed are likely to be induced by environmental stressors, especially hypoxia. As hypoxia is triggering ATP-catabolism, leading to elevated endogenous adenosine concentrations, this and the increased

Effects of weather anomalies on the intellectual performance: Chess mistakes of the world top-ranked players

NASA Astrophysics Data System (ADS)

Mika, J.; Verőci, Zs.; Fülöp, A.; Hirsch, T.; Dúll, A.

2009-04-01

Weather disturbances like fronts, influence human biorhythm, our biological balance becomes manipulated, and adaptation mechanisms are impaired. Our working hypothesis is that even the best chess players of the world are not exceptions from this rule. As their movements on the chess board, as well as the best possible ones, if they missed to make, are already assessed by computers objectively, we can use this game as a model of intellectual performance. By the date of the Abstract edition, 580 wrong chess moves were selected with the threshold of over 1/3 peasant to be lost. I.e. this is the minimum difference between the assessment of the positions after the best possible and the really performed move. (Obviously, all moves both sides in ca. the same number of games were checked, i.e. over 35,000 moves were assessed.) For assessing the moves, the most popular database is MegaDatabase 2006 (ChessBase- Hamburg), Chess Informant Expert from Chess Informant Beograd and the program ChessBase 9.0 together with the engines Fritz 10, Rybka 2.3, Junior 10. First of all the World Chess Champions, Karpov, Kasparov, Kramnik and Anand were examined played in the traditional big chess tournaments, category 19th and more (average rating more the 2701 Elo-points). We further selected the games by the top-ranked players of the world between 2005 and 2008. This selection is explained by the likely fact that they make the less wrong moves for simply the lack of chess understanding, moreover, as full professionals, they allow the minimum of non-weather disturbing circumstances (e.g. imperfect sleeping before the game, etc.). Their moves were selected as (i) very wrong move with more than 3.0 differences, (i.e. unforced loss of a knight, or a bishop, (ii) very weak move with an assessment of 1.0-3.0, (i.e. unforced loss between one peasant and one bishop/knight) and (iii) weak move with less than 1.0 assessment of the passed chance, or unforced loss of less than one peasant. These new