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Sample records for lnelaid alar nurkse

  1. Alar

    Integrated Risk Information System (IRIS)

    Alar ; CASRN 1596 - 84 - 5 Human health assessment information on a chemical substance is included in the IRIS database only after a comprehensive review of toxicity data , as outlined in the IRIS assessment development process . Sections I ( Health Hazard Assessments for Noncarcinogenic Effects ) a

  2. [Correction of severe alar retraction with alar rotation flap].

    PubMed

    Hong, Chun; Zheng, Dongxue; Lu, Lixin

    2015-01-01

    To investigate the therapeutic effect of alar rotation flap for severe alar retraction. Patients with severely retracted alar underwent ala reconstruction using alar rotation flaps and autogenous cartilage batten grafts. First, costal cartilage was used to reshape the nasal tip and nasal dorsum. Then cartilage patch was used to extend and thicken the retracted alar. Then the alar rotation flap was transferred to correct retracted alar. Fourteen patients with severe alar retraction underwent alar reconstruction with alar rotation flap and alar batten grafts. The alar retraction was corrected in all cases, with improvements functionally and aesthetically. No recurrence of alar retraction was noted. The incision healed with acceptable cosmetic results, with obvious scar in only one patient (one side). The alar rotation flap is an effective and reliable surgical option to correct severe alar retraction. Scar can be kept inconspicuous by precise placement of the incision within the junction of the ala and the nasal dorsum, following principles of the aesthetic nasal subunits.

  3. Alar Rim Deformities.

    PubMed

    Totonchi, Ali; Guyuron, Bahman

    2016-01-01

    The alar rim plays an important role in nasal harmony. Alar rim flaws are common following the initial rhinoplasty. Classification of the deformities helps with diagnosis and successful surgical correction. Diagnosis of the deformity requires careful observation of the computerized or life-sized photographs. Techniques for treatment of these deformities can easily be learned with attention to detail. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. [Traumatology of the alar ligaments].

    PubMed

    Saternus, K S; Thrun, C

    1987-10-01

    A postmortem study of craniocerebral traumas of varying severity was done to determine the pattern of injury of the alar ligaments. It was found that in the entire group of patients (n = 30) the alar ligaments were ruptured or suffused with blood 11 times. No close relationship was found between the massive nature of the cranial trauma and the severity of the injury of the alar ligaments. In some cases the alar ligaments were not at all involved even though the skull had suffered extensive osseous lesions, whereas on the other hand the ligaments were injured even though only soft parts had been involved (e.g., haematoma or dehiscent wounds of the scalp). Ruptures of the alar ligaments were typically involved in extended ruptures of the ligamentous apparatus (see Figure 6a involving the ligamentum apicis dentis, ligamentum transversum atlantis, m.atlanto-occipitalis anterior, m.tectoria, m.atlanto-axialis anterior et posterior). In some cases the pattern of injury of the alar ligaments was found to be decisive in enabling reconstruction of the course of the accident. Damage to the alar ligaments near the dens axis represent rotation injuries. On the other hand, insertion tears out of the condyli occipitales must be related to a lateral thrust tendency in indirect fracture of the skull (bursting fracture). Within this overall framework a new mechanism of fracture of the condylus occipitalis is described. As a matter of principle, the alar ligaments can become involved in consequence of rotation, traction and compression of the cranium.

  5. Reconstruction of the alar groove.

    PubMed

    Chait, L A; Fayman, M S

    1989-05-01

    The obliteration of a well-defined alar groove is common after nasal alar reconstruction. A method is described that can be used at the time of reconstruction to ensure the continued definition of the groove or to restore it in cases where it has been obliterated. The technique is based on the natural tendency of the skin to tube itself. Cheek skin is advanced beneath the posterior free edge of the reconstructed ala so that this edge now comes into contact with an epidermal surface. As this edge now tends to tube itself, a natural alar groove is produced. This method has been used successfully in six cases.

  6. An Alternative Alar Cinch Suture

    PubMed Central

    Rauso, Raffaele; Freda, Nicola; Curinga, Giuseppe; Del Pero, Claudio; Tartaro, Gianpaolo

    2010-01-01

    Nasal widening is commonly associated to maxillary osteotomies, but it is only partially dependent on the amount of skeletal movement. Techniques for controlling lateralization of the ala, including the alar base cinch technique, originally described by Millard, have been well reported by Collins and Epker and later modified by others. In this article, authors report the effect of a new alar cinch suture technique on a sample of 32 patients. PMID:21187940

  7. Alar retraction: etiology, treatment, and prevention.

    PubMed

    Alexander, Ashlin J; Shah, Anil R; Constantinides, Minas S

    2013-01-01

    The effect of different rhinoplasty maneuvers on alar retraction remains to be elucidated. To determine the etiology and treatment of alar retraction based on a series of specific rhinoplasty maneuvers. Retrospective review of a single surgeon's rhinoplasty digital photo database, examining preoperative alar retraction from January 1, 2002, to December 31, 2005, in 520 patients. Patients with more than 1 mm of alar retraction on preoperative photographs were identified. Postoperative photographs were examined to determine the effect of specific rhinoplasty maneuvers on the position of the alar margin; these maneuvers included cephalic trim, cephalic positioning of the lower lateral cartilage, composite grafts, alar rim grafts, alar batten grafts, and overlay of the lower lateral cartilage. Tertiary care academic health center. Forty-five patients with alar retraction met inclusion criteria, resulting in 63 nasal halves with alar retraction. Intraoperative findings, postoperative results. Forty-seven percent of the patients (n = 21) had prior surgery; 47% also had cephalically positioned lower lateral cartilages. Among patients with less than 4 mm of cartilage width at the outset, 46% of those who received supportive grafts achieved target correction vs only 7% for patients who did not undergo supportive cartilage grafting. In patients who underwent more than 4 mm of cephalic trim, those who received supportive grafts achieved 46% of target correction vs 11% among those who did not. Ninety-five percent of composite grafts, 69% of alar strut grafts, 47% of alar rim grafts, 43% of vertical lobule division, and 12% of alar batten grafts achieved their target correction values. Alar retraction is a highly complex problem. It can be seen de novo and is associated with cephalically positioned lower lateral cartilages. Structurally supportive grafting-including composite grafts, alar strut grafts, alar rim grafts, vertical lobule division, and alar batten grafts

  8. Dynamics of the alar rim graft.

    PubMed

    Guyuron, Bahman; Bigdeli, Yaas; Sajjadian, Ali

    2015-04-01

    The purpose of this study was to review the dynamics and frequency of the use of the alar rim graft. The recorded intraoperative information for the purpose of rhinoplasty research was reviewed to investigate the frequency of the use of alar rim grafts. Intraoperative observations were also made while inserting the alar rim graft to identify the changes that occur in the structures that could be influenced by placement of this graft. The data were tabulated in an Excel file and analyzed. Of the 1427 patients who underwent nose reconstruction or rhinoplasty in this study, 565 (39.56 percent) received alar rim grafts. This included 73 primary nose reconstructions, 20 secondary nose reconstructions, two revision nose reconstructions, 304 primary rhinoplasties, 107 secondary rhinoplasties, 43 revision operations following primary rhinoplasties, and seven revision operations following secondary rhinoplasties. However, when 100 more recent consecutive cases were reviewed, 88 percent of primary rhinoplasty patients and 67 percent of secondary rhinoplasty patients received alar rim grafts. The observed dynamic changes after insertion of each graft included (1) correction of the concavity of the ala, (2) caudal advancement of the alar rim, (3) elongation of nostril, and (4) widening of the nostril. The majority of patients who undergo rhinoplasty would benefit from the alar rim graft, and this study demonstrates a steady increase in its use. Placement of an alar rim graft results in elongation of the short nostril, correction of the alar concavity, widening of the nostril, and slight caudal transposition of the alar rim.

  9. Anatomy of the alar ligament.

    PubMed

    Iwanaga, Joe; Sardi, Juan P; Laws, Tyler; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

    2017-08-18

    There are four layers of ligamentous stabilizers at the cranio-cervical junction and the second layer is comprised of the apical and paired alar ligaments. The purpose of this study is to establish the tensile strength of the alar ligaments for better understanding the implications that can arise from trauma and other pathologies in the craniocervical region. Nineteen sides from ten fresh frozen adult cadaveric Caucasian heads were used in this study. The specimens were derived from six males and four females, and the age of the cadavers at death ranged from 67 to 90-years-old to measure the tensile strength, a tensile testing machine (M2-200, Mark-10 corporation, USA) was used in this study. The force (N) necessary until failure for all alar ligaments ranged from 87 to 346 N with a mean of 186.9±69.7 N. There was a significant difference when comparing tensile strength between males and females. Further studies will be needed to determine their importance as secondary stabilizers and measure their ability to support similar forces when subject to rotation and lateral bending forces, as well as with flexion-extension. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Update in alar base reduction in rhinoplasty.

    PubMed

    Lima, Leila Freire Rego; Arroyo, Helena Hotz; Jurado, José Roberto Parisi

    2016-08-01

    The purpose of this article is to further explore the techniques available for alar base reduction by a recent review in this topic, focusing in the current advances in the field, in a clear and readable format. Among the numerous techniques available, the management of cases with wide nasal base and alar flaring remains limited to three options: cinching sutures to pull in the alae together; or to use alar base excisions that remove tissue from the alar lobule to decrease flare and from inside the nostril to decrease width; and flap advancement. Surgical modification of the nasal base is not a routine part of rhinoplasty and should be performed in a conservative manner to prevent complications like nasal stenosis. Moreover, this maneuver should always be the last one in rhinoplasty, as alar base modifications cannot be properly assessed until all other steps have been carried out. VIDEO ABSTRACT.

  11. New classification for correction of alar retraction using the alar spreader graft.

    PubMed

    Kim, Jae Hoon; Park, Sung Wan; Oh, Won Suk; Lee, Joo Heon

    2012-08-01

    Identifying the cause of alar retraction is essential for proper correction of this deformity. In secondary surgery, aimed primarily at cephalic orientation and medialization of the lateral crus, corrections involving spreading and lateralization of the lateral crus can achieve a more horizontal orientation. In their clinic, the authors have practiced the use of an alar spreader graft to support the spread of the lateral crus. For the lateral crus to move freely without any resistance, it is critical to release the nasal hinge and pyriform ligament. A frontal view of the alar notching and the direction of the lateral crus are highly important factors needed to determine the cause of alar retraction. This report describes a new classification system for alar retractions viewed from the front to aid in determining the cause of the retraction and the surgical management. From March 2008 to July 2010, 31 alar retractions were corrected using alar spreader grafts for patients showing clear alar retractions in frontal views. Satisfactory results without severe complications were obtained in 30 cases, with undercorrection in only 1 case. The alar cartilage was completely released to facilitate lateralization and caudal mobilization. An alar spreader graft then was used to support the lateral crus until a biologic scar cast was formed. The use of alar spreader grafts to correct alar retractions provided consistently good results. The attempt also was made to enhance the treatment strategy based on this classification system derived from frontal views of alar retraction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors at www.springer.com/00266 .

  12. Alar flap combined with free auricular composite flap for the reconstruction of nasal alar defect.

    PubMed

    Lin, Wentao; Qing, Yong; Liu, Jia; Cen, Ying

    2015-03-01

    The nasal ala plays an important role in the aesthetic appearance of the nose. Repairing the nasal alar defect, especially full-thickness alar defect, is one of the difficulties of plastic surgeons. In this article, a new surgical method is introduced about repairing full-thickness alar defect with free auricular composite flaps and local nasal alar rotation and advancement tissue flaps. We retrospectively reviewed 6 patients with a diagnosis of full-thickness alar defect between 2010 and 2013. All of them accepted this new surgical method. The patients were followed up for 6 to 12 months. The method used local nasal alar rotation and advancement tissue flap to form new nasal rim and made the defect of nasal rim shift to alar groove region. After that, we harvested free auricular composite flap to repair the new defect. All patients attained relatively symmetrical nostrils with a natural, smooth, integrated alar rim and inconspicuous scars. All the reconstructed nasal alae were aesthetically satisfactory. Slight atrophy of grafts was observed in all patients. The shape of the donor ear changed a little. Two patients experienced hyperpigmentation change and one patient presented slight hypertrophic scar in the suture site. No other complications were observed. This simple method not only reconstructed almost normal nasal alar rims and alar grooves but also improved the survival rate of the composite grafts without any free edges. This method also changed the traditional free auricular tissue flap location from the nasal alar rim to the upper alar groove region, which would help achieve more aesthetic appearance. This new method is a creative and useful technique for the repair of full-thickness alar defect.

  13. Anterior septal deviation and contralateral alar collapse.

    PubMed

    Schalek, P; Hahn, A

    2011-01-01

    Septal deviation is often found in conjunction with other pathological conditions that adversely affect nasal patency. Anterior septal deviation, together with contralateral alar collapse, is a relatively rare type of anatomical and functional incompetence. In our experience, it can often be resolved with septoplasty, without the necessity of surgery involving the external valve. The aim of this paper was to verify this hypothesis prospectively. Twelve patients with anterior septal deviation and simultaneous alar collapse on the opposite side were prospectively enrolled in the study. Subjective assessment of nasal patency was made on post-operative day 1, and again 6 months after surgery, using a subjective evaluation of nasal breathing. The width of the nostril (alar-columellar distance) on the side with the alar collapse was measured during inspiration pre-operatively, 1 day after surgery and again 6 months after surgery. Immediately after surgery, all patients reported improved or excellent nasal breathing on the side of the original septal deviation. On the collapsed side, one patient reported no change in condition. With the exception of one patient, all measurements showed some degree of improvement in the extension of the alar-columellar distance. The average benefit 6 months after surgery was an improvement of 4.54 mm. In our group of patients (anterior septal deviation and simultaneous contralateral alar collapse and no obvious structural changes of the alar cartilage) we found septoplasty to be entirely suitable and we recommend it as the treatment of choice in such cases.

  14. Nasal base narrowing: the alar flap advancement technique.

    PubMed

    Ismail, Ahmed Soliman

    2011-01-01

    To evaluate the role of creating an alar-based advancement flap in narrowing the nasal base and correcting excessive alar flare. Case series with chart review. This is a retrospective record review study. The study included 35 cases presenting with a wide nasal base and excessive alar flaring. The surgical procedure combined the alar base reduction with alar flare excision by creating a single laterally based alar flap. Any caudal septal deformities and any nasal tip modification procedures were corrected before the nasal base narrowing. The mean follow-up period was 23 months. The mean alar flap narrowing was 6.3 mm, whereas the mean width of sill narrowing was 2.9 mm. This single laterally based advancement alar flap resulted in a more conservative external resection, thus avoiding alar wedge overresection or blunting of the alar-facial crease. No cases of postoperative bleeding, infection, or keloid were encountered, and the external alar wedge excision healed with no apparent scar that was hidden in the depth of the alar-facial crease. The risk of notching of the alar rim at the sill incision is reduced by adopting a 2-layer closure of the vestibular floor. The alar base advancement flap is an effective technique in narrowing both the nasal base and excessive alar flare. It adopts a single skin excision to correct the 2 deformities while commonly feared complications were avoided.

  15. Novel technique and simple approach for supra-alar region and supra-alar crease correction by supra-alar cinching

    PubMed Central

    Selvaraj, Loganathan

    2016-01-01

    This technical report describes a simple and innovative surgical technique for supra-alar sidewall region constriction and supra-alar crease attenuation by cinching technique through intraoral approach. PMID:28163492

  16. Novel technique and simple approach for supra-alar region and supra-alar crease correction by supra-alar cinching.

    PubMed

    Selvaraj, Loganathan

    2016-01-01

    This technical report describes a simple and innovative surgical technique for supra-alar sidewall region constriction and supra-alar crease attenuation by cinching technique through intraoral approach.

  17. Assessment of Alar Flare and Efficacy of Alar Cinch Suture in the Management of Alar Flare Following Le Fort 1 Superior Repositioning: A Comparative Study.

    PubMed

    Mustafa, K; Shehzana, Fatima; Bhat, H Hari Kishore

    2016-12-01

    To prospectively analyze the amount of alar flare, factors contributing to alar flare and efficacy of cinch suture as an adjunctive procedure for alar flare reduction. Thirty adult patients with vertical maxillary excess, who underwent Le Fort 1 impaction, were divided into 2 groups of 15 each. Alar cinch was performed as an adjunct procedure in group 2 patients and results were compared to group 1 which was the control group. Measurements were made on the patients and on 1:1 standardized photographs. Group 2 showed a near pre-operative alar position compared to group 1. The alar flare resulting from every millimeter of impaction was significantly less in group 2 compared to group 1. Alar cinch suture restores the normal alar width by preventing the lateral drift of the naso-labial muscle and thereby reducing the postoperative nasal flare significantly.

  18. The Articulated Alar Rim Graft: Reengineering the Conventional Alar Rim Graft for Improved Contour and Support.

    PubMed

    Ballin, Annelyse C; Kim, Haena; Chance, Elizabeth; Davis, Richard E

    2016-08-01

    Surgical refinement of the wide nasal tip is challenging. Achieving an attractive, slender, and functional tip complex without destabilizing the lower nasal sidewall or deforming the contracture-prone alar rim is a formidable task. Excisional refinement techniques that rely upon incremental weakening of wide lower lateral cartilages (LLC) often destabilize the tip complex and distort tip contour. Initial destabilization of the LLC is usually further exacerbated by "shrink-wrap" contracture, which often leads to progressive cephalic retraction of the alar margin. The result is a misshapen tip complex accentuated by a conspicuous and highly objectionable nostril deformity that is often very difficult to treat. The "articulated" alar rim graft (AARG) is a modification of the conventional rim graft that improves treatment of secondary alar rim deformities, including postsurgical alar retraction (PSAR). Unlike the conventional alar rim graft, the AARG is sutured to the underlying tip complex to provide direct stationary support to the alar margin, thereby enhancing graft efficacy. When used in conjunction with a well-designed septal extension graft (SEG) to stabilize the central tip complex, lateral crural tensioning (LCT) to tighten the lower nasal sidewalls and minimize soft-tissue laxity, and lysis of scar adhesions to unfurl the retracted and scarred nasal lining, the AARG can eliminate PSAR in a majority of patients. The AARG is also highly effective for prophylaxis against alar retraction and in the treatment of most other contour abnormalities involving the alar margin. Moreover, the AARG requires comparatively little graft material, and complications are rare. We present a retrospective series of 47 consecutive patients treated with the triad of AARG, SEG, and LCT for prophylaxis and/or treatment of alar rim deformities. Outcomes were favorable in nearly all patients, and no complications were observed. We conclude the AARG is a simple and effective method for

  19. Bilateral alar cartilage reduction rhinoplasty allows primary repair of alar defects in the bulbous nose.

    PubMed

    Al-Benna, Sammy

    2012-01-01

    Plastic surgeons have many reconstructive options for lower nasal skin defects, but given the unique aesthetic features of nasal skin the best source for reconstruction is nasal skin itself, when sufficient quantity exists. The purpose of this study is to determine the outcome of bilateral alar cartilage reduction rhinoplasty in combination with a nasal flap to facilitate immediate reconstruction of defects of the nasal tip, soft triangle and alar margin. This prospective study analyzed the aesthetic outcome after reconstruction with bilateral alar cartilage reduction rhinoplasty to reduce the nasal rim and create an excess of skin sufficient to facilitate immediate reconstruction of defects of the nasal tip, soft triangle and alar margin. All wounds healed primarily and patient satisfaction was achieved. Bilateral alar cartilage reduction rhinoplasty allows single-stage reconstruction of defects of the nasal tip, soft triangle, and medial alar rim in the bulbous nose. By placing incisions along the borders of the aesthetic subunits, this novel approach to primary reconstruction of the nasal tip, soft triangle, and medial alar rim provides skin with a superior color and texture match, maintains a satisfactory contour of the nasal rim, and optimizes the likelihood of good scar quality.

  20. Rhinoplasty: the lateral crura-alar ring.

    PubMed

    Daniel, Rollin K; Palhazi, Peter; Gerbault, Olivier; Kosins, Aaron M

    2014-05-01

    Rhinoplasty surgeons routinely excise or incise the lateral crura despite nostril rim retraction, bossa, and collapse. Given recent emphasis on preserving the lateral crura, a review of the lateral crura's anatomy is warranted. The authors quantify specific anatomical aspects of the lateral crura in cadavers and clinical patients. This was a 2-part investigation, consisting of a prospective clinical measurement study of 40 consecutive rhinoplasty patients (all women) and 20 fresh cadaver dissections (13 males, 1 female). In the clinical phase, the alar cartilages were photographed intraoperatively and alar position (ie, orientation), axis, and width were measured. Cadaver dissections concentrated on parts of the lateral crura (alar cartilages and alar ring) that were inaccessible clinically. Average clinical patient age was 28 years (range, 14-51 years). Average cadaver age was 74 (range, 57-88 years). Clinically, the distance of the lateral crura from the mid-nostril point averaged 5.9 mm, and the cephalic orientation averaged 43.6 degrees. The most frequent configuration of the axis was smooth-straight in the horizontal axis and a cephalic border higher than the caudal border in the vertical axis. Maximal lateral crura width averaged 10.1 mm. In the cadavers, average lateral crural dimensions were 23.4 mm long, 6.4 mm wide at the domal notch, 11.1 mm wide at the so-designated turning point (TP), and 0.5 mm thickness. The accessory cartilage chain was present in all dissections. The lateral crura-alar ring was present in all dissections as a circular ring continuing around toward the anterior nasal spine but not abutting the pyriform. The lateral crura (1) begins at the domal notch and ends at the accessory cartilages, (2) exhibits a distinct TP from the caudal border, (3) has distinct horizontal and vertical vectors, and (4) should have a caudal border higher than the cephalic border. Alar malposition may be associated with position, orientation, or configuration.

  1. Rhinoplasty: congenital deficiencies of the alar cartilage.

    PubMed

    Kosins, Aaron M; Daniel, Rollin K; Sajjadian, Ali; Helms, Jill

    2013-08-01

    Congenital deficiencies of the alar cartilages are rare and often visible at birth but can occasionally present later. The authors review the anatomical development and discuss the incidence and treatment of congenital defects within the alar cartilages seen in rhinoplasty cases. The charts of 869 consecutive patients who underwent open rhinoplasty were retrospectively reviewed, and 8 cases of congenital defects of the alar cartilage within the middle crura were identified. Intraoperative photographs were taken of the alar deformities, and each patient underwent surgical correction. To simplify analysis, a classification of the defects was developed. A division was a cleft in the continuity of the alar cartilage with the 2 ends separate. A gap was a true absence of cartilage ranging from 1 to 4 mm, which can be accurately assessed in unilateral cases. A segmental loss was a defect greater than 4 mm. The 8 cases of deformity could be classified as 4 divisions, 3 gaps, and 1 segmental loss. None of the patients had a history of prior nasal trauma or nasal surgery. Six patients were women and 2 patients were men. In all cases, adequate projection and stability were achieved with a columellar strut. Asymmetry was minimized through concealer or tip grafts. There were no complications. Surgeons performing rhinoplasty surgery will encounter and should be prepared to deal with unexpected congenital defects of the alar cartilage. These defects within the middle crura will require stabilization with a columellar strut and, often, coverage with a concealer tip graft. We speculate that the cause of these defects is a disruption of the hedgehog signals that may arrest the condensation or block the differentiation of the underlying neural crest cells.

  2. Alar Contour Grafts in Rhinoplasty: A Safe and Reproducible Way to Refine Alar Contour Aesthetics.

    PubMed

    Unger, Jacob G; Roostaeian, Jason; Small, Kevin H; Pezeshk, Ronnie A; Lee, Michael R; Harris, Ryan; Rohrich, Rod J

    2016-01-01

    Alar rim deformities such as retraction, notching, collapse, and asymmetry are common problems in rhinoplasty patients. Although alar rim deformities may be improved through rhinoplasty, this area is prone to late changes because of scarring of the soft triangles and a paucity of native structural support. The purpose of this study was to analyze the effect of alar contour grafts on primary rhinoplasty. Fifty consecutive primary rhinoplasty patients with preoperative and postoperative photographs who received alar contour grafts were evaluated for alar aesthetics; 50 consecutive primary rhinoplasty patients without such grafts served as controls. Differences among alar retraction, notching, collapse, and asymmetry from anterior, lateral, and basal views were evaluated. Follow-up ranged from 1 to 4 years and was graded on a four-point scale. The average difference between the two groups' aggregate preoperative scores was 0.21 (p = 0.24). The average preoperative and postoperative scores in the nongraft group were significant for worsening retraction, notching, and collapse but insignificant for asymmetry. The preoperative and postoperative scores for the graft group were insignificant for retraction but improved significantly for notching, collapse, and asymmetry. Postoperatively, the aggregate average of the scores in the nongroup was 0.32 points worse (p < 0.01), whereas the graft group had a 0.33-point improvement (p < 0.01). Alar contour grafts have a clear and important impact on cosmetic results of primary rhinoplasty. Use of alar contour grafts has been shown to improve aesthetics, whereas there is a worsening of the measured parameters postoperatively without use of these grafts. Therapeutic, III.

  3. Functional anatomy of the alar ligaments.

    PubMed

    Dvorak, J; Panjabi, M M

    1987-03-01

    Nineteen upper cervical spine specimens were dissected to examine the macroscopic and functional anatomy of alar ligaments. They are on both sides, symmetrically placed, approximately 10-13 mm long and elliptical in cross-section 3 X 6 mm in diameter. The fiber orientation is dependent on the height of dens axis, mostly in the cranial caudal direction. In 12 specimens there was a ligamentous connection between dens and lateral mass of the atlas as a part of the alar ligament. In 2 specimens anterior atlanto-dental ligament was identified. The computerized tomographic (CT) images can clearly show alar ligaments in axial, coronal, and sagittal planes. The ligaments limit the axial rotation in the occipito-atlanto-axial complex (to the right by left alar and vice versa) as well as in side bending. The ligament is most stretched, and consequently most vulnerable, when the head is rotated and in addition flexed. This mechanism, common in whiplash injuries, could lead to irreversible overstretching or rupture of the ligaments especially as the ligaments consist of mainly collagen fibers.

  4. Nasal base narrowing: the combined alar base excision technique.

    PubMed

    Foda, Hossam M T

    2007-01-01

    To evaluate the role of the combined alar base excision technique in narrowing the nasal base and correcting excessive alar flare. The study included 60 cases presenting with a wide nasal base and excessive alar flaring. The surgical procedure combined an external alar wedge resection with an internal vestibular floor excision. All cases were followed up for a mean of 32 (range, 12-144) months. Nasal tip modification and correction of any preexisting caudal septal deformities were always completed before the nasal base narrowing. The mean width of the external alar wedge excised was 7.2 (range, 4-11) mm, whereas the mean width of the sill excision was 3.1 (range, 2-7) mm. Completing the internal excision first resulted in a more conservative external resection, thus avoiding any blunting of the alar-facial crease. No cases of postoperative bleeding, infection, or keloid formation were encountered, and the external alar wedge excision healed with an inconspicuous scar that was well hidden in the depth of the alar-facial crease. Finally, the risk of notching of the alar rim, which can occur at the junction of the external and internal excisions, was significantly reduced by adopting a 2-layered closure of the vestibular floor (P = .01). The combined alar base excision resulted in effective narrowing of the nasal base with elimination of excessive alar flare. Commonly feared complications, such as blunting of the alar-facial crease or notching of the alar rim, were avoided by using simple modifications in the technique of excision and closure.

  5. Isolated unilateral rupture of the alar ligament.

    PubMed

    Wong, Sui-To; Ernest, Kimberly; Fan, Grace; Zovickian, John; Pang, Dachling

    2014-05-01

    Only 6 cases of isolated unilateral rupture of the alar ligament have been previously reported. The authors report a new case and review the literature, morbid anatomy, and pathogenesis of this rare injury. The patient in their case, a 9-year-old girl, fell head first from a height of 5 feet off the ground. She presented with neck pain, a leftward head tilt, and severe limitation of right rotation, extension, and right lateral flexion of the neck. Plain radiographs and CT revealed no fracture but a shift of the dens toward the right lateral mass of C-1. Magnetic resonance imaging of the cervical spine showed signal hyperintensity within the left dens-atlas space on both T1- and T2-weighted sequences and interruption of the expected dark signal representing the left alar ligament, suggestive of its rupture. After 12 weeks of immobilization in a Guilford brace, MRI showed lessened dens deviation, and the patient attained full and painless neck motion. Including the patient in this case, the 7 patients with this injury were between 5 and 21 years old, sustained the injury in traffic accidents or falls, presented with marked neck pain, and were treated with external immobilization. All patients had good clinical outcome. The mechanism of injury is hyperflexion with rotation. Isolated unilateral alar ligament rupture is a diagnosis made by excluding associated fracture, dislocation, or disruption of other major ligamentous structures in the craniovertebral junction. CT and MRI are essential in establishing the diagnosis. External immobilization is adequate treatment.

  6. Alar base reduction: the boomerang-shaped excision.

    PubMed

    Foda, Hossam M T

    2011-04-01

    A boomerang-shaped alar base excision is described to narrow the nasal base and correct the excessive alar flare. The boomerang excision combined the external alar wedge resection with an internal vestibular floor excision. The internal excision was inclined 30 to 45 degrees laterally to form the inner limb of the boomerang. The study included 46 patients presenting with wide nasal base and excessive alar flaring. All cases were followed for a mean period of 18 months (range, 8 to 36 months). The laterally oriented vestibular floor excision allowed for maximum preservation of the natural curvature of the alar rim where it meets the nostril floor and upon its closure resulted in a considerable medialization of alar lobule, which significantly reduced the amount of alar flare and the amount of external alar excision needed. This external alar excision measured, on average, 3.8 mm (range, 2 to 8 mm), which is significantly less than that needed when a standard vertical internal excision was used ( P < 0.0001). Such conservative external excisions eliminated the risk of obliterating the natural alar-facial crease, which did not occur in any of our cases. No cases of postoperative bleeding, infection, or vestibular stenosis were encountered. Keloid or hypertrophic scar formation was not encountered; however, dermabrasion of the scars was needed in three (6.5%) cases to eliminate apparent suture track marks. The boomerang alar base excision proved to be a safe and effective technique for narrowing the nasal base and elimination of the excessive flaring and resulted in a natural, well-proportioned nasal base with no obvious scarring.

  7. Optimizing the Soft Tissue Triangle, Alar Margin Furrow, and Alar Ridge Aesthetics: Analysis and Use of the Articulate Alar Rim Graft.

    PubMed

    Goodrich, Jennifer L; Wong, B J F

    2016-12-01

    The alar lobule, alar margin, and soft triangle facet are receiving more attention in the literature as critical elements to address both preoperatively and during rhinoplasty. We have found that the use of the articulated alar rim graft (AARG) corrects deficiencies in these areas as well as provides mechanical stability to the external valve. In this article, we describe indications for AARG, describe in detail the procedure for AARG placement, and highlight the transformation AARGs can achieve in two illustrated case studies. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  8. Alar and Apples: Newspaper Coverage of a Major Risk Issue.

    ERIC Educational Resources Information Center

    Friedman, Sharon M.; And Others

    A study reviewed coverage in 13 newspapers during 1989 of the issue of spraying the pesticide Alar on apples. Using VU/TEXT, a newspaper database, 297 articles in 13 newspapers that included the specified code words "Alar" with or without "apple" or "apples" were retrieved and analyzed using a 33-question coding…

  9. The Seesaw Technique for Correction of Vertical Alar Discrepancy.

    PubMed

    Hyun, Sang Min; Medikeri, Gaurav Shankar; Jung, Dong-Hak

    2015-09-01

    Alar vertical discrepancy including alar base has been viewed as one of the most challenging reconstructive problems in rhinoplasty. The authors have created a simple technique that consistently gives aesthetically acceptable results. The authors have designed the seesaw technique to correct alar discrepancy (type 1 to 3). Type 1 has been used in 14 patients, type 2 has been used in three patients, and type 3 has been used in seven patients. Alar discrepancy was corrected satisfactorily in all cases, with good cosmetic outcome. One case required scar revision and another case required revision for overcorrection; satisfactory results were ultimately achieved in both cases. This new technique is quite easy to design and is effective in the correction of alar discrepancy. It yields good postoperative results along with satisfactory aesthetic outcomes.

  10. Modified versus classic alar base sutures after LeFort I osteotomy: a systematic review.

    PubMed

    Liu, Xianwen; Zhu, Songsong; Hu, Jing

    2014-01-01

    The purpose of this systematic review is to evaluate the efficacy of a new modified alar base cinch suture by comparing it with the commonly used classic alar base suture after LeFort I osteotomy. A comprehensive search strategy was performed to include interventional studies involving the comparisons of alar base suturing methods after LeFort I osteotomy. Data analyses were conducted using the random-effects model. Three studies with 146 participants undergoing LeFort I maxillary osteotomy were included in this review. The results showed that, compared with the classic method, both modified transseptal alar base suture and modified reinsertion sutures significantly decreased postoperative alar and alar base widening. The modified alar base cinch suture was more effective than the classic alar base suture in maintaining preoperative alar and alar base width after LeFort I osteotomy. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Preventing alar retraction by preservation of the lateral crus.

    PubMed

    Gruber, Ronald P; Zhang, Andrew Y; Zang, Andrew; Mohebali, Khashayar

    2010-08-01

    Resecting the cephalic component of the lateral crus in an attempt to reduce tip bulbosity has the potential to aggravate and/or cause alar retraction. It is a more serious problem for those patients who exhibit borderline alar retraction. Fourteen primary rhinoplasty patients with borderline alar/columellar relationships for alar retraction formed the study. They did not warrant frank treatment of alar retraction but did exhibit tip bulbosity. An "island" of cephalic lateral crus was developed by an intercartilaginous incision and another 6 mm cephalic to the caudal border of the lateral crus. One or more mattress sutures were placed in the main body of the lateral crus to stiffen and straighten it. The "island" of cephalic crus was then slipped under the main body of the lateral crus. At 11 months to 2(1/2) years, 13 of the 14 patients demonstrated no significant change in their preoperative alar/columellar relationships. Bulbosity was corrected in all patients. One patient, however, required a revision using an alar contour rim graft. The mean preoperative alar-nostril axis measurement was 1.48 mm (range, 1.3 to 1.9 mm) in contrast to a mean postoperative measurement of 1.71 mm (range, 1.5 to 2.2 mm). A one-tailed paired t test indicated no statistically significant difference between preoperative and postoperative values. The cephalic part of the lateral crus can act as a lateral crural strut to maintain the ala in a more caudal position. The technique is useful for borderline alar retraction and when lengthening the short nose for which there is a need to preserve side wall length.

  12. Simple Correction of Alar Retraction by Conchal Cartilage Extension Grafts.

    PubMed

    Jang, Yong Jun; Kim, Sung Min; Lew, Dae Hyun; Song, Seung Yong

    2016-11-01

    Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting. Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction. Conchal cartilage extension grafts were fixed to the caudal margins of the lateral crura and covered with vestibular skin advancement flaps. Preoperative and postoperative photographs were reviewed and analyzed. Patient satisfaction was surveyed and categorized into 4 groups (very satisfied, satisfied, moderate, or unsatisfied). According to the survey, 8 patients were very satisfied, 9 were satisfied, and 1 considered the outcome moderate, resulting in satisfaction for most patients. The average distance from the alar rim to the long axis of the nostril was reduced by 1.4 mm (3.6 to 2.2 mm). There were no complications, except in 2 cases with palpable cartilage step-off that resolved without any aesthetic problems. Conchal cartilage alar extension graft is a simple, effective method of correcting alar retraction that can be combined with aesthetic rhinoplasty conveniently, utilizing conchal cartilage, which is the most similar cartilage to alar cartilage, and requiring a lesser volume of cartilage harvest compared to previously devised methods. However, the current procedure lacks efficacy for severe alar retraction and a longer follow-up period may be required to substantiate the enduring efficacy of the current procedure.

  13. Simple Correction of Alar Retraction by Conchal Cartilage Extension Grafts

    PubMed Central

    Jang, Yong Jun; Kim, Sung Min; Lew, Dae Hyun

    2016-01-01

    Background Alar retraction is a challenging condition in rhinoplasty marked by exaggerated nostril exposure and awkwardness. Although various methods for correcting alar retraction have been introduced, none is without drawbacks. Herein, we report a simple procedure that is both effective and safe for correcting alar retraction using only conchal cartilage grafting. Methods Between August 2007 and August 2009, 18 patients underwent conchal cartilage extension grafting to correct alar retraction. Conchal cartilage extension grafts were fixed to the caudal margins of the lateral crura and covered with vestibular skin advancement flaps. Preoperative and postoperative photographs were reviewed and analyzed. Patient satisfaction was surveyed and categorized into 4 groups (very satisfied, satisfied, moderate, or unsatisfied). Results According to the survey, 8 patients were very satisfied, 9 were satisfied, and 1 considered the outcome moderate, resulting in satisfaction for most patients. The average distance from the alar rim to the long axis of the nostril was reduced by 1.4 mm (3.6 to 2.2 mm). There were no complications, except in 2 cases with palpable cartilage step-off that resolved without any aesthetic problems. Conclusions Conchal cartilage alar extension graft is a simple, effective method of correcting alar retraction that can be combined with aesthetic rhinoplasty conveniently, utilizing conchal cartilage, which is the most similar cartilage to alar cartilage, and requiring a lesser volume of cartilage harvest compared to previously devised methods. However, the current procedure lacks efficacy for severe alar retraction and a longer follow-up period may be required to substantiate the enduring efficacy of the current procedure. PMID:27896189

  14. Feasibility and accuracy of nasal alar pulse oximetry.

    PubMed

    Morey, T E; Rice, M J; Vasilopoulos, T; Dennis, D M; Melker, R J

    2014-06-01

    The nasal ala is an attractive site for pulse oximetry because of perfusion by branches of the external and internal carotid arteries. We evaluated the accuracy of a novel pulse oximetry sensor custom designed for the nasal ala. After IRB approval, healthy non-smoking subjects [n=12; aged 28 (23-41) yr; 6M/6F] breathed hypoxic mixtures of fresh gas by a facemask to achieve oxyhaemoglobin saturations of 70-100% measured by traditional co-oximetry from radial artery samples. Concurrent alar and finger pulse oximetry values were measured using probes designed for these sites. Data were analysed using the Bland-Altman method for multiple observations per subject. Bias, precision, and accuracy root mean square error (ARMS) over a range of 70-100% were significantly better for the alar probe compared with a standard finger probe. The mean bias for the alar and finger probes was 0.73% and 1.90% (P<0.001), respectively, with corresponding precision values of 1.65 and 1.83 (P=0.015) and ARMS values of 1.78% and 2.72% (P=0.047). The coefficients of determination were 0.96 and 0.96 for the alar and finger probes, respectively. The within/between-subject variation for the alar and finger probes were 1.14/1.57% and 1.87/1.47%, respectively. The limits of agreement were 3.96/-2.50% and 5.48/-1.68% for the alar and finger probes, respectively. Nasal alar pulse oximetry is feasible and demonstrates accurate pulse oximetry values over a range of 70-100%. The alar probe demonstrated greater accuracy compared with a conventional finger pulse oximeter. © The Author [2014]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. Alar Pinning in Rigid External Distraction for Midfacial Hypoplasia.

    PubMed

    Yu, Jenny L; Woo, Albert S

    2017-09-01

    Distraction osteogenesis with a rigid external distractor is a widely accepted treatment for midfacial hypoplasia. In this study, the authors introduce the utilization of alar pinning with the external halo distractor for maxillary advancement, in place of an oral splint. A retrospective chart review was conducted of 7 patients who successfully underwent distraction osteogenesis using the alar pinning technique. Midfacial hypoplasia was secondary to Crouzon syndrome (n = 4), Apert syndrome (n = 1), Pfeiffer syndrome (n = 1), or bacterial meningitis (n = 1). Three patients were managed with monobloc osteotomies, 2 with Le Fort III osteotomies, 1 with Le Fort III osteotomy and frontoorbital advancement, and 1 with Le Fort I osteotomy alone. Patient charts were analyzed for postoperative course and complications relating to the alar pins. Two patients had minor complications specifically related to the alar pins. One patient had concern for a mild skin infection at a pin site that resolved with oral antibiotics. The other patient had loosening of an alar pin, which did not require operative management. Retrospective chart review indicated that all patients were pleased with their results from the distraction, and no patients opted for further advancement. Utilization of alar pin sites for external distraction is a feasible and reasonable option for treatment of midfacial hypoplasia involving a Le Fort osteotomy or monobloc procedure. Fixation sites within the alar crease minimize the visibility of pin site scars and eliminate the need for a custom-made oral splint, which prevents usage of the upper dentition and frequently requires consulting a dentist or orthodontist for fabrication. Alar pinning with an external halo distraction system for management of midfacial hypoplasia has minimal complications and is an alternative to using a custom-made oral splint.

  16. Revisiting the clinical anatomy of the alar ligaments.

    PubMed

    Osmotherly, Peter G; Rivett, Darren A; Mercer, Susan R

    2013-01-01

    The morphology of the alar ligaments has been inconsistently described, particularly with regard to the existence of an atlantal portion. Despite these inconsistencies, these descriptions have been used to develop physical tests for the integrity of these ligaments in patients with cervical spine problems. The purpose of this study was to describe the detailed macrostructure of the alar ligaments. The alar ligaments of 11 cervical spine specimens from embalmed adult cadavers were examined by fine dissection. A detailed description of the macrostructure of these ligaments and their attachment sites was recorded. Measurements were performed with respect to ligament dimensions and relations with selected bony landmarks. No atlantal portion of the alar ligament was viewed in any specimen. The attachment of the ligaments on the odontoid process occurred on its lateral and posterolateral aspects, frequently below the level of the apex. The occipital attachment was on the medial surface of the occipital condyles in close proximity to the atlanto-occipital joints. The orientation of the ligaments was primarily horizontal. The presence of transverse bands extending occiput to occiput with minimal or no attachment to the odontoid process was a common variant. The absence of findings with respect to the atlantal portion of the alar ligament suggests that it may be considered an anatomical variant, not an essential component for stability of the craniocervical complex. These findings may inform the use and interpretation of clinical tests for alar ligament integrity.

  17. Alar setback technique: a controlled method of nasal tip deprojection.

    PubMed

    Foda, H M

    2001-11-01

    To describe an alar cartilage-modifying technique aimed at decreasing nasal tip projection in cases with overdeveloped alar cartilages and to compare it with other deprojection techniques used to correct such deformity. Selected case series. University and private practice settings in Alexandria, Egypt. Twenty patients presenting for rhinoplasty who had overprojected nasal tips primarily due to overdeveloped alar cartilages. All cases were primary cases except for one patient, who had undergone 2 previous rhinoplasties. An external rhinoplasty approach was used to set back the alar cartilages by shortening their medial and lateral crura. The choice of performing a high or low setback depended on the preexisting lobule-to-columella ratio. Following the setback, the alar cartilages were reconstructed in a fashion that increased the strength and stability of the tip complex. Subjective evaluation included clinical examination, analysis of preoperative and postoperative photographs, and patient satisfaction. Objective evaluation of nasal tip projection, using the Goode ratio and the nasofacial angle, was performed preoperatively and repeated at least 6 months postoperatively. A low setback was performed in 16 cases (80%) and a high setback in 4 (20%). The mean follow-up period was 18 months (range, 6-36 months). The technique effectively deprojected the nasal tip as evidenced by the considerable postoperative decrease in values of the Goode ratio and the nasofacial angle. No complications were encountered and no revision surgical procedures were required. The alar setback technique has many advantages; it results in precise predictable amounts of deprojection, controls the degree of tip rotation, preserves the natural contour of the nasal tip, respects the tip support mechanisms, increases the strength and stability of nasal tip complex, preserves or restores the normal lobule-to-columella proportion, and does not lead to alar flaring. However, the technique requires

  18. Correction of Alar Retraction Based on Frontal Classification.

    PubMed

    Kim, Jae Hoon; Song, Jin Woo; Park, Sung Wan; Bartlett, Erica; Nguyen, Anh H

    2015-11-01

    Among the various types of alar deformations in Asians, alar retraction not only has the highest occurrence rate, but is also very complicated to treat because the ala is supported only by cartilage and its soft tissue envelope cannot be easily stretched. As patients' knowledge of aesthetic procedures is becoming more extensive due to increased information dissemination through various media, doctors must give more accurate, logical explanations of the procedures to be performed and their anticipated results, with an emphasis on relevant anatomical features, accurate diagnoses, detailed classifications, and various appropriate methods of surgery.

  19. Correction of Alar Retraction Based on Frontal Classification

    PubMed Central

    Kim, Jae Hoon; Song, Jin Woo; Park, Sung Wan; Bartlett, Erica; Nguyen, Anh H.

    2015-01-01

    Among the various types of alar deformations in Asians, alar retraction not only has the highest occurrence rate, but is also very complicated to treat because the ala is supported only by cartilage and its soft tissue envelope cannot be easily stretched. As patients' knowledge of aesthetic procedures is becoming more extensive due to increased information dissemination through various media, doctors must give more accurate, logical explanations of the procedures to be performed and their anticipated results, with an emphasis on relevant anatomical features, accurate diagnoses, detailed classifications, and various appropriate methods of surgery. PMID:26648808

  20. Alar Suspension Sutures in the Management of Nasal Valve Collapse.

    PubMed

    Manickavasagam, Jaiganesh; Iqbal, Isma; Wong, Smeeta; Raghavan, Ullas

    2015-09-01

    This study assesses the efficacy of alar suspension sutures in the management of nasal valve collapse causing nasal obstruction. These sutures are inserted between the vestibular skin and lateral crura and hitched to the periosteum of the medial inferior orbital margin; this is a variation of the alar (change everywhere) suspension suture technique. A retrospective review of patients who underwent alar suspension suture insertion between January 2009 and December 2010 in the management of nasal obstruction was undertaken. Symptoms of nasal obstruction were assessed using the Visual Analogue Scale (VAS) and peak inspiratory flow rate (PIFR). This was measured preprocedure and repeated at 3, 6, and 12 months postoperatively. A total of 35 patients were identified, and 26 were included in the study; 90% of patients were satisfied with the outcome of surgery, supported by improvement in the VAS and PIFR scores. The mean difference in VAS preprocedure and postprocedure was 4.97 (P value = 0.00), and the average improvement in PIFR was 25.5 L/min (P value = 0.00). Our study shows a significant improvement in patient's symptoms following insertion of alar suspension sutures. It is, therefore, a reliable, safe, and effective technique in treating nasal obstruction secondary to nasal valve collapse. © The Author(s) 2015.

  1. Grafting the alar rim: application as anatomical graft.

    PubMed

    Gruber, Ronald P; Fox, Paige; Peled, Anne; Belek, Kyle A

    2014-12-01

    Alar rim contour and alar rim grafts have become essential components of rhinoplasty. Ideally, grafts of the nose should be anatomical in shape. So doing might make grafts of the alar rim more robust. The authors considered doing that by applying the graft as a continuous extension of the lateral crus. Twelve patients (two men and 10 women) constituted the study group (seven primary and five secondary cases). Of those, there were five concave rims, two concave rims with rim retraction, two boxy tips, and three cephalically oriented lateral crura. Surgical technique included the following: (1) an open approach was used; (2) a marginal incision that ignored the caudal margin of the lateral crus (the incision went straight posteriorly to a point 5 to 6 mm from the rim margin) was used; (3) a triangular graft was made to cover the exposed vestibular skin; (4) it was secured end to end to the caudal border of the lateral crus; and (5) the poster end was allowed to sit in a small subcutaneous pocket. Follow-up was 11 to 19 months. All 12 patients exhibited good rims as judged by a blinded panel. Rim retraction was not fully corrected in one patient, but no further treatment was required. One patient did require a secondary small rim graft for residual rim concavity. The concept of grafting the alar rim is strongly supported by the authors' results. The modifications the authors applied by designing the graft to be anatomical in shape has been a technical help.

  2. Anatomy of the Alar Ligament: Part II: Variations of Its Attachment onto the Dens.

    PubMed

    Sardi, Juan P; Iwanaga, Joe; Schmidt, Cameron; Rustagi, Tarush; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

    2017-08-09

    Various authors have described the morphology of the alar ligaments; however, there are no reports of a cadaveric study focusing on their attachments onto the dens. The purpose of this study was to use fresh cadaveric specimens to describe in detail different attachment patterns of the alar ligaments onto the dens. This study used 22 sides from 11 fresh frozen cadaveric heads. Specimens were obtained from 8 men and 3 women who were 67-99 years old at death. Dissection of the exact attachment of the alar ligaments onto the dens was observed from posterior, superior, and anterior views under the surgical microscope. From a posterior view, 6 alar ligaments passed over the tip of the dens, and 16 alar ligaments attached onto the posterolateral part of the dens; the right and left ligaments had no continuity. From a superior view, the alar ligament was classified in 2 ways: depending on the covered area of the dens (entirely or posterior two thirds) and continuity of the alar ligament (transversely, separately, or combination). Fourteen alar ligaments covered the posterior two thirds of the dens. From an anterior view, in 1 specimen, the alar ligament extended to the anterior surface of the dens. Wide posterolateral anchoring to the dens coupled with the nearly horizontal trajectory explains the biomechanical advantage of the alar ligaments in undertaking a stabilizing function in limiting head rotation that would otherwise be ineffective in the case of weaker attachments or a more vertical orientation. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Reconstruction of nasal alar defects in asian patients.

    PubMed

    Han, Doo Hee; Mangoba, Dennis Cristobal S; Lee, Doh Young; Jin, Hong Ryul

    2012-01-01

    To present the aesthetic and functional outcomes of nasal alar reconstruction in Asian patients and to propose a working surgical algorithm. Seventeen patients underwent nasal alar reconstruction at a university-based facial plastic surgery practice from March 1, 1998, through February 28, 2010. The male-female ratio was 10:7, with a median age of 59 years (range, 34-78 years), and the mean follow-up duration was 64 months. The defect was mostly caused by basal cell carcinoma resection (14 of 17 [82%]), followed by the resection of squamous cell carcinoma, trauma, and excision of a previous scar. The mean defect size was 1.71 cm (range, 1-4 cm). The full-thickness defects were noted for 8 patients, whereas 9 had partial-thickness defects. The choice of reconstruction method was primarily based on the size and depth of the surgical defect. Most of the defects 1 to 2 cm in diameter needed nasolabial flaps (10 of 17 [59%]), whereas full-thickness defects larger than 2 cm needed forehead flaps (3 of 17 [18%]) to reconstruct the external defect. Smaller defects less than 1 cm were reconstructed with composite grafts (2 of 17 [12%]), a bilobed flap (1 of 17 [6%]), or primary closure (1 of 17 [6%]). Seven of 8 full-thickness defects had the internal nasal lining reconstructed using a septal mucoperichondrial flap, and 1 case was reconstructed using a cutaneous turn-in flap. Reinforcement cartilage graft was used in 8 patients. No flap failure occurred except in 1 case, in which necrosis of the internal lining flap caused contraction of the external flap with resultant alar rim elevation. An elevation of the alar margin and alar groove blunting occurred in 3 cases. No functional problems emerged. Subjective surgical outcome on a 4-point satisfaction scale revealed that 5 patients (29%) were much satisfied, 10 patients (59%) were satisfied, 1 patient (6%) was fairly satisfied, and 1 patient (6%) was dissatisfied. The choice of reconstruction method of nasal alar defect in

  4. Relationship between Hyperactivity of Depressor Septi Nasi Muscle and Changes of Alar Base and Flaring during Smile

    PubMed Central

    Beiraghi-Toosi, Arash; Rezaei, Ezatollah; Zanjani, Elham

    2016-01-01

    BACKGROUND Hyperactivity of depressor septi nasi muscle leads to smiling deformity and nasal tip depression. Lateral fascicles of this muscle help in widening the nostrils. The purpose of this study was to evaluate the relationship between the nasal length changes and the alar base and the alar flaring changes during smile. METHODS Standard photographs are performed in the face and lateral views with forward gaze in the repose and maximum smile. Nasal length, alar base, and alar flaring were measured on the prints of the photographs. To decrease possible errors in the size of the printed photographs, middle face height from glabella to ANS was measured in the lateral view and the interpupil distance in the face view to standardize the measurements. RESULTS Fifty cases were enrolled in this study. In 39 cases (78%), the nasal length was increased during smile. Forty-six cases (92%) had an increase in alar base diameter during smile. Alar flaring during smile increased in 48 cases (96%). Nasal length and alar base changes during smiling were not significantly correlated. Nasal length and alar flaring changes during smiling were not significantly related too. On the other hand, alar base and alar flaring changes during smile showed correlation. Alar base and alar flaring changes during smile were not significantly different in hyperactive and non-hyperactive cases. CONCLUSION Nasal length change during smiling and hypertrophy of the medial fascicles of depressor septi nasi were not related to alar base or alar flaring change during smile. PMID:27308240

  5. Relationship between Hyperactivity of Depressor Septi Nasi Muscle and Changes of Alar Base and Flaring during Smile.

    PubMed

    Beiraghi-Toosi, Arash; Rezaei, Ezatollah; Zanjani, Elham

    2016-01-01

    Hyperactivity of depressor septi nasi muscle leads to smiling deformity and nasal tip depression. Lateral fascicles of this muscle help in widening the nostrils. The purpose of this study was to evaluate the relationship between the nasal length changes and the alar base and the alar flaring changes during smile. Standard photographs are performed in the face and lateral views with forward gaze in the repose and maximum smile. Nasal length, alar base, and alar flaring were measured on the prints of the photographs. To decrease possible errors in the size of the printed photographs, middle face height from glabella to ANS was measured in the lateral view and the interpupil distance in the face view to standardize the measurements. Fifty cases were enrolled in this study. In 39 cases (78%), the nasal length was increased during smile. Forty-six cases (92%) had an increase in alar base diameter during smile. Alar flaring during smile increased in 48 cases (96%). Nasal length and alar base changes during smiling were not significantly correlated. Nasal length and alar flaring changes during smiling were not significantly related too. On the other hand, alar base and alar flaring changes during smile showed correlation. Alar base and alar flaring changes during smile were not significantly different in hyperactive and non-hyperactive cases. Nasal length change during smiling and hypertrophy of the medial fascicles of depressor septi nasi were not related to alar base or alar flaring change during smile.

  6. [Injuries of the alar ligaments in children and adolescents].

    PubMed

    Briem, D; Linhart, W; Dickmann, C; Rueger, J M

    2002-06-01

    Cervical spine trauma most commonly involves the lower parts in adults. In children lesions of the cervical spine can predominantly be found in the region of C1/C2 including ligament injuries at this level. However such injuries are difficult to detect and only few data are available concerning therapy and prognosis of atlantoxial ligament lesions. We report on two children suffering from isolated rupture of the alar ligaments. Both injuries were proven by magnetic resonance imaging which is recommended as the resource of choice for the evaluation of the cervical spine soft tissues in children. Although the biomechanic properties of the alar ligaments remain unclear non-operative treatment for the rupture of these ligaments seems to be adequate. In order to avoid neurologic symptoms or long term complications an immediate diagnosis is indispensable.

  7. Alar and apples: newspapers, risk and media responsibility.

    PubMed

    Friedman, S M; Villamil, K; Suriano, R A; Egolf, B P

    1996-01-01

    During 1989, a major environmental and health risk issue, the spraying of Alar on apples, created a furor among the American people. After hearing charges from the Natural Resources Defense Council (NRDC) that eating Alar-laden apples significantly increased a child's risk of developing cancer, numbers of school districts dropped apples from their menus and parents poured apple juice down the drains. Apple sales plummeted. The NRDC's charges, which were disseminated by a well-planned and effective public relations campaign, brought counter-charges from the US environmental Protection Agency, which accused the NRDC of basing its study on poor data, among other things. The core of the dispute was in the risk figures and risk interpretations being used by each organization.

  8. Radiologic misunderstanding of cutaneous angiomyolipoma in the alar base.

    PubMed

    Han, Hyun Ho; Choi, Jong Yun; Seo, Bommie F; Mun, Suk Ho; Rhie, Jong Won; Ahn, Sang Tae; Oh, Deuk Young

    2014-07-01

    In this article, we will examine a case of cutaneous angiomyolipoma in the right nasal alar base area of a 36-year-old man. Generally, angiomyolipoma occurs in the kidney and, histologically, has features that are similar to cutaneous angiomyolipoma: smooth muscle cells, mature adipose cells, and a convoluted thick-walled blood vessel. Clinically, renal angiomyolipoma is related to tuberous sclerosis, but cutaneous angiomyolipomas occur very rarely, with a total of only 23 cases documented in the literature, with 39% (9/23) of those cases occurring in the ear or surrounding areas. In particular, the abundance of blood vessels inside a cutaneous angiomyolipoma produces good enhancement on computed tomographic image, making it easy for the tumor to be mistaken for a vascular tumor. In this particular case, we will report about a previously unheard case of cutaneous angiomyolipoma occurring in the nasal alar base that was mistaken for a vascular tumor.

  9. Delayed diagnosis of isolated alar ligament rupture: A case report.

    PubMed

    Kaufmann, Robin A; Marzi, Ingo; Vogl, Thomas J

    2015-10-28

    Ligament disruptions at the craniovertebral junction are typically associated with atlantoaxial rotatory dislocation during upper cervical spine injuries and require external orthoses or surgical stabilization. Only in few patients isolated ruptures of the alar ligament have been reported. Here we present a further case, in which the diagnosis was initially obscured by a misleading clinical symptomatology but finally established six month following the trauma, demonstrating the value of contrast-enhanced high resolution 3 Tesla magnetic resonance imaging in identifying this particular lesion.

  10. Aesthetic Outcomes of Alar Base Resection in Asian Patients Undergoing Rhinoplasty.

    PubMed

    Kim, Ji Heui; Park, Joon Pyo; Jang, Yong Ju

    2016-12-01

    Combined sill and alar excision is a useful procedure for correcting a wide nasal base and flared alar lobules. However, the aesthetic outcomes of this technique remain poorly reported. To evaluate the aesthetic outcomes of combined sill and alar excision in Asian patients undergoing rhinoplasty. A retrospective cohort study of 73 consecutive patients who underwent combined sill and alar excision from March 1, 2004, to January 31, 2013, was conducted at a tertiary referral hospital in Korea. Combined sill and alar excision. Changes in the ratio of the interalar distance to intercanthal distance and frequencies of alar flaring, nostril symmetry, and nostril shape, as measured by reviewing photographs taken before and after the surgery. Among the 73 patients (50 men and 23 women; mean [SD] age, 36.5 [12.3] years) the mean (SD) ratio of interalar distance to intercanthal distance changed significantly from 1.07 (0.11) to 1.04 (0.08) (P < .001). Of the 60 patients with alar flaring, 45 (75%) no longer had flaring after the procedure. The frequency of nostril symmetry increased from 38 patients (52%) to 46 (63%) (P < .001). The frequency of horizontally shaped nostrils decreased from 21 patients (29%) to 2 (3%), while the frequency of the preferred pear-shaped nostrils increased from 20 patients (27%) to 35 (48%) (odds ratio, 1.16; 95% CI, 0.63-2.14; P = .02). There were 4 cases of complications, namely, alar deformity (1 patient [1%]), unsatisfactory correction of asymmetrical nostrils (1 [1%]), and unsatisfactory correction of alar flaring (2 [3%]). Combined sill and alar excision was a useful technique with a low complication rate for correcting wide alar base, alar flaring, nostril asymmetry, and nostril shape. 4.

  11. [The anatomical structure similarity research on auricular cartilage and nasal alar cartilage].

    PubMed

    Chen, Changyong; Fan, Fei; Li, Wenzhi; Li, Binbin; You, Jianjun; Wang, Huan

    2015-09-01

    There are many scaffold materials of repairing nasal alar cartilage defects. Auricuiar cartilage was used extensively in terms of its abundant tissues, good elasticity, little donor-site malformation, good plasticity etc. The authors dissected auricular cartilage and nasal alar cartilage, measured cartilage's morphous data and found some similar territories with nasal alar cartilage in the structure of auricular cartilage. An anatomical study was performed using 10 adult cadavers acquired through Plastic Surgery Hospital, Peking Union Medical College, Beijing, China. Seven male and three female cadav-ers were included in the study. Harvest 20 auricular cartilage specimens and 20 nasal alar cartilage specimens. Then, Computed Tomography Scan on the auricular cartilage and nasal alar cartilage were performed. The datas were imported into mimics and three-dimensional reconstructions of the auricular cartilage and nasal alar cartilage were carried on. Parts of the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are ana-tomically similar to nasal alar cartilage. This study reports the anatomy of auricular cartilage and nasal alar cartilage, found some territories in the auricular cartilage, such as conchal fossa, tragus, intertragic notch, and cymba of auricular concha, curs of helix and curs of helix, triangular fossa, are anatomically similar to nasal alar cartilage. This research provides the anatomical basis that auricular cartilage was used to repair the nasal cartilage defect.

  12. Is the Pyriform Ligament Important for Alar Width Maintenance After Le Fort I Osteotomy?

    PubMed

    Peacock, Zachary S; Susarla, Srinivas M

    2015-12-01

    To determine whether identification and incorporation of the pyriform ligament in the alar cinch results in decreased alar base widening compared with standard alar cinch techniques. This was a retrospective case series and the sample was composed of patients undergoing Le Fort I osteotomy. Intraoperatively, the pyriform ligament was identified and incorporated in the alar cinch suture. Greatest alar width (GAW) measured immediately after closure was compared with GAW measured at least 5 months postoperatively. The change in alar base width was compared with that reported in the literature using other alar cinch techniques. Two case examples are reported. The sample was composed of 15 patients (mean age, 27.1 yr; 27% female). The mean postoperative change in GAW was 1.0 ± 0.6 mm (2.59 ± 1.59%). Postoperative change in alar base width reported in the literature ranged from 0.5 to 10.8%. The pyriform ligament is easily identified during exposure of the maxilla and pyriform aperture and can be used to control widening of the alar base after Le Fort I osteotomy. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Correction of unilateral cleft lip nose deformity using nasal alar rim flap.

    PubMed

    Wang, Huan; Fan, Fei; You, Jianjun; Wang, Sheng

    2012-09-01

    The objective of this study was to show the use and effectiveness of nasal alar rim flap on the correction of unilateral cleft lip nasal deformity. Thirty-one patients (age range, 10-29 years; mean, 15.1 years; 14 male and 17 female patients) with unilateral cleft lip underwent rhinoplasty surgery using alar rim flap. The excessive skin of nasal alar was marked, then a skin flap was raised. This flap can be transferred medially (type 1) or laterally (type 2) to narrow the nostril or to augment the nasal sill and, of course, to correct the alar web deformity. Preoperative and postoperative photographs were measured for photogrammetric analysis in 16 patients. The alar rim flap used in patients with unilateral cleft lip made the nostrils more symmetrical. The nostril sill was augmented with flap type 1. The alar base width was narrowed with flap type 2 (P = 0.03). The alar web deformity was corrected. The alar rim flap could be an ideal treatment option for correction of alar web deformity in patients of unilateral cleft lip.

  14. The alar rim flap: a novel technique to manage malpositioned lateral crura.

    PubMed

    Kemaloğlu, Cemal Alper; Altıparmak, Mehmet

    2015-11-01

    Alar cartilage malposition is a common anatomic variation in which the axis of the lateral crus lies cephalically and may be parallel to the cephalic septum. Malposition of the lateral crura may produce inward collapse of the alae that is observable on deep inspiration. The authors performed the alar rim flap technique to treat patients with alar malposition and assessed functional and aesthetic outcomes. Twelve patients who underwent primary open rhinoplasty with the alar rim flap technique were evaluated in a prospective study. A 2- or 3-mm caudal portion of the lateral crus was elevated from the underlying mucosa, pulled caudally, and extended with a cartilage graft. This extension of the alar rim flap was placed through the pyriform aperture for additional support. Patients completed pre- and postoperative questionnaires addressing nasal obstruction and underwent paranasal computed tomography. Patients received follow-up for an average of 16 months (range, 8-27 months). Patients with alar cartilage malposition and external valve insufficiency experienced aesthetic and functional improvements after rhinoplasty with the alar rim flap technique. No patients developed alar rim collapse or flap displacement. The alar rim flap technique is effective for the correction of malpositioned lateral crura and external valve insufficiency. Because this technique does not damage the scroll area, disruption of the internal valve area is avoided. 4 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  15. Alar web in cleft lip nose deformity: study in adult unilateral clefts.

    PubMed

    Agarwal, Rajiv; Chandra, Ramesh

    2012-09-01

    The correction of alar webbing in unilateral cleft lip nose deformity is challenging because of progressive distortions in the alar web region during the period of growth. Alar webbing is a persistent universal deformity in both the primary and secondary cleft lip noses. The purpose of this article is to study the alar web deformity in adult patients with unilateral cleft lip noses. Twenty-five patients aged 13 years and older presenting with unilateral cleft nasal deformity were included. Preoperative and postoperative measurements of the nose, along with detailed intraoperative recording of the deformed anatomy, were done. Preoperative magnetic resonance imaging was also done in selected cases. Transcolumellar open rhinoplasty was performed in all the cases, and nasal septal straightening with centralization was done. Cleft alar base augmentation was done using bone graft to restore symmetry of the nasal tripod. Both the cleft and noncleft alar cartilages were extensively mobilized from the skin and mucosal sides. The overgrown and caudally slumped cleft-side alar cartilage was resected caudally and was then resuspended in a symmetrical position with the noncleft alar cartilage. A midline-strut septal cartilage extension graft was used to restore the tip aesthetics. The skin overlying the alar web was in-rolled after semilunar cartilage resection, and skin excision was also done to restore symmetry with the opposite vestibule. The remaining secondary cleft nasal and lip deformities were corrected depending upon the specific presenting pathologic abnormality. The cleft alar cartilage was found to be caudally displaced in all the cases. The caudal border of the lateral crus was prolapsing in the cavity of the vestibule on the superomedial aspect and was tenting the skin in the area of the weak triangle, producing the characteristic alar web deformity. In the study group, the maximum width of the cleft alar cartilage at the level of the lateral crus was increased by

  16. [Alar ligaments: radiological aspects in the diagnosis of patients with whiplash injuries].

    PubMed

    Muhle, C; Brossmann, J; Biederer, J; Jahnke, Th; Grimm, J; Heller, M

    2002-04-01

    Post-traumatic changes of the alar ligaments have been proposed to be the cause of chronic pain in patients after whiplash injury of the cervical spine. In addition to an asymmetric dens position, widening of the atlantodental distance to more than 12 mm can be an indirect sign of an alar ligament rupture. CT is recommended for detection of a avulsion fracture of the occipital condyle. Isolated ruptures of the alar ligaments are best visualized on MRI. In patients with chronic impairments after whiplash injuries changes of the alar ligaments on MRI must be differentiated from normal variants in healthy individuals.

  17. Calcification of the alar ligament of the cervical spine in a patient with rheumatoid arthritis

    PubMed Central

    Soubai, Rahma Boussaadani; Tahiri, Latifa; Abourazzak, Fatima Zahra; Tizniti, Siham; Harzy, Taoufik

    2012-01-01

    Calcification of the alar ligament is rare. It usually develops as a result of traumatic injury and is especially prominent in the elderly. CT scanning is the gold standard of the diagnosis. We report a case of a calcification of the transverse and alar ligament in a patient with rheumatoid arthritis. PMID:23330032

  18. [Influence of different surgeries on growth and development of alar cartilage in young-rabbit].

    PubMed

    Jiang, Lian; Dong, Xiqian; Song, Qinggao; Chen, Shang; Zou, Sihai

    2011-01-01

    The purpose of this study is to observe the affection of different clinical surgeries on alar nasal cartilages' growth and development. The experimental results can provide some theory basis for clinical surgeries. Twenty-eight New Zealand immature rabbits were used in this study, and divided into normal control group, hidden dissection group and cutting off alar nasal cartilages group randomly, which included 4,12 and 12 rabbits, separately. Arc incision were made on the mucous membrane of nasal cavity,and then dissect the alar nasal cartilages hidden or cut off the alar nasal cartilages, separately. The growth and development of the alar cartilage were observed at different stages after the surgery using histological and immuno-histochemical methods. Four weeks, eight weeks, twelve weeks and sixteen weeks after surgery, there were no significant differences in the indexes of chondrocytes between hidden dissection group and control group. In cutting off alar nasal cartilages group, fiber tissue were observed in the vacancy left after being cut off cartilages, and even mucous membrane tissue could be seen in some slices. There is no adverse influence on the growth and development of the alar cartilage after being hidden dissected. Contrarily, the restoring capability of transparent cartilage cannot counteract the injury resulted form the surgery after the alar nasal cartilages being cut off.

  19. Defining the Morphology and Distribution of the Alar Fascia: A Sheet Plastination Investigation.

    PubMed

    Scali, Frank; Nash, Lance G; Pontell, Matthew E

    2015-10-01

    This study aims to delineate the morphology, integrity, and distribution of the alar fascia using dissection and E12 sheet plastination. This is the first study that employs E12 sheet plastination to investigate the alar fascia and its adjacent potential spaces. Twenty-nine manual dissections and 3 sets of E12 sheet plastinations were used to examine the posterior pharyngeal region for the architecture and distribution of the alar fascia. Specimens were examined from the inferior nuchal line to C6. The alar fascia originated as a well-defined midline structure at the level of C1 and could be identified down to C6. There was no evidence of the alar fascia between the inferior nuchal line and the base of the skull. Notably, the alar fascia permitted resistance to manual traction. E12 sheet plastination allowed for visualization of the alar fascia's superior attachments within the deep cervical region. Resistance to traction suggests that the alar fascia may be more than just a loose fibroareolar matrix. The findings in this study suggest an alternative point of entry into the danger space. Understanding the continuity of this fascial layer is critically important with regard to the pathophysiology of deep neck space infections. © The Author(s) 2015.

  20. Delayed diagnosis of isolated alar ligament rupture: A case report

    PubMed Central

    Kaufmann, Robin A; Marzi, Ingo; Vogl, Thomas J

    2015-01-01

    Ligament disruptions at the craniovertebral junction are typically associated with atlantoaxial rotatory dislocation during upper cervical spine injuries and require external orthoses or surgical stabilization. Only in few patients isolated ruptures of the alar ligament have been reported. Here we present a further case, in which the diagnosis was initially obscured by a misleading clinical symptomatology but finally established six month following the trauma, demonstrating the value of contrast-enhanced high resolution 3 Tesla magnetic resonance imaging in identifying this particular lesion. PMID:26516433

  1. Anatomy of the alar ligamentPart I: Morphometrics and variants.

    PubMed

    Iwanaga, Joe; Sardi, Juan; Voin, Vlad; Chapman, Jens R; Oskouian, Rod J; Tubbs, R Shane

    2017-08-18

    The alar ligaments are one of the primary ligamentous structures contributing to craniovertebral stability. The purpose of this study is to clarify the morphology of the alar ligament using fresh cadaveric specimens. Twenty-two fresh frozen cadaveric alar ligaments were used in this study. The occiput, C1 and C2 were removed en bloc from each specimen and various measurements and observations, including variations, were documented. The angle formed by both alar ligaments was measured in a neutral position (149±24.19°), as well as during forced flexion (134.18±27.08°) and extension (163.81±24.54°). The current cadaveric evaluation offers an interesting window into better understanding the anatomy of the alar ligaments. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. [Mystery of alar ligament rupture: value of MRI in whiplash injuries--biomechanical, anatomical and clinical studies].

    PubMed

    Bitterling, H; Stäbler, A; Brückmann, H

    2007-11-01

    Whiplash injury of the cervical spine is a frequent issue in medical expertise and causes enormous consequential costs for motor insurance companies. Some authors accuse posttraumatic changes of alar ligaments to be causative for consequential disturbances. Review of recent studies on biomechanics, anatomical and clinical MR imaging. Biomechanical experiments can not induce according injuries of alar ligaments. Although MRI provides excellent visualization of alar ligaments, the range of normal variants is high. Biomechanical studies give no evidence of alar ligament involvement in whiplash disease. Using MRI, signal alterations of alar ligaments can hardly be differentiated from common normal variants. Functional MRI provides no diagnostic yield.

  3. Three-dimensional evaluation of the alar cinch suture after Le Fort I osteotomy.

    PubMed

    van Loon, B; Verhamme, L; Xi, T; de Koning, M J J; Bergé, S J; Maal, T J J

    2016-10-01

    Orthognathic surgery has an influence on the overlying soft tissues of the translated bony maxillomandibular complex. Improvements in both function and facial appearance are the goals of surgery. However, unwanted changes to the soft tissues, especially in the nose region, frequently occur. The most common secondary change in the nasolabial region is widening of the alar base. Various surgical techniques have been developed to minimize this effect. The purpose of this study was to evaluate the changes in the nasal region due to orthognathic surgery, especially the alar width and nasal volume, using combined cone beam computed tomography (CBCT) and three-dimensional (3D) stereophotogrammetry datasets. Twenty-six patients who underwent a Le Fort I advancement osteotomy between 2006 and 2013 were included. From 2006 to 2010, no alar base cinch sutures were performed. From 2010 onwards, alar base cinch sutures were used. Preoperative and postoperative documentation consisted of 3D stereophotogrammetry and CBCT scans. 3D measurements were performed on the combined datasets, and the alar base width and nose volume were analyzed. No difference in alar base width or nose volume was observed between patients who had undergone an alar cinch and those who had not. Postoperatively the nose widened and the volume increased in both groups. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  4. Correction of an alar web with a feather-edge rolled-in flap.

    PubMed

    Park, Jong Lim; Oh, Chang Hyun; Hwang, Kun; Kim, Dae Joong; Jeong, Ji Myeong; Heo, Won Young; Park, Chul Gyoo

    2014-11-01

    The aim of this study was to see the histological nature of the alar web and to introduce a featheredged rolled-in flap to reduce the alar web.On a cadaver, the perpendicular section of the alar web revealed a thickened dermis portion on both the skin side and the nasal side distal to the alar cartilage. According to histological results, we thought the thinning and rolling in of the distal margin of the end of the open rhinoplasty incision could reduce the alar web. An open rhinoplasty incision was made just distal to the hair-bearing vestibular skin and a V-Y shape incision created at the alar base. After the cartilage work, the skin of the distal end of the flap was featheredged to a 0.5-mm thickness. The distal margin was rolled in and sutured to the nasal lining. A bolster dressing was applied using a 4-0 nylon suture.Thirteen patients (8 males, 5 females) were operated on, and 8 patients were followed up for more than 12 months. Their preoperative and postoperative worm's eye views were compared. Four anthropometric distances were measured preoperatively and postoperatively. The columellar length increased significantly after the operation (P = 0.001 [independent 2-sample t test]) on the cleft side. Preoperatively, the alar width was significantly greater (P = 0.02 [paired-samples t test]) on the cleft side (0.17 ± 0.03 of an intercanthal distance) than the noncleft side (0.14 ± 0.03). After the operations, they became similar (0.16 ± 0.03 on cleft side, 0.16 ± 0.04 on the noncleft side; P = 1.00 [paired-samples t test]).We think this featheredged rolling-in flap might be a good method for the correction of an alar web since this technique increased the columellar length and decreased the alar width on the cleft side.

  5. A Composite Buccal Flap for Alar Based Defect Reconstruction: A Technical Note

    PubMed Central

    Pourdanesh, F.; Khojasteh, A.

    2011-01-01

    It is difficult to reconstruct an alar defect with cartilage involvement. Here in the authors report a case of traumatic alar loss during childhood in which an alar reconstruction was carried out with a composite auricular graft put over the pedicle buccal flap which was rotated and passed through the intraoral side. The lining skin and auricular cartilage for the flap was obtained from the auricular region which was acceptable for the patient. All procedures were performed under general anesthesia. One year follow up revealed satisfactory results with minimal contracture of the graft. PMID:22509460

  6. Sliding alar cartilage (SAC) flap: a new technique for nasal tip surgery.

    PubMed

    Ozmen, Selahattin; Eryilmaz, Tolga; Sencan, Ayse; Cukurluoglu, Onur; Uygur, Safak; Ayhan, Suhan; Atabay, Kenan

    2009-11-01

    Congenital anatomic deformities or acquired weakness of the lateral crura of the lower lateral cartilages after rhinoplasty could cause alar rim deformities. As lower lateral cartilages are the structural cornerstone of the ala and tip support, deformities and weakness of the alar cartilages might lead to both functional and esthetic problems. In this article, we are introducing sliding alar cartilage flap as a new technique to reshape and support nasal tip. One hundred sixty consecutive patients between 18 and 55 years of age (mean age: 27.51) were included in the study between January 2007 and May 2008. Of the total number of patients 60 were male and 100 of them were female. None of the patients had rhinoplasty procedure including lower lateral cartilage excision previously. Sliding alar cartilage technique was used in an open rhinoplasty approach to shape the nasal tip in all patients. This technique necessitates about 2 to 3 minutes for suturing and undermining the alar cartilages. The follow-up period was between 4 and 18 months. In no patients any revision related to the sliding alar cartilage technique was required. Revision was applied in 3 patients due to thick nasal tip skin and in one patient due to unpleasant columellar scar. In this article, we are presenting the "sliding alar cartilage flap" as a new technique for creating natural looking nasal tip. This technique shapes and supports nasal tip by spontaneous sliding of the cephalic portion of the lower lateral cartilage beneath the caudal alar cartilage, with minimal manipulation, without any cartilage resection, or cartilage grafting.

  7. Resonant photoionization spectroscopy of refractory metal-rare gas complexes: AlAr

    NASA Astrophysics Data System (ADS)

    Gardner, John M.; Lester, Marsha I.

    1987-06-01

    Mass-resolved resonance-enhanced multiphoton ionization is used to probe AlAr complexes in the spectral region about the Al 2S 1/2- 2P 1/2 transition. Analysis of a vibrational progression in the AlAr 2Σ +state provides lower limits for binding energies in the X 2Π 1/2and B 2Σ + states of 133 and 373 cm -1, respectively.

  8. A geometrical model of vertical translation and alar ligament tension in atlanto-axial rotation.

    PubMed

    Boszczyk, B M; Littlewood, A P; Putz, R

    2012-08-01

    While allowing the greatest range of axial rotation of the entire spine with 40° to each side, gradual restraint at the extremes of motion by the alar ligaments is of vital importance. In order for the ligaments to facilitate a gradual transition from the neutral to the elastic zone, a complex interaction of axial rotation and vertical translation via the biconvex articular surfaces is essential. The aim of this investigation is to establish a geometrical model of the intricate interaction of the alar ligaments and vertical translatory motion of C1/C2 in axial rotation. Bilateral alar ligaments including the odontoid process and condylar bony entheses were removed from six adult cadavers aged 65-89 years within 48 h of death. All specimens were judged to be free of abnormalities with the exception of non-specific degenerative changes. Dimensions of the odontoid process and alar ligaments were measured. Graphical multiplanar reconstruction of atlanto-axial rotation was done in the transverse and frontal planes for the neutral position and for rotation to 40° with vertical translation of 3 mm. The necessary fibre elongation of the alar ligaments in the setting with and without vertical translation of the atlas was calculated. The mean diameter of the odontoid process in the sagittal plane was 10.6 mm (SD 1.1). The longest fibre length was measured from the posterior border of the odontoid enthesis to the posterior border of the condylar enthesis with an average of 13.2 mm (SD 2.5) and the shortest between the lateral (anterior) border odontoid enthesis and the anterior condylar enthesis with an average of 8.2 mm (SD 2.2). In graphical multiplanar reconstruction of atlanto-axial rotation to 40° without vertical translation of C1/C2, theoretical alar fibre elongation reaches 27.1% for the longest fibres, which is incompatible with the collagenous structure of the alar ligaments. Allowing 3 mm caudal translation of C1 on C2 at 40° rotation, as facilitated by the

  9. Alar soft-tissue techniques in rhinoplasty: algorithmic approach, quantifiable guidelines, and scar outcomes from a single surgeon experience.

    PubMed

    Warner, Jeremy P; Chauhan, Nitin; Adamson, Peter A

    2010-01-01

    To describe various techniques, including alar base reduction, alar flaring reduction, and alar hooding reduction and present a decision-making treatment algorithm and quantifiable guidelines for soft-tissue excision, along with scar outcomes from a single-surgeon practice. The soft tissue of the nasal tip, ala, and nostrils is important in overall nasal tip dynamics. Excisional alar contouring is an essential part of many successful cosmetic rhinoplasty outcomes. The various soft-tissue excision techniques are described in detail and an algorithm is provided. Quantitative analysis of excision parameters was performed using statistical analysis. Finally, qualitative scar analysis was performed and scar outcomes were statistically derived. Seventy-four patients were female and 26 were male. Of the procedures reviewed, 47% involved alar soft-tissue excision. Alar base reduction was performed in 46 patients (46%). Alar flare reduction was performed in 16 patients (16%). Alar hooding reduction was performed in 2 patients (2%). Mean scar outcome scores ranged from 0.55 to 0.69. Alar soft-tissue techniques are often necessary to achieve a balanced outcome and superior results when performing rhinoplasty surgery. Therefore, they should be an integral part of every rhinoplasty evaluation and surgical plan as indicated.

  10. Comparative analysis of two different alar base sutures after Le Fort I osteotomy: randomized double-blind controlled trial.

    PubMed

    Ritto, Fabio G; Medeiros, Paulo José; de Moraes, Márcio; Ribeiro, Danilo Passeado Branco

    2011-02-01

    The aim of this prospective study was to analyze the efficacy of a new alar base cinch suture by comparing it with the commonly used cinch suture described by Schendel and Delaire in Dr. William Bell's book. Thirty-five patients submitted to maxillary impaction and/or advancements of ≥ 3 mm were randomly divided into 2 groups. Group 1 received an extra oral alar base cinch suture, and patients from group 2 received the classic intraoral suture. Alar and alar base width were measured before and after surgery in digital photographs, with the patient's head in a submental oblique view. Data were reported as means and standard deviations, and difference between groups were determined using Welch t test. A P value of <.05 was considered to be statistically significant. Mean alar base widening was 1.38 mm in group 1 and 2.5 mm in group 2, and mean alar widening was 1.40 mm in group 1 and 2.31 mm in group 2. The difference was statistically significant (P < .05). Extraoral alar base cinch suture was more effective in maintaining preoperative Alar and alar base width compared with classic intraoral nasal suture. Copyright © 2011 Mosby, Inc. All rights reserved.

  11. Evaluation of modified nasal to oral endotracheal tube switch-For modified alar base cinching after maxillary orthognathic surgery.

    PubMed

    Shaik, Taj Nizam Shakeel; Meka, Sridhar; Ch, Pavan Kumar; Kolli, Naga Neelima Devi; Chakravarthi, P Srinivas; Kattimani, Vivekanand S; L, Krishna Prasad

    2017-01-01

    Soft tissue changes secondary to Maxillary orthognathic surgery are many fold. The alar flare is one among them, which affects the appearance of the patient. Cinch suture has been used to prevent alar flare; but the presence of anaesthetic tube hinders cinching. So, the study was aimed to assess an efficacy of modified nasal to oral tube switch technique for modified alar cinching to prevent alar flare after orthognathic and nasal corrective surgeries. Patients were randomly allocated in each group, who underwent modified alar base cinching with and without nasal to oral tube switch. Changes in alar base width, upper lip length was measured with Digital Vernier Caliper and nasolabial angle (Cotg-Sn-Ls) on lateral cephalogram at 1st, 3rd, 6th, and 12th months after surgery. The time taken and ease of tube switch were noted. The data obtained were tabulated and interpreted using a test of significance. Study results showed no statistical significant difference in perinasal soft changes among both groups. But tube switch appears to be beneficial to prevent alar flare. Modified alar base cinching was performed effectively in patients with a modified tube switch technique. It increased positive results in comparison with non-shift. The technique of tube switch used is effective in prevention of alar flare. Because of small sample size and limited period of follow up, our study suggests multi centre, randomized studies to know the technical difficulties of tube switch for cinching and aesthetic results with varying anaesthetist and the surgeon's experience.

  12. Variability of morphology and signal intensity of alar ligaments in healthy volunteers using MR imaging.

    PubMed

    Lummel, N; Zeif, C; Kloetzer, A; Linn, J; Brückmann, H; Bitterling, H

    2011-01-01

    Evaluation of alar traumatic injuries by using MR imaging is frequently performed. This study investigates the variability of morphology and signal intensity of alar ligaments in healthy volunteers so that pathology can be more accurately defined. Fifty healthy volunteers were examined on a 1.5T MR imaging scanner with 2-mm PD-weighted sequences in 3 planes. Delineation of the alar ligaments in 3 planes and signal-intensity characteristics on sagittal planes were analyzed by using a 4-point grading scale. Variability of courses and morphologic characteristics were described. Delineation of alar ligaments was best viewed in the coronal plane, followed by the sagittal and axial planes. In the sagittal view, 6.5% of alar ligaments appeared homogeneously dark. Hyperintense signal intensity in up to one-third of the cross-sectional area was present in 33% of cases; in up to two-thirds of the cross-sectional area, in 45% of cases; and in more than two-thirds of the cross-sectional area, in 15% of cases. Of alar ligaments, 58.5% ascended laterally, 40.5% ran horizontally, and 1% descended laterally. The cross-sectional area was round in 41.5%, oval in 51.5%, and winglike in 6.5%. On 1.5T MR imaging, the alar ligaments can be delineated best in the coronal and sagittal planes. Our data indicate a remarkable variability of morphology and course as well as signal intensity. This finding is contradictory to former publications assigning such alterations exclusively to patients with trauma.

  13. MR investigation in evaluation of chronic whiplash alar ligament injury in elderly patients.

    PubMed

    Chen, Jianqiang; Wang, Wei; Han, Guibin; Han, Xiangjun; Li, Xiangying; Zhan, Yuefu

    2015-01-01

    To observe the imaging features for chronic whiplash alar ligament injury in elderly patients and to provide an effective diagnostic method for long-term neck pain and headaches due to alar ligament injury in elderly patients. A total of 134 elderly patients, who engaged in the work or activities related to whiplash motion and suffered from chronic neck pain, were enrolled for the study. All patients were performed comprehensive health examination (CT, MR, ultrasound and laboratory examination) and high resolution PDWI. The patients were divided into 2 groups according to the results of comprehensive health examination: a clear etiology group(CE group, n=96) and an unknown etiology group(UE group, n=38). Th e characteristics of PDWI signal in the ligament were analyzed between the 2 groups. Th e anatomy and signal characteristics of the alar ligament were clearly displayed by high resolution PDWI. Th e alar ligaments were effectively displayed by oblique coronal image. In the CE group, 7 patients (7/96) showed the positive sign of ligament injured, while 21 (21/38) patients showed positive sign of ligament injured in the UE group (P<0.01). Chronic whiplash ligament injury was proved to be the reason for long-term neck pain and headaches in 15.7% patients. Th e whiplash injury of alar ligament is an important reason for chronic neck pain in elderly patients. High resolution PDWI is an effective method to evaluate the image features of alar ligament and can provide an accurate diagnosis for chronic neck pain and headaches caused by the alar ligament whiplash injury.

  14. Versatility of three-dimensional total alar cartilage dissection in aesthetic rhinoplasty.

    PubMed

    Yun, In Sik; Rah, Dong Kyun; Kim, Sung Min

    2010-11-01

    In many cases, Asians' noses are shorter; their nasal tips have a bulbous shape and typically lack the projection. To correct these problems, we completely dissected the alar cartilage in a three-dimensional manner by which the alar cartilage could be repositioned. Thus, no external force was exerted to the alar cartilage. For approximately 4 years, a total of 502 patients were treated with this surgical method. Using the open rhinoplasty, the alar cartilage was dissected in such a manner that it should be completely isolated from the skin, nasal mucosa, and upper lateral cartilage in 3 layers. Thereafter, using various nasal tip plasty techniques, the alar cartilage was reshaped and then repositioned. Patients were followed up for a mean period of 18 months. Then, the degree of subjective satisfaction of patients was analyzed with the use of 4-point visual analog scale scores. On the assessment of the degree of subjective satisfaction of patients, of a total of 502 patients, 87% responded as "very satisfactory" or "satisfactory." Through an analysis of the photographs taken before and after surgery, in patients with a short nose, the current surgical procedure was effective in extending the length of nose without the septal extension graft. The nasolabial angle was ideally expressed. Through meticulous cartilage manipulation, the tip projection improved and a bulbous shape of the nasal tip was resolved. In an aesthetic rhinoplasty for Asians, if plastic surgery of the nasal tip should be performed using a three-dimensional dissection of the alar cartilage, it would be helpful for surgeons to effectively and freely manipulate the alar cartilage according to their plans.

  15. [Static-dynamic computerized tomography in the diagnosis of traumatic lesions of alar ligaments. Preliminary results].

    PubMed

    Urso, S; Pacciani, E; Ascani, E; Salsano, M L; Randisi, F; Fassari, F M

    1994-12-01

    The patients affected with cervical injuries often complain of cervical pain, headache and dizziness even when no bone fractures are detected. Such patients are likely to have a post-traumatic injury of the cervical ligaments. Twenty-five symptomatic patients (19 women and 6 men) were examined with upper spine CT and functional CT scans (right and left rotation) to detect ligament injuries and hypermotility of the craniocervical junction, both related to traumatic events. Eleven patients showed no alterations, while unilateral densitometric alterations of the alar ligaments were observed in 14 cases and thought to be related to trauma. On axial CT scans, the normal alar ligaments were identified as paramedian, quadrangular soft-tissue structures at the apex of the dens epistrophei and right above it. In 14 patients with alar ligament injuries, CT showed incomplete ligament interruption and thinning in 12 cases and its total absence on all images in 2 cases. The laterodental space in the affected side was hypodense due to fat tissue replacement. Of 14 patients with alar ligament injuries, only 14 patients with alar ligament injuries, only 4 exhibited rotatory hypermotility at C0-C1 and C1-C2. The low frequency of rotatory hypermotility is probably due to the high rate of incomplete alar ligament injuries as well as to cervical muscle stiffness, which is marked in some subjects. In conclusion, static and functional CT of the upper spine is not only useful to predict trauma outcome, but also allows the detection of the alar ligaments, of their morphodensitometric changes and of the segmental instability of the craniocervical junction.

  16. A new modification of Doyle splint (Hemi-split Doyle) in rhinoplasty with alar base reduction.

    PubMed

    Koçak, İlker; Şentürk, E

    2017-08-09

    Patients perceive the pulling of a nasal splints as the most feared and stressful part of nasal surgery. Even the incisions made for alar base surgery can partly or entirely dehisce. So, we have been using modified Doyle silicone splints. We compared the modified Doyle silicone splints with conventional Doyle silicone splint. Included in the study were 64 patients undergoing alar base surgery together with open septorhinoplasty. Group 1 (n = 32) patients received a conventional Doyle intranasal silicone splint and group 2 (n = 32) received modified splint that we call a hemi-split Doyle splint. The pain felt by the patients during the removal of the splints was recorded according to the visual analogue scale (VAS). On days two and four postoperatively, the nasal stuffiness score (NOSE) was recorded. On day four postoperatively an intranasal examination was conducted to establish if dehiscence had occurred on the alar base incision line. In group 2, the pain scores during splints removal were significantly lower than those in group 1. Whereas no dehiscence on the alar base incision line was observed after tampon removal in group 2, the incision dehisced in eight patients in group 1. The NOSE scores on postoperative days two and four showed no difference between the groups. The hemi-split Doyle splint causes less pain during removal and particularly does not lead to dehiscence of incisions made during alar base surgery in rhinoplasty patients.

  17. Three-dimensional virtual simulation of alar width changes following bimaxillary osteotomies.

    PubMed

    Liebregts, J; Xi, T; Schreurs, R; van Loon, B; Bergé, S; Maal, T

    2016-10-01

    The aim of this study was to evaluate the accuracy of three-dimensional (3D) soft tissue simulation of nose width changes following bimaxillary osteotomies and to identify patient- and surgery-related factors that may affect the accuracy of simulation. Sixty patients (mean age 26 years) who underwent bimaxillary osteotomies participated in this study. Cone beam computed tomography scans were acquired preoperatively and at 1-year postoperative. The 3D hard and soft tissue rendered preoperative and postoperative virtual head models were superimposed, after which the maxilla and mandible were segmented and aligned to the postoperative position. The postoperative changes in alar width were simulated using a mass tensor model (MTM)-based algorithm and compared with the postoperative outcome. 3D cephalometric analyses were used to quantify the simulation error. The postoperative alar width was increased by 1.6±1.1mm and the mean error between the 3D simulation and the actual postoperative alar width was 1.0±0.9mm. The predictability was not correlated to factors such as age, sex, alar cinch suture, VY closure, maxillary advancement, or a history of surgically assisted rapid maxillary expansion. The MTM-based simulation model of postoperative alar width change was found to be reasonably accurate, although there is room for further improvement. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. The Effects of Secondary Cleft Procedures on Alar Base Position and Nostril Morphology in Patients with Unilateral Clefts.

    PubMed

    Power, Stephanie M; Matic, Damir B

    2017-07-01

    To compare effects of secondary cleft procedures on alar base position and nostril morphology. Retrospective review. Multidisciplinary cleft clinic at tertiary center. Seventy consecutive patients with unilateral clefts were grouped according to secondary procedure. Alveolar bone graft versus total lip takedown with anatomic muscle repair versus single-stage total lip with cleft septorhinoplasty (nose-lip) versus rhinoplasty alone. Anthropometric measurements were recorded from pre- and postoperative photographs. Ratios of cleft to noncleft side were compared within and across groups pre- and postoperatively using parametric and nonparametric tests. Within the bone graft group, no differences were seen postoperatively in alar base position in long-term follow-up. The total lip group demonstrated greater symmetry at the alar base (P < .001), increased vertical lip dimension (P < .001), and decreased nostril height (P = .004) postoperatively. Within the nose-lip group, increased vertical dimension and alar base support (P < .001) were also seen postoperatively. Across groups, the single-stage nose-lip group demonstrated greatest alar base symmetry on worm's-eye view (P < .04). Alar base asymmetry in patients with unilateral clefts may be related to soft tissue deficiency and was not affected by alveolar bone grafting. Total lip takedown with anatomic muscle reapproximation was associated with increased alar base symmetry and vertical lip dimension on cleft to noncleft side. Greatest symmetry at the alar base was seen following single-stage nose-lip reconstruction, which may be an effective technique for correcting the secondary cleft lip nasal deformity.

  19. Forensic Facial Reconstruction: Relationship Between the Alar Cartilage and Piriform Aperture.

    PubMed

    Strapasson, Raíssa Ananda Paim; Herrera, Lara Maria; Melani, Rodolfo Francisco Haltenhoff

    2017-03-29

    During forensic facial reconstruction, facial features may be predicted based on the parameters of the skull. This study evaluated the relationships between alar cartilage and piriform aperture and nose morphology and facial typology. Ninety-six cone beam computed tomography images of Brazilian subjects (49 males and 47 females) were used in this study. OsiriX software was used to perform the following measurements: nasal width, distance between alar base insertion points, lower width of the piriform aperture, and upper width of the piriform aperture. Nasal width was associated with the lower width of the piriform aperture, sex, skeletal vertical pattern of the face, and age. The current study contributes to the improvement of forensic facial guides by identifying the relationships between the alar cartilages and characteristics of the biological profile of members of a population that has been little studied thus far. © 2017 American Academy of Forensic Sciences.

  20. Z-plasty of the alar subunit to correct nasal vestibular stenosis.

    PubMed

    Choudhury, Natasha; Hariri, Ahmad; Saleh, Hesham

    2014-04-01

    Nasal vestibular stenosis can result in a challenging cosmetic deformity, for which a variety of techniques have been described, including scar excision and replacement with local flaps, composite or cartilage grafts, with or without stents. We describe the Z-plasty technique to widen the alar base and assess patient satisfaction from the surgery. A retrospective review of patients who underwent Z-plasty to the alar subunit for nasal vestibular stenosis over a 4-year period was conducted. Demographic data and patient satisfaction were evaluated using pre- and postoperative visual analog scores and Rhinoplasty Outcome Evaluation questionnaires. Eight patients underwent the procedure, and all confirmed significant improvement in their esthetic outcome. We describe our Z-plasty technique to the alar base and review patient satisfaction.

  1. The dissociation energies of AlH 2 and AlAr

    NASA Astrophysics Data System (ADS)

    Partridge, Harry; Bauschlicher, Charles W., Jr.; Visscher, Luuk

    1995-11-01

    The D0 values for AlH 2 and AlAr are computed using the coupled cluster approach in conjunction with large basis sets. Basis set superposition and spin-orbit effects are accounted for, as they are significant due to the small binding energy. The computed dissociation energy ( D0) for AlAr is 114 cm -1, which is 93% of the experimental value (122.4 cm -1). Our best estimate for the AlH 2 binding energy is 38 ± 26 cm -1.

  2. The Dissociation Energies of AlH2 and AlAr

    NASA Technical Reports Server (NTRS)

    Ricca, Alessandra; Partridge, Harry; Bauschlicher, Charles W., Jr.; Visscher, Luuk; Langhoff, Stephen R. (Technical Monitor)

    1995-01-01

    The D(sub 0) values for AlH2 and AlAr are computed using the coupled cluster approach in conjunction with large basis sets. Basis set superposition and spin-orbit effects are accounted for as they are sizeable due to the small binding energy. The computed dissociation energy for AlAr is 101 /cm , which is 83% of the experimental value (122.4/ cm). Our best estimate for the H2 binding energy in AlH2 is 40 +/- 28 /cm.

  3. A modified nasolabial flap for reconstruction of transfixing alar wing defects.

    PubMed

    Bouhassira, J; Hersant, B; Noel, W; Aguilar, P; Niddam, J; Meningaud, J-P

    2017-08-22

    Reconstruction of an entire alar wing is a frequently encountered reconstructive challenge in onco-dermatologic surgery. The aim of this technical note was to describe a surgical technique total for reconstruction of the alar wing, with a modified nasolabial flap with an inferior pedicle associated with a cartilaginous graft. This rapid procedure seems to be a well alternative for elderly people and patients who do not want a forehead flap. The aesthetic and functional outcomes of the donor and recipient sites were satisfactory. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  4. Nasal alar necrosis following hyaluronic Acid injection into nasolabial folds: a case report.

    PubMed

    Manafi, Ali; Barikbin, Behrooz; Manafi, Amir; Hamedi, Zahra Sadat; Ahmadi Moghadam, Shokoofeh

    2015-01-01

    Injection of synthetic fillers for soft tissue augmentation is increasing over the last decade. One of the most common materials used is hyaluronic acid (HA) that is safe and temporary filler for soft tissue augmentation. We present a case of 54-year-old female who experienced vascular occlusion and nasal alar necrosis following HA injection to the nasolabial folds. She suffered from pain, necrosis, infection, and alar loss that finally required a reconstructive surgery for cosmetic appearance of the nose. The case highlights the importance of proper injection technique by an anesthesiologist, as well as the need for immediate recognition and treatment of vascular occlusion.

  5. Nasal Alar Necrosis Following Hyaluronic Acid Injection into Nasolabial Folds: A Case Report

    PubMed Central

    Manafi, Ali; Barikbin, Behrooz; Manafi, Amir; Hamedi, Zahra Sadat; Ahmadi Moghadam, Shokoofeh

    2015-01-01

    Injection of synthetic fillers for soft tissue augmentation is increasing over the last decade. One of the most common materials used is hyaluronic acid (HA) that is safe and temporary filler for soft tissue augmentation. We present a case of 54-year-old female who experienced vascular occlusion and nasal alar necrosis following HA injection to the nasolabial folds. She suffered from pain, necrosis, infection, and alar loss that finally required a reconstructive surgery for cosmetic appearance of the nose. The case highlights the importance of proper injection technique by an anesthesiologist, as well as the need for immediate recognition and treatment of vascular occlusion. PMID:25606480

  6. The Dissociation Energies of AlH2 and AlAr

    NASA Technical Reports Server (NTRS)

    Ricca, Alessandra; Partridge, Harry; Bauschlicher, Charles W., Jr.; Visscher, Luuk; Langhoff, Stephen R. (Technical Monitor)

    1995-01-01

    The D(sub 0) values for AlH2 and AlAr are computed using the coupled cluster approach in conjunction with large basis sets. Basis set superposition and spin-orbit effects are accounted for as they are sizeable due to the small binding energy. The computed dissociation energy for AlAr is 101 /cm , which is 83% of the experimental value (122.4/ cm). Our best estimate for the H2 binding energy in AlH2 is 40 +/- 28 /cm.

  7. Comparison between the classical and a modified trans-septal technique of alar cinching for Le Fort I osteotomies: a prospective randomized controlled trial.

    PubMed

    Nirvikalpa, N; Narayanan, V; Wahab, A; Ramadorai, A

    2013-01-01

    The aim of this prospective randomized control trial was to analyse the efficacy of a new trans-septal alar base cinch suture in controlling alar width in patients undergoing maxillary intrusion and setback by comparing it with the traditional cinch suture. Statistical evaluation was carried out in 62 of 76 patients. Group I (31 patients) received the traditional alar base cinch suture, and group II (31 patients) received the alar base cinch suture with an anchoring bite taken through the nasal septum 10mm behind its anterior edge. In both groups the accurate identification of alar fibroareolar tissue was facilitated by an 18 gauge green needle passed extra orally. Alar base width was measured before and 6 months after surgery using Vernier callipers. Preoperative alar base width for group I was 29.76 mm (1.901SD) and for group II 29.79 mm (3.141SD); the postoperative values were 32.42 mm (1.858SD) and 29.94 mm (2.568SD), respectively. Mean alar base widening was 2.661 mm (0.800SD) in group I and 0.145 mm (2.050) in group II. The difference in alar widening was statistically significant (p<0.001). In conclusion, the trans-septal modified alar cinch suture offers better control of alar base architecture in maxillary intrusion and setback. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Refinement of Nasal Reconstruction with a V/Y-alar-perforator Flap

    PubMed Central

    Langer, Martin F.; Roldán, J. Camilo

    2017-01-01

    Background: The ala of the nose is vascularized by a dense net of perforators originating from the lateral nasal artery or the angular artery. These vessels reach the ala in a cascade fashion from the alar groove/lateral nasal wall. Based on these vessels, a V/Y flap can be dissected with a wide range of mobility. Materials and Methods: Nineteen patients underwent reconstruction of the nose by means of a V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap from the lateral nasal wall and/or from the nasal dorsum for reconstruction of defects at the nasal tip, ala of the nose, and/or lateral nasal wall. All patients were followed up 8 months after surgery in average. Results: There was no prolonged congestion or any tissue loss. All patients presented postoperatively with excellent aesthetic results, and no nasal distortion was observed. Conclusion: The V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap proved to be a reliable tool in the armamentarium for reconstruction of nasal tip and alar defects providing good aesthetic results. PMID:28203497

  9. Refinement of Nasal Reconstruction with a V/Y-alar-perforator Flap.

    PubMed

    Feinendegen, Dominik L; Langer, Martin F; Roldán, J Camilo

    2017-01-01

    The ala of the nose is vascularized by a dense net of perforators originating from the lateral nasal artery or the angular artery. These vessels reach the ala in a cascade fashion from the alar groove/lateral nasal wall. Based on these vessels, a V/Y flap can be dissected with a wide range of mobility. Nineteen patients underwent reconstruction of the nose by means of a V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap from the lateral nasal wall and/or from the nasal dorsum for reconstruction of defects at the nasal tip, ala of the nose, and/or lateral nasal wall. All patients were followed up 8 months after surgery in average. There was no prolonged congestion or any tissue loss. All patients presented postoperatively with excellent aesthetic results, and no nasal distortion was observed. The V/Y-alar-perforator flap alone or in combination with a myocutaneous rotation flap proved to be a reliable tool in the armamentarium for reconstruction of nasal tip and alar defects providing good aesthetic results.

  10. Reconstruction of Congenital Isolated Alar Defect Using Mutaf Triangular Closure Technique in Pediatric Patients.

    PubMed

    Temel, Metin; Gunal, Ertan; Kahraman, Serif Samil

    2016-06-01

    Congenital isolated alar defects are extremely rare, occurring in approximately 1 in 20,000 to 40,000 live births. The patients are presented here of 2 pediatric patients operated on for congenital isolated alar defect. The reconstruction of congenital isolated alar defects was made in a 3-layered fashion. The skin defects were covered using the Mutaf triangular closure technique in which 2 cutaneous local flaps are designed in an unequal Z-plasty manner. Conchal cartilage graft was used between the skin and mucosal closure to replace the missing part of the lower lateral cartilage in these patients. The early results were promising in Patient 1, but sufficient improvement was detected in the alar cartilage postoperative follow-up period in Patient 2. Hence, this patient required revision 1 to 2 years postoperatively. This technique provides excellent aesthetic and functional results, except for this problem in Tessier 2 cleft patients. The use of the Stair step flap technique with Mutaf triangle closure technique achieved cosmetically and functionally excellent results in the reconstruction and repair of a large, irregular, narrow cleft, in the inadequate rotation of the lateral part of the lower lateral cartilage. However, because of this problem, evaluation of the long-term follow-up of patients is necessary.

  11. New anatomical profile of the nasal musculature: dilator naris vestibularis, dilator naris anterior, and alar part of the nasalis.

    PubMed

    Hur, Mi-Sun; Hu, Kyung-Seok; Youn, Kwan-Hyun; Song, Wu-Chul; Abe, Shinichi; Kim, Hee-Jin

    2011-03-01

    The aim of this study was to clarify the morphology and topography of the dilator naris vestibularis, dilator naris anterior, and alar part of the nasalis. Anatomical variations in the topographic relationships are also described to provide critical data for understanding nasal muscular functions. Anatomical and histological examinations were performed on 40 specimens of embalmed Korean adult cadavers. The dilator naris vestibularis muscle (named by the present authors) was located between the external and vestibular skin of the alar lobule. The muscle fibers radiated along the dome-shaped nasal vestibule. The dilator naris anterior muscle originated from the frontal surfaces of the lateral half of the lateral crus and the accessory alar cartilage adjacent to the lateral crus. The extent of the lower insertion of the dilator naris anterior muscle was at the alar groove. The alar part of the nasalis originated with the transverse part of nasalis from the maxilla. It ascended to attach to the alar crease and the adjacent deep surface of external skin of the alar lobule. These findings may provide anatomical knowledge required to understand the structure and function of these nasal muscles such as during rhinoplasty or other surgery of the face. Copyright © 2010 Wiley-Liss, Inc.

  12. Delineation of alar ligament morphology: comparison of magnetic resonance imaging at 1.5 and 3 Tesla.

    PubMed

    Schmidt, Peter; Mayer, Thomas E; Drescher, Robert

    2012-11-01

    Rupture of the alar and transverse ligaments due to whiplash injury can lead to upper cervical spine instability and subsequent neurological deterioration. The purpose of this study was to evaluate the normal anatomical variability of the alar ligaments in asymptomatic individuals with 3-T magnetic resonance imaging (MRI) and to compare the findings with standard 1.5-T examinations. Thirty-six participants underwent 3-T and 1.5-T MRIs. Magnetic resonance imaging findings were analyzed by classifying the alar ligaments with regard to the features detectability, signal intensity compared with muscle tissue, homogeneity, shape, spatial orientation, and symmetry. Delineation of the alar ligaments was significantly better on 3-T images, which were subjectively preferred for evaluation. The alar ligaments showed great variability. In the majority of participants, the alar ligaments were hypointense to muscle tissue, inhomogeneous, and different in shape and orientation. A statistically significantly higher number of ligaments appeared symmetric on 3-T imaging, indicating that 1.5-T imaging may underestimate the proportion of patients with normal, symmetric ligaments. This study demonstrates that high-field 3-T MRI provides better visualization of the alar ligaments compared with 1.5-T MRI. The higher signal-to-noise ratio allows detection of small signal changes. A great interindividual variety of the MRI morphology of the alar ligaments was found in participants with no history of neck trauma. Further studies with more participants are necessary to evaluate alar ligament pathologies in patients with a history of whiplash injury. Copyright 2012, SLACK Incorporated.

  13. Evaluation of soft tissue morphologic changes after using the alar base cinch suture in Le Fort I osteotomy in mandibular prognathism with and without asymmetry.

    PubMed

    Moroi, Akinori; Ishihara, Yuri; Sotobori, Megumi; Nakazawa, Ryuichi; Higuchi, Masatoshi; Nakano, Yoshio; Marukawa, Kohei; Ueki, Koichiro

    2014-09-01

    The purpose of this study was to investigate the effects of alar base cinch suture in Le Fort I osteotomy in mandibular prognathism with and without asymmetry. Forty patients who underwent Le Fort I osteotomy were divided into an asymmetry group and a symmetry group (n = 20 each). Computed tomography (CT) was taken in all patients before and 1 year after surgery. The CT-3D volume rendering data with Aquarius Net (TeraRecon, Foster City, CA, USA) was reconstructed and the soft tissue was measured as follows, the distance between the bilateral alar base (Alar base width), the distance between the bilateral alar (Alar width), the angles between the FH plane and the line between the bilateral alar base (Alar base angle), the angle between the FH plane and the line between the bilateral alar (Alar angle), the angle between the FH plane and the line between the bilateral corners of the mouth (Lip angle), and the angle between the perpendicular line to the FH plane and the Philtrum (Philtrum angle). Significant differences were observed in the Alar width (P = 0.0448), the Alar angle (P = 0.0044), the Lip angle (P < 0.0001), and the Philtrum angle (P = 0.0057) between before and after surgery in the asymmetry group. This study suggested that the alar base cinch suture could prevent increases in the alar base width in both groups and help to improve the angle of soft tissue in the asymmetry group, although alar width significantly increases after surgery. Copyright © 2013 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  14. Characterization of the hypothalamus of Xenopus laevis during development. I. The alar regions.

    PubMed

    Domínguez, Laura; Morona, Ruth; González, Agustín; Moreno, Nerea

    2013-03-01

    The patterns of expression of a set of conserved developmental regulatory transcription factors and neuronal markers were analyzed in the alar hypothalamus of Xenopus laevis throughout development. Combined immunohistochemical and in situ hybridization techniques were used for the identification of subdivisions and their boundaries. The alar hypothalamus was located rostral to the diencephalon in the secondary prosencephalon and represents the rostral continuation of the alar territories of the diencephalon and brainstem, according to the prosomeric model. It is composed of the supraoptoparaventricular (dorsal) and the suprachiasmatic (ventral) regions, and limits dorsally with the preoptic region, caudally with the prethalamic eminence and the prethalamus, and ventrally with the basal hypothalamus. The supraoptoparaventricular area is defined by the orthopedia (Otp) expression and is subdivided into rostral and caudal portions, on the basis of the Nkx2.2 expression only in the rostral portion. This region is the source of many neuroendocrine cells, primarily located in the rostral subdivision. The suprachiasmatic region is characterized by Dll4/Isl1 expression, and was also subdivided into rostral and caudal portions, based on the expression of Nkx2.1/Nkx2.2 and Lhx1/7 exclusively in the rostral portion. Both alar regions are mainly connected with subpallial areas strongly implicated in the limbic system and show robust intrahypothalamic connections. Caudally, both regions project to brainstem centers and spinal cord. All these data support that in terms of topology, molecular specification, and connectivity the subdivisions of the anuran alar hypothalamus possess many features shared with their counterparts in amniotes, likely controlling similar reflexes, responses, and behaviors. Copyright © 2012 Wiley Periodicals, Inc.

  15. The Shark Alar Hypothalamus: Molecular Characterization of Prosomeric Subdivisions and Evolutionary Trends.

    PubMed

    Santos-Durán, Gabriel N; Ferreiro-Galve, Susana; Menuet, Arnaud; Quintana-Urzainqui, Idoia; Mazan, Sylvie; Rodríguez-Moldes, Isabel; Candal, Eva

    2016-01-01

    The hypothalamus is an important physiologic center of the vertebrate brain involved in the elaboration of individual and species survival responses. To better understand the ancestral organization of the alar hypothalamus we revisit previous data on ScOtp, ScDlx2/5, ScTbr1, ScNkx2.1 expression and Pax6 immunoreactivity jointly with new data on ScNeurog2, ScLhx9, ScLhx5, and ScNkx2.8 expression, in addition to immunoreactivity to serotonin (5-HT) and doublecortin (DCX) in the catshark Scyliorhinus canicula, a key species for this purpose since cartilaginous fishes are basal representatives of gnathostomes (jawed vertebrates). Our study revealed a complex genoarchitecture for the chondrichthyan alar hypothalamus. We identified terminal (rostral) and peduncular (caudal) subdivisions in the prosomeric paraventricular and subparaventricular areas (TPa/PPa and TSPa/PSPa, respectively) evidenced by the expression pattern of developmental genes like ScLhx5 (TPa) and immunoreactivity against Pax6 (PSPa) and 5-HT (PPa and PSPa). Dorso-ventral subdivisions were only evidenced in the SPa (SPaD, SPaV; respectively) by means of Pax6 and ScNkx2.8 (respectively). Interestingly, ScNkx2.8 expression overlaps over the alar-basal boundary, as Nkx2.2 does in other vertebrates. Our results reveal evidences for the existence of different groups of tangentially migrated cells expressing ScOtp, Pax6, and ScDlx2. The genoarchitectonic comparative analysis suggests alternative interpretations of the rostral-most alar plate in prosomeric terms and reveals a conserved molecular background for the vertebrate alar hypothalamus likely acquired before/during the agnathan-gnathostome transition, on which Otp, Pax6, Lhx5, and Neurog2 are expressed in the Pa while Dlx and Nkx2.2/Nkx2.8 are expressed in the SPa.

  16. The Shark Alar Hypothalamus: Molecular Characterization of Prosomeric Subdivisions and Evolutionary Trends

    PubMed Central

    Santos-Durán, Gabriel N.; Ferreiro-Galve, Susana; Menuet, Arnaud; Quintana-Urzainqui, Idoia; Mazan, Sylvie; Rodríguez-Moldes, Isabel; Candal, Eva

    2016-01-01

    The hypothalamus is an important physiologic center of the vertebrate brain involved in the elaboration of individual and species survival responses. To better understand the ancestral organization of the alar hypothalamus we revisit previous data on ScOtp, ScDlx2/5, ScTbr1, ScNkx2.1 expression and Pax6 immunoreactivity jointly with new data on ScNeurog2, ScLhx9, ScLhx5, and ScNkx2.8 expression, in addition to immunoreactivity to serotonin (5-HT) and doublecortin (DCX) in the catshark Scyliorhinus canicula, a key species for this purpose since cartilaginous fishes are basal representatives of gnathostomes (jawed vertebrates). Our study revealed a complex genoarchitecture for the chondrichthyan alar hypothalamus. We identified terminal (rostral) and peduncular (caudal) subdivisions in the prosomeric paraventricular and subparaventricular areas (TPa/PPa and TSPa/PSPa, respectively) evidenced by the expression pattern of developmental genes like ScLhx5 (TPa) and immunoreactivity against Pax6 (PSPa) and 5-HT (PPa and PSPa). Dorso-ventral subdivisions were only evidenced in the SPa (SPaD, SPaV; respectively) by means of Pax6 and ScNkx2.8 (respectively). Interestingly, ScNkx2.8 expression overlaps over the alar-basal boundary, as Nkx2.2 does in other vertebrates. Our results reveal evidences for the existence of different groups of tangentially migrated cells expressing ScOtp, Pax6, and ScDlx2. The genoarchitectonic comparative analysis suggests alternative interpretations of the rostral-most alar plate in prosomeric terms and reveals a conserved molecular background for the vertebrate alar hypothalamus likely acquired before/during the agnathan-gnathostome transition, on which Otp, Pax6, Lhx5, and Neurog2 are expressed in the Pa while Dlx and Nkx2.2/Nkx2.8 are expressed in the SPa. PMID:27932958

  17. Nasolabial-alar crease: a natural line to facilitate transposition of the nasolabial flap for lower nasal reconstruction.

    PubMed

    Bi, Hongda; Xing, Xin; Li, Junhui

    2014-11-01

    Nasolabial flaps have been widely used for nasal reconstruction. However, transposition of the nasolabial flap to lower nasal defects may be challenging because of functional and aesthetic concerns. The upper part of the alar crease joins with the nasolabial fold seamlessly, forming the nasolabial-alar crease line, which provides a natural strategy for easy concealment of the surgical scar. In this article, we would like to introduce a method for transferring a nasolabial flap along the nasolabial-alar crease to reconstruct lower nasal defects. Incision was made along the nasolabial-alar crease, and the nasolabial flap was transferred for lower nasal reconstruction in 9 patients. Subcutaneously based nasolabial flaps were designed, and undermining of the superolateral skin was made along the nasolabial-alar crease to obtain a robust subcutaneously based pedicle, so as to readily achieve flap transposition without tension and concealment of the subcutaneous pedicle. The nasolabial fold could be reproduced by closing the donor site. Lower nasal defects were successfully repaired with nasolabial flap in 9 patients. Good nasal contour and appropriate symmetry of the reconstructed nasolabial fold were achieved, and there were no conspicuous scars in the 9 cases. The natural nasolabial-alar crease can serve as a useful incision line to facilitate the nasolabial flap transposition for lower nasal reconstruction while minimizing the scar.

  18. Spectroscopy of AlAr and AlKr from 31 000 cm-1 to the ionization limit

    NASA Astrophysics Data System (ADS)

    Heidecke, Scott A.; Fu, Zhenwen; Colt, John R.; Morse, Michael D.

    1992-08-01

    Spectra of jet-cooled AlAr and AlKr have been collected over the range from 31 000 cm-1 to the ionization limit, using the technique of resonant two-photon ionization spectroscopy with mass spectrometric detection. Adiabatic ionization potentials have been accurately measured for both molecules, and have been estimated for AlAr2 and AlAr3. The spin-orbit splittings in the X 2Π ground state have been determined for both AlAr and AlKr, and ground-state bond strengths have been accurately measured as D0[AlAr, X1 2Π1/2(3p)] =122.4±4 cm-1 and D0[27Al 84Kr, X1 2Π1/2(3p)] =194.7±0.8 cm-1. These values have also been combined with the measured ionization potentials to derive D0(Al+-Ar)=982.3± 5 cm-1 and D0(Al+-Kr)=1528.5±2 cm-1.

  19. [Reconstruction of full-thickness nasal alar defect with combined nasolabial flap and free auricular composite flap].

    PubMed

    Peng, Weihai; Rong, Li; Wang, Wangshu; Liu, Chao; Zhang, Duo

    2014-05-01

    To investigate the technique and its effect of combined nasolabial flap and free auricular composite flap for full-thickness nasal alar defect. From March 2010 to March 2013, 9 patients with full-thickness nasal alar defects were treated with combined nasolabial flaps and free auricular composite flaps. Composite auricular flap was used as inner lining and cartilage framework. The nasolabial flap at the same side was used as outer lining. All the patients were followed up for 6-18 months (average, 12 months). All the 9 composite auricular flaps survived completely. Epidermal necrosis happened at the distal end of 1 nasolabial flap. Alar rim was almost normal and symmetric nose was achieved in 6 cases. The arc and the thickness of the alar rim was not enough in 3 cases, resulting in asymmetric appearance. The survival area of auricular composite flap can be enlarged with nasolabial flap. The auricular helix edge can be reserved to reconstruct nasal alar rim with smooth and natural arc. Large full-thickness nasal alar defedts can be reconstructed with combined nasolabial flaps and free auricular composite flaps.

  20. Repair of Full-Thickness Nasal Alar Defects Using Nasolabial Perforator Flaps.

    PubMed

    Durgun, Mustafa; Özakpınar, Hülda Rıfat; Selçuk, Caferi Tayyar; Sari, Elif; Seven, Ergin; İnözü, Emre

    2015-10-01

    The repair of full-thickness nasal alar defects presents difficulties because of their complex 3-dimensional structure. Reconstructions using inappropriate methods may lead to asymmetries and dissatisfying functional results. In this study, our aim was to present the repairs of full-thickness alar defects performed using cartilage-supported nasolabial perforator flaps. Eight patients who presented to our clinic between January 2011 and April 2014 with full-thickness defects in the alar wings were included in this study. The nasolabial perforator flap was prepared on the basis of the closest perforator to the defect area and in a way to include 2 to 3 mm of subcutaneous adipose tissue. The medial section of the flap was adapted to form the nasal lining. In the 7 patients in whom cartilage support was used, the cartilage graft was obtained from the septum nasi. After the cartilage was placed on the flap, the lateral section of the flap was folded over the medial section and the defect was repaired. In 1 patient in whom cartilage support was not required, the flap was folded over itself before the repair was performed. The flap donor area was primarily repaired. No detachment around the suture lines, infection, venous insufficiency in the flap, or partial or total flap losses were observed in any of the patients. Retraction developed in 1 patient in whom no cartilage support was used. No retraction was observed in any of the patients in whom cartilage support was used. The results were functionally and esthetically satisfying in all the patients. The greatest advantage of perforator-based nasolabial flaps is the greater mobilization achieved in comparison with the other nasolabial flaps. Thus, full-thickness defects can be repaired in 1 session in some patients, no revision is required around the flap pedicle, and much less donor area morbidity occurs. Nasal alar reconstructions performed using this type of flap lead to both esthetically and functionally satisfying

  1. Sacral-Alar-Iliac Fixation in Children with Neuromuscular Scoliosis: Minimum 5-Year Follow-Up.

    PubMed

    Jain, Amit; Sullivan, Brian T; Kuwabara, Anne; Kebaish, Khaled; Sponseller, Paul D

    2017-09-05

    The aim of our study was to investigate the 5-year outcomes of children with neuromuscular scoliosis treated with sacral-alar-iliac screws. We reviewed clinical and radiographic records of patients ≤18 years old treated by 1 pediatric orthopaedic surgeon for neuromuscular scoliosis with spinal fusion using sacral-alar-iliac pelvic anchors. Thirty-eight patients, with a minimum 5-year radiographic follow-up (6.0 ± 1.2 years), were studied. Mean patient age was 13 ± 2.0 years and 47% were female. The mean number of levels fused was 18 ± 0.7. The diagnosis was cerebral palsy in 66% of patients. Between the preoperative period and final follow-up there was a mean 79% correction of the major coronal curve (85° to 18°) and 57% correction of the pelvic obliquity (16° to 7°). Patients maintained correction of mean pelvic obliquity from the early postoperative period (6°) to final follow-up (7°). Preoperatively, 76% of patients had pelvic obliquity of >10°compared with 26% after surgery. There were no cases of neurologic or vascular complications or pseudarthrosis. Radiographs revealed bilateral sacral-alar-iliac screw lucency in 8 patients; 4 of these patients had deep wound infections, and the other 4 were asymptomatic. Unilateral screw fracture was found in 1 patient with an 8-mm screw diameter (1.3%, 1 of 76 screws); the patient was observed and remained asymptomatic. There were no cases of set screw displacement, screw back-out, or rod dislodgement. Sacral-alar-iliac screws are safe and effective pelvic anchors for use in children with neuromuscular scoliosis. Copyright © 2017. Published by Elsevier Inc.

  2. [Middle third of the nose and internal valve. Alar wall and external valve].

    PubMed

    Duron, J B; Nguyen, P S; Jallut, Y; Bardot, J; Aiach, G

    2014-12-01

    To many surgeons, nasal airway obstruction is synonymous with either septal deviation or inferior turbinate hypertrophy. The role of internal and external nasal valves is often less known by surgeons even if it is crucial in nasal breathing and strongly interrelated with esthetic of the middle third of the nose and alar wall. Therefore, precise examination of the two valves and conservative surgery should help to avoid many functional and esthetic problems. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques.

    PubMed

    Foda, Hossam M T

    2003-10-01

    The droopy tip is a common nasal deformity in which the tip is inferiorly rotated. Five hundred consecutive rhinoplasty cases were studied to assess the incidence and causes of the droopy tip deformity and to evaluate the role of three alar cartilage-modifying techniques--lateral crural steal, lateral crural overlay, and tongue in groove--in correcting such a deformity. The external rhinoplasty approach was used in all cases. Only one of the three alar cartilage-modifying techniques was used in each case, and the degree of tip rotation and projection was measured both preoperatively and postoperatively. The incidence of droopy tip was 72 percent, and the use of an alar cartilage-modifying technique was required in 85 percent of these cases to achieve the desired degree of rotation. The main causes of droopy tip included inferiorly oriented alar cartilages (85 percent), overdeveloped scrolls of upper lateral cartilages (73 percent), high anterior septal angle (65 percent), and thick skin of the nasal lobule (56 percent). The lateral crural steal technique increased nasal tip rotation and projection, the lateral crural overlay technique increased tip rotation and decreased tip projection, and the tongue-in-groove technique increased tip rotation without significantly changing the amount of projection. The lateral crural overlay technique resulted in the highest degrees of rotation, followed by the lateral crural steal and finally the tongue-in-groove technique. According to these results, the lateral crural steal technique is best indicated in cases with droopy underprojected nasal tip, the lateral crural overlay technique in cases of droopy overprojected nasal tip, and the tongue-in-groove technique in cases where the droopy nasal tip is associated with an adequate amount of projection.

  4. Primary rhinocheiloplasty: Comparison of open and closed methods of alar cartilage reposition

    PubMed Central

    Yasonov, S. A.; Lopatin, A. V.; Kugushev, A. Yu.

    2016-01-01

    Aims: To establish which rhinoplasty method for primary repairing of unilateral cleft lip (UCL) is better. Settings and Design: Two patient groups with cleft lip were compared. Each group was operated on either by McComb's technique as closed rhinoplasty method or by Vissarionov–Kosin technique as an open method. Subjects and Methods: First group included 29 patients and the second consisted of 31. All patients were operated on by single surgeon over 10 years. Randomization was based on wishes and intention of surgeon to use one of two methods. Evaluation of results was based on impartial data, and subjective information collected from respondents with different levels of knowledge about UCL. The objective scale was based on the evaluation of five noticeable residual deformations of nose that usually appear after primary lip-nose surgery: Alar flattening, low position of alar, widening or narrowing of nostril, and deformation of the upper part of nostril rim. Subjective evaluation was based on the opinion of respondents who were ranged every case depending on own judgment. Statistical Analysis: Was performed using Fisher method and Chi-square by Statistica 10.0, StatSoft Inc. Results: Approach with general analysis indicated no difference between two methods. Despite of absence of clear differences between two groups we consider the closed rhinoplasty more favorable due to less damage to alar cartilages and no scars inside nostrils. Conclusions: We think that mentioned scarring may complicate secondary rhinoplasty, which is often needed to correct nose deformation. PMID:27563601

  5. MRI and Additive Manufacturing of Nasal Alar Constructs for Patient-specific Reconstruction.

    PubMed

    Visscher, Dafydd O; van Eijnatten, Maureen; Liberton, Niels P T J; Wolff, Jan; Hofman, Mark B M; Helder, Marco N; Don Griot, J Peter W; Zuijlen, Paul P M van

    2017-08-30

    Surgical reconstruction of cartilaginous defects remains a major challenge. In the current study, we aimed to identify an imaging strategy for the development of patient-specific constructs that aid in the reconstruction of nasal deformities. Magnetic Resonance Imaging (MRI) was performed on a human cadaver head to find the optimal MRI sequence for nasal cartilage. This sequence was subsequently used on a volunteer. Images of both were assessed by three independent researchers to determine measurement error and total segmentation time. Three dimensionally (3D) reconstructed alar cartilage was then additively manufactured. Validity was assessed by comparing manually segmented MR images to the gold standard (micro-CT). Manual segmentation allowed delineation of the nasal cartilages. Inter- and intra-observer agreement was acceptable in the cadaver (coefficient of variation 4.6-12.5%), but less in the volunteer (coefficient of variation 0.6-21.9%). Segmentation times did not differ between observers (cadaver P = 0.36; volunteer P = 0.6). The lateral crus of the alar cartilage was consistently identified by all observers, whereas part of the medial crus was consistently missed. This study suggests that MRI is a feasible imaging modality for the development of 3D alar constructs for patient-specific reconstruction.

  6. Paradox of mistranslation of serine for alanine caused by AlaRS recognition dilemma.

    PubMed

    Guo, Min; Chong, Yeeting E; Shapiro, Ryan; Beebe, Kirk; Yang, Xiang-Lei; Schimmel, Paul

    2009-12-10

    Mistranslation arising from confusion of serine for alanine by alanyl-tRNA synthetases (AlaRSs) has profound functional consequences. Throughout evolution, two editing checkpoints prevent disease-causing mistranslation from confusing glycine or serine for alanine at the active site of AlaRS. In both bacteria and mice, Ser poses a bigger challenge than Gly. One checkpoint is the AlaRS editing centre, and the other is from widely distributed AlaXps-free-standing, genome-encoded editing proteins that clear Ser-tRNA(Ala). The paradox of misincorporating both a smaller (glycine) and a larger (serine) amino acid suggests a deep conflict for nature-designed AlaRS. Here we show the chemical basis for this conflict. Nine crystal structures, together with kinetic and mutational analysis, provided snapshots of adenylate formation for each amino acid. An inherent dilemma is posed by constraints of a structural design that pins down the alpha-amino group of the bound amino acid by using an acidic residue. This design, dating back more than 3 billion years, creates a serendipitous interaction with the serine OH that is difficult to avoid. Apparently because no better architecture for the recognition of alanine could be found, the serine misactivation problem was solved through free-standing AlaXps, which appeared contemporaneously with early AlaRSs. The results reveal unconventional problems and solutions arising from the historical design of the protein synthesis machinery.

  7. Alar-columellar and lateral nostril changes following tongue-in-groove rhinoplasty.

    PubMed

    Shah, Ajul; Pfaff, Miles; Kinsman, Gianna; Steinbacher, Derek M

    2015-04-01

    Repositioning the medial crura cephalically onto the caudal septum (tongue-in-groove; TIG) allows alteration of the columella, ala, and nasal tip to address alar-columellar disproportion as seen from the lateral view. To date, quantitative analysis of nostril dimension, alar-columellar relationship, and nasal tip changes following the TIG rhinoplasty technique have not been described. The present study aims to evaluate post-operative lateral morphometric changes following TIG. Pre- and post-operative lateral views of a series of consecutive patients who underwent TIG rhinoplasty were produced from 3D images at multiple time points (≤2 weeks, 4-10 weeks, and >10 weeks post-operatively) for analysis. The 3D images were converted to 2D and set to scale. Exposed lateral nostril area, alar-columellar disproportion (divided into superior and inferior heights), nasolabial angle, nostril height, and nostril length were calculated and statistically analyzed using a pairwise t test. A P ≤ 0.05 was considered statistically significant. Ninety-four lateral views were analyzed from 20 patients (16 females; median age: 31.8). One patient had a history of current tobacco cigarette use. Lateral nostril area decreased at all time points post-operatively, in a statistically significant fashion. Alar-columellar disproportion was reduced following TIG at all time points. The nasolabial angle significantly increased post-operatively at ≤2 weeks, 4-10 weeks, and >10, all in a statistically significant fashion. Nostril height and nostril length decreased at all post-operative time points. Morphometric analysis reveals reduction in alar-columellar disproportion and lateral nostril shows following TIG rhinoplasty. Tip rotation, as a function of nasolabial angle, also increased. These results provide quantitative substantiation for qualitative descriptions attributed to the TIG technique. Future studies will focus on area and volumetric measurements, and assessment of long

  8. An Analysis of Lateral Crural Repositioning and Its Effect on Alar Rim Position.

    PubMed

    Paquet, Christian A; Choroomi, Sim; Frankel, Andrew S

    2016-01-01

    Cephalically malpositioned lateral crura are a frequent cause of alar rim retraction during both primary and revision rhinoplasty. To demonstrate the efficacy of lateral crural repositioning as an isolated maneuver as and combined with adjunctive grafts for lowering the alar rim. From August through December 2014, we retrospectively reviewed the cases of 54 patients (102 hemi-noses) who had lateral crural repositioning performed by the same surgeon between 2007 and 2013. Only patients with standardized photographs taken preoperatively and at least 6 months postoperatively were included in the study. All primary and revision cases were completed via an open rhinoplasty approach and had lateral crural repositioning performed. Preoperative and postoperative photographs were compared using Adobe Photoshop CS via a modified Gunter technique to measure the degree of alar rim retraction on lateral views. The change in angle was then calculated, and statistical analysis conducted using a paired t test. A total of 54 patients (102 hemi-noses) met inclusion criteria; 42 (79%) were women, and the average patient age was 41.3 years. Forty-five (83%) of the cases were revision rhinoplasties, and the average time to obtaining postoperative photographs was 11.3 months. The mean (SD) anterior nostril apex angles preoperatively (31.3° [8.9°]) and postoperatively (24.5° [6.8°]) indicated a net decrease of 6.8° (P < .001). Excluding patients who had other rim-lowering grafts (alar rim and/or composite grafts), we saw a similar result comparing preoperative (31.1° [8.2°]) and postoperative (24.5° [6.7°]) angles, with a net decrease of 6.6° degrees (P < .001). When examining patients who underwent lateral crural repositioning alone compared with those who also had lateral crural strut grafts, we saw a decrease of 6.9° (P < .001) and 6.7° degrees (P < .001), respectively. Repositioning of the lower lateral cartilages results in a statistically significant

  9. The correction of alar-columella web deformities in unilateral cleft-lip nasal deformities with web graft technique.

    PubMed

    Go, Ju Young; Mun, Goo-Hyun; Bang, Sa Ik; Oh, Kap Sung; Lim, So Young

    2014-10-01

    Among the many secondary deformities in cleft-lip nose, the alar-columella web is unsightly and is a recurrent deformity. The purpose of this article is to revisit the correction of alar web deformity in patients with cleft-lip nasal deformities and to introduce our web graft technique. Thirteen patients with alar webbing underwent surgery between June 2012 and February 2013. The age range of the patients at the time of surgery was 14-29 years. An open rhinoplasty incision, including a reverse-U incision, was made and cartilage work was performed. After the cleft side was equalized with the dome angle of the healthy side, we used contralateral alar or auricular cartilage grafts as a stiff batten to stabilize the converted web skin. The web graft was fixed to the cleft-side web skin's inner side with at least three sutures to maintain the tucking of the vestibular skin. The follow-up period ranged from 1 to 20 months. The postoperative frontal and basal views showed that the nostrils and columella had better shape. Most patients demonstrated correction of the drooping alar rim and satisfactory symmetry of the nostrils. A web graft supports the vestibular lining of the reverse-U incision and increases the strength of the new concavity of the tucked skin. We expect that a long-lasting concave web contour could be achieved with this technique.

  10. Large Auricular Chondrocutaneous Composite Graft for Nasal Alar and Columellar Reconstruction

    PubMed Central

    Kwak, Minho; Yun, Sangho; Yeo, Hyeonjung; Kim, Junhyung; Han, Kihwan

    2012-01-01

    Background Among the various methods for correcting nasal deformity, the composite graft is suitable for the inner and outer reconstruction of the nose in a single stage. In this article, we present our technique for reconstructing the ala and columella using the auricular chondrocutaneous composite graft. Methods From 2004 to 2011, 15 cases of alar and 2 cases of columellar reconstruction employing the chondrocutaneous composite graft were studied, all followed up for 3 to 24 months (average, 13.5 months). All of the patients were reviewed retrospectively for the demographics, graft size, selection of the donor site and outcomes including morbidity and complications. Results The reasons for the deformity were burn scar (n=7), traumatic scar (n=4), smallpox scar (n=4), basal cell carcinoma defect (n=1), and scar contracture (n=1) from implant induced infection. In 5 cases of nostril stricture and 6 cases of alar defect and notching, composite grafts from the helix were used (8.9×12.5 mm). In 4 cases of retracted ala, grafts from the posterior surface of the concha were matched (5×15 mm). For the reconstruction of the columella, we harvested the graft from the posterior scapha (9×13.5 mm). Except one case with partial necrosis and delayed healing due to smoking, the grafts were successful in all of the cases and there was no deformity of the donor site. Conclusions An alar and columellar defect can be reconstructed successfully with a relatively large composite graft without donor site morbidity. The selection of the donor site should be individualized according to the 3-dimensional configuration of the defect. PMID:22872834

  11. Tissue engineering of human nasal alar cartilage precisely by using three-dimensional printing.

    PubMed

    Xu, Yihao; Fan, Fei; Kang, Ning; Wang, Sheng; You, Jianjun; Wang, Huan; Zhang, Bo

    2015-02-01

    Tissue engineering strategies hold promise for the restoration of damaged cartilage. However, the results of most studies report irregularly shaped beads of cartilage, which are not precise enough. Thus, a precise shape of cartilage graft must be taken into consideration. The goal of this study was to develop a simple method of creating a precisely predetermined nasal alar shape with the aid of three-dimensional printing. Lower lateral cartilage from cadavers was observed and scanned by computed tomography. Molds of the lower lateral cartilage were achieved by using three-dimensional printing. Human nasal cartilage was obtained and chondrocytes were harvested. Then, the mixture of cells and poly(glycolic acid)/poly-L-lactic acid was cultured in vitro and implanted into the subcutaneous tissue of nude mice. After subcutaneous implantation, the length and width of the samples were measured, and the results were not statistically significantly different from the native lower lateral cartilage (p > 0.05). Their thickness was measured and the results were statistically different from the native lower lateral cartilage (p < 0.05). Histologic examination of the engineered constructs revealed that both the cell and tissue morphologic features of engineered cartilage were similar to those of native lower lateral cartilage. The biomechanical properties of the engineered cartilage exceeded those of native cartilage. This study demonstrates that three-dimensional printing-aided tissue engineering can achieve precise three-dimensional shapes of human nasal alar cartilage. To our knowledge, this is the first reported creation of a precise nasal alar cartilage with a tissue-engineering strategy and three-dimensional printing technique.

  12. Securing aesthetic outcomes for composite grafts to alar margin and columellar defects: A long term experience.

    PubMed

    Ahuja, Rajeev B; Gupta, Rajat; Chatterjee, Pallab; Shrivastava, Prabhat

    2014-01-01

    Composite grafts for nasal reconstruction have been around for over a century but the opinion on its virtues and failings keeps vacillating with a huge difference on the safe size of the graft for transfer. Alar margin and columellar defects are more distinct than dorsal nasal defects in greater difficulty in ensuring a good aesthetic outcome. We report our series of 19 consecutive patients in whom a composite graft was used to reconstruct a defect of alar margin (8 patients), alar base (7 patients) or columella (4 patients). Patient ages ranged from 3-35 years with 5 males and 14 females. The grafts to alar margin and base ranged 0.6-1 cm in width, while grafts to columella were 0.7-1.2 cm. The maximum dimension of the graft in this series was 0.9 mm x 10 mm. Composite grafts were sculpted to be two layered (skin + cartilage), three layered wedges (skin + cartilage + skin) or their combination (two layered in a portion and three layered in another portion). All grafts were cooled in postoperative period for three days by applying an indigenous ice pack of surgical glove. The follow up ranged from 3-9 months with an average of 4.5 months. All of our 19 composite grafts survived completely but they all shrank by a small percentage of their bulk. Eleven patients rated the outcome between 90-95% improvement. We noticed that composite grafts tended to show varied pigmentation in our patients, akin to split skin grafts. In our opinion, most critical to graft survival is its size and the ratio of the marginal raw area to the graft bulk. We recommend that graft width should not exceed 1 cm to ensure complete survival even though larger sized grafts have been reported to survive. We recommend cooling of the graft and justify it on the analogy of 'warm ischemia time' for a replantation, especially in warmer climes like ours in India. We have outlined several considerations in the technique, with an analysis of differing opinions that should facilitate a surgeon in making an

  13. Securing aesthetic outcomes for composite grafts to alar margin and columellar defects: A long term experience

    PubMed Central

    Ahuja, Rajeev B.; Gupta, Rajat; Chatterjee, Pallab; Shrivastava, Prabhat

    2014-01-01

    Introduction: Composite grafts for nasal reconstruction have been around for over a century but the opinion on its virtues and failings keeps vacillating with a huge difference on the safe size of the graft for transfer. Alar margin and columellar defects are more distinct than dorsal nasal defects in greater difficulty in ensuring a good aesthetic outcome. We report our series of 19 consecutive patients in whom a composite graft was used to reconstruct a defect of alar margin (8 patients), alar base (7 patients) or columella (4 patients). Patients and Methods: Patient ages ranged from 3-35 years with 5 males and 14 females. The grafts to alar margin and base ranged 0.6-1 cm in width, while grafts to columella were 0.7-1.2 cm. The maximum dimension of the graft in this series was 0.9 mm x 10 mm. Composite grafts were sculpted to be two layered (skin + cartilage), three layered wedges (skin + cartilage + skin) or their combination (two layered in a portion and three layered in another portion). All grafts were cooled in postoperative period for three days by applying an indigenous ice pack of surgical glove. The follow up ranged from 3-9 months with an average of 4.5 months. Results: All of our 19 composite grafts survived completely but they all shrank by a small percentage of their bulk. Eleven patients rated the outcome between 90-95% improvement. We noticed that composite grafts tended to show varied pigmentation in our patients, akin to split skin grafts. Conclusion: In our opinion, most critical to graft survival is its size and the ratio of the marginal raw area to the graft bulk. We recommend that graft width should not exceed 1 cm to ensure complete survival even though larger sized grafts have been reported to survive. We recommend cooling of the graft and justify it on the analogy of ‘warm ischemia time’ for a replantation, especially in warmer climes like ours in India. We have outlined several considerations in the technique, with an analysis of

  14. Follow-up MR imaging of the alar and transverse ligaments after whiplash injury: a prospective controlled study.

    PubMed

    Vetti, N; Kråkenes, J; Ask, T; Erdal, K A; Torkildsen, M D N; Rørvik, J; Gilhus, N E; Espeland, A

    2011-01-01

    The cause and clinical relevance of upper neck ligament high signal intensity on MR imaging in WAD are controversial. The purpose of this study was to explore changes in the signal intensity of the alar and transverse ligaments during the first year after a whiplash injury. Dedicated high-resolution upper neck proton attenuation-weighted MR imaging was performed on 91 patients from an inception WAD1-2 cohort, both in the acute phase and 12 months after whiplash injury, and on 52 controls (noninjured patients with chronic neck pain). Two blinded radiologists independently graded alar and transverse ligament high signal intensity 0-3, compared initial and follow-up images to assess alterations in grading, and solved any disagreement in consensus. The Fisher exact test was used to compare proportions. Alar and transverse ligament grading was unchanged from the initial to the follow-up images. The only exceptions were 1 alar ligament changing from 0 to 1 and 1 ligament from 1 to 0. The prevalence of grades 2-3 high signal intensity in WAD was thus identical in the acute phase and after 12 months, and it did not differ from the prevalence in noninjured neck pain controls (alar ligaments 33.0% versus 46.2%, P = .151; transverse ligament 24.2% versus 23.1%, P = 1.000). Alar and transverse ligament high signal intensity in patients with WAD1-2 observed within the first year after injury cannot be explained by the trauma. Dedicated upper neck MR imaging cannot be recommended as a routine examination in these patients.

  15. Association of Skin Thickness With Alar Base Reduction in Patients Undergoing Lateral Crural Repositioning and Strut Grafting.

    PubMed

    Ilhan, A Emre; Sozen, Tevfik; Caypinar Eser, Basak; Cengiz, Betul

    2017-07-27

    Knowing the operation plan is important for rhinoplasty surgeons to prevent unpredictable results. To investigate the frequency of alar base resection in patients with different skin thickness who underwent lateral crural repositioning and lateral crural strut graft and to evaluate the results in the context of the current literature. This retrospective case series study included 621 patients who underwent primary open septorhinoplasty by the same surgeon between January 1, 2012, and June 30, 2015. From the surgical notes, operation type (lateral crural repositioning [LCrep] with lateral crural strut grafting [LCSG] and with or without alar base resection) and skin type were recorded. Study participants' skin types were determined intraoperatively and divided into 3 groups: (1) thick skin (the tip definition was limited by skin thickness and subcutaneous tissue), (2) thin skin (the tip cartilage was visible and could be observed despite overlying soft tissue and skin), and (3) normal skin (the tip cartilage during the procedure had no effect on the tip definition). Of the 621 patients in the study, 95 (15.3%) were men and 526 (84.7%) were women. Lateral crural repositioning with LCSG was performed in 319 surgical procedures (51.4%), and alar base reduction was performed in 329 (53.0%). The rate of alar base resection differed significantly on the basis of whether LCrep with LCSG was performed (odds ratio [OR], 1.82; 95% CI, 1.32-2.50; P < .001). In patients with thin skin, there was no significant difference in the incidence of alar base resection associated with LCrep with LCSG (OR, 2.034; 95% CI, 0.912-4.539; P = .08). In patients with thick skin, a significant difference in the frequency of alar base resection was associated with the application of LCrep with LCSG (OR, 1.995; 95% CI, 1.228-3.241; P = .005). In patients with normal skin, LCrep with LCSG had no significant association with the frequency of alar base resection (OR, 1.557; 95% CI, 0

  16. Rhinoplasty. The difficult nasal tip: total resection of the alar cartilages.

    PubMed

    Rodriguez-Camps, Salvador

    2009-01-01

    There are many ways to reconstruct and make nasal tips more attractive. Sometimes we cannot find the best way unless we at least remove all surplus from the tip. This may occur in primary or secondary rhinoplasty. In principle, anything is possible when relocating and reconstructing. However, sometimes we face reality when we uncover the tip: broken or bulging cartilages that are difficult to put right. For this reason, in 1987 we thought of totally resectioning the alar cartilages in a case of secondary rhinoplasty with an unsightly appearance. After a year the result was seen to be correct from an aesthetic and a functional perspective and is still so today. Aesthetically, it kept its shape and did not collapse with nasal respiratory failure. We covered the end of the crus medialis with a small, temporary, one- to two-layered fascia patch. Except in exceptional cases, we now use this procedure: Total sectioning of the alar cartilages including the domes, or maintenance of them by preserving the fibroadipose tip tissue with a suture in the middle of the end of the crus medialis and by covering this with temporary fascia, which usually has two layers depending on the thickness of the skin of the tip. This procedure is indicated mainly in secondary rhinoplasty when the cartilages of the tip are completely destroyed, and in primary rhinoplasty when the tip is excessively wide and bulbous. Our philosophy is, therefore, elegance and beauty of the nasal tip with a solid and equilateral base without prejudices.

  17. Postoperative alar base symmetry in complete unilateral cleft lip and palate:A prospective study.

    PubMed

    Vyloppilli, Suresh; Krishnakumar, K S; Sayd, Shermil; Latheef, Sameer; Narayanan, Saju V; Pati, Ajit

    2017-06-09

    In the evolution of cleft lip repair, there have been continuous attempts to minimize local trauma and to improve lip and nasal appearances. In order to obtain an aesthetically balanced development of midface, the primary surgical correction of the nasolabial area is of paramount importance. In this study, the importance of a back-cut extending cephalically above the inferior turbinate at the mucocutaneous junction which elevates the nostril floor on the cleft side for the purpose of achieving symmetry of the alar bases are analyzed by pre and postoperative photographic anthropometry. This study comprised of fifty cases of the unilateral complete cleft lip. At the time of surgery, the patient age ranged from 3-9 months. The surgeries, performed by a single surgeon, employed the standard Millard technique, incorporating Mohler modifications of lip repair. Anthropometric analysis revealed that the preoperative mean difference between the normal side and the cleft side was 0.2056 with a standard deviation of 0.133. In the postoperative analysis, the mean difference was reduced to 0.0174 with a standard deviation of 0.141. The paired t-test showed that the p-value is <0.001, indicating high statistical significance. To conclude, in complete unilateral cleft lip and palate, the geometrically placed nasal back-cut incision has a definite role in the correction of the alar base symmetry during primary surgery. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Functional results in airflow improvement using a "flip-flap" alar technique: our experience.

    PubMed

    Di Stadio, Arianna; Macro, Carlo

    2017-02-21

    Pinched nasal point can be arising as congenital malformation or as results of unsuccessfully surgery. The nasal valve alteration due to this problem is not only an esthetic problem but also a functional one because can modify the nasal airflow. Several surgical techniques were proposed in literature, we proposed our. The purpose of the study is the evaluation of nose airway flow using our flip-flap technique for correction of pinched nasal tip. This is a retrospective study conducted on twelve patients. Tip cartilages were remodeled by means of autologous alar cartilage grafting. The patients underwent a rhinomanometry pre and post-surgery to evaluate the results, and they performed a self-survey to evaluate their degree of satisfaction in term of airflow sensation improvement. Rhinomanometry showed improved nasal air flow (range from 25% to 75%) in all patients. No significant differences were showed between unilateral and bilateral alar malformation (p=0.49). Patient's satisfaction reached the 87.5%. Our analysis on the combined results (rhinomanometry and surveys) showed that this technique leads to improvement of nasal flow in patients affected by pinched nasal tip in all cases. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  19. Designing and Implementing Collaborative Improvement in the Extended Manufacturing Enterprise: Action Learning and Action Research (ALAR) in CO-IMPROVE

    ERIC Educational Resources Information Center

    Coghlan, David; Coughlan, Paul

    2006-01-01

    Purpose: The purpose of this article is to provide a design and implementation framework for ALAR (action learning action research) programme which aims to address collaborative improvement in the extended manufacturing enterprise. Design/methodology/approach: This article demonstrates the design of a programme in which action learning and action…

  20. Is Early Nasal Shaping With a Limited Alar Base Incision Possible in the Repair of Cleft Lips?

    PubMed

    Kapi, Emin; Bozkurt, Mehmet; Ozer, Torun; Celik, Mehmet Yusuf

    2016-05-01

    The repair of cleft lips has an important place in plastic and reconstructive surgery. In the treatment of these deformities, the aim was to restore the normal lip morphology in the cleft area as well as repairing any coexisting nasal deformities. Various methods are in use for this purpose. One of the most commonly employed surgical methods is Millard repair. However, this method may lead to additional scarring in the alar base on the cleft side subsequent to the incision. In this study, the results obtained from a group who have been applied alar base incisions during the modified Millard repair are compared to a group who have undergone intranasal wide dissections.The patients enrolled in the study were randomized into 2 groups. The first group were applied the modified Millard repair. In the second group, the rotation, advancement, and C-flaps were prepared according to Millard surgical repair technique; however, instead of an alar base and nasofacial groove incision on the cleft side, a nasal and maxillary supraperiosteal wide dissection was made through the incision in the mucosa of the nostril.The intranasal dissection performed during the study was observed to provide the targeted outcome and a more satisfactory cosmetic result through the modified Millard repair. In conclusion, the authors are of the opinion that the limited alar base incision and the wide supraperiosteal dissection performed in patients with cleft lips is an alternative method that can be employed in a wide range of patients.

  1. [Repair of middle and lower face scars using alar thin expanded cervical flap with pedicle in anterior neck].

    PubMed

    Xu, Lisi; Li, Yangqun; Tang, Yong; Chen, Wen; Yang, Zhe; Zhao, Muxin; Ma, Ning; Feng, Jun

    2014-04-01

    To explore the application of alar thin expanded cervical flap with pedicle in anterior neck for large scars on middle and lower face. From February 2000 to July 2013, 26 patients with scars on the middle and lower face were treated with the alar thin expanded cervical flaps with pedicle in anterior neck. After the skin of anterior neck was expanded by implanting skin expanders, alar thin expanded cervical flap with pedicle in anterior neck was obtained with size of 163-275 cm(2). Then the scars on the middle and lower face with the size of 135-196 cm(2) were excised, with the area of excision allowing full coverage of the expanded flap. The flap was rotated and advanced to the middle and lower face, and the incision was closed in layers. The 26 patients were followed up for 2 to 24 months. Twenty-one flaps survived, with good appearance and function. Four flaps showed venous retardation at distal part, and only one flap showed necrosis of the right edge. They were healed by free skin grafting. The alar thin expanded cervical flap not only makes maximum use of expanded flap on the premise of ensuring blood supply, but also guarantees good color, texture, and contour of face and neck.

  2. A Novel Approach for Full-Thickness Defect of the Nasal Alar Rim: Primary Closure of the Defect and Reduction of the Contralateral Normal Ala for Symmetry.

    PubMed

    Choe, Yun Seon; Kim, Min-Woo; Jo, Seong Jin

    2015-12-01

    In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim.

  3. The Wave Flap: A Single-Stage, Modified Nasal Sidewall Rotation Flap for the Repair of Defects Involving the Mid-Alar Groove.

    PubMed

    Bryan, Zachary T; Garrett, Algin B; Lavigne, Kerry; Trace, Anthony; Maher, Ian A

    2016-02-01

    Reconstruction of defects straddling the alar groove presents the dual challenges of resurfacing the nasal sidewall and alar subunits while simultaneously recreating the alar groove. The wave flap (WF) is a modified, medially based, nasal sidewall rotation flap that uses locally recruited tissue from the nasal sidewall to facilitate color and texture match and permit camouflage of scars. To detail a surgical repair for defects in the horizontally oriented middle third of the alar groove. This retrospective case series describes a technique for repair of defects involving the alar groove. Using postoperative photographs, outcomes were assessed by blinded noninvestigator dermatologist raters using the Observer Scar Assessment Scale. Between February 2012 and June 2013, 10 patients were reconstructed using a WF design. Subjective assessment of scar vascularity, pigment, pliability, relief, and thickness by 3 independent reviewers yielded an overall cosmesis score of 11.1 (out of 50). No complications were noted. The WF provides an excellent reconstructive option for Mohs defects of the middle third of the alar groove by recruiting local tissue and permitting maximum scar camouflage. A well-designed and executed WF provides cosmetically exceptional results for defects of the alar groove.

  4. A Novel Approach for Full-Thickness Defect of the Nasal Alar Rim: Primary Closure of the Defect and Reduction of the Contralateral Normal Ala for Symmetry

    PubMed Central

    Choe, Yun Seon; Kim, Min-Woo

    2015-01-01

    In full-thickness defects of the nasal alar rim, to achieve projection and maintain airway patency, cartilage graft is frequently needed. However, cartilage graft presents a challenge in considerations such as appropriate donor site, skeletal shape and size, and healing of the donor area. To avoid these demerits, we tried primary closure of alar rim defects by also making the contralateral normal ala smaller. We treated two patients who had a full-thickness nasal alar defect after tumor excision. Cartilage graft was considered for the reconstruction. However, their alar rims were overly curved and their nostril openings were large. To utilize their nasal shape, we did primary closure of the defect rather than cartilage graft, and then downsized the contralateral nasal ala by means of wedge resection to make the alae symmetric. Both patients were satisfied with their aesthetic results, which showed a smaller nostril and nearly straight alar rims. Moreover, functionally, there was no discomfort during breathing in both patients. We propose our idea as one of the reconstruction options for nasal alar defects. It is a simple and easy-to-perform procedure, in addition to enhancing the nasal contour. This method would be useful for patients with a large nostril and an overly curved alar rim. PMID:26719646

  5. Fractional photothermolysis improves a depressed alar scar following Mohs micrographic surgery.

    PubMed

    Schulz, Kimberly K; Walling, Hobart W

    2010-01-01

    Fractional photothermolysis (FPT; Fraxel SR laser) is a 1550 nm non-ablative erbium laser device with a variety of clinical applications. FPT has been used to treat photodamage, photoaging, melasma, actinic keratoses and acne scarring. We present the case of a 49-year-old woman with a depressed 0.7 x 0.5 cm alar scar resulting from Mohs micrographic surgery for basal cell carcinoma with secondary intention healing. She was treated with FPT initially eight weeks post-operatively. FPT was performed a total of five times at four-week intervals. At the completion of FPT, the scar was nearly imperceptible and has remained so eighteen months later. To the authors' knowledge, treatment of facial scars resulting from Mohs micrographic surgery for cutaneous malignancy has not previously been reported.

  6. S2 Alar-iliac Fixation: A Powerful Procedure for the Treatment of Kyphoscoliosis.

    PubMed

    Liu, Zhen; Qiu, Yong; Yan, Huang; Hu, Zong-shan; Zhu, Feng; Qiao, Jun; Xu, Lei-lei; Wang, Bin; Yu, Yang; Qian, Bang-ping; Zhu, Ze-zhang

    2016-02-01

    The purpose of this study was to introduce a powerful technique for the treatment of kyphoscoliosis. There are currently multiple techniques for sacropelvic fixation, including trans-iliac bars and iliac and iliosacral screws. Several studies have documented the use of these instrumentation techniques; however, a ubiquitous problematic issue concerns the need for separate incisions for the use of offset connectors, which add to surgical time and morbidity. Any additional dissection of the skin, subcutaneous tissue or muscle in this area is believed to increase the incidence of complications of wound healing. However, as stated above, the above-mentioned techniques require separate incisions for the use of offset connectors, which add to surgical time and morbidity. The novel technique of S2 alar-iliac (S2AI) pelvic fixation has been developed to address some of these issues. However, a technique for achieving correction of kyphoscoliosis with pelvic obliquity in adult patients with spinal deformity has not previously been described. Our entry point is based on the S1 foramen and is typically up to 5 mm caudal and 2 to 3 mm lateral to that foramen. Once the S1 foramen has been identified, a blunt instrument can be used to probe the alar ridge. The screw trajectory is 40°-50° from horizontal and 20°-30° caudal, aimed toward the greater trochanter and rostral to the sciatic notch. A 36-year-old female patient presented with a 3-year history of low back pain, and progressive thoracolumbar kyphoscoliosis. In this typical case, we performed S2AI fixation with transforaminal lumbar interbody fusion and hemivertebra resection technique to treat her lumbosacral kyphoscoliosis. Satisfactory improvement in her preoperative lumbar kyphoscoliosis was found at 3-month follow-up. © 2016 Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd.

  7. Arthroscopic lateral acromion resection (ALAR) optimizes rotator cuff tear relevant scapula parameters.

    PubMed

    Altintas, Burak; Kääb, Max; Greiner, Stefan

    2016-06-01

    The acromion index (AI), critical shoulder angle (CSA) and lateral acromion angle (LAA) are predictive for degenerative rotatory cuff tears. Their unfavorable values are associated with a suboptimal deltoid force vector. The aim of this study was to evaluate whether an optimization of the radiological parameters could be achieved through a specific arthroscopic lateral acromion resection (ALAR). The procedure was performed in eight fresh frozen cadaver shoulders. True a.p. and axial radiographs were taken before and after the intervention for radiological evaluation. The anterior and posterior acromion edges were marked with a spinal needle. Then 1 cm of the lateral acromion was resected with a 5.0 acromionizer (Arthrex Inc., Naples, FL, USA) beginning from the anterior aspect. The resection was completed over the total width of 1 cm from anterior to posterior. Finally the deltoid insertion was dissected via an open approach to ensure its integrity. The fluoroscopy images were evaluated regarding the pre- and postinterventional parameters AI, CSA and LAA. After the intervention, the mean AI could be significantly reduced from 0.62 ± 0.11 to 0.40 ± 0.15 (p = 0.012). Also the mean CSA was significantly reduced from 35.0° ± 7.65° to 25.12° ± 8.29° (p = 0.018). The LAA could not be significantly changed (76.5° ± 14.02° vs. 82.13 ± 8.93; p = 0.107). There was no injury to the deltoid insertion. The radiographic parameters AI und CSA can be optimized significantly by ALAR without macroscopic discontinuity of the deltoid insertion. Level IV, case series without comparison group.

  8. Toward less misleading comparisons of uncertain risks: the example of aflatoxin and alar.

    PubMed Central

    Finkel, A M

    1995-01-01

    Critics of comparative risk assessment (CRA), the increasingly common practice of juxtaposing disparate risks for the purpose of declaring which one is the "larger" or the "more important," have long focused their concern on the difficulties in accommodating the qualitative differences among risks. To be sure, people may disagree vehemently about whether "larger" necessarily implies "more serious," but the attention to this aspect of CRA presupposes that science can in fact discern which of two risks has the larger statistical magnitude. This assumption, encouraged by the indiscriminate calculation of risk ratios using arbitrary point estimates, is often incorrect: the fact that environmental and health risks differ in unknown quantitative respects is at least as important a caution to CRA as the fact that risks differ in known qualitative ways. To show how misleading CRA can be when uncertainty is ignored, this article revisits the claim that aflatoxin contamination of peanut butter was "18 times worse" than Alar contamination of apple juice. Using Monte Carlo simulation, the number 18 is shown to lie within a distribution of plausible risk ratios that ranges from nearly 400:1 in favor of aflatoxin to nearly 40:1 in the opposite direction. The analysis also shows that the "best estimates" of the relative risk of aflatoxin to Alar are much closer to 1:1 than to 18:1. The implications of these findings for risk communication and individual and societal decision-making are discussed, with an eye toward improving the general practice of CRA while acknowledging that its outputs are uncertain, rather than abandoning it for the wrong reasons. Images Figure 1. Figure 2. PMID:7607139

  9. Subcutaneous C Shape Muscular Flap for Correcting the Depression of Alar Base in Affected Side in Patients With Unilateral Complete Cleft Lip/Palate During Primary Surgery.

    PubMed

    Wu, Dandan; Wang, Guomin; Ouyang, Ningjuan; Lin, Yuhen; Chen, Yang; Dai, Jiewen

    2017-06-01

    The depression of alar base in affected side in patients with unilateral complete cleft lip/palate (CL/P) is one of common clinical features. In this study, the authors try to explore the effect of subcutaneous C shape muscular flap for correcting the depression of alar base in affected side in patients with unilateral complete CL/P during primary surgery. A total of 30 patients with unilateral complete CL/P who received primary correction of the lip nose deformity were included in this study. The C flap was used to drop and lengthen the height of upper lip in unaffected side, and the subcutaneous muscular flap was dissected from the C flap and positioned at the alar base in the affected side of upper lip to correct the depression. Then the surgical effect was evaluated based on clinical examination during follow-up. Alar base symmetry was obtained in 26 patients of this case series, and 4 patients showed slight improvement in alar base symmetry. No major complications such as flap necrosis, infection, or hypertrophic scars were observed during surgery and follow-up. No additional incisions and operative time were necessary. The subcutaneous C shape muscular flap described in this article could offer enough muscular support and markedly correct the depression of nostril and alar base in affected side in primary lip nose repair with no additional incisions and operative time for patients with unilateral complete CL/P.

  10. Feasibility, repeatability, and safety of ultrasound-guided stimulation of the first cervical nerve at the alar foramen in horses.

    PubMed

    Mespoulhès-Rivière, Céline; Brandenberger, Olivier; Rossignol, Fabrice; Robert, Céline; Perkins, Justin D; Marie, Jean-Paul; Ducharme, Norm

    2016-11-01

    OBJECTIVE To develop and assess the feasibility, repeatability, and safety of an ultrasound-guided technique to stimulate the first cervical nerve (FCN) at the level of the alar foramen of the atlas of horses. ANIMALS 4 equine cadavers and 6 clinically normal Standardbreds. PROCEDURES In each cadaver, the FCN pathway was determined by dissection, and any anastomosis between the first and second cervical nerves was identified. Subsequently, each of 6 live horses underwent a bilateral ultrasound-guided stimulation of the FCN at the alar foramen 3 times at 3-week intervals. After each procedure, horses were examined daily for 5 days. RESULTS In each cadaver, the FCN passed through the alar foramen; a communicating branch between the FCN and the accessory nerve and anastomoses between the ventral branches of the FCN and second cervical nerve were identified. The anastomoses were located in the upper third of the FCN pathway between the wing of the atlas and the nerve's entry in the omohyoideus muscle. Successful ultrasound-guided electrical stimulation was confirmed by twitching of the ipsilateral omohyoideus muscle in all 6 live horses; this finding was observed bilaterally during each of the 3 experimental sessions. No complications developed at the site of stimulation. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that ultrasound-guided stimulation of the FCN at the alar foramen appears to be a safe and straightforward procedure in horses. The procedure may have potential for use in horses with naturally occurring recurrent laryngeal neuropathy to assess reinnervation after FCN transplantation or nerve-muscle pedicle implantation in the cricoarytenoideus dorsalis muscle.

  11. Full-Thickness Entire Nasal Alar Reconstruction Using a Forehead Flap in Asians: No Cartilaginous Infrastructural Lining Is Necessary.

    PubMed

    Funayama, Emi; Yamamoto, Yuhei; Furukawa, Hiroshi; Murao, Naoki; Shichinohe, Ryuji; Yamao, Takeshi; Hayashi, Toshihiko; Oyama, Akihiko

    2017-05-01

    Full-thickness defects of the entire nasal ala, including the rim, can be challenging to reconstruct. A forehead flap may provide a more imperceptible and natural-appearing reconstructed nasal ala. Previously, many authors have insisted adding cartilaginous infrastructural support for an entire, full-thickness defect to keep the postoperative alar structure symmetrical. They finally use a forehead flap after thinning of the distal covering portion subcutaneously, possibly for a Caucasian-type nasal ala. However, Asian skin has a thicker and more compact dermis than that of Caucasian skin, and the Asian ala is rounder and thicker. There may be another approach for an Asian-type nasal ala. The authors propose the possibility of nasal alar reconstruction for an entire, full-thickness defect in Asians using a forehead flap without structural support. Six patients with entire full-thickness nasal alar defects treated with full-thickness forehead flaps above the periosteum without structural support were reviewed. Five patients demonstrated esthetically good to excellent outcomes in color, texture, and symmetry. Their nasal linings were reconstructed using mucoperiosteal flaps or mucosal grafts. One patient treated with a nasal lining using a local flap showed a fair result esthetically. Asians forehead above the periosteum has adequate thickness and supportability to reconstruct the entire full-thickness nasal ala in Asians. No cartilage support is necessary.

  12. Magnetic resonance imaging signal changes of alar and transverse ligaments not correlated with whiplash-associated disorders: a meta-analysis of case-control studies.

    PubMed

    Li, Quan; Shen, Hongxing; Li, Ming

    2013-01-01

    Hypothesis that loss of integrity of the membranes in the craniocervical junction might be the cause of neck pain in patients with whiplash-associated disorders (WADs) has been proposed. In recent years, with development of more detailed magnetic resonance imaging (MRI) techniques, morphologic changes of the ligaments and membranes in the craniocervical junction, especially alar and transverse ligaments have been discussed. A meta-analysis was performed to evaluate the relationship of MRI signal changes of alar and transverse ligaments and WADs. A systematic search of EMBASE, PUBMED, and Cochrane Library and references from eligible articles were conducted. Comparative studies reporting on evaluating the relationship between MRI high-signal changes of alar and transverse ligaments and WADs were regarded eligible. A pooled estimate of effect size was produced. Alar ligaments: Six studies (total n = 622) were included. MRI signal changes of alar ligaments did not appear to be related with WADs (P = 0.20, OR = 1.54, 95 % CI = 0.80-2.94). Heterogeneity was present (I (2) = 46 %, P = 0.10), which was eliminated upon sensitivity analysis bringing the OR to 1.27 (95 % CI = 0.87-1.86, I (2) = 0 %). Transverse ligaments: Four studies (total n = 489) were included. MRI signal changes of transverse ligament did not appear to be related with WADs (P = 0.51, OR = 1.44, 95 % CI = 0.49-4.21). Heterogeneity was present (I (2) = 77 %, P = 0.005), which was eliminated upon sensitivity analysis bringing the OR to 0.79 (95 % CI = 0.49-1.28, I (2) = 0 %). MRI signal changes of alar and transverse ligaments are not supposed to be caused by whiplash injury, and MRI examination of alar and transverse ligaments should not be used as the routine workup of patients with WADs.

  13. A novel approach to navigated implantation of S-2 alar iliac screws using inertial measurement units.

    PubMed

    Jost, Gregory F; Walti, Jonas; Mariani, Luigi; Cattin, Philippe

    2016-03-01

    The authors report on a novel method of intraoperative navigation with inertial measurement units (IMUs) for implantation of S-2 alar iliac (S2AI) screws in sacropelvic fixation of the human spine and its application in cadaveric specimens. Screw trajectories were planned on a multiplanar reconstruction of the preoperative CT scan. The pedicle finder and screwdriver were equipped with IMUs to guide the axial and sagittal tilt angles of the planned trajectory, and navigation software was developed. The entry points were chosen according to anatomical landmarks on the exposed spine. After referencing, the sagittal and axial orientation of the pedicle finder and screwdriver were wirelessly monitored on a computer screen and aligned with the preoperatively planned tilt angles to implant the S2AI screws. The technique was performed without any intraoperative imaging. Screw positions were analyzed on postoperative CT scans. Seventeen of 18 screws showed a good S2AI screw trajectory. Compared with the postoperatively measured tilt angles of the S2AI screws, the IMU readings on the screwdriver were within an axial plane deviation of 0° to 5° in 15 (83%) and 6° to 10° in 2 (11%) of the screws and within a sagittal plane deviation of 0° to 5° in 15 (83%) and 6° to 10° in 3 (17%) of the screws. IMU-based intraoperative navigation may facilitate accurate placement of S2AI screws.

  14. Fetal development of the transverse atlantis and alar ligaments at the craniovertebral junction.

    PubMed

    Abe, Hiroshi; Ishizawa, Akimitsu; Cho, Kwang Ho; Suzuki, Ryoji; Fujimiya, Mineko; Rodríguez-Vázquez, Jose Francisco; Murakami, Gen

    2012-09-01

    Although the fetal development of the craniovertebral junction has long been of major interest to embryologists from the viewpoint of segmentation, development of the associated ligaments has received scant attention. Using semiserial horizontal sections from 18 embryos and fetuses (six embryos with a crown-rump length (CRL) of 20-26 mm or ~6-7 weeks of gestation; five fetuses with a CRL of 32-58 mm or 8-9 weeks; seven fetuses with a CRL of 90-115 mm or 14-15 weeks) without any abnormalities of cartilage configuration such as atlas assimilation, we studied the ligamentous structures along and around the odontoid process of the axis. The transverse atlantis and alar ligaments originated from a common mesenchymal condensation possibly corresponding to the proatlas segment: the former started to develop slightly earlier than the latter, and the morphologies of both were established at 7 weeks of gestation. Development of the joint cavitation around the odontoid process began in the mid-anterior area at 6 weeks, but was not fully completed even at 15 weeks (115 mm CRL). The presumptive joint cavity expressed vimentin and CD34 and contained abundant CD68-positive macrophages. We always found a mid-anterior joint cavitation facing the basi-occipital, but the embryological meaning remained unclear. The apical ligament appeared most likely to originate from the notochord sheath. The notochord was exposed from the tip of the odontoid process toward the loose epidural tissue and entered the occipital bone, but was difficult to trace to the anterior surface of the basi-occipital. Copyright © 2011 Wiley Periodicals, Inc.

  15. Are MRI high-signal changes of alar and transverse ligaments in acute whiplash injury related to outcome?

    PubMed Central

    2010-01-01

    Background Upper neck ligament high-signal changes on magnetic resonance imaging (MRI) have been found in patients with whiplash-associated disorders (WAD) but also in non-injured controls. The clinical relevance of such changes is controversial. Their prognostic role has never been evaluated. The purpose of this study was to examine if alar and transverse ligament high-signal changes on MRI immediately following the car accident are related to outcome after 12 months for patients with acute WAD grades 1-2. Methods Within 13 days after a car accident, 114 consecutive acute WAD1-2 patients without prior neck injury or prior neck problems underwent upper neck high-resolution proton-weighted MRI. High-signal changes of the alar and transverse ligaments were graded 0-3. A questionnaire including the impact of event scale for measuring posttraumatic stress response and questions on patients' expectations of recovery provided clinical data at injury. At 12 months follow-up, 111 (97.4%) patients completed the Neck Disability Index (NDI) and an 11-point numeric rating scale (NRS-11) on last week neck pain intensity. Factors potentially related to these outcomes were assessed using multiple logistic regression analyses. Results Among the 111 responders (median age 29.8 years; 63 women), 38 (34.2%) had grades 2-3 alar ligament changes and 25 (22.5%) had grades 2-3 transverse ligament changes at injury. At 12 months follow-up, 49 (44.1%) reported disability (NDI > 8) and 23 (20.7%) neck pain (NRS-11 > 4). Grades 2-3 ligament changes in the acute phase were not related to disability or neck pain at 12 months. More severe posttraumatic stress response increased the odds for disability (odds ratio 1.46 per 10 points on the impact of event scale, p = 0.007) and so did low expectations of recovery (odds ratio 4.66, p = 0.005). Conclusions High-signal changes of the alar and transverse ligaments close after injury did not affect outcome for acute WAD1-2 patients without previous

  16. Keystone Perforator Island Flap as an Alternative Reconstructive Option for Partial Thickness Alar Defects Up to 1.5 Centimeters.

    PubMed

    Kostopoulos, Epameinondas; Agiannidis, Christos; Konofaos, Petros; Kotsakis, Ioannis; Champsas, Grigorios; Frangoulis, Marios; Papadopoulos, Othon; Casoli, Vincent

    2016-07-01

    The ala is a unique landmark of the nose disposing aesthetic and functional properties. The head and neck area is the main site of appearance of nonmelanoma skin cancer. One third of them are located in the nose with an alar preponderance compared with other nasal subunits. Correction of alar defects is a challenging reconstructive task. The keystone perforator island flap (KPIF) was introduced as an alternative in nasal reconstruction by senior authors. In the present case series, KPIFs' application is introduced into the alar subunit as an alternative, versatile, and reproducible reconstructive option, even for the novice plastic surgeon. From April 2014 to September 2015, patients presenting with partial thickness alar defects (≤1.5 cm) secondary to tumor extirpation sustained reconstruction with different types of KPIF. A total of 31 patients (mean age of 72 years) were treated with various types of KPIF. The mean diameter of the defect was 1.14 cm. The vast majority of reconstructions concerned a type IV KPIF (18/31 or 58.1%). Sometimes an upward alar retraction was noted. A minimal rim wedge excision was performed (≤0.3 mm) using counterbalancing correcting sutures. All flaps survived without any sign of venous congestion, whereas the rim healed uneventfully. The mean follow-up period was 6.5 months. KPIF was introduced as a single-stage alternative reconstructive option for partial thickness alar defects, completing author's experience with this flap into such a challenging and aesthetically critical anatomic area.

  17. The sudden death of Alaric I (c. 370-410AD), the vanquisher of Rome: A tale of malaria and lacking immunity.

    PubMed

    Galassi, Francesco M; Bianucci, Raffaella; Gorini, Giacomo; Paganotti, Giacomo M; Habicht, Michael E; Rühli, Frank J

    2016-06-01

    Alaric I (c. 370-410AD), King of the Visigoths, sacked Rome for the second time in over eight centuries of history. Historians suggest that malaria, probably contracted either in Rome or in the Pontine Marshes, was responsible for his sudden death in Cosenza (Calabria) in the autumn of 410AD, where he was allegedly buried in the River Busento. In this article, we aim to examine this hypothesis through a full pathographic reassessment of the most likely cause of Alaric's demise. To achieve this, we resorted to a dual philological-medical approach: clinical likelihood and malaria seasonality coupled with primary historical sources (mainly Jordanes' work De origine actibusque Getarum) and the reconstruction of the itineraries followed by Alaric and his army after the sack of Rome. Sudden death is caused by several factors. The possibility that Alaric died of a cardiovascular disease was discarded since no description of potentially pathological signs emerged from the available sources. Given his lack of semi-immunity, falciparum malaria was considered as the most likely cause of his demise. It took him over two months to reach the coasts of Calabria during the peak of malaria's transmission (summer-autumn). During the march, Alaric did not suffer from recurrent fevers or other ailments, which would have been reported by historians. The scenario emerging from this multidisciplinary reanalysis allows us to hypothesise that Plasmodium falciparum malaria, contracted during his journey through Calabria, was the most likely candidate responsible for Alaric's unexpected demise. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  18. Short Segment Stabilization by Protecting the Alar Ligaments in a Case of Eosinophilic Granuloma Involving the C2 Spine.

    PubMed

    Ilik, Mustafa Kemal; Tumturk, Abdülfettah; Ulutabanca, Halil; Kücük, Ahmet; Koc, Rahmi Kemal

    2016-07-01

    The craniocervical junction is a complex anatomic location that contains the occipital bone, atlas, axis, and important complex ligamentous structures. The stability of this region is ensured only with the help of ligaments. A 6-year-old boy was admitted to our clinic for neck pain. Computed tomography and magnetic resonance imaging revealed a lytic bone lesion involving the C2 vertebral body and pedicle without odontoid tip. The tumor was resected using an anterior retropharyngeal approach and a wide marginal resection method. The odontoid tip and alar ligaments were protected, and the costal autografts were located between the C1-odontoid tip and the C3 body. The costal graft was stabilized in the C3 body with a miniplate. Then, C1-C3 posterior fixation with fusion was performed. The craniocervical junction was not considered unstable because the occipital bone was not involved in the fusion. Histologic examination confirmed the diagnosis of eosinophilic granuloma. Fusion was detected on a 1-year postoperative cervical computed tomography scan. The occiput should not be involved in the fusion area when the alar ligaments are preserved during surgery for a C2 lesion. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Morphology of the transverse ligament of the atlas and the alar ligaments in the silver fox (Vulpes vulpes var)

    PubMed Central

    2013-01-01

    Background Recent new anatomical and histological features of craniocervical junction in dogs and cats were described providing evidence of differences between the carnivore species. No information on these structures in foxes exists. Results Two parts of the alar ligaments were found. A longer one aroused from dens of axis to the internal (medial) surface of the occipital condyles and was called apical part. A shorter part originated from the entire length of the lateral edge of the dens of axis and terminated on the internal wall of the vertebral foramen of atlas and thus was called the lateral part. The transverse ligament of the atlas was widened in the mid region, above the dens of axis, and thickened at enthesis. Periosteal fibrocartilage was detected in the transverse ligament of the atlas at the enthesis, and sesamoid fibrocartilage was present on periphery in the middle of the ligament. Conclusions The craniocervical junction in foxes differs in part from other carnivores such as dogs and cats but resembles that of mesaticephalic dogs. The sesamoid and periosteal fibrocartilage supports the transverse ligament of the atlas whereas the alar ligaments have no cartilage. PMID:23557095

  20. A Refined Technique for Management of Nasal Flaring: The Quest for the Holy Grail of Alar Base Modification.

    PubMed

    Agrawal, Kapil S; Pabari, Mansi; Shrotriya, Raghav

    2016-11-01

    "A smile is happiness you'll find right under your nose"- Tom Wilson. This quote holds true just for patients, not for surgeons. The correction of the nose always poses a challenge to the cosmetic surgeon. Deformities of the external and internal nose may be congenital or acquired and may be secondary to soft tissue and/or osseo-cartilaginous abnormalities, leading to aesthetic and/or functional consequences. Alar flare poses a common problem, sometimes alone and sometimes in conjunction with other external deformities. Alar base reduction is generally considered when the interalar distance exceeds the intercanthal distance. It has been well documented that this simple additional procedure brings about a substantial enhancement in the nose. Various techniques have been described and used in the past, each having their benefits and drawbacks, with the modified Weir wedge excision, Aufricht nasal sill excision, and Bernstein V-Y advancement being the common ones. We hereby describe a technique that is simple yet effective in achieving the desired results and at the same time aims at preventing relapse to obtain satisfactory long term results.

  1. Wnt signal specifies the intrathalamic limit and its organizer properties by regulating Shh induction in the alar plate.

    PubMed

    Martinez-Ferre, Almudena; Navarro-Garberi, Maria; Bueno, Carlos; Martinez, Salvador

    2013-02-27

    The structural complexity of the brain depends on precise molecular and cellular regulatory mechanisms orchestrated by regional morphogenetic organizers. The thalamic organizer is the zona limitans intrathalamica (ZLI), a transverse linear neuroepithelial domain in the alar plate of the diencephalon. Because of its production of Sonic hedgehog, ZLI acts as a morphogenetic signaling center. Shh is expressed early on in the prosencephalic basal plate and is then gradually activated dorsally within the ZLI. The anteroposterior positioning and the mechanism inducing Shh expression in ZLI cells are still partly unknown, being a subject of controversial interpretations. For instance, separate experimental results have suggested that juxtaposition of prechordal (rostral) and epichordal (caudal) neuroepithelium, anteroposterior encroachment of alar lunatic fringe (L-fng) expression, and/or basal Shh signaling is required for ZLI specification. Here we investigated a key role of Wnt signaling in the molecular regulation of ZLI positioning and Shh expression, using experimental embryology in ovo in the chick. Early Wnt expression in the ZLI regulates Gli3 and L-fng to generate a permissive territory in which Shh is progressively induced by planar signals of the basal plate.

  2. Morphology of the transverse ligament of the atlas and the alar ligaments in the silver fox (Vulpes vulpes var).

    PubMed

    Kupczynska, Marta; Barszcz, Karolina; Janczyk, Pawel; Wasowicz, Michal; Czubaj, Norbert

    2013-04-04

    Recent new anatomical and histological features of craniocervical junction in dogs and cats were described providing evidence of differences between the carnivore species. No information on these structures in foxes exists. Two parts of the alar ligaments were found. A longer one aroused from dens of axis to the internal (medial) surface of the occipital condyles and was called apical part. A shorter part originated from the entire length of the lateral edge of the dens of axis and terminated on the internal wall of the vertebral foramen of atlas and thus was called the lateral part. The transverse ligament of the atlas was widened in the mid region, above the dens of axis, and thickened at enthesis. Periosteal fibrocartilage was detected in the transverse ligament of the atlas at the enthesis, and sesamoid fibrocartilage was present on periphery in the middle of the ligament. The craniocervical junction in foxes differs in part from other carnivores such as dogs and cats but resembles that of mesaticephalic dogs. The sesamoid and periosteal fibrocartilage supports the transverse ligament of the atlas whereas the alar ligaments have no cartilage.

  3. A Refined Technique for Management of Nasal Flaring: The Quest for the Holy Grail of Alar Base Modification

    PubMed Central

    Agrawal, Kapil S; Pabari, Mansi

    2016-01-01

    “A smile is happiness you'll find right under your nose”– Tom Wilson. This quote holds true just for patients, not for surgeons. The correction of the nose always poses a challenge to the cosmetic surgeon. Deformities of the external and internal nose may be congenital or acquired and may be secondary to soft tissue and/or osseo-cartilaginous abnormalities, leading to aesthetic and/or functional consequences. Alar flare poses a common problem, sometimes alone and sometimes in conjunction with other external deformities. Alar base reduction is generally considered when the interalar distance exceeds the intercanthal distance. It has been well documented that this simple additional procedure brings about a substantial enhancement in the nose. Various techniques have been described and used in the past, each having their benefits and drawbacks, with the modified Weir wedge excision, Aufricht nasal sill excision, and Bernstein V-Y advancement being the common ones. We hereby describe a technique that is simple yet effective in achieving the desired results and at the same time aims at preventing relapse to obtain satisfactory long term results. PMID:27896197

  4. Effects of two alar base suture techniques suture techniques on nasolabial changes after bimaxillary orthognathic surgery in Taiwanese patients with class III malocclusions.

    PubMed

    Chen, C Y-H; Lin, C C-H; Ko, E W-C

    2015-07-01

    A randomized controlled trial was designed to assess the effectiveness of two alar base cinch techniques on the changes in nasolabial morphology after bimaxillary orthognathic surgery. Sixty patients requiring a Le Fort I osteotomy to correct skeletal discrepancies were selected randomly to receive either conventional or modified alar base cinching during the intraoral wound closure procedure. Conventional cinching passed through nasalis muscle and anterior nasal spine. Modified cinching also passed through dermis tissue to increase the anchorage. Postoperative hard and soft tissue changes were evaluated using cone beam computed tomography and three-dimensional stereophotogrammetry at predefined time points. Forty-eight patients with a skeletal class III malocclusion were included. In the conventional group, there was an increase of 0.31 ± 1.31 mm in nasal width and an increase of 0.97 ± 1.60mm in columellar length. In the modified group, there was an increase of 0.81 ± 1.87 mm in the cutaneous height of the upper lip and a decrease of 0.76 ± 1.56 mm in lower prolabial width. Patients with an initial narrow nasal width, alar base width, and less vertical nostril show were more susceptible to a greater degree of change after surgery. Both alar base suture techniques are effective at controlling nasolabial form changes resulting from class III dual-jaw orthognathic surgery. Copyright © 2015 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. Long-term stability of limiting nasal alar base width changes with a cinch suture following Le Fort I osteotomy with submental intubation.

    PubMed

    Raithatha, R; Naini, F B; Patel, S; Sherriff, M; Witherow, H

    2017-06-29

    The aim of this study was to assess the effectiveness of the nasal alar base cinch suture following Le Fort I osteotomy at long-term follow-up. One hundred and forty participants (89 female, 51 male) aged between 16 and 51 years underwent Le Fort I osteotomy with submental intubation. Anthropometric measurements of the nose were taken intraoperatively, immediately postoperative, and for up to 3 years postoperative: the maximum lateral convexity of the alae (Al-Al) and the lateral extremity of the alar base curvature at the alar groove (Ac-Ac). The use of a cinch suture was recorded. The results were analysed using a linear mixed-effects model analysis. One hundred and six participants had cinch sutures and 34 had no cinch sutures. Following Le Fort I osteotomy, there were significant increases in Ac-Ac (by 4.29mm) and Al-Al (by 3.70mm) (both P<0.0001). Cinch sutures significantly reduced the widths back to preoperative values (P<0.0001). Alar width remained stable over 3 years, with an increase of 0.36mm for Al-Al (P>0.05) and 1.03mm for Ac-Ac (P<0.05) compared to the postoperative measurement. In conclusion, a cinch suture was helpful in reducing the unwanted alar base width changes, which were found to be relatively stable at 3 years. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. Signal changes of the alar ligament in a healthy population: a dispositional or degenerative consequence?

    PubMed

    Wenz, Holger; Kerl, Hans Ulrich; Maros, Mate Elod; Wenz, Ralf; Kalvin, Kira; Groden, Christoph; Nölte, Ingo

    2015-07-17

    OBJECT The alar ligaments (ALs) are vital for stabilizing the craniocervical junction. In terms of morphology, their appearance varies and is visible on MRI. Dark signal of the AL on proton-density (PD)-weighted images is generally considered the norm, but the etiology of frequently observed signal hyperintensities is poorly understood. Using spectral fat suppression, signal hyperintensities can be differentiated into fat- and nonfat-related hyperintensities (NFH). Although signal hyperintensities have no evident association with whiplash-associated disorder, age-related degeneration has often been theorized. Therefore, this study investigates the signal intensities of the ALs on 3.0-T MRI with special reference to age. Expanding thereon, the authors investigated the relationship between signal hyperintensities and patient characteristics, such as height, weight, and sex. METHODS Sixty-six healthy volunteers were scanned using 3.0-T PD-weighted MRI, including spectral fat suppression of the craniocervical junction. The study population was separated into 2 groups (old vs young) using 2 approaches: dichotomization at the median age (40.0 years) and the calculated threshold (28.5 years) using receiver operating characteristics (ROC). The AL was independently characterized with respect to continuity, course, shape, signal intensity, and graduation of homogeneity by 2 experienced neuroradiologists. Signal intensity was differentiated into fat-related hyperintensity and NFH. Univariate and multivariate logistic regression models were employed to investigate the relationship between patient characteristics and signal intensities. RESULTS Two different AL patterns were observed: inhomogeneous (33.3%) and homogeneous (66.7%). The latter pattern was mostly surrounded by a small dark rim (56.8%). Fat could be identified in 15.9% of all ALs (21 of 132 patients), and NFH was identified in 17.4% of all ALs (23 of 132 patients). Here, 28.5 years was the preferred threshold

  7. Three-dimensional image-guided placement of S2 alar screws to adjunct or salvage lumbosacral fixation.

    PubMed

    Nottmeier, Eric W; Pirris, Stephen M; Balseiro, Sarah; Fenton, Douglas

    2010-07-01

    Achieving fusion across the lumbosacral junction is challenging because of the unfavorable biomechanics associated with ending a fusion at this level. Bicortical placement of S1 pedicle screws can increase the construct stability at the lumbosacral junction; however, construct failure and pseudoarthrosis can still result. Iliac screws have been shown to increase the stiffness of lumbosacral constructs, but disadvantages include difficulty in connecting the iliac screw to adjacent sacral screws, painful screw loosening or prominence requiring removal, and the inability to place the screws in some patients with previous iliac crest autograft harvest. The purpose of the study is to describe a technique of S2 alar screw placement using three-dimensional image guidance. The study design is a retrospective analysis. Twenty patients undergoing lumbosacral fusion had 32 screws placed using this technique. An independent radiologist graded screw placement and lumbosacral fusion on thin-cut postoperative computed tomographic (CT) scans. Image guidance in this study was accomplished with the Medtronic Stealth Station Treon (Medtronic Inc., Littleton, MA, USA) used in conjunction with the O-ARM (Medtronic Inc.). Indications for placement of S2 alar screws included the following: to adjunct S1 pedicle screws in multilevel fusion cases; as an adjunct or alternative to S1 pedicle screws in pseudoarthrosis revision cases in which the S1 screws had loosened; as an alternative to S1 pedicle screws in cases where medial trajectory of an S1 pedicle screw was difficult to obtain because of a low-set lumbosacral junction; and a combination of the above. The entry point of the screw was typically chosen lateral and superior to the S2 dorsal foramen with the trajectory directed anterior, inferior, and lateral. Attempt was made to place the screw with the tip purchasing, but not penetrating through, the triangular area of cortical bone that can be found at the anterior, inferior, and

  8. Haplopacha (Lepidoptera: Lasiocampidae) reviewed: four new species, first descriptions of the genitalia of both sexes, and unique alar scale organs.

    PubMed

    Dupont, Steen; Simonsen, Thomas J; Zilli, Alberto

    2016-05-10

    The collection of five specimens of Haplopacha at Ndumo Nature Reserve in South Africa highlights unknown species diversity in the monotypic genus. A total of four new species; H. riftensis sp. nov., H. tangani sp. nov., H. lunata sp. nov. and H. ndoumoi sp. nov., were identified in the Natural History Museum of London collection and the study of fresh specimens also revealed the presence of uniquely characteristic alar scale patches absent from the original species description of the genus type species H. cinerea. Based on the new species the descriptions of Haplopacha is amended. The identification of the new species was done using conventional light microscopy and scanning electron microscopy of the general morphology, wing venation and genitalia observations.

  9. Two-photon excitation of the 2Π(4p)-X2Π(3p) transition of AlAr

    NASA Astrophysics Data System (ADS)

    Mascaritolo, Kyle J.; Antonov, Ivan O.; Heaven, Michael C.

    2014-03-01

    The 2Π(4p)-X2Π(3p) band system of AlAr has been observed using two-photon excitation. The spectrum consists of a short progression of doublet bands, with spin-orbit intervals that are close to that of Al(4p). Potential energy curve fitting yielded a bond dissociation energy for 2Π(4p) of De = 495(5) cm-1 and an approximate bond length of Re = 3.33(4) Å.

  10. Ablative fractionated erbium:YAG laser for the treatment of ice pick alar scars due to neodymium:YAG laser burns.

    PubMed

    Cohen, Joel L; Babcock, Michael J

    2009-01-01

    The authors present a case of ice pick scars forming in the nasal alar grooves of a patient who was treated with a 1064-nm neodymium:yttrium-aluminum-garnet (Nd:YAG) laser for facial telangiectasias. Treatment options for these types of scars are reviewed and specifically we report the success of an ablative fractionated 2940-nm erbium:yttrium-aluminum-garnet (Er:YAG) laser.

  11. Anatomical variations of the anterior atlanto-dental joint and relations to the apical and alar ligaments in a geriatric population.

    PubMed

    Rustagi, Tarush; Iwanaga, Joe; Sardi, Juan P; Alonso, Fernando; Oskouian, Rod J; Tubbs, R Shane

    2017-08-17

    Degenerative changes in the upper cervical spine may be age related degeneration or a pathological process such as rheumatoid arthritis. However, to our knowledge, the relationship between the apical and alar ligaments and these anomalies has not been discussed. We present anatomical variations of the anterior atlanto-dental joint observed during cadaveric dissection of adult craniovertebral junctions, the relationship with the alar and apical ligaments and discuss possible origins and clinical implications. The upper cervical spine including part of the occiput was dissected from cadavers whose mean age at death was 78.9 years-old. The anterior atlanto-dental joint and apical and alar ligaments were observed and any atypical findings were noted. In eleven specimens, seven had a dens corona, three had an os odontoideum and one had a dens aureola, which arose from the upper part of the anterior arch of the atlas. Only four specimens had an apical ligament. The possible etiologies and the clinical applications of these craniovertebral anomalies in a geriatric population should be appreciated by the clinician treating patients with disease in this area or interpreting imaging in the region. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The influence of a Le Fort I impaction and advancement osteotomy on smile using a modified alar cinch suture and V-Y closure: a prospective study.

    PubMed

    Muradin, M S M; Rosenberg, A J W P; van der Bilt, A; Stoelinga, P J W; Koole, R

    2012-05-01

    A previous report from the authors' department showed that a modified alar cinch suture combined with a muco-musculo-periosteal V-Y closure (mACVY) improves nasolabial mobility. To test if the improvements were equal to the range of nasolabial mobility in non-dysgnathic persons, a prospective study was carried out in 56 patients: 31 with mACVY, 25 with simple closing sutures (SCS) and 18 non-operated, angle class I volunteers. Standardized full facial frontal photographs, taken immediately preoperatively and 18 months postoperatively were used. The landmarks, alare, crista philtri and cheilion were analysed. The test has a standard deviation of 0.9 mm. Intra-group changes, paired t-test, and inter-group differences, unpaired t-test (p<0.05) were statistically analysed. The results show significant preoperative differences in nasolabial mobility compared with the control group, for both groups. Postoperative mobility improved in both groups, but significantly with mACVY with horizontal movement of cheilion and alare, and the vertical movement of crista philtri and less so for the vertical movement of crista philtri with SCS. Postoperative inter-group differences in mobility were small and significant for SCS vs the control group. It can be concluded that using mACVY improves orofacial movement to the level of normal class I volunteers. Copyright © 2011 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  13. Measurement and evaluation of the alar base in unilateral secondary lip nasal deformities by three-dimensional computed tomography.

    PubMed

    Wu, Yilai; Yang, Yusheng; Chen, Yang; Zhang, Yong; Wang, Guomin

    2013-11-01

    Objective : This study aimed to analyze the asymmetry of the pyriform aperture and alar base in patients with unilateral secondary nasal deformities by three-dimensional computed tomography (3D-CT). Methods : 3D-CT images of the subject group of 101 adult patients and of a control group of 65 normal adults were examined. Sixty-nine patients without alveolar bone grafting (ABG) were classified as Group A, and 32 patients with ABG were classified as Group B. Seven landmarks (INM, LPA, IPA, Gbase, Gsup, Glat, and Sbal) were measured for both the subject and control groups, and comparative analyses were done to assess the degree of asymmetry in the subject group. Results : For over 95% of Group A and 80% to 85% of Group B, the index of LPA and IPA showed asymmetry or marked asymmetry. The index of Gbase, Glat, Gsup, and Sbal showed symmetry for around 50% of Group A and about 60% of Group B. In Group A, dorsal, lateral, and caudal translocation was found on the cleft side in LPA and IPA, while all soft landmarks showed dorsal translocation. In Group B, caudal translocation was found in both LPA and IPA, but only LPA appeared dorsal on the cleft side, while Glat showed dorsal and caudal translocation. Conclusion : The results indicated that the degree of asymmetry of hard tissue landmarks far exceeded that of the soft tissue landmarks, and the degree of asymmetry of pyriform aperture was higher than expected for patients after ABG.

  14. Utilization of a Technique of Percutaneous S2 Alar-Iliac Fixation in Immunocompromised Patients with Spondylodiscitis.

    PubMed

    Funao, Haruki; Kebaish, Khaled M; Isogai, Norihiro; Koyanagi, Takahiro; Matsumoto, Morio; Ishii, Ken

    2017-01-01

    Spondylodiscitis still remains a serious problem, especially in immunocompromised patients. Surgery is necessary when nonsurgical treatment is unsuccessful. Although minimally invasive spine stabilization (MISt) with percutaneous pedicle screws is less invasive, percutaneous sacropelvic fixation techniques are not common practice. Here, we describe 2 cases in which spondylodiscitis in the lumbosacral spine was treated with percutaneous stabilization using an S2 alar-iliac (S2AI) screw technique. Case 1 is a 77-year-old man who presented with low back pain and high fever. He was diagnosed with spondylodiscitis at L4-5. He had a history of lung cancer, which was complicated by the recurrence. Because nonsurgical treatment failed, MISt with percutaneous S2AI screws was performed. The patient's low back pain subsided markedly 1 week after surgery, and there was no screw/rod breakage or recurrence of infection during the follow-up period. Case 2 is a 71-year-old man who presented with hemiparesis because of a stroke. He also developed high fever and was diagnosed with spondylodiscitis at L5-S1. Because nonsurgical treatment failed, the patient was treated by MISt with percutaneous S2AI screws while being maintained on anticoagulants for stroke. Although his clinical symptoms had markedly improved, a postoperative lumbar computed tomography scan demonstrated a bone defect at L5-S1. An anterior spinal fusion with an iliac bone graft at L5-S1 was performed when a temporary cessation of anticoagulants was permitted. Both patients tolerated the procedures well and had no major perioperative complications. MISt with percutaneous S2AI screws was less invasive and efficacious for lumbosacral spondylodiscitis in providing rigid percutaneous sacropelvic fixation. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. AlAr3(THF): highly efficient reagents for cross-couplings with aryl bromides and chlorides catalyzed by the economic palladium complex of PCy3.

    PubMed

    Ku, Shih-Lun; Hui, Xin-Ping; Chen, Chien-An; Kuo, Yi-Ying; Gau, Han-Mou

    2007-10-07

    Novel and highly efficient cross couplings of aryl bromides and chlorides with AlAr3(THF) (Ar = Ph, 2,4,6-Me3C6H2, 2-naphthyl or 4-Me3SiC6H4) catalyzed by the economic palladium catalyst of PCy3 are reported without the use of a base and under mild reaction conditions at room temperature or temperatures < or = 60 degrees C even for couplings of bulky aryl halides and the Al(2,4,6-Me3C6H2)3(THF) reagent.

  16. Modified alar base cinch suture fixation at the bilateral lower border of the piriform rim after a maxillary Le Fort I osteotomy.

    PubMed

    Yen, C Y; Kuo, C L; Liu, I H; Su, W C; Jiang, H R; Huang, I G; Liu, S Y; Lee, S Y

    2016-11-01

    Classic cinch suture narrowing of the nasal alar base by medially suturing the bilateral nasolabial soft tissue with one long suture has a limited effect. The modified cinch method described in the present study anchors non-absorbable sutures to the bilateral lower border of the piriform rim and provides optimal direction, position, and stability. The sutures can be shortened and the strength kept stable while the surgical wounds heal. Separate bilateral sutures can also reduce interference and distortion from nasotracheal intubation and make the nasolabial profile more symmetrical. Seventeen consecutive cases of maxillary Le Fort I osteotomy were analyzed. The nasal and alar base width changes were 0.4±1.2mm and 0.1±1.1mm, respectively, and the widening rate was only 1.1%. Compared with the results of other studies, postoperative nasal flaring was well controlled using the modified cinch suture anchored to the bilateral lower border of the piriform rim described in this study. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Nostril and alar reshaping.

    PubMed

    Planas, J; Planas, J

    1993-01-01

    The authors recommend, when necessary, the use of external excisions for correcting variations in the shape of the nostrils and alae in the cleft lip-nose deformity, in primary rhinoplasties, and in secondary rhinoplasties. Their experience in the use of external incisions was originally stimulated by Millard's paper of 1960 which recommended different types of remodeling external excisions in his analysis of how to handle variations in the shape of the nostrils and alae.

  18. Spectroscopy of the AlAr van der Waals complex: Rotationally resolved B 2Σ+←X 2Π1/2 electronic transitions

    NASA Astrophysics Data System (ADS)

    McQuaid, Michael J.; Gole, James L.; Heaven, Michael C.

    1990-03-01

    Rotationally resolved spectra were recorded for six bands of the AlAr B 2Σ+←X 2Π1/2 transition. Vibrational and rotational constants derived from these spectra were used to determine the upper and lower state potential energy curves. The accuracy of these potentials was assessed through calculations of the spectroscopic constants and Franck-Condon factors. Dissociation energies of D'e=440+35-8 cm-1 and D'e=180+40-10 cm-1 were obtained for the B and X states, respectively. The interaction between X 2Π1/2 and the low-lying A 2Σ+ state has been characterized by analysis of the ground-state lambda doublet splitting.

  19. Calcification of the Alar Ligament Mimics Fracture of the Craniovertebral Junction (CVJ): An Incidental Finding from Computerised Tomography of the Cervical Spine Following Trauma

    PubMed Central

    Che Mohamed, Siti Kamariah; Abd. Aziz, Azian

    2009-01-01

    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury. PMID:22135515

  20. Calcification of the Alar Ligament Mimics Fracture of the Craniovertebral Junction (CVJ): An Incidental Finding from Computerised Tomography of the Cervical Spine Following Trauma.

    PubMed

    Che Mohamed, Siti Kamariah; Abd Aziz, Azian

    2009-10-01

    When performing a radiological assessment for a trauma case with associated head injury, a fragment of dense tissue detected near the craniovertebral junction would rapidly be assessed as a fractured bone fragment. However, if further imaging and evaluation of the cervical spine with computerised tomography (CT) did not demonstrate an obvious fracture, then the possibility of ligament calcification would be considered. We present a case involving a previously healthy 44-yearold man who was admitted following a severe head injury from a road traffic accident. CT scans of the head showed multiple intracranial haemorrhages, while scans of the cervical spine revealed a small, well-defined, ovoid calcification in the right alar ligament. This was initially thought to be a fracture fragment. Although such calcification is uncommon, accident and emergency physicians and radiologists may find this useful as a differential diagnosis in patients presenting with neck pain or traumatic head injury.

  1. Single-stage reconstruction of a full-thickness alar defect using a folded nasolabial flap combined with a redundant skin turnover flap.

    PubMed

    Takeda, Akira; Akimoto, Minekatsu; Park, Keiichi; Kounoike, Natsuko; Shimakura, Yasuhito; Nemoto, Mitsuru; Uchinuma, Eiju

    2014-11-01

    The reconstructive strategy for full-thickness nasal skin defects should include recreation of a cutaneous cover, support, and internal nasal lining. The most challenging aspect of this procedure is provision of the nasal lining. These reconstructions typically require a 2-step process. Satisfactory nasal skin reconstruction in a single operation is ideal. We used a folded nasolabial flap combined with a turnover flap for reconstruction of full-thickness alar defects. The donor material of the lining flap was a combination of the distal portion of the nasolabial flap and redundant skin resected during its transposition. The redundant skin flap was turned upside down, with the skin surface inside the nasal cavity. The remaining portion of the defect was covered with a folded nasolabial flap. This procedure was successful in all 5 patients. All flaps survived completely without evidence of necrosis or narrowing of airways. Aesthetic concerns, including effacement of the nasofacial sulcus, were minor. This method has the advantage of providing well-vascularized tissue of appropriate color, texture, and thickness for external coverage, as well as a satisfactory internal lining in a single-stage procedure.

  2. Free Hand Insertion Technique of S2 Sacral Alar-Iliac Screws for Spino-Pelvic Fixation: Technical Note, Acadaveric Study

    PubMed Central

    Park, Jong-Hwa; Kim, Ki-Jeong; Jahng, Tae-Ahn

    2015-01-01

    A rigid spino-pelvic fixation to anchor long constructs is crucial to maintain the stability of long fusion in spinal deformity surgery. Besides obtaining immediate stability and proper biomechanical strength of constructs, the S2 alar-iliac (S2AI) screws have some more advantages. Four Korean fresh-frozen human cadavers were procured. Free hand S2AI screw placement is performed using anatomic landmarks. The starting point of the S2AI screw is located at the midpoint between the S1 and S2 foramen and 2 mm medial to the lateral sacral crest. Gearshift was advanced from the desired starting point toward the sacro-iliac joint directing approximately 20° angulation caudally in sagittal plane and 30° angulation horizontally in the coronal plane connecting the posterior superior iliac spine (PSIS). We made a S2AI screw trajectory through the cancellous channel using the gearshift. We measured caudal angle in the sagittal plane and horizontal angle in the coronal plane. A total of eight S2AI screws were inserted in four cadavers. All screws inserted into the iliac crest were evaluated by C-arm and naked eye examination by two spine surgeons. Among 8 S2AI screws, all screws were accurately placed (100%). The average caudal angle in the sagittal plane was 17.3±5.4°. The average horizontal angle in the coronal plane connecting the PSIS was 32.0±1.8°. The placement of S2AI screws using the free hand technique without any radiographic guidance appears to an acceptable method of insertion without more radiation or time consuming. PMID:26819698

  3. [Reconstruction of superficial defects from the crossroad of nasal subunits, tip, alar lobule and lateral side wall: Study of 36 patients].

    PubMed

    Grandpierre, X; Sartre, J Y; Duteille, F

    2016-08-01

    Conventionally, articles dealing with nasal defects plan reconstructions regarding the aesthetic subunits, imposing their systematic respect. We propose to study the reconstruction of a crossroad region of three subunits, tip, alar lobule and lateral sidewall, where that full compliance is not possible, in our experience of 36 patients. Our retrospective study from January 2011 to December 2012 focused on patients with a defect in this crossroad region that was repaired by skin graft or flap. We described the population of the study, histological type of the lesions, surgical procedures and complications. We evaluated the reconstructions performed with a photographic review 1 year post-surgery according to the criteria of symmetry, discoloration, thickness, shrinkage, and rating on the Vancouver Scar Scale, which helped create an overall aesthetic score for the reconstruction. Of 144 patients with a nasal defect, 36 of them (25%) were included, presenting a defect in our study area. The reconstruction was made by eight hatchet flaps, eight frontal flaps, seven bilobed flaps, five advanced-rotated lateronasal flaps, four nasolabial flaps, two Rybka flaps and two total skin grafts. The advanced-rotated flap, hatchet flap and bilobed flap had the highest results and scores, according to the criteria assessed. Rybka flap and total skin grafts had the lowest results. The occurrence of a defect in the crossroads seems common. In this indication, specific local flaps had a favourable outcome, including review of the overall esthetic score which was created to standardize the assessment of reconstructions. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  4. Combined S-1 and S-2 sacral alar-iliac screws as a salvage technique for pelvic fixation after pseudarthrosis and lumbosacropelvic instability: combined S-1 and S-2 sacral alar-iliac screws as a salvage technique for pelvic fixation after pseudarthrosis and lumbosacropelvic instability: technical note.

    PubMed

    Mattei, Tobias A; Fassett, Daniel R

    2013-09-01

    Lumbosacropelvic pseudarthrosis after long spinal fusions for treatment of adult degenerative scoliosis remains a challenging condition. Moreover, although pelvic fixation with iliac screws is widely used in deformity surgery to provide a biomechanically strong distal anchor for long thoracolumbar constructs, there are very few options available after failed pelvic fixation with iliac screws. The authors conducted a retrospective review of the surgical charts and imaging findings of patients subjected to revision surgery for lumbosacropelvic pseudarthrosis from August 2011 to August 2012. This review identified 5 patients in whom a salvage technique combining both S-1 and S-2 sacral alar-iliac (SAI) screws had been performed. In this technical note, the authors present a detailed anatomical discussion and an appraisal of the sequential intraoperative steps of this new technique involving a combination of S-1 and S-2 SAI screws. The discussion is illustrated with a surgical case in which this technique was used to treat a patient with pseudarthrosis that had developed after fixation with classic iliac screws. In conclusion, although S-2 SAI screws have previously been reported as an interesting alternative to classic iliac wing screws, this report is the first on the use of combined S-1 and S-2 SAI screws for pelvic fixation as a salvage technique for lumbosacropelvic instability. According to the reported experience, this technique provides a biomechanically robust construct for definitive pelvic fixation during revision surgeries in the challenging scenarios of pseudarthrosis and instability of the lumbosacropelvic region.

  5. Reconstruction of Alar Nasal Cartilage Defects Using a Tissue Engineering Technique Based on a Combined Use of Autologous Chondrocyte Micrografts and Platelet-rich Plasma: Preliminary Clinical and Instrumental Evaluation

    PubMed Central

    Scioli, Maria G.; Bielli, Alessandra; Orlandi, Augusto; Cervelli, Valerio

    2016-01-01

    Background: Developing cartilage constructs with injectability, appropriate matrix composition, and persistent cartilaginous phenotype remains an enduring challenge in cartilage repair. The combined use of autologous chondrocyte micrografts and platelet-rich plasma (PRP) is an alternative that opens a new era in this field. Methods: At the Department of Plastic and Reconstructive Surgery, University of Rome Tor Vergata, Italy, 11 patients underwent nasal alar reconstruction with chondrocyte micrografts gently poured onto PRP in solid form. A computed tomographic scan control was performed after 12 months. Pearson’s Chi-square test was used to investigate difference in cartilage density between native and newly formed cartilages. Results: The constructs of chondrocyte micrografts–PRP that were subcutaneously injected resulted in a persistent cartilage tissue with appropriate morphology, adequate central nutritional perfusion without central necrosis or ossification, and further augmented nasal dorsum without obvious contraction and deformation. Conclusion: This report demonstrated that chondrocyte micrografts derived from nasal septum poured onto PRP in solid form are useful for cartilage regeneration in patients with external nasal valve collapse. PMID:27826462

  6. A comparative study to find out the relationship between the inner inter-canthal distance, interpupillary distance, inter-commissural width, inter-alar width, and the width of maxillary anterior teeth in Aryans and Mongoloids

    PubMed Central

    Mishra, Meena Kumari; Singh, Raj Kumar; Suwal, Pramita; Parajuli, Prakash Kumar; Shrestha, Pragya; Baral, Dharanidhar

    2016-01-01

    Background One of the most confusing and difficult aspects of complete denture prosthodontics is the selection of appropriately sized maxillary anterior denture teeth. Various guidelines have been suggested for determining the size of anterior teeth, but different opinions have been reported regarding their significance. In the study reported here, the relationships between facial measurements and the width of maxillary anterior teeth in two ethnic groups, namely Aryans and Mongoloids, were determined. Objective The aims of the study were to determine the inner inter-canthal distance (ICAD), inter-pupillary distance (IPD), inter-commissural width (ICOW), inter-alar width (IAW), and the combined width of maxillary anterior teeth (CW) in Aryans and Mongoloids and to determine the relationships between these measurements. Materials and methods Impressions of the teeth of 170 dentulous subjects (85 males and 85 females) were made with alginate then Type IV gypsum product was poured in. Measurements of the cast maxillary anterior teeth at their widest dimension (contact areas) were made with the Boley gauge. ICAD, IPD, ICOW, and IAW distances were also measured with a Boley gauge. Results For all 170 subjects, 85 Aryans and 85 Mongoloids, Pearson’s correlation coefficient (r) for IAW, IPD, ICOW, ICAD, and CW was calculated. In Aryans, highly significant (P<0.001) but weak correlations were found between CW and IAW, IPD, and ICOW. In Mongoloids, a highly significant (P<0.001) and weak correlation was found only between CW and IPD. Conclusion Within the limitations of this study, the results suggest that the IAW, IPD, and ICOW for Aryans and IPD for Mongoloids can be used as a preliminary method for determining the width of the maxillary anterior teeth in edentulous patients. PMID:26955292

  7. AlAr X 2П1/2 Aluminum - argon (1/1)

    NASA Astrophysics Data System (ADS)

    Hüttner, W.

    This document is part of Subvolume A1 'Diamagnetic Diatomic Molecules. Part 1' of Volume 29 'Molecular Constants Mostly from Microwave, Molecular Beam, and Sub-Doppler Laser Spectroscopy' of Landolt-Börnstein - Group II 'Molecules and Radicals'.

  8. Transformation of the plant growth regulator daminozide (Alar) and structurally related compounds with CuII ions: oxidation versus hydrolysis.

    PubMed

    Huang, Ching-Hua; Stone, Alan T

    2003-05-01

    As part of a study of metal ion effects on chemical transformations of nitrogen-containing agrochemicals, conversion of daminozide to succinate via cleavage of the hydrazide C-N bond was examined in the presence and absence of divalent metal ions. No conversion was observed in metal ion-free solutions or in the presence of 1.0 mM NiII, ZnII, and PbII. CuII, in contrast, markedly increased rates of daminozide to succinate conversion. Halide ions (CI-, Br-) had no effect on daminozide conversion in the absence of metal ions but markedly increased conversion rates observed in the presence of CuII. The nitrogen-donor ligands ethylenediamine, N-(2-hydroxyethyl)ethylenediamine, and 1,4,7,10-tetraazacyclododecane decreased rates of CuII-facilitated conversion, while 1,5,9-triazacyclododecane actually increased rates of conversion. H NMR and UV spectroscopy provide evidence for the formation of 1:1 CuII-daminozide complexes. Halide ion effects and nitrogen-donor ligand effects point to an oxidative mechanism for CuII-facilitated daminozide breakdown, rather than hydrolysis. The structurally related compound butyric acid 2,2-dimethylhydrazide (BH) is subject to the same CuII-facilitated breakdown via an oxidative mechanism. N,N-Dimethylsuccinamic acid (SA), in contrast, breaks down via a hydrolytic mechanism.

  9. A HEL Testbed for High Accuracy Beam Pointing and Control

    DTIC Science & Technology

    2009-07-01

    43  4.1.4.  ALAR ...n wG w f f s w s w π ξ ξ = = = + + = 4.1.4. ALAR The ALAR which is direct drive rotary stage, provides superior angular positioning and velocity...vibrations. Applications of the ALAR include single and multi-axis electro optical sensor testing, missile seeker testing, antenna testing

  10. Interatomic potentials for van der Waals complexes of group 13 metal atoms: AlAr, AlKr, and AlXe

    NASA Astrophysics Data System (ADS)

    Callender, C. L.; Mitchell, S. A.; Hackett, P. A.

    1989-05-01

    Interatomic potential parameters for the ground X1,2 2Π1/2,3/2 and excited B 2Σ+1/2 states of jet-cooled van der Waals complexes of Al atoms with rare gases have been determined from fluorescence excitation and emission spectra. Vibrational numbering in the B states is established from isotopic and rotational broadening of fluorescence excitation line shapes. Bond distances are estimated by comparison with analogous states of alkali-rare gas molecules, and by modeling observed relative emission intensities with calculated Franck-Condon factors. Morse potentials are found to adequately describe the data for the ground states, but for the excited states there are indications of departures from Morse functions at large internuclear distances. Dissociation energies De are estimated from Birge-Sponer extrapolations. Multiplet splittings in Al-rare gas complexes are compared to those in In-rare gas complexes and are discussed in terms of an empirical treatment of spin-orbit coupling, which assumes that the spin-orbit coupling constant for the molecule is the same as that for the atom. The ground X1 state of each Al-rare gas molecule is more stable than that of the analogous In complex, whereas the spin-orbit excited X2 state is less stable. This is explained by the greater mixing between the X1 state and the dissociative A 2Σ+1/2 state for indium over aluminum, caused by the greater spin-orbit coupling constant for the heavier metal.

  11. Range of motion, sacral screw and rod strain in long posterior spinal constructs: a biomechanical comparison between S2 alar iliac screws with traditional fixation strategies

    PubMed Central

    Field, Antony; Ferrara, Lisa A.; Freeman, Andrew L.; Phan, Kevin

    2016-01-01

    Background S1 screw failure and L5/S1 non-union are issues with long fusions to S1. Improved construct stiffness and S1 screw offloading can help avoid this. S2AI screws have shown to provide similar stiffness to iliac screws when added to L3–S1 constructs. We sought to examine and compare the biomechanical effects on an L2–S1 pedicle screw construct of adding S2AI screws, AxiaLIF, L5–S1 interbody support via transforaminal lumbar interbody fusion (TLIF), and to examine the effect of the addition of cross connectors to each of these constructs. Methods Two S1 screws and one rod with strain gauges (at L5/S1) were used in L2–S1 screw-rod constructs in 7 L1-pelvis specimens (two with low BMD). ROM, S1 screw and rod strain were assessed using a pure-moment flexibility testing protocol. Specimens were tested intact, and then in five instrumentation states consisting of: (I) Pedicle screws (PS) L2–S1; (II) PS + S2AI screws; (III) PS + TLIF L5/S1; (IV) PS + AxiaLIF L5/S1; (V) PS + S2AI + AxiaLIF L5/S1. The five instrumentation conditions were also tested with crosslinks at L2/3 and S1/2. Tests were conducted in flexion-extension, lateral bending and axial torsion with no compressive preload. Results S2A1 produces reduced S1 screw strain for flexion-extension, lateral bending and axial torsion, as well as reduced rod strain in lateral bending and axial torsion in comparison to AxiaLIF and interbody instrumentation, at the expense of increased rod flexion-extension strain. Cross-connectors may have a role in further reduction of S1 screw and rod strain. Conclusions From a biomechanical standpoint, the use of the S2AI technique is at least equivalent to traditional iliac screws, but offers lower prominence and ease of assembly compared to conventional sacroiliac stabilization. PMID:28097243

  12. Correlation consistent basis sets for molecular core-valence effects with explicitly correlated wave functions: The atoms B-Ne and Al-Ar

    NASA Astrophysics Data System (ADS)

    Hill, J. Grant; Mazumder, Shivnath; Peterson, Kirk A.

    2010-02-01

    Correlation consistent basis sets have been optimized for accurately describing core-core and core-valence correlation effects with explicitly correlated F12 methods. The new sets, denoted cc-pCVnZ-F12 (n =D, T, Q) and aug-cc-pCF12VnZ (n =D, T, Q, 5), were developed by augmenting the cc-pVnZ-F12 and aug-cc-pVnZ families of basis sets with additional functions whose exponents were optimized based on the difference between all-electron and valence-electron correlation energies. The number of augmented functions added is fewer, in general, than in the standard cc-pCVnZ and cc-pwCVnZ families of basis sets. Optimal values of the geminal Slater exponent for use with these basis sets in MP2-F12 calculations are presented and are also recommended for CCSD-F12b calculations. Auxiliary basis sets for use in the resolution of the identity approximation in explicitly correlated calculations have also been optimized and matched to the new cc-pCVnZ-F12 series of orbital basis sets. The cc-pCVnZ-F12 basis sets, along with the new auxiliary sets, were benchmarked in CCSD(T)-F12b calculations of spectroscopic properties on a series of homo- and heteronuclear first and second row diatomic molecules. Comparing the effects of correlating the outer core electrons in these molecules with those from conventional CCSD(T) at the complete basis set limit, which involved calculations with new cc-pCV6Z basis sets for the second row elements that were also developed in the course of this work, it is observed that the F12 values are reasonably well converged already at just the triple-ζ level.

  13. Evaluation and Improvement of Spectral Features for the Detection of Buried Explosive Hazards Using Forward-Looking Ground-Penetrating Radar

    DTIC Science & Technology

    2012-07-01

    ROC) curves, and Section 5 is the conclusion. 1.1 ALARIC FLGPR The FLGPR images we use in this paper were collected using a system called ALARIC ...classifier Figure 1. FLGPR explosive hazard detection block diagram The ALARIC system is equipped with an accurate GPS system. As a result, it...the 32 T/R images which adaptively suppresses artifacts such as sidelobes and aliasing ghosts. Table 1 contains the parameters of the ALARIC FLGPR

  14. In Vitro and In Vivo Studies of Alar-Nasal Cartilage Using Autologous Micro-Grafts: The Use of the Rigenera® Protocol in the Treatment of an Osteochondral Lesion of the Nose

    PubMed Central

    Ceccarelli, Gabriele; Gentile, Pietro; Marcarelli, Marco; Balli, Martina; Ronzoni, Flavio Lorenzo; Benedetti, Laura; Cusella De Angelis, Maria Gabriella

    2017-01-01

    Cartilage defects represent a serious problem due to the poor regenerative properties of this tissue. Regarding the nose, nasal valve collapse is associated with nasal blockage and persistent airway obstruction associated with a significant drop in the quality of life for patients. In addition to surgical techniques, several cell-based tissue-engineering strategies are studied to improve cartilage support in the nasal wall, that is, to ameliorate wall insufficiency. Nevertheless, there are no congruent data available on the benefit for patients during the follow-up time. In this manuscript, we propose an innovative approach in the treatment of cartilage defects in the nose (nasal valve collapse) based on autologous micro-grafts obtained by mechanical disaggregation of a small portion of cartilage tissue (Rigenera® protocol). In particular, we first analyzed in vitro murine and human cartilage micro-grafts; secondly, we analyzed the clinical results of a patient with pinched nose deformity treated with autologous micro-grafts of chondrocytes obtained by Rigenera® protocol. The use of autologous micro-graft produced promising results in surgery treatment of cartilage injuries and could be safely and easily administrated to patients with cartilage tissue defects. PMID:28608799

  15. Biomechanical Comparison of Sacral Fixation Characteristics of Standard S1-Pedicle Screw Fixation versus a Novel Constrained S1-Dual-Screw Anchorage in the S1-Pedicle and S1-Alar Bone.

    PubMed

    Mayer, Michael; Stephan, Daniel; Resch, Herbert; Augat, Peter; Auffarth, Alexander; Blocher, Martina; Ernstbrunner, Lukas; Hitzl, Wolfgang; Defossez, Henri; Rouge, Renaud; Koller, Heiko

    2015-12-01

    Biomechanical Laboratory Study. Analysis of the biomechanical characteristics of a novel sacral constrained dual-screw fixation device (S1-PALA), combining a S1-pedicle screw and a S1-ala screw, compared to a standard bicortical S1-pedicle screw (S1-PS) fixation. Instrumented fusions to the sacrum are biomechanically challenging and plagued by a high risk of nonunion when S1-PS is used as the sole means of fixation. Thus, lumbopelvic fixation is increasingly selected instead, although associated with a reasonable number of instrumentation-related complications. Around 30 fresh-frozen human sacral bones were harvested and embedded after CT scans. Instrumentation was conducted in alternating order with bicortical 7.0 mm S1-PS and with the S1-PALA including a S1-PS screw and a S1-ala screw, of 7.0 and 6.0 mm diameter, respectively. Specimens were subjected to cyclic loading with increasing loads (25-250 N) until a maximum of 2000 cycles or displacement >2 mm occurred. All implant sacral units (ISUs) were subject to coaxial pullout tests. Failure load, number of ISUs surpassing 2000 cycles, number of cycles, and loads at failure were recorded and compared. Donors' age averaged 77 ± 14.2 years, and BMD was 115 ± 64.8 mgCA-HA/ml. Total working length of screws implanted was 90 ± 8.6 mm in the S1-PALA group and 46 ± 5 mm in the S1-PS group (P = 0.0002). In the S1-PALA group, displacement >2 mm occurred after 845 ± 325 cycles at 149 ± 41 N compared to 512 ± 281 cycles at 106 ± 36 N in the S1-PS group (P = 0.004; P = 0.002). In coaxial pull-out testing, failure load was 2118.1 ± 1166 N at a displacement of 2.5 ± 1 mm in the S1-PALA group compared to 1375.6 ± 750.1 N at a displacement of 1.6 ± 0.5 mm in the S1-PS group (P = 0.0007; P = 0.0003). The novel sacral constrained dual-screw anchorage (S1-PALA) significantly improved holding strength after cyclic loading compared to S1-PS. The S1-PALA demonstrated mechanical potential as a useful adjunct in the armamentarium of lumbosacral fixations indicated in cases that need advanced construct stability, but where instrumentation to the ilium or distal dissection to S2 should be avoided. N/A.

  16. Locally Adaptive Detection Algorithm for Forward-Looking Ground-Penetrating Radar

    DTIC Science & Technology

    2011-02-22

    the ground. This results in an excessive number of FAs. The FLGPR images we present in this paper were collected by a system called ALARIC . This...intelligence, surveillance and reconnaissance (ISR) applications. The ALARIC system is equipped with an accurate GPS system. As a result, we are capable...effective system for improving the detection capabilities of the ALARIC system. Figure 5 showed that the locally- adaptive prescreener not only enabled

  17. Detection of Explosive Hazards Using Spectrum Features From Forward-Looking Ground Penetrating Radar Imagery

    DTIC Science & Technology

    2011-01-01

    applications such as a vehicle traveling a road in which mines are buried. The data used for this paper was collected in this way. A system called ALARIC ...research. The ALARIC system used to collect the data for our research is still under development. Currently, more field tests are being conducted to...improve the system. Our algorithms were developed using the limited amount of data so far collected by ALARIC . These data have given us a chance to

  18. A Flexible Distributed Scheduling Scheme for Dynamic ESG Environments

    DTIC Science & Technology

    2006-06-01

    Branke, and H. Abbass, “Multi-objective opti- mization for dynamic environments”, The Artificial Life and Adaptive Robotics Laboratory ALAR Technical...Report Series TR- ALAR -200504007, Northcott Drive, Campbell, Canberra, Aus- tralia, 2005. [27] K. Yamasaki, “Dynamic Pareto optimum GA against the changing

  19. Improved Detection and False Alarm Rejection Using FLGPR and Color Imagery in a Forward-Looking System

    DTIC Science & Technology

    2010-01-01

    called ALARIC . This system is an FLGPR system that is composed of a physical array of sixteen receivers and two transmitters. In the past decade...for airborne intelligence, surveillance and reconnaissance (ISR) applications. The ALARIC system is equipped with an accurate GPS system. As a result

  20. Lower lateral crural reverse plasty.

    PubMed

    Kubilay, Utku; Azizli, Elad; Erdoğdu, Suleyman

    2013-11-01

    The lateral crus plays a significant role in the aesthetic appearance of the nose. Excessive concavities of the lower lateral crura can lead to heavy aesthetic disfigurement of the nasal tip and to insufficiencies of the external nasal valve. The lateral crus of the alar cartilage may also cause a concavity of the alar rim and even collapse of the alar rim in severe cases. Surgical techniques performed on the lateral crus help to treat both functional and aesthetic deformities of the lateral nasal tip. We present a reverse plasty technique for the lateral crus, and we evaluated the advantages and disadvantages of the technique.

  1. Yes You Can! Personal Experience of Writing for "School Science Review"

    ERIC Educational Resources Information Center

    Thompson, Alaric; Auty, Geoff

    2013-01-01

    Alaric Thompson describes his experience of writing for "School Science Review" for the first time in the hope that his experience will encourage others. Geoff Auty introduces his piece and explains how it came about.

  2. Yes You Can! Personal Experience of Writing for "School Science Review"

    ERIC Educational Resources Information Center

    Thompson, Alaric; Auty, Geoff

    2013-01-01

    Alaric Thompson describes his experience of writing for "School Science Review" for the first time in the hope that his experience will encourage others. Geoff Auty introduces his piece and explains how it came about.

  3. Auto-Rim Flap Technique for Lateral Crura Caudal Excess Treatment.

    PubMed

    Çakır, Barış; Küçüker, İsmail; Aksakal, İbrahim Alper; Sağır, Hacı Ömer

    2017-01-01

    There are many variables that influence nose tip harmony. Even in a rhinoplasty that appears successful in profile, one may see nostril asymmetries, alar retractions, or irregularities in the soft triangle, and patients express their dissatisfaction with these simple deformities. In this study, we define the ratio of caudal and cephalic excess of the lower lateral cartilage. We evaluate whether it is possible to eliminate nostril asymmetries and alar retractions by means of supporting the facet polygon with the help of a lower lateral cartilage auto-rim flap, a technique we have developed in our rhinoplasties. The auto-rim flap was used successively on 498 primary rhinoplasty patients on whom the same surgeon operated between May 2013 and June 2015, performing marginal incisions. Of the 498 patients in the series, only 1 of the first 10 required a revision due to tip asymmetry related to the auto-rim flap. A minimal nostril asymmetry that did not require intervention occurred in 10 patients. In none of the patients could an increased alar retraction be seen postoperatively. All patients exhibited alar cartilage in the anatomically correct position. With the auto-rim flap technique, a part of the caudal excess of the alar cartilage remains as a flap in the facet region; therefore, there is no need in the cephalic region to perform more of an excision than what is strictly necessary. 4 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  4. [Standard rhinoplasty].

    PubMed

    Bardot, J; Jallut, Y; Nguyen, P-S

    2014-12-01

    Most patients who consult a surgeon for rhinoplasty do not want a radical change in their nose. They seek a reduction in the volume of the nasal pyramid and correction of a precise element that they judge to be ungainly--most often an osteocartilaginous hump. The procedure that we qualify as "standard" will eliminate the osteocartilaginous hump, decrease the dimensions of the septum and reduce the size of the alar crus of the alar cartilage. Although the required technical maneuvers are simple, their sequence must be coherent with a few basic rules that are simple but rarely explained in order to avoid defects linked to excessive, or on the contrary, insufficient corrections.

  5. Reflecting on a Leadership Development Programme: A Case Study in South African Higher Education

    ERIC Educational Resources Information Center

    Louw, Ina; Zuber-Skeritt, Ortrun

    2009-01-01

    Leadership development in higher education is of vital importance to South Africa's future. We present a case study that focuses on a leadership development programme (LDP) through action learning and action research (ALAR) for women academics in South Africa during 2000 and 2001. It identifies the effects of the LDP on participants five years…

  6. Traumatic vertical atlantoaxial dislocation.

    PubMed

    Payer, M; Wetzel, S; Kelekis, A; Jenny, B

    2005-08-01

    We present a case of traumatic vertical atlantoaxial dislocation of 16 millimetres with a fatal outcome. We hypothesize that this extremely rare traumatic vertical atlantoaxial dislocation results from insufficiency of the C1/C2 facet capsules after rupture of the tectorial membrane and the alar ligaments.

  7. Atlantoaxial rotatory dislocation. A case report.

    PubMed

    Niibayashi, H

    1998-07-01

    Report of a child who sustained an acute atlantoaxial rotatory dislocation, associated with fractures of the clavicle and the temporal bone, and rupture of the alar ligament demonstrated by magnetic resonance imaging. To describe the radiographic and pathoanatomic characteristics of the injury process. Only five cases of traumatic atlantoaxial rotatory dislocation associated with fracture of the clavicle have been reported previously. This is the first report of a ruptured alar ligament demonstrated on magnetic resonance imaging in a patient with atlantoaxial rotatory dislocation associated with fractures of the clavicle and the temporal bone. Computed tomography revealed the Type 1 rotatory dislocation described by Fielding and Hawkins, and magnetic resonance imaging delineated the ruptured alar ligament. Traction in a halter, followed by 6 weeks of immobilization with a cervical collar, was successful in the management of the injury. Concomitant fractures of the right temporal bone and the right clavicle may yield excessive left rotation of the atlas on the axis, resulting in the rupture of the right alar ligament. Awareness of this condition allows early diagnosis and effective conservative treatment.

  8. CT-functional diagnostics of the rotatory instability of upper cervical spine. 1. An experimental study on cadavers.

    PubMed

    Dvorak, J; Panjabi, M; Gerber, M; Wichmann, W

    1987-04-01

    Twelve specimens of the upper cervical spine were functionally examined by using radiography, cineradiography and computerized tomographic (CT) scan. The range of rotation was measured from CT images after maximal rotations to both sides. The left alar ligament was then cut and the examination repeated. The alar and transverse ligaments could be differentiated on CT images in axial, sagittal, and coronal views. Rotation at occiput-atlas was 4.35 degrees to the right and 5.9 degrees to the left and at atlas-axis it was 31.4 degrees to the right and 33 degrees to the left. After one-sided lesion of the alar ligament, there was an overall increase of 10.8 degrees or 30% of original rotation to the opposite side, divided about equally between the occiput-atlas and the atlas-axis. It is concluded that a lesion (irreversible overstretching or rupture of alar ligaments) can result in rotatory hypermobility or instability of the upper cervical spine.

  9. Reflecting on a Leadership Development Programme: A Case Study in South African Higher Education

    ERIC Educational Resources Information Center

    Louw, Ina; Zuber-Skeritt, Ortrun

    2009-01-01

    Leadership development in higher education is of vital importance to South Africa's future. We present a case study that focuses on a leadership development programme (LDP) through action learning and action research (ALAR) for women academics in South Africa during 2000 and 2001. It identifies the effects of the LDP on participants five years…

  10. The Learning Conference: Knowledge Creation through Participation and Publication

    ERIC Educational Resources Information Center

    Louw, Ina; Zuber-Skerritt, Ortrun

    2011-01-01

    Purpose: The aim of this paper is to identify the principles and characteristics of a learning conference which uses action learning and action research (ALAR) processes to create: optimal learning for all participants through a collaborative, inclusive conference culture; further knowledge creation in publishing conference papers post-conference…

  11. Descending Mediastinitis in Epstein-Barr Virus Infection

    PubMed Central

    van Driel, E. M.; Janssen, M. J. F. M.

    2015-01-01

    Our case report describes a previously healthy 34-year-old male who develops a descending mediastinitis as a complication of an Epstein-Barr virus (EBV) infection. The mediastinitis was suspected to have developed by a breakthrough of a peritonsillar abscess through the space between the alar and prevertebral space. PMID:25740774

  12. Lower lateral crural turnover flap in open rhinoplasty.

    PubMed

    Janis, Jeffrey E; Trussler, Andrew; Ghavami, Ashkan; Marin, Vincent; Rohrich, Rod J; Gunter, Jack P

    2009-06-01

    Lower lateral crural deformities are common problems in rhinoplasty. The shape and position of the lower lateral crura directly influence the alar contour and external valve function. This study reviews an extensive experience with the lower lateral crural turnover flap, which represents a versatile and reproducible technique for correction of lower lateral crural deformities and improvement of external valve function. A retrospective review of our experience with the lateral crural turnover flap in consecutive primary (n = 21), secondary (n = 2), and tertiary (n = 1) open rhinoplasties was conducted to evaluate the indications, contraindications, and long-term outcomes of this technique. Patient case examples are used to illustrate this technique and its results. The lower lateral crural turnover flap is beneficial for deformities, weakness, and collapse of the lower lateral crura. It can also be used to improve lower lateral crural strength during tip reshaping. It is contraindicated when there is insufficient width of the lower lateral crura. A lower lateral crural turnover flap can complement other external valve and alar arch supporting techniques, such as placement of alar contour grafts and/or alar batten grafts. The shape and position of the lower lateral crural turnover flaps have had long-lasting results (>1 year) after open rhinoplasty. The lower lateral crural turnover flap is a useful and reproducible technique in rhinoplasty with enduring results. The use of adjacent cartilage provides a local source of viable tissue to correct and support the lower lateral crura in both primary and revision rhinoplasty.

  13. Pelvic Fixation in Adult and Pediatric Spine Surgery: Historical Perspective, Indications, and Techniques: AAOS Exhibit Selection.

    PubMed

    Jain, Amit; Hassanzadeh, Hamid; Strike, Sophia A; Menga, Emmanuel N; Sponseller, Paul D; Kebaish, Khaled M

    2015-09-16

    Achieving solid osseous fusion across the lumbosacral junction has historically been, and continues to be, a challenge in spine surgery. Robust pelvic fixation plays an integral role in achieving this goal. The goals of this review are to describe the history of and indications for spinopelvic fixation, examine conventional spinopelvic fixation techniques, and review the newer S2-alar-iliac technique and its outcomes in adult and pediatric patients with spinal deformity. Since the introduction of Harrington rods in the 1960s, spinal instrumentation has evolved substantially. Indications for spinopelvic fixation as a means to achieve lumbosacral arthrodesis include a long arthrodesis (five or more vertebral levels) or use of three-column osteotomies in the lower thoracic or lumbar spine, surgical treatment of high-grade spondylolisthesis, and correction of lumbar deformity and pelvic obliquity. A variety of techniques have been described over the years, including Galveston iliac rods, Jackson intrasacral rods, the Kostuik transiliac bar, iliac screws, and S2-alar-iliac screws. Modern iliac screws and S2-alar-iliac screws are associated with relatively low rates of pseudarthrosis. S2-alar-iliac screws have the advantages of less implant prominence and inline placement with proximal spinal anchors. Collectively, these techniques provide powerful methods for obtaining control of the pelvis in facilitating lumbosacral arthrodesis.

  14. Urea Unfolding Study of E. coli Alanyl-tRNA Synthetase and Its Monomeric Variants Proves the Role of C-Terminal Domain in Stability

    PubMed Central

    Banerjee, Baisakhi; Banerjee, Rajat

    2015-01-01

    E. coli alanyl-tRNA exists as a dimer in its native form and the C-terminal coiled-coil part plays an important role in the dimerization process. The truncated N-terminal containing the first 700 amino acids (1–700) forms a monomeric variant possessing similar aminoacylation activity like wild type. A point mutation in the C-terminal domain (G674D) also produces a monomeric variant with a fivefold reduced aminoacylation activity compared to the wild type enzyme. Urea induced denaturation of these monomeric mutants along with another alaRS variant (N461 alaRS) was studied together with the full-length enzyme using various spectroscopic techniques such as intrinsic tryptophan fluorescence, 1-anilino-8-naphthalene-sulfonic acid binding, near- and far-UV circular dichroism, and analytical ultracentrifugation. Aminoacylation activity assay after refolding from denatured state revealed that the monomeric mutants studied here were unable to regain their activity, whereas the dimeric full-length alaRS gets back similar activity as the native enzyme. This study indicates that dimerization is one of the key regulatory factors that is important in the proper folding and stability of E. coli alaRS. PMID:26617997

  15. A peculiar new Helina Robineau-Desvoidy (Diptera: Muscidae) from Mexico and Panama.

    PubMed

    Couri, M S

    2012-12-01

    Helina sinaloensis n. sp. (Diptera: Muscidae) is described and illustrated from Mexico and Panama. The new species shows a unique combination of characters and can be distinguished from the other species of the genus by the prosternum with lateral cilia, pre-alar seta absent, anepimeron bare, katepimeron setulose, postalar wall setulose and scutellum with setulae on lateroventral margin.

  16. The Learning Conference: Knowledge Creation through Participation and Publication

    ERIC Educational Resources Information Center

    Louw, Ina; Zuber-Skerritt, Ortrun

    2011-01-01

    Purpose: The aim of this paper is to identify the principles and characteristics of a learning conference which uses action learning and action research (ALAR) processes to create: optimal learning for all participants through a collaborative, inclusive conference culture; further knowledge creation in publishing conference papers post-conference…

  17. Unilateral cleft nasal deformity correction using conchal cartilage lily flower graft.

    PubMed

    Hwang, Kun; Kim, Han Joon; Paik, Moo Hyun

    2012-11-01

    We present a conchal cartilage lily flower graft for correcting depressed and laterally displaced alar cartilage for correction of unilateral cleft nasal deformity.After making a V incision at the base of the columellar and then marginal incisions, the alar cartilages were exposed. A fusiform-shaped cartilage larger than 2.5 cm in length and 1 cm in width was obtained. The midline long axis was scored with a No. 15 knife, and the lateral one third was split. Two-thirds length portions were folded in half, and they became straightened in the shape of a stalk of a lily flower. Two symmetrical one-third length portions were fanned out bilaterally in the shape of the leaf of a lily flower. The stalk portion was positioned in a pocket between the medial crura, and the 2 leaf portions were placed on the dome of the alar cartilages. The marked points of the cleft side and contralateral side were secured with sutures. The V incision at the base of the columellar and the marginal incisions were closed with a V-Y shape. In this technique, the 2 leaf portions were placed on the dome of the alar cartilages and sutured; therefore, the suture holds the dome of the cleft side to the contralateral side without peaking.Thirteen patients (6 male and 7 female subjects; age range, 13-30 years) were operated. Among them, 6 patients were very satisfied, and 5 patients were satisfied with the results. Two patients felt they were improved.We think the conchal cartilage lily flower graft might be a good method for correction of depressed and laterally displaced alar cartilage in unilateral cleft nasal deformity.

  18. A 3D analysis of Caucasian and African American facial morphologies in a US population.

    PubMed

    Talbert, Leslie; Kau, Chung How; Christou, Terpsithea; Vlachos, Christos; Souccar, Nada

    2014-03-01

    This study aimed to compare facial morphologies of an adult African-American population to an adult Caucasian-American population using three-dimensional (3D) surface imaging. The images were captured using a stereophotogrammetric system (3dMDface(TM) system). Subjects were aged 19-30 years, with normal body mass index and no gross craniofacial anomalies. Images were aligned and combined using RF6 Plus Pack 2 software to produce a male and female facial average for each population. The averages were superimposed and the differences were assessed. The most distinct differences were in the forehead, alar base and perioricular regions. The average difference between African-American and Caucasian-American females was 1·18±0·98 mm. The African-American females had a broader face, wider alar base and more protrusive lips. The Caucasian-American females had a more prominent chin, malar region and lower forehead. The average difference between African-American and Caucasian-American males was 1·11±1·04 mm. The African-American males had a more prominent upper forehead and periocular region, wider alar base and more protrusive lips. No notable difference occurred between chin points of the two male populations. Average faces were created from 3D photographs, and the facial morphological differences between populations and genders were compared. African-American males had a more prominent upper forehead and periocular region, wider alar base and more protrusive lips. Caucasian-American males showed a more prominent nasal tip and malar area. African-American females had broader face, wider alar base and more protrusive lips. Caucasian-American females showed a more prominent chin point, malar region and lower forehead.

  19. Thorns and dermal denticles of skates Atlantoraja cyclophora and A. castelnaui: Microscopic features and functional implications.

    PubMed

    Rangel, Bianca de Sousa; Wosnick, Natascha; Magdanelo Leandro, Rafael; Amorim, Alberto Ferreira de; Kfoury Junior, José Roberto; Rici, Rose Eli Grassi

    2016-12-01

    Some batoid species are covered with dermal denticles (or placoid scales) that occasionally develop into thorns. In sexually mature males, sharp teeth and alar thorns found on the apex of the lateral disc are used to hold the female during copulation. This study set out to analyze microscopic features of modified dermal denticles and thorns and to investigate sexual dimorphism in Atlantoraja cyclophora and A. castelnaui species. Skin samples collected from areas covered with thorns were fixed in 10% formaldehyde, processed and analyzed using scanning electron microscopy. Alar thorn morphology varied within species, while caudal thorn, rostral and caudal dermal denticle morphology varied within and between species. These structures play an important role in the protection and reproduction of the species studied and constitute important taxonomic information, given they are often the only elements preserved in archaeological sites and fossil records.

  20. Description of Lutzomyia (Helcocyrtomyia) tolimensis, a new species of phlebotomine sandfly (Diptera: Psychodidae) from Colombia

    PubMed Central

    Carrasquilla, María C; Munstermann, Leonard; Marín, Dairo; Ocampo, Clara; Ferro, Cristina

    2016-01-01

    A description is presented of Lutzomyia tolimensis sp. nov., a new species of the subgenus Helcocyrtomyia, series sanguinaria. It was collected in dwellings, peridomestic environment and in nearby forest patches located in the foothills of the Andean Central Cordillera, where in 2004–2006 occurred the largest epidemic ever recorded of leishmaniasis in Colombia. The male of this species is differentiated from other members of the series sanguinaria based on the following combination of characters: (i) base of coxite with 0–3 subequal setae, (ii) spines of gonostyle organized in positions 2.1.2, (iii) spines inserted on distal half of gonostyle and (iv) relationship of alar indices. The female is recognized principally by the following characters: (i) palpomere V longer than III, (ii) length of labro-epipharynx and (iii) relationship of the alar indices. PMID:23295748

  1. Embryonic rationale for the primary correction of classical congenital clefts of the lip and palate.

    PubMed Central

    Millard, D. R.

    1994-01-01

    Primary correction of congenital clefts of the lip and palate should be designed to carry the interrupted embryonic process to normal completion. This is best accomplished by maxillary alignment with presurgical orthodontics, stabilisation of the maxillary alignment, obliteration of the alveolar cleft and construction of the nasal floor with periosteoplasty. This allows early construction of the lip by rotation and advancement and correction of the nose with columella lengthening, alar cartilage positioning and alar base cinching. This can be accomplished before school age. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 Figure 14 Figure 15 Figure 16 Figure 17 Figure 18 Figure 19 Figure 20 PMID:8017808

  2. Modeling the Biodynamical Response of the Human Head for Injury Analysis

    DTIC Science & Technology

    2001-09-01

    Human Spine. From Ref. [3]. .......................6 Figure 3. Occiput-Atlas-Axis Articulation. The Attachment of the Alar Ligaments to the...Figure 6. Intervertebral Disk Sectioned to Expose the Annular Organization. From Ref. [3]. .............11 Figure 7. Ligaments of the Spine. From Ref...sacral vertebrae, which are fused. The vertebrae and disks along with seven intervertebral ligaments spanning each set of adjacent vertebrae, and two

  3. A structure-based design approach for the identification of novel inhibitors: application to an alanine racemase

    NASA Astrophysics Data System (ADS)

    Mustata, Gabriela Iurcu; Briggs, James M.

    2002-12-01

    We report a new structure-based strategy for the identification of novel inhibitors. This approach has been applied to Bacillus stearothermophilus alanine racemase (AlaR), an enzyme implicated in the biosynthesis of the bacterial cell wall. The enzyme catalyzes the racemization of l- and d-alanine using pyridoxal 5'-phosphate (PLP) as a cofactor. The restriction of AlaR to bacteria and some fungi and the absolute requirement for d-alanine in peptidoglycan biosynthesis make alanine racemase a suitable target for drug design. Unfortunately, known inhibitors of alanine racemase are not specific and inhibit the activity of other PLP-dependent enzymes, leading to neurological and other side effects. This article describes the development of a receptor-based pharmacophore model for AlaR, taking into account receptor flexibility (i.e. a `dynamic' pharmacophore model). In order to accomplish this, molecular dynamics (MD) simulations were performed on the full AlaR dimer from Bacillus stearothermophilus (PDB entry, 1sft) with a d-alanine molecule in one active site and the non-covalent inhibitor, propionate, in the second active site of this homodimer. The basic strategy followed in this study was to utilize conformations of the protein obtained during MD simulations to generate a dynamic pharmacophore model using the property mapping capability of the LigBuilder program. Compounds from the Available Chemicals Directory that fit the pharmacophore model were identified and have been submitted for experimental testing. The approach described here can be used as a valuable tool for the design of novel inhibitors of other biomolecular targets.

  4. Job Language Performance Requirements for MOS 13B, Cannon Crewman. Volume I & II.

    DTIC Science & Technology

    1982-10-01

    broken manage . brought medic S but mouth to mouth resuscitation causes obstruction certain pause checking pinched check pliable * chest position... woods super user vehicle I \\S 51 • o - M OS : TASK: 031-503-1006 TASK TITLE: GIVE VOCAL, VISUAL AND OR SOUND ALAR.MS FOR CHL11CAL OR BIOLOGCAL ATTACK...examine handcrank holes insulating inspection insulation I.N’ knot pliers maintenance reels rt/splice operator section sections pass (v) sets perform

  5. The tripod graft: nasal tip cartilage reconstruction during revision rhinoplasty.

    PubMed

    Pedroza, Fernando; Pedroza, Luis Fernando; Achiques, Maria Teresa; Felipe, Edgar; Becerra, Felix

    2014-01-01

    IMPORTANCE Nasal tip revision remains one of the most challenging surgical procedures for facial plastic surgeons to perform. OBJECTIVE To describe preoperative and postoperative findings related to nasal tip functional and aesthetic aspects following revision rhinoplasty using the "tripod" technique. DESIGN, SETTING, AND PARTICIPANTS A retrospective descriptive study was performed in patients who underwent revision rhinoplasty between 2007 and 2012 at a clinic in Bogota, Colombia. A preoperative diagnosis of nasal tip deformity was made on the basis of photographic records and compared with postoperative nasal tip findings in patients who required the tripod technique. Photographs were evaluated before and after surgery every month for the first 3 months, and after 6, 9, and 12 months postoperatively. MAIN OUTCOMES AND MEASURES Nasal projection, tip rotation, columellar and alar retraction, alar pinch, lack of tip definition, and nasal tip asymmetry. RESULTS Sixty-four of the 69 patients who received revision rhinoplasty using the tripod technique during the study period were enrolled in the study. The tripod technique improved all of the following aesthetic and functional parameters (all P < .001). Nasal tip definition improved in 43 of 49 patients (88%). After surgery, projection was normal in 28 of 40 patients (70%) who had underprojection and overprojection preoperatively, and rotation improved in 29 of 38 patients (76%) who had overrotation or underrotation preoperatively. Columellar retraction improved after surgery in 18 of 24 patients (75%). The alar region improved in 41 of 52 patients (79%) who had alar retraction and/or pinch preoperatively, and inspiratory collapse improved in 49 of 50 patients (98%). CONCLUSIONS AND RELEVANCE The tripod technique is an efficient surgical alternative for nasal tip reconstruction during revision rhinoplasty. This technique allows the destroyed cartilaginous framework to be recreated and returns original nasal tip

  6. Offpost Operable Unit Remedial Investigation and Chemical Specific Applicable or Relevant and Appropriate Requirements, Version 3.1. Volume 3

    DTIC Science & Technology

    1988-12-01

    3 Sodium cabomate,..I.........................................3 Sodium methy late, alcohol mixture...Potential Biota ARAR: No 53. P•PTARY NAME: Sodium methylate, alcohol mixture CERCL,\\ Hazardous Substance: Yes Ranking on ATSDR Priority List: No Air Aralyte...ARARs for Chromium Ill. Whether these potential ARARs merit selection as AlARs will be determined in the context of the Feasibility Study/Endan- erment

  7. Aesthetic proportions of the nasal aperture in 3 different racial groups of men.

    PubMed

    Abdelkader, Maged; Leong, Samuel; White, Paul S

    2005-01-01

    To define baseline aesthetic dimensions of the nasal aperture in 3 different racial groups. Healthy volunteers from 3 different racial groups (15 white, 15 Chinese, and 15 Indian men) were enrolled in the study at the Department of Otolaryngology, University of Dundee, Dundee, Scotland. Those with a history of nasal or facial surgery or trauma were excluded from the study. Images were obtained and stored in a digital format. The dimensions of nasal aperture were defined by the length of the columella at the narrowest point, the width of the columella at the narrowest point, the length of the nasal aperture at the maximum length, the width of the nasal aperture at the maximum width, and the width of the alar cartilage base. There was no significant difference in the length or the width of the columella for the 3 racial groups. There was no significant difference in the length of the nasal aperture between the Chinese and the white groups. The nasal aperture was longer in the Indian group compared with the other 2 groups (P<.002). The nasal aperture at the maximum width was narrower in the Chinese group compared with the other groups (P<.002); there was no significant difference between the white and Indian groups. The nasal alar width was slightly narrower at the alar base in the Chinese group compared with other racial groups (P<.001). The aesthetic dimensions of the nasal aperture differ between racial groups. The nasal aperture and the alar base were narrower in the Chinese group, and the nasal aperture was longer in the Indian group. The aesthetic surgeon should ideally have an understanding of these ethnic variations.

  8. A Literature Review of Musculoskeletal Injuries to the Human Neck and the Effects of Head-Supported Mass Worn by Soldier

    DTIC Science & Technology

    2005-10-01

    1298-1310. Panjabi, M.M., Crisco, J.J., Lydon, C., and Dvorak, J. (1998) The Mechanical Properties of Human Alar and Transverse Ligaments at Slow and...Biomechanics Laboratory, Department of Mechanical Engineering 460 Turner Street CR-2006-01 Blacksburg, VA 24061 9. SPONSORING/MONITORING AGENCY NAME(S) AND...develop a complete model of the biomechanical mechanism or structure of interest. Each of these rigid bodies may have different inertial or stiffness

  9. Depicting the inner and outer nose: the representation of the nose and the nasal mucosa on the human primary somatosensory cortex (SI).

    PubMed

    Gastl, Mareike; Brünner, Yvonne F; Wiesmann, Martin; Freiherr, Jessica

    2014-09-01

    The nose is important not only for breathing, filtering air, and perceiving olfactory stimuli. Although the face and hands have been mapped, the representation of the internal and external surface of the nose on the primary somatosensory cortex (SI) is still poorly understood. To fill this gap functional magnetic resonance imaging (fMRI) was used to localize the nose and the nasal mucosa in the Brodman areas (BAs) 3b, 1, and 2 of the human postcentral gyrus (PG). Tactile stimulation during fMRI was applied via a customized pneumatically driven device to six stimulation sites: the alar wing of the nose, the lateral nasal mucosa, and the hand (serving as a reference area) on the left and right side of the body. Individual representations could be discriminated for the left and right hand, for the left nasal mucosa and left alar wing of the nose in BA 3b and BA 1 by comparing mean activation maxima and Euclidean distances. Right-sided nasal conditions and conditions in BA 2 could further be separated by different Euclidean distances. Regarding the alar wing of the nose, the results concurred with the classic sensory homunculus proposed by Penfield and colleagues. The nasal mucosa was not only determined an individual and bilateral representation, its position on the somatosensory cortex is also situated closer to the caudal end of the PG compared to that of the alar wing of the nose and the hand. As SI is commonly activated during the perception of odors, these findings underscore the importance of the knowledge of the representation of the nasal mucosa on the primary somatosensory cortex, especially for interpretation of results of functional imaging studies about the sense of smell.

  10. n-3 Fatty acids preserve muscle mass and insulin sensitivity in a rat model of energy restriction.

    PubMed

    Galmiche, Guillaume; Huneau, Jean-François; Mathé, Véronique; Mourot, Jacques; Simon, Noémie; Le Guillou, Céline; Hermier, Dominique

    2016-10-01

    In obese subjects, the loss of fat mass during energy restriction is often accompanied by a loss of muscle mass. The hypothesis that n-3 PUFA, which modulate protein homoeostasis via effects on insulin sensitivity, could contribute to maintain muscle mass during energy restriction was tested in rats fed a high-fat diet (4 weeks) rich in 18 : 1 n-9 (oleic acid, OLE-R), 18 : 3 n-3 (α-linolenic acid, ALA-R) or n-3 long-chain (LC-R) fatty acid and then energy restricted (8 weeks). A control group (OLE-ad libitum (AL)) was maintained with AL diet throughout the study. Rats were killed 10 min after an i.v. insulin injection. All energy-restricted rats lost weight and fat mass, but only the OLE-R group showed a significant muscle loss. The Gastrocnemius muscle was enriched with ALA in the ALA-R group and with LC-PUFA in the ALA-R and LC-R groups. The proteolytic ubiquitin-proteasome system was differentially affected by energy restriction, with MAFbx and muscle ring finger-1 mRNA levels being decreased in the LC-R group (-30 and -20 %, respectively). RAC-α serine/threonine-protein kinase and insulin receptor substrate 1 phosphorylation levels increased in the LC-R group (+70 %), together with insulin receptor mRNA (+50 %). The ALA-R group showed the same overall activation pattern as the LC-R group, although to a lesser extent. In conclusion, dietary n-3 PUFA prevent the loss of muscle mass associated with energy restriction, probably by an improvement in the insulin-signalling pathway activation, in relation to enrichment of plasma membranes in n-3 LC-PUFA.

  11. Classification of Chronic Whiplash Associated Disorders With Artificial Neural Networks

    DTIC Science & Technology

    2007-11-02

    J. Hayek, T. Ettlin, “"Whiplash" injury of the cervical spine: value of modern diagnostic imaging ”, Schweiz -Med- Wochenschr, vol 127, pp 1643-51...standard X-ray. Instead other imaging techniques e.g., MRT can in some instances show changes [10]. Despite absence of abnormal imaging findings, patients...1997. [11] C.W. Pfirrmann, C.A. Binkert, M. Zanetti, N. Boos, J. Hodler, “Functional MR imaging of the craniocervical junction. Correlation with alar

  12. The same Arabidopsis gene encodes both cytosolic and mitochondrial alanyl-tRNA synthetases.

    PubMed Central

    Mireau, H; Lancelin, D; Small, I D

    1996-01-01

    In plants, all aminoacyl-tRNA synthetases are nuclearly encoded, despite the fact that their activities are required in the three protein-synthesizing cell compartments (cytosol, mitochondria, and chloroplasts). To investigate targeting of these enzymes, we cloned cDNAs encoding alanyl-tRNA synthetase (AlaRS) and the corresponding nuclear gene, ALATS, from Arabidopsis by using degenerate polymerase chain reaction primers based on highly conserved regions shared between known AlaRSs from other organisms. Analysis of the transcription of the gene showed the presence of two potential translation initiation codons in some ALATS mRNAs. Translation from the upstream AUG would generate an N-terminal extension with features characteristic of mitochondrial targeting peptides. A polyclonal antibody raised against part of the Arabidopsis AlaRS revealed that the Arabidopsis cytosolic and mitochondrial AlaRSs are immunologically similar, suggesting that both isoforms are encoded by the ALATS gene. In vitro experiments confirmed that two polypeptides can be translated from AlATS transcripts, with most ribosomes initiating on the downstream AUG to give the shorter polypeptide corresponding in size to the cytosolic enzyme. The ability of the presequence encoded between the two initiation codons to direct polypeptides to mitochondria was demonstrated by expression of fusion proteins in tobacco protoplasts and in yeast. We conclude that the ALATS gene encodes both the cytosolic and the mitochondrial forms of AlaRS, depending on which of the two AUG codons is used to initiate translation. PMID:8672889

  13. Nose tip refinement using interdomal suture in caucasian nose

    PubMed Central

    Pasinato, Rogério; Mocelin, Marcos; Berger, Cezar Augusto Sarraf

    2012-01-01

    Summary Introduction: Refinement of the nose tip can be accomplished by a variety of techniques, but currently, the use of sutures in the nasal tip with conservative resection of the alar cartilage is the most frequently recommended approach. Objective: To classify the nasal tip and to demonstrate the interdomal suture applied to nasal tip refinement in the Caucasian nose, as well as to provide a simple and practical presentation of the surgical steps. Method: Development of surgical algorithm for nasal tip surgery: 1. Interdomal suture (double binding suture), 2. Interdomal suture with alar cartilage weakening (cross-hatching), 3. Interdomal suture with cephalic removal of the alar cartilage (McIndoe technique) based on the nasal tip type classification. This classification assesses the interdomal distance (angle of domal divergence and intercrural distance), domal arch width, cartilage consistency, and skin type. Interdomal suture is performed through endonasal rhinoplasty by basic technique without delivery (Converse-Diamond technique) under local anesthesia. Conclusion: This classification is simple and facilitates the approach of surgical treatment of the nasal tip through interdomal suture, systematizing and standardizing surgical maneuvers for better refinement of the Caucasian nose. PMID:25991963

  14. The transverse occipital ligament: anatomy and potential functional significance.

    PubMed

    Tubbs, R Shane; Griessenauer, Christoph J; McDaniel, Jenny Gober; Burns, Amanda M; Kumbla, Anjali; Cohen-Gadol, Aaron A

    2010-03-01

    Knowledge of the anatomy of ligaments that bind the craniocervical junction is important for treating patients with lesions of this region. Although the anatomy and function of these ligaments have been well described, those of the transverse occipital ligament (TOL) have remained enigmatic. To describe the anatomy and functions of the transverse occipital ligament. Via a posterior approach, 9 cadaveric specimens underwent dissection of the craniocervical junction with special attention to the presence and anatomy of the TOL. The TOL was identified in 77.8% of the specimens. The ligament was found to be rectangular with fibers running horizontally between the lateral aspects of the foramen magnum. The attachment of each ligament near the occipital condyle was consistent, and each ligament was found superior to the transverse portion of the cruciform ligament and inserted just posterior to the lateral attachment sites of the alar ligaments. The average width, length, and thickness of the TOL was 0.34, 1.94, and 0.13 cm, respectively. The TOL in some specimens also had connections to the alar and transverse ligaments. The TOL was found in the majority of our specimens. The possible functions of this ligament when attached to the alar ligaments include providing additional support to these structures in stabilizing lateral bending, flexion, and axial rotation of the head. Knowledge of this ligament may aid in further understanding craniocervical stability and help in differentiating normal from pathology via imaging modalities.

  15. Mesencephalic basolateral domain specification is dependent on Sonic Hedgehog

    PubMed Central

    Martinez-Lopez, Jesus E.; Moreno-Bravo, Juan A.; Madrigal, M. Pilar; Martinez, Salvador; Puelles, Eduardo

    2015-01-01

    In the study of central nervous system morphogenesis, the identification of new molecular markers allows us to identify domains along the antero-posterior and dorso-ventral (DV) axes. In the past years, the alar and basal plates of the midbrain have been divided into different domains. The precise location of the alar-basal boundary is still under discussion. We have identified Barhl1, Nhlh1 and Six3 as appropriate molecular markers to the adjacent domains of this transition. The description of their expression patterns and the contribution to the different mesencephalic populations corroborated their role in the specification of these domains. We studied the influence of Sonic Hedgehog on these markers and therefore on the specification of these territories. The lack of this morphogen produced severe alterations in the expression pattern of Barhl1 and Nhlh1 with consequent misspecification of the basolateral (BL) domain. Six3 expression was apparently unaffected, however its distribution changed leading to altered basal domains. In this study we confirmed the localization of the alar-basal boundary dorsal to the BL domain and demonstrated that the development of the BL domain highly depends on Shh. PMID:25741244

  16. Fetal anatomy of the lower cervical and upper thoracic fasciae with special reference to the prevertebral fascial structures including the suprapleural membrane.

    PubMed

    Miyake, Naritomo; Takeuchi, Hiromi; Cho, Baik Hwan; Murakami, Gen; Fujimiya, Mineko; Kitano, Hiroya

    2011-07-01

    The aim of this study was to find basic rules governing the fetal anatomy of the deep cervical fasciae and their connections to the mediastinal fasciae. We examined the histology of paraffin-embedded preparations of 18 mid-term fetuses (5 between 9 and 12 weeks of gestation, 3 between 15 and 18 weeks, and 10 between 20 and 25 weeks). The prevertebral lamina of the deep cervical fasciae (PLDCF) developed as an intermediate aponeurosis for the bilateral bellies of the longus colli muscles. In contrast, the alar fascia developed as a connecting band between the bilateral adventitiae of the common carotid artery. The retropharyngeal fascia became evident much later than the latter two fasciae. The fascia covering the thymus was thicker than the fascia for the strap muscles (the pretracheal lamina of the cervical fascia). The primitive suprapleural membrane, or Sibson's fascia, contained veins and fatty tissues, and was composed of the alar fascia rather than the PLDCF, tranversalis fascia, or endothoracic fascia. The prevertebral two-laminar configuration was rather evident in the early stages of development because, in the later stages, the fasciae together provided a multilaminar structure, especially in the lateral area in front of the longus colli, which suspended the cupula pleurae. To consider a continuation from the base of the neck to the upper mediastinum, the alar fascia seems to be a key structure for connecting the vascular sheath to the parietal pleura.

  17. The selective tRNA aminoacylation mechanism based on a single G•U pair.

    PubMed

    Naganuma, Masahiro; Sekine, Shun-ichi; Chong, Yeeting Esther; Guo, Min; Yang, Xiang-Lei; Gamper, Howard; Hou, Ya-Ming; Schimmel, Paul; Yokoyama, Shigeyuki

    2014-06-26

    Ligation of tRNAs with their cognate amino acids, by aminoacyl-tRNA synthetases, establishes the genetic code. Throughout evolution, tRNA(Ala) selection by alanyl-tRNA synthetase (AlaRS) has depended predominantly on a single wobble base pair in the acceptor stem, G3•U70, mainly on the kcat level. Here we report the crystal structures of an archaeal AlaRS in complex with tRNA(Ala) with G3•U70 and its A3•U70 variant. AlaRS interacts with both the minor- and the major-groove sides of G3•U70, widening the major groove. The geometry difference between G3•U70 and A3•U70 is transmitted along the acceptor stem to the 3'-CCA region. Thus, the 3'-CCA region of tRNA(Ala) with G3•U70 is oriented to the reactive route that reaches the active site, whereas that of the A3•U70 variant is folded back into the non-reactive route. This novel mechanism enables the single wobble pair to dominantly determine the specificity of tRNA selection, by an approximate 100-fold difference in kcat.

  18. The selective tRNA aminoacylation mechanism based on a single G•U pair

    PubMed Central

    Naganuma, Masahiro; Sekine, Shun-ichi; Chong, Yeeting Esther; Guo, Min; Yang, Xiang-Lei; Gamper, Howard; Hou, Ya-Ming; Schimmel, Paul; Yokoyama, Shigeyuki

    2015-01-01

    Ligation of tRNAs with their cognate amino acids, by aminoacyl-tRNA synthetases, establishes the genetic code. Throughout evolution, tRNAAla selection by alanyl-tRNA synthetase (AlaRS) has depended predominantly on a single wobble base pair in the acceptor stem, G3•U70, mainly on the kcat level. Here we report the crystal structures of an archaeal AlaRS in complex with tRNAAla with G3•U70 and its A3•U70 variant. AlaRS interacts with both the minor- and major-groove sides of G3•U70, widening the major groove. The geometry difference between G3•U70 and A3•U70 is transmitted along the acceptor stem to the 3′-CCA region. Thus, the 3′-CCA region of tRNAAla with G3•U70 is oriented to the reactive route that reaches the active site, whereas that of the A3•U70 variant is folded back into the “non-reactive route”. This novel mechanism enables the single wobble pair to dominantly determine the specificity of tRNA selection, by an approximate 100-fold difference in kcat. PMID:24919148

  19. Investigation of whiplash injuries in the upper cervical spine using a detailed neck model.

    PubMed

    Fice, Jason B; Cronin, Duane S

    2012-04-05

    Whiplash injuries continue to have significant societal cost; however, the mechanism and location of whiplash injury is still under investigation. Recently, the upper cervical spine ligaments, particularly the alar ligament, have been identified as a potential whiplash injury location. In this study, a detailed and validated explicit finite element model of a 50th percentile male cervical spine in a seated posture was used to investigate upper cervical spine response and the potential for whiplash injury resulting from vehicle crash scenarios. This model was previously validated at the segment and whole spine levels for both kinematics and soft tissue strains in frontal and rear impact scenarios. The model predicted increasing upper cervical spine ligament strain with increasing impact severity. Considering all upper cervical spine ligaments, the distractions in the apical and alar ligaments were the largest relative to their failure strains, in agreement with the clinical findings. The model predicted the potential for injury to the apical ligament for 15.2 g frontal or 11.7 g rear impacts, and to the alar ligament for a 20.7 g frontal or 14.4 g rear impact based on the ligament distractions. Future studies should consider the effect of initial occupant position on ligament distraction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  20. Three dimensional laser scan assessment of the Oriental nose with a new classification of Oriental nasal types.

    PubMed

    Aung, S C; Foo, C L; Lee, S T

    2000-03-01

    The Oriental nose, which has been broadly classified as mesorrhine, differs in anatomy and morphology from other racial groups. The objective of this study is to carry out anthropometric measurements in the nose region, in order to establish norms for the Oriental nose and also to identify the variations that might occur within this group. Knowledge of the unique shape, anatomy and dimensions of the Oriental nose would be very useful for surgeons undertaking repair and reconstruction of Oriental noses. Ninety, normal Oriental subjects were scanned using a laser surface scanner, and the assessments were then carried out on the laser scan images. The 3-D laser scan images permit adjustment and positioning to achieve the correct standard views for assessment. Subjective assessment of the nose shape, as well as linear and angular measurements were carried out. Depending on the fullness and roundness of the nasal tip and the prominence of the alar lobules on either side, the Oriental nasal base may take on varied shapes and accordingly, three distinct shapes have been identified. They have been classified into types A, B and C where type A has a very prominent alar lobule and a full and rounded nasal tip. In type B, the alar lobule was less prominent and the nasal tip was more defined while in type C the alar lobule was the least prominent resulting in the lateral walls forming a relatively straight slope from the tip to the alar base. The linear and angular measurements for Oriental noses were also obtained and compared to values for other racial groups. The proportion indices for the Oriental nose showed that it was broader in relation to the nose height, and had less tip protrusion in relation to both the height and width of the nose. The data collected from this study can be used as norms for Oriental cases and the simple classification of the nose shape will serve as a guide for quick reference, when planning aesthetic or reconstructive rhinoplasties for the

  1. Preliminary evaluation of a differential effect of an α-linolenate-rich supplement on ketogenesis and plasma ω-3 fatty acids in young and older adults.

    PubMed

    Hennebelle, Marie; Courchesne-Loyer, Alexandre; St-Pierre, Valérie; Vandenberghe, Camille; Castellano, Christian-Alexandre; Fortier, Mélanie; Tessier, Daniel; Cunnane, Stephen C

    2016-01-01

    The aim of the present study was to compare the effects of an α-linolenic acid-rich supplement (ALA-RS) on the ketogenic response and plasma long-chain ω-3 polyunsaturated fatty acid in healthy young adults and older individuals. Ten young (25 ± 0.9 y) and 10 older adults (73.1 ± 2.2 y) consumed a flaxseed oil supplement providing 2 g/d of ALA for 4 wk. Plasma ketones, nonesterified fatty acids (NEFA), triacylglycerols, glucose, and insulin were measured over 6 h, before and after supplementation. Total body fat mass was assessed before and after the ALA-RS. The ALA-RS did not significantly modify fasting ketones but postprandial production of β-hydroxybutyrate was increased by 26% (P = 0.037) only in the young adult group. Fasting plasma ketones were positively correlated to fasting plasma NEFA (P < 0.01) in both groups. However, the relation was shifted to the right in the older group, suggesting that older adults needed higher plasma NEFA levels to achieve the same ketone amounts as young adults. At baseline, the older group had 47% higher total plasma fatty acids than the young group (P = 0.007). After the ALA-RS, plasma ALA doubled in both groups (P < 0.01), an effect that was associated in the older group with a 40% higher eicosapentaenoic acid (EPA; P = 0.004), but no difference in docosahexaenoic acid. The postsupplementation increase in plasma ALA correlated positively with percent total body fat, especially in the older group (r(2) = 0.77; P = 0.0016). In young adults, ALA-RS mildly stimulated postprandial ketogenesis, whereas in the older group, it favored increased plasma ALA and EPA. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. NMR studies of protonation and hydrogen bond states of internal aldimines of pyridoxal 5'-phosphate acid-base in alanine racemase, aspartate aminotransferase, and poly-L-lysine.

    PubMed

    Chan-Huot, Monique; Dos, Alexandra; Zander, Reinhard; Sharif, Shasad; Tolstoy, Peter M; Compton, Shara; Fogle, Emily; Toney, Michael D; Shenderovich, Ilya; Denisov, Gleb S; Limbach, Hans-Heinrich

    2013-12-04

    Using (15)N solid-state NMR, we have studied protonation and H-bonded states of the cofactor pyridoxal 5'-phosphate (PLP) linked as an internal aldimine in alanine racemase (AlaR), aspartate aminotransferase (AspAT), and poly-L-lysine. Protonation of the pyridine nitrogen of PLP and the coupled proton transfer from the phenolic oxygen (enolimine form) to the aldimine nitrogen (ketoenamine form) is often considered to be a prerequisite to the initial step (transimination) of the enzyme-catalyzed reaction. Indeed, using (15)N NMR and H-bond correlations in AspAT, we observe a strong aspartate-pyridine nitrogen H-bond with H located on nitrogen. After hydration, this hydrogen bond is maintained. By contrast, in the case of solid lyophilized AlaR, we find that the pyridine nitrogen is neither protonated nor hydrogen bonded to the proximal arginine side chain. However, hydration establishes a weak hydrogen bond to pyridine. To clarify how AlaR is activated, we performed (13)C and (15)N solid-state NMR experiments on isotopically labeled PLP aldimines formed by lyophilization with poly-L-lysine. In the dry solid, only the enolimine tautomer is observed. However, a fast reversible proton transfer involving the ketoenamine tautomer is observed after treatment with either gaseous water or gaseous dry HCl. Hydrolysis requires the action of both water and HCl. The formation of an external aldimine with aspartic acid at pH 9 also produces the ketoenamine form stabilized by interaction with a second aspartic acid, probably via a H-bond to the phenolic oxygen. We postulate that O-protonation is an effectual mechanism for the activation of PLP, as is N-protonation, and that enzymes that are incapable of N-protonation employ this mechanism.

  3. Patterns of hypothalamic regionalization in amphibians and reptiles: common traits revealed by a genoarchitectonic approach

    PubMed Central

    Domínguez, Laura; González, Agustín; Moreno, Nerea

    2015-01-01

    Most studies in mammals and birds have demonstrated common patterns of hypothalamic development highlighted by the combination of developmental regulatory genes (genoarchitecture), supporting the notion of the hypothalamus as a component of the secondary prosencephalon, topologically rostral to the diencephalon. In our comparative analysis we have summarized the data on the expression patterns of different transcription factors and neuroactive substances, used as anatomical markers, in the developing hypothalamus of the amphibian Xenopus laevis and the juvenile turtle Pseudemys scripta. This analysis served to highlight the organization of the hypothalamus in the anamniote/amniotic transition. We have identified supraoptoparaventricular and the suprachiasmatic regions (SCs) in the alar part of the hypothalamus, and tuberal and mammillary regions in the basal hypothalamus. Shared features in the two species are: (1) The supraoptoparaventricular region (SPV) is defined by the expression of Otp and the lack of Nkx2.1/Isl1. It is subdivided into rostral, rich in Otp and Nkx2.2, and caudal, only Otp-positive, portions. (2) The suprachiasmatic area contains catecholaminergic cell groups and lacks Otp, and can be further divided into rostral (rich in Nkx2.1 and Nkx2.2) and a caudal (rich in Isl1 and devoid of Nkx2.1) portions. (3) Expression of Nkx2.1 and Isl1 define the tuberal hypothalamus and only the rostral portion expresses Otp. (4) Its caudal boundary is evident by the lack of Isl1 in the adjacent mammillary region, which expresses Nkx2.1 and Otp. Differences in the anamnio-amniote transition were noted since in the turtle, like in other amniotes, the boundary between the alar hypothalamus and the telencephalic preoptic area shows distinct Nkx2.2 and Otp expressions but not in the amphibian (anamniote), and the alar SPV is defined by the expression of Otp/Pax6, whereas in Xenopus only Otp is expressed. PMID:25691860

  4. Lipid II-independent trans editing of mischarged tRNAs by the penicillin resistance factor MurM.

    PubMed

    Shepherd, Jennifer; Ibba, Michael

    2013-09-06

    Streptococcus pneumoniae is a causative agent of nosocomial infections such as pneumonia, meningitis, and septicemia. Penicillin resistance in S. pneumoniae depends in part upon MurM, an aminoacyl-tRNA ligase that attaches L-serine or L-alanine to the stem peptide lysine of Lipid II in cell wall peptidoglycan. To investigate the exact substrates the translation machinery provides MurM, quality control by alanyl-tRNA synthetase (AlaRS) was investigated. AlaRS mischarged serine and glycine to tRNA(Ala), as observed in other bacteria, and also transferred alanine, serine, and glycine to tRNA(Phe). S. pneumoniae tRNA(Phe) has an unusual U4:C69 mismatch in its acceptor stem that prevents editing by phenylalanyl-tRNA synthetase (PheRS), leading to the accumulation of misaminoacylated tRNAs that could serve as substrates for translation or for MurM. Although the peptidoglycan layer of S. pneumoniae tolerates a combination of both branched and linear muropeptides, deletion of MurM results in a reversion to penicillin sensitivity in strains that were previously resistant. However, because MurM is not required for cell viability, the reason for its functional conservation across all strains of S. pneumoniae has remained elusive. We now show that MurM can directly function in translation quality control by acting as a broad specificity lipid-independent trans editing factor that deacylates tRNA. This activity of MurM does not require the presence of its second substrate, Lipid II, and can functionally substitute for the activity of widely conserved editing domain homologues of AlaRS, termed AlaXPs proteins, which are themselves absent from S. pneumoniae.

  5. The principle of rotation advancement for repair of unilateral complete cleft lip and nasal deformity: technical variations and analysis of results.

    PubMed

    Mulliken, J B; Martínez-Pérez, D

    1999-10-01

    This is an assessment of one surgeon's 15-year experience (1981-1995) using the Millard rotation-advancement principle for repair of unilateral complete cleft lip and nasal deformity. All infants underwent a prior labio-nasal adhesion. Since 1991, dentofacial orthopedics with a pin-retained (Latham) appliance was used for infants with a cleft of the lip and palate. Technical variations are described, including modifications in sequence of closure. A high rotation and releasing incision in the columella lengthens the medial labial element and produces a symmetric prolabium with minimal transgression of the upper philtral column by the advancement flap. Orbicularis oris muscle is everted, from caudad to cephalad, to form the philtral ridge. A minor variation of unilimb Z-plasty is used to level the cleft side of Cupid's bow handle, and cutaneous closure proceeds superiorly from this junction. The dislocated alar cartilage is visualized though a nostril rim incision and suspended to the ipsilateral upper lateral cartilage. Symmetry of the alar base is addressed in three dimensions, including maneuvers to position the deviated anterior-caudal septum, configure the sill, and efface the lateral vestibular web. Secondary procedures were analyzed in 105 consecutive patients, both revised (n = 30) and unrevised (n = .75). The possible need for revision in the latter group was determined by panel assessment of six indicators of nasolabial asymmetry, documented by frontal and submental photographs. In the entire study period, a total of 80 percent of children required or will need nasal revision, and a total of 42 percent required or will require labial revision. In the last 5 years, as compared with the earlier decade, there was a significantly diminished incidence of patients requiring labial revision (54 percent to 21 percent) and alar suspension (63 percent to 32 percent). These improvements are attributable to technical refinements and experience, although dentofacial

  6. Head position and impact direction in whiplash injuries: associations with MRI-verified lesions of ligaments and membranes in the upper cervical spine.

    PubMed

    Kaale, Bertel Rune; Krakenes, Jostein; Albrektsen, Grethe; Wester, Knut

    2005-11-01

    In the present study, we compared magnetic resonance imaging (MRI) findings of soft tissue structures in the upper cervical spine between whiplash-associated disorder (WAD) patients and population-based control persons, and examined whether MRI-verified abnormalities in WAD patients were related to accident-related factors hypothesized to be of importance for severity of injury. A total of 92 whiplash patients and 30 control persons, randomly drawn, were included. Information on the accident-related factors (i.e., head position and impact direction) was obtained by a questionnaire that was answered within 1 week after the accident. The MRI examination was performed 2-9 (mean 6) years after the accident. Focus was on MRI abnormalities of the alar and the transverse ligaments, and the tectorial and posterior atlanto-occipital membranes, graded 0-3. For all neck structures, the whiplash patients had more high-grade lesions (grade 2 or 3) than the control persons (Chi-square test, p < 0.055). An abnormal alar ligament was most common (66.3% graded 2 or 3). Whiplash patients who had been sitting with their head/neck turned to one side at the moment of collision more often had high-grade lesions of the alar and transverse ligaments (p < 0.001, p = 0.040, respectively). Severe injuries to the transverse ligament and the posterior atlanto-occipital membrane were more common in front than in rear end collisions (p < 0.001, p = 0.001, respectively). In conclusion, the difference in MRI-verified lesions between WAD patients and control persons, and in particular the association with head position and impact direction at time of accident, indicate that these lesions are caused by the whiplash trauma.

  7. A Collaborative Study of Source Apportionment and Total City Emissions of CH4 from Indianapolis

    NASA Astrophysics Data System (ADS)

    Hajny, K. D.; Davis, K. J.; Franklin, J. E.; Harvey, R. M.; Lavoie, T. N.; Miles, N. L.; Richardson, S.; Salmon, O. E.; Sarmiento, D. P.; Shepson, P. B.; Stirm, B. H.; Wofsy, S.

    2016-12-01

    Methane (CH4) is the second most important greenhouse gas emitted in the United States, accounting for about 11% of all US greenhouse gas emissions in 2014. Over 60% of CH4 emissions globally are due to human activity and two of the largest anthropogenic sources of CH4 are waste decomposition in landfills and losses from the energy sector. Indianapolis has been a testbed site for development of methods for quantitative urban-scale greenhouse gas emissions measurements, through the Indianapolis Flux Experiment (INFLUX) since 2010. Multiple airborne mass balance experiments with Purdue University's Airborne Laboratory for Atmospheric Research (ALAR) have been performed in the area to quantify greenhouse gas emissions, since 2008. Previous research has shown that the large landfill in Indianapolis is the only significant point source, emitting 45 ± 14 mols CH4/s or roughly 1/3 of all CH4 emissions. Propane/methane ratios have indicated that all other CH4 emissions were due to leaks in the natural gas distribution system in the city, but not all the sources have been identified. A recent collaborative effort aimed to investigate this further using tower based inversions from INFLUX data, ground based Lagrangian transport modeling using Fourier Transform Spectrometers, and airborne based mass balance experiments using ALAR. Within the 2-week long project there were 4 days with atmospheric conditions that allowed for simultaneous airborne and ground based measurements. Here we will discuss selected outcomes from this effort, including city-wide mass balance measurements from ALAR, our results in light of the FTS observations, and how the results compare to the historical data base for Indianapolis.

  8. Topography of Somatostatin Gene Expression Relative to Molecular Progenitor Domains during Ontogeny of the Mouse Hypothalamus

    PubMed Central

    Morales-Delgado, Nicanor; Merchan, Paloma; Bardet, Sylvia M.; Ferrán, José L.; Puelles, Luis; Díaz, Carmen

    2010-01-01

    The hypothalamus comprises alar, basal, and floor plate developmental compartments. Recent molecular data support a rostrocaudal subdivision into rostral (terminal) and caudal (peduncular) halves. In this context, the distribution of neuronal populations expressing somatostatin (Sst) mRNA was analyzed in the developing mouse hypothalamus, comparing with the expression pattern of the genes Orthopedia (Otp), Distal-less 5 (Dlx5), Sonic Hedgehog (Shh), and Nk2 homeobox 1 (Nkx2.1). At embryonic day 10.5 (E10.5), Sst mRNA was first detectable in the anterobasal nucleus, a Nkx2.1-, Shh-, and Otp-positive basal domain. By E13.5, nascent Sst expression was also related to two additional Otp-positive domains within the alar plate and one in the basal plate. In the alar plate, Sst-positive cells were observed in rostral and caudal ventral subdomains of the Otp-positive paraventricular complex. An additional basal Sst-expressing cell group was found within a longitudinal Otp-positive periretromamillary band that separates the retromamillary area from tuberal areas. Apart of subsequent growth of these initial populations, at E13.5 and E15.5 some Sst-positive derivatives migrate tangentially into neighboring regions. A subset of cells produced at the anterobasal nucleus disperses ventralward into the shell of the ventromedial hypothalamic nucleus and the arcuate nucleus. Cells from the rostroventral paraventricular subdomain reach the suboptic nucleus, whereas a caudal contingent migrates radially into lateral paraventricular, perifornical, and entopeduncular nuclei. Our data provide a topologic map of molecularly defined progenitor areas originating a specific neuron type during early hypothalamic development. Identification of four main separate sources helps to understand causally its complex adult organization. PMID:21441981

  9. Patterns of hypothalamic regionalization in amphibians and reptiles: common traits revealed by a genoarchitectonic approach.

    PubMed

    Domínguez, Laura; González, Agustín; Moreno, Nerea

    2015-01-01

    Most studies in mammals and birds have demonstrated common patterns of hypothalamic development highlighted by the combination of developmental regulatory genes (genoarchitecture), supporting the notion of the hypothalamus as a component of the secondary prosencephalon, topologically rostral to the diencephalon. In our comparative analysis we have summarized the data on the expression patterns of different transcription factors and neuroactive substances, used as anatomical markers, in the developing hypothalamus of the amphibian Xenopus laevis and the juvenile turtle Pseudemys scripta. This analysis served to highlight the organization of the hypothalamus in the anamniote/amniotic transition. We have identified supraoptoparaventricular and the suprachiasmatic regions (SCs) in the alar part of the hypothalamus, and tuberal and mammillary regions in the basal hypothalamus. Shared features in the two species are: (1) The supraoptoparaventricular region (SPV) is defined by the expression of Otp and the lack of Nkx2.1/Isl1. It is subdivided into rostral, rich in Otp and Nkx2.2, and caudal, only Otp-positive, portions. (2) The suprachiasmatic area contains catecholaminergic cell groups and lacks Otp, and can be further divided into rostral (rich in Nkx2.1 and Nkx2.2) and a caudal (rich in Isl1 and devoid of Nkx2.1) portions. (3) Expression of Nkx2.1 and Isl1 define the tuberal hypothalamus and only the rostral portion expresses Otp. (4) Its caudal boundary is evident by the lack of Isl1 in the adjacent mammillary region, which expresses Nkx2.1 and Otp. Differences in the anamnio-amniote transition were noted since in the turtle, like in other amniotes, the boundary between the alar hypothalamus and the telencephalic preoptic area shows distinct Nkx2.2 and Otp expressions but not in the amphibian (anamniote), and the alar SPV is defined by the expression of Otp/Pax6, whereas in Xenopus only Otp is expressed.

  10. A Reliable Method to Measure Lip Height Using Photogrammetry in Unilateral Cleft Lip Patients.

    PubMed

    van der Zeeuw, Frederique; Murabit, Amera; Volcano, Johnny; Torensma, Bart; Patel, Brijesh; Hay, Norman; Thorburn, Guy; Morris, Paul; Sommerlad, Brian; Gnarra, Maria; van der Horst, Chantal; Kangesu, Loshan

    2015-09-01

    There is still no reliable tool to determine the outcome of the repaired unilateral cleft lip (UCL). The aim of this study was therefore to develop an accurate, reliable tool to measure vertical lip height from photographs. The authors measured the vertical height of the cutaneous and vermilion parts of the lip in 72 anterior-posterior view photographs of 17 patients with repairs to a UCL. Points on the lip's white roll and vermillion were marked on both the cleft and the noncleft sides on each image. Two new concepts were tested. First, photographs were standardized using the horizontal (medial to lateral) eye fissure width (EFW) for calibration. Second, the authors tested the interpupillary line (IPL) and the alar base line (ABL) for their reliability as horizontal lines of reference. Measurements were taken by 2 independent researchers, at 2 different time points each. Overall 2304 data points were obtained and analyzed. Results showed that the method was very effective in measuring the height of the lip on the cleft side with the noncleft side. When using the IPL, inter- and intra-rater reliability was 0.99 to 1.0, with the ABL it varied from 0.91 to 0.99 with one exception at 0.84. The IPL was easier to define because in some subjects the overhanging nasal tip obscured the alar base and gave more consistent measurements possibly because the reconstructed alar base was sometimes indistinct. However, measurements from the IPL can only give the percentage difference between the left and right sides of the lip, whereas those from the ABL can also give exact measurements. Patient examples were given that show how the measurements correlate with clinical assessment. The authors propose this method of photogrammetry with the innovative use of the IPL as a reliable horizontal plane and use of the EFW for calibration as a useful and reliable tool to assess the outcome of UCL repair.

  11. Short-term evaluation of tegumentary changes of the nose in oral breathers undergoing rapid maxillary expansion.

    PubMed

    Badreddine, Fauze Ramez; Fujita, Reginaldo Raimundo; Cappellette, Mario

    2017-06-26

    Rapid maxillary expansion is an orthodontic and orthopedic procedure that can change the form and function of the nose. The soft tissue of the nose and its changes can influence the esthetics and the stability of the results obtained by this procedure. The objective of this study was to assess the changes in nose dimensions after rapid maxillary expansion (RME) in oral breathers with maxillary atresia, using a reliable and reproducible methodology through computed tomography. A total of 30 mouth-breathing patients with maxillary atresia were analyzed and divided into a treatment group who underwent RME (20 patients, 10 of which were male and 10 female, with a MA of 8.9 years and a SD of 2.16, ranging from 6.5 to 12.5 years) and a Control Group (10 patients, 5 of which were male and 5 female, with a MA of 9.2 years, SD of 2.17, ranging from 6.11 to 13.7 years). In the treatment group, multislice computed tomography scans were obtained at the start of the treatment (T1) and 3 months after expansion (T2). The patients of the control group were submitted to the same exams at the same intervals of time. Four variables related to soft tissue structures of the nose were analyzed (alar base width, alar width, height of soft tissue of the nose and length of soft tissue of the nose), and the outcomes between T1 and T2 were compared using Osirix MD software. In the TG, the soft tissues of the nose exhibited significant increases in all variables studied (p<0.05), whereas, changes did not occur in the control group (p>0.05). In the treatment group, mean alar base width increased by 4.87% (p=0.004), mean alar width increased by 4.04% (p=0.004), mean height of the soft tissues of the nose increased by 4.84% (p=0.003) and mean length of the soft tissues of the nose increased by 4.29% (p=0.012). In short-term, RME provided a statistically significant increase in the dimensions of the soft tissues of the nose. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e

  12. Spectroscopic Characterization of Metal-Based Complexes and Metal-Based Complex Oxidation Processes.

    NASA Astrophysics Data System (ADS)

    McQuaid, Michael James

    The entrainment in carbon monoxide of metal (M) vaporized from an oven based source was used to create M(CO)_{rm x} complexes. The optical signatures associated with their oxidation to form chemiluminescing reaction products were analyzed to evaluate the nature of the M(CO)_{rm x } adducts and study MOcdotCO solvation complexes. The study was facilitated by comparing the optical signatures for the chemiluminescent oxidation of rare gas entrained metal atoms. Oxidation processes involving vanadium, chromium, and aluminum complexes were studied. In the case of vanadium, transitions associated with two previously unreported states of vanadium monoxide (VO) were observed and characterized. Transitions which may be associated with a VOcdotCO complex were also observed. For the case of chromium, three previously unreported states of chromium monofluoride (CrF) were characterized. Two band systems, which are tentatively ascribed to Cr_2F, were also observed. For the case of aluminum, the differences in the AlO B state population distribution formed in the Al+CO+O_3 and Al+Ar+O_3 systems provided a means of evaluating the binding energy of the Al(CO)_2 complex. Laser induced fluorescence (LIF) was used to probe the van der Waals complex AlAr formed in a free jet expansion. Based on rotationally resolved B^2Sigma ^{+} >=ts X^2 Pi_{1/2} electronic transitions, definitive interatomic potential parameters were developed for the AlAr B^2Sigma^{+ } state. AlAr X^2Pi_ {1/2} state interatomic potential parameter were developed assuming a Morse potential. Lambda doubling of the X^2Pi_ {1/2} state is evident, consistent with the presence of an unobserved repulsive AlAr A ^2Sigma^{+} state. Finally, the LIF excitation and emission spectra obtained for Fe/Ar and photolyzed Fe(CO)_5 /Ar matrices were compared. Previously unreported transitions associated with matrix-isolated Fe atoms were observed in the range from 500 to 1600 nm. Differences were observed in the spectra characterizing

  13. Electronic spectroscopy of the Al +-Ar complex

    NASA Astrophysics Data System (ADS)

    Lei, Jie; Dagdigian, Paul J.

    1999-05-01

    The laser fluorescence excitation spectrum of the Al +-Ar complex near the Al + ion 3s3p 1P ← 3s 2 1S resonance transition is reported. An excited-state ( v', 0) progression and the (0, 1) hot band were observed. Rotational analysis revealed that these bands involve an electronic transition from the Al +-Ar X 1Σ+ ground state to the 1Σ+ state correlating with the Al +( 1P)+Ar asymptote. Rotational constants and upper-state vibrational constants and the dissociation energy were determined. The spectroscopic constants of the two observed Al +-Ar electronic states are compared with those for neutral AlAr states.

  14. Fire Protection System for Hardened Aircraft Shelters. Volume 1. Discussion and Appendixes A-C

    DTIC Science & Technology

    1987-10-01

    in any configuration, for exanple IR, lR-lR, UV -IR, UV , UV -IR- UV . The advantage of multiwavelength detectors is a reduced likelihood of false alarm. B...11late is ,ai led the work function if the metal. Th, operating envelope of a UV detector is . function u (i) the Inc-tal used fir the cathode, and Ŗ...second or two longer. E. DI1AL-CHANNEL UV /IR JETIT .OIRS iiarmy false alar.m sources for UV and IR detectors are mutally exclusive. Th -. has led to the

  15. A Model for Predicting Late Prehistoric Architectural Sites at the Pinon Canyon Maneuver Site in Southeastern Colorado

    DTIC Science & Technology

    2007-01-01

    Topography in the project area consists of flat-topped hills, grassy steppes dissected by numerous canyons, and an igneous hogback ridge (Schuldenrien et al...are steppe, Hogback , arroyo/canyon, and hill. I predict that site elevation will be an easily patterned variable linked to food and water resources...Cedar Hills and on the Hogback . Lower elevations, like those between 4,400 and 4,800 ft, were recorded inside the canyons. 60 50 S40 0 30 10 oW v 0 .0

  16. Easy removal of nasal magnets.

    PubMed

    Starke, Lori

    2005-09-01

    This article uses a case report and discussion to demonstrate the removal of magnets which have become lodged in the nasal cavity as a result of using magnet-backed earrings to decorate the alae. If bi-alar decoration is used, removal of nasal magnets can present more of a challenge than other nasal foreign bodies. This is because of their attraction to each other through the septum and because of the edema that can form around the magnets. This case discusses that removal of magnets lodged in the nares can be easily achieved with minimal trauma, by the use of a household pocket magnet.

  17. Three-dimensional nasal changes following maxillary advancement in cleft patients.

    PubMed

    Stewart, A; McCance, A M; James, D R; Moss, J P

    1996-06-01

    Three-dimensional laser surface scanning of the face was performed before and after Le Fort I maxillary advancement in 24 patients with replaced clefts of the lip and palate. The surgery resulted in advancement of the upper lip and para-alar tissues and an increase in the relative prominence of the nose within the face. These changes were produced at the expense of an increase in nasal width and a reduction in nasal tip protrusion. The changes in nasal morphology showed significant variation among patients.

  18. Characterization of ultradispersed aluminum

    SciTech Connect

    Simpson, R.L.; Maienschein, J.L.; Swansiger, R.W.; Garcia, F.; Darling, D.H.

    1994-12-08

    Samples of ultradispersed Al were received, which were produced by electrically exploding Al wires in argon. These samples comprised very small particles that were not significantly oxidized and that were stable in air. Particle morphology were studied with SE, micropycnometry, and gas adsorption surface area. Composition were determined using various techniques, as were thermal stability and reaction exotherms. The inexplicable reports of an Al-Ar compound and of an exothermic reaction were not confirmed. The material is a stable, nonoxidized, small-particle, highly reactive form of aluminum that is of interest in energetic materials formulations.

  19. Comparing Ada and FORTRAN Lines of Code: Some Experimental Results

    DTIC Science & Technology

    1993-11-01

    34"yseidued predisute IA ohilews’ fhey usually eam"d resuts sfts 0is "let 11h14h (8) haew a direst bud"e SO decIsIons a1146t10g MWjo 1 0ra, (hi addrees...or IDA Document are nsed for the cowaveniene of the spoases or the analysts ( a ) to record substantive work done in quick reaction studies, (h) to...orm &j rey alar Ia i I* a embedo., -d w~ma. in"Ag suagaulbota Worduutg thills d , Wasllhirtgb d•ead s ft8mseewbas. 01 N IVm -1 sadm O W R9e 1216

  20. Digital Servocontroller System. Volume 1. Operations Manual.

    DTIC Science & Technology

    1985-02-01

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  1. A New Classification System for Unilateral Cleft Lip and Palate Infants to assist Presurgical Infant Orthopedics.

    PubMed

    Daigavane, P S; Hazarey, P V; Niranjane, P; Vasudevan, S D; Thombare, B R; Daigavane, S

    2015-01-01

    The proposed advantages of pre-surgical naso-alveolar moulding (PNAM) are easy primary lip repair which heals under minimum tension reducing the scar formation and improving the aesthetic results in addition to reshaping of alar cartilage and improvement of nasal symmetry.However, the anatomy and alveolar morphology varies for each cleft child; the procedure for PNAM differs accordingly. In an attempt to categorize unilateral cleft lip and palate cases as per anatomical variations, a new classification system has been proposed. This classification aims to give an insight in unilateral cleft morphology based on which modification in PNAM procedure could be done.

  2. Multifactorial Approaches for Correction of the Drooping Tip of a Long Nose in East Asians

    PubMed Central

    Jeong, Hoijoon; Ye, Choon Ho

    2014-01-01

    A long nose with a drooping tip is a major aesthetic problem. It creates a negative and aged appearance and looks worse when smiling. In order to rectify this problem, the underlying anatomical causes should be understood and corrected simultaneously to optimize surgical outcomes. The causes of a drooping tip of a long nose are generally classified into two mechanisms. Static causes usually result from malposition and incorrect innate shape of the nasal structure: the nasal septum, upper and lower lateral cartilages, and the ligaments in between. The dynamic causes result from the facial expression muscles, the depressor septi nasi muscle, and the levator labii superioris alaeque nasi muscle. The depressor septi nasi depresses the nasal tip and the levator labii superioris alaeque nasi pulls the alar base upwards. Many surgical methods have been introduced, but partial approaches to correct such deformities generally do not satisfy East Asians, making the problem more challenging to surgeons. Typically, East Asians have thick nasal tip soft tissue and skin, and a depressed columella and alar bases. The authors suggest that multifactorial approaches to static and dynamic factors along with ancillary causes should be considered for correcting the drooping tip of the long noses of East Asians. PMID:25396173

  3. [Morphometric analysis of nasal shapes and angles in young adults].

    PubMed

    Uzun, Ahmet; Ozdemir, Fikri

    2014-01-01

    The size, angle, shape and type of nose are a signature indicating race, age and sex. Describe and compare nasal angles, nose types, nostril models, and nasal profiles in young Turkish males and females. The study group consisted of university students, 56 males and 59 females. Nasal measurements were obtained from all subjects, using anthropometric methods. The nose types of females and males were 78% and 70% narrow nose, respectively. The means of females' nasofrontal, nasal tip, nasolabial, and alar slope angles were 133.16° ± 8.88°; 77.91° ± 9.80°; 98.91° ± 10.01°, and 80.89° ± 8.33°, respectively. The means of males' nasofrontal, nasal tip, nasolabial, and alar slope angles were 123.85° ± 13.23°; 82.16° ± 9.98°; 97.91° ± 8.78° and 85.98° ± 8.72°, respectively. The average values of the nose in this population may be used as a guide to plan corrective esthetic-cosmetic surgery and for burn scars of the nose. Copyright © 2014 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  4. Analysis of rapid maxillary expansion effects on nasal soft tissues widths.

    PubMed

    Santariello, C; Nota, A; Baldini, A; Ballanti, F; Cozza, P

    2014-09-01

    The aim of this study was to analyze the variations in nasal dimensions in prepubertal patients associated with RME therapy compared with an untreated age matched control group. A group of 61 subjects (26 F, 35 M; mean age 10.5±1.8 years) was enrolled in the study to undergo a rapid maxillary expansion therapy; 41 subjects (26 F, 15 M; mean age 10.7±2.2 years) were enrolled as a control group. Both groups underwent nasal soft tissues width measurements using a caliper at three separate time points: T0 - prior to the placement of RME; T1 - after completion of active expansion phase; T2 - at the removal of the expander (nearly 6 months after T1). The ANOVA showed statistically significant increments (P<0.0001) of the greater alar cartilage (GAC) measurement (0.8±0.2 mm) in the study group, differences for the AB measurements were not statistically significant (P=0.0784). The treatment of rapid maxillary expansion can induce an increase in GAC soft tissues width of about 1 mm in prepubertal patients. This increase could not be considered of clinical impact. The alar base width increase less than GAC, this increase is without statistical significance.

  5. A 20 year audit of nose-tip symmetry in patients with unilateral cleft lip and palate.

    PubMed

    Timoney, N; Smith, G; Pigott, R W

    2001-06-01

    The purpose of this study was to audit the process and outcome in terms of nasal-tip symmetry of the first 20 patients with unilateral complete cleft lip and palate treated by the Pigott alar leapfrog primary nasal correction in the early 1970s and followed for 20 years. Symmetry was assessed using the Coghlan computer-based analysis of frontal and basal views to determine the stability of the correction. The Abyholm technique of alveolar bone grafting was performed in 12 of the 20 patients. Various other secondary procedures have been performed on the nose tip and septum to improve the airway or appearance. Photographs were taken within one year of ages 5, 10, 15 and 20 years, and the lower border of the nose, the alar domes and the nostrils were assessed. To assess the overall change from 5 years to 20 years, both views were available for 17 patients. No significant change was found in the lower border or nostril symmetry, but significant deterioration at the P< 0.01 level was found on the basal view. We assessed the 10, 15 and 20 year views of all 12 patients who had undergone alveolar bone grafting to determine early and late changes. No significant benefit was found from alveolar bone grafting or minor secondary procedures for appearance. Consequently, our criteria for undertaking minor adjustments to improve appearance have become more stringent. We consider that objective reporting of appearance should become essential in peer-reviewed journals.

  6. [A nasal congenital malformation not published in the literature: About 5 cases].

    PubMed

    Colson, T R; Bertrand, B; Degardin, N; Bardot, J; Casanova, D

    2017-02-01

    Five cases of the same congenital malformation of the nose, affecting the nasal dorsum and the supra-tip, were supported in our university plastic surgery center. This malformation has not been described in the literature known to the authors. The aim of this study is to analyze this nasal deformity. Five children presented this congenital deformity between 1994 and 2014. The patients were examined and the malformation precisely described. Genetic and histological examinations were carried on. The diagnosis and treatment of this pathology were discussed. This malformation associated 4 anomalies: hypertrophy of soft tissue of the dorsum located in the middle third of the nasal bridge, deformed alar cartilages turned back downward and outside, advanced support default and median skin brand similar to a scar. These patients showed no other abnormalities of the midline or respiratory disorders. No genetic disorder was found for these five patients, and no histological arguments were found. Three patients were operated, one until adulthood with a satisfying cosmetic result. Bibliographic research has not allowed us to make an accurate diagnosis of this malformation that appears to be non-syndromic and to have a genetic origin. Our therapeutic approach became more clear and it now seems legitimate to propose early excision of fat mass to prevent alar deformations, associated with a cortico-cancellous graft, which in our experience grows with age, to support the tip. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  7. Measuring the nose in septorhinoplasty patients: ultrasonographic standard values and clinical correlations.

    PubMed

    Stenner, Markus; Koopmann, Mario; Rudack, Claudia

    2017-02-01

    Although septorhinoplasty is the most commonly performed operation in plastic surgery, and the surgical plan as well as its outcome is directly related to the configuration of the anatomical structures in the nose, these are not routinely assessed preoperatively. The aim of our study was to evaluate the nasal soft tissue and cartilaginous structures by means of high-resolution ultrasonography to set up clinical correlations and standard values. We examined 44 patients before septorhinoplasty by high-resolution ultrasonography in noncontact mode. All pictures were quantitatively evaluated by measuring 13 lengths and 4 ratios. All patients underwent a rhinomanometry measuring the nasal air flow. Besides others, men as well as older patients have a significantly thicker alar cartilage. Patients with thinner alar cartilages have a significantly smaller interdomal distance as well as significantly thinner upper lateral cartilages. The soft tissue above the bony dorsum was significantly thicker in older patients. Younger patients have significantly thicker soft tissue in relation to their cartilage. Patients with thicker soft tissue and thinner cartilage have a smaller tip. The interdomal distance and the thickness of the cartilaginous septum significantly correlated with the nasal air flow. We set up standard values of nasal structures in septorhinoplasty patients which can be used as reference values. By judging cartilage and soft tissue characteristics preoperatively, relevant factors for distinct procedures could be analyzed and the surgical steps can be better planned. Visualization by ultrasonography enables the surgeon to achieve treatment goals in a more predictable fashion.

  8. Rigid Posterior Lumbopelvic Fixation without Formal Debridement for Pyogenic Vertebral Diskitis and Osteomyelitis Involving the Lumbosacral Junction: Technical Report.

    PubMed

    Mazur, Marcus D; Ravindra, Vijay M; Dailey, Andrew T; McEvoy, Sara; Schmidt, Meic H

    2015-01-01

    Pelvic fixation with S2-alar-iliac (S2AI) screws can increase the rigidity of a lumbosacral construct, which may promote bone healing, improve antibiotic delivery to infected tissues, and avoid L5-S1 pseudarthrosis. To describe the use of single-stage posterior fixation without debridement for the treatment of pyogenic vertebral diskitis and osteomyelitis (PVDO) at the lumbosacral junction. Technical report. We describe the management of PVDO at the lumbosacral junction in which the infection invaded the endplates, disk space, vertebrae, prevertebral soft tissues, and epidural space. Pedicle involvement precluded screw fixation at L5. Surgical management consisted of a single-stage posterior operation with rigid lumbopelvic fixation augmented with S2-alar-iliac screws and without formal debridement of the infected area, followed by long-term antibiotic treatment. At 2-year follow-up, successful fusion and eradication of the infection were achieved. PVDO at the lumbosacral junction may be treated successfully using rigid posterior-only fixation without formal debridement combined with antibiotic therapy.

  9. Ontogenetic Expression of Sonic Hedgehog in the Chicken Subpallium

    PubMed Central

    Bardet, Sylvia M.; Ferran, José L. E.; Sanchez-Arrones, Luisa; Puelles, Luis

    2010-01-01

    Sonic hedgehog (SHH) is a secreted signaling factor that is implicated in the molecular patterning of the central nervous system (CNS), somites, and limbs in vertebrates. SHH has a crucial role in the generation of ventral cell types along the entire rostrocaudal axis of the neural tube. It is secreted early in development by the axial mesoderm (prechordal plate and notochord) and the overlying ventral neural tube. Recent studies clarified the impact of SHH signaling mechanisms on dorsoventral patterning of the spinal cord, but the corresponding phenomena in the rostral forebrain are slightly different and more complex. This notably involves separate Shh expression in the preoptic part of the forebrain alar plate, as well as in the hypothalamic floor and basal plates. The present work includes a detailed spatiotemporal description of the singular alar Shh expression pattern in the rostral preoptic forebrain of chick embryos, comparing it with FoxG1, Dlx5, Nkx2.1, and Nkx2.2 mRNA expression at diverse stages of development. As a result of this mapping, we report a subdivision of the preoptic region in dorsal and ventral zones; only the dorsal part shows Shh expression. The positive area impinges as well upon a median septocommissural preoptic domain. Our study strongly suggests tangential migration of Shh-positive cells from the preoptic region into other subpallial domains, particularly into the pallidal mantle and the intermediate septum. PMID:20700498

  10. Ontogeny of gamma-aminobutyric acid-immunoreactive neurons in the rhombencephalon and spinal cord of the sea lamprey.

    PubMed

    Meléndez-Ferro, Miguel; Pérez-Costas, Emma; Villar-Cheda, Begoña; Rodríguez-Muñoz, Rolando; Anadón, Ramón; Rodicio, María Celina

    2003-09-08

    The development of neurons expressing gamma-aminobutyric acid (GABA) in the rhombencephalon and spinal cord of the sea lamprey (Petromyzon marinus) was studied for the first time with an anti-GABA antibody. The earliest GABA-immunoreactive (GABAir) neurons appear in late embryos in the basal plate of the isthmus, caudal rhombencephalon, and rostral spinal cord. In prolarvae, the GABAir neurons of the rhombencephalon appear to be distributed in spatially restricted cellular domains that, at the end of the prolarval period, form four longitudinal GABAir bands (alar dorsal, alar ventral, dorsal basal, and ventral basal). In the spinal cord, we observed only three GABAir longitudinal bands (dorsal, intermediate, and ventral). The larval pattern of GABAir neuronal populations was established by the 30-mm stage, and the same populations were observed in premetamorphic and adult lampreys. The ontogeny of GABAergic populations in the lamprey rhombencephalon and spinal cord is, in general, similar to that previously described in mouse and Xenopus. Copyright 2003 Wiley-Liss, Inc.

  11. Unilateral cleft lip/nose repair using an equal bows /straight line advancement technique - A preliminary report and postoperative symmetry-based anthropometry.

    PubMed

    Hakim, Samer George; Aschoff, Horst Heinrich; Jacobsen, Hans-Christian; Sieg, Peter

    2014-04-01

    In the evolution of cleft lip repair there has been continuous attempt to minimize local trauma, improve lip and nasal appearance and, especially, prevent conspicuous scars. The surgical technique presented meets these criteria, resulting in an appropriate scar course in children with a specific philtral ridge shape. Postoperative digital anthropometry was performed in 18 patients who underwent unilateral cleft lip repair using the equal bows/straight line advancement technique and in matched healthy control individuals. Symmetry values were assessed for lip length, philtral ridge length, vermilion height, width of the alar base, nasocanthal length, circumference of the nostrils, nostril width and height in both cleft and control groups. Evaluation revealed no significant differences in the symmetry values between cleft patients and control group (lip length: p = 0.71, philtral ridge length: p = 0.52, vermilion height: p = 0.23, alar base width: p = 0.69, nasocanthal length: p = 0.25, nostril circumference: p = 0.17, nostril width: p = 0.34, nostril height: p = 0.33). Principles of cleft lip repair can be achieved using the described technique which provides adequate lip length and natural nasal appearance in patients with a parallel-shaped philtral ridge.

  12. Nasal Soft Tissue Change Following Bimaxillary Orthognathic Surgery.

    PubMed

    Jeong, Hye-In; Lee, Ho-Sung; Jung, Young-Soo; Park, Hyung-Sik; Jung, Hwi-Dong

    2017-05-31

    The purpose of this study is to identify the correlation between maxillary movement and nasal soft tissue changes on three-dimensional reconstructed cone beam computed tomography (CBCT) images after Le Fort I osteotomy. The authors also investigate the long-term change of alar base width (ABW) to determine the effect of cinch suture. The authors retrospectively studied 52 subjects (14 males and 38 females) who were treated by bimaxillary orthognathic surgery including Le Fort I osteotomy and mandibular ramus surgery. The landmarks and planes were established on three-dimensional reconstructed CBCT images. The authors measured each parameters preoperatively, 1 month postoperatively, and 1 year postoperatively. There was no significant correlation between the horizontal movement of A-point and the widening of ABW (P < 0.038), nor was there a significant correlation between the vertical movement of A-point and the change of ABW (P < 0.61). There was no significant correlation between horizontal and vertical movement of anterior nasal spine and the widening of ABW, nor was there a significant correlation between the nasal tip length and the vector of maxillary movement. There was no significant correlation between the ABW widening and the vector of surgical maxillary movement. The effect and stability of the alar base cinch suture is difficult to determine and require further investigation.

  13. Facial surface changes after cleft alveolar bone grafting.

    PubMed

    Krimmel, Michael; Schuck, Nils; Bacher, Margit; Reinert, Siegmar

    2011-01-01

    The aim of this study was to assess the 3-dimensional facial surface changes after cleft alveolar bone grafting with digital surface photogrammetry. In a prospective study, 22 patients with cleft lip and palate underwent alveolar bone grafting. Before the procedure and 6 weeks postoperatively and before the continuation of orthodontic treatment, 3-dimensional images were taken with digital surface photogrammetry. Seven standard craniofacial landmarks on the nose and the upper lip were identified. Their spatial change because of bone grafting was assessed. Statistical analysis was performed with analysis of variance and t test. A significant increase in anterior projection on the operative side (P < .05) was found for the labial insertion points of the alar base (subalare). No significant changes were detected for the position of the labial landmarks. Our results show 3-dimensionally that there is a positive influence of the alveolar bone graft on the projection of the alar base on the cleft side. Copyright © 2011 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  14. [Acoustic behavior of Fenestra bohlsii Giglio-Tos (Orthoptera: Acrididae: Gomphocerinae)].

    PubMed

    Lorier, Estrellita; Clemente, Maria E; García, Maria D; Presa, Juan J

    2010-01-01

    The acoustic behavior of Fenestra bohlsii Giglio-Tos is described for the first time. The sounds and behaviors were observed and registered in captivity. The signals were digitized with the Sound-Blaster AWE64 Gold program and analysed with the Avisoft SAS Lab Pro 30 PC for MS Windows software. Seven different types of sounds are described as produced by males: spontaneous song (also used during the courtship), two different types of courtship song, assault song, tapping associated to the courtship, interaction between males and fly crackling. For each one, the characteristic oscillograms and frequency spectra are given. Sounds are produced by different mechanisms: femoro-tegminal stridulation, typical for Gomphocerinae, fly crackling, hind tarsi tapping and alar beat, the last produced by the beat and clash of hind alae, that is, the castanet method which up to now was only known, among Orthoptera, in Stenobothrus rubicundulus Kruseman & Jeekel. A description of the stridulatory file of male and female is given, as well as that of the alar special structures. Behavioral units and their sequence during the courtship are defined. There, in addition to the acoustic signals, visual signals are present, referring to positions, hind legs, antennae and palpi movements and body vibrations.

  15. Analysis of the cleft-lip nose in submental-vertical view, Part I--reliability of a new measurement instrument.

    PubMed

    Nagy, Krisztián; Mommaerts, Maurice Y

    2007-01-01

    Objective evaluation of nasal form and symmetry in cleft patients is difficult. The aim of this study was to establish a computer analysis of nasal form and symmetry (intranasal symmetry and symmetrical position of the nose), in order to evaluate primary and secondary cleft rhinoplasty outcomes. Indirect anthropometric measurements were performed on digital photographs processed by Photoshop 7.0 (Adobe Systems Inc., San Jose, California) with the help of Scion Image software (National Institutes of Health, Maryland, USA). For assessing intranasal symmetry, the ratio of nasal tip projection to total nasal width, the ratio of nostril widths, the ratio of nostril heights, the ratio of mid-alar widths and nostril symmetry were determined. Bifidity of the nose, columellar deviation and angulations of the nostrils were also measured. For assessing the symmetrical position of the nose, the ratio of the distances of alar points to the endocanthial lines and nasal base inclination were determined. The reliability of this analysis was tested by using submento-vertical photographs of bilateral cleft noses, of which the lips were primarily operated on by different techniques and different surgeons in Zurich and Bruges. There were highly significant intraobserver (ICC=0.994) and interobserver reliabilities (ICC=0.893). This nasal analysis is appropriate for comparing results of different surgical techniques.

  16. Seagull wing graft: a technique for the replacement of lower lateral cartilages.

    PubMed

    Pedroza, Fernando; Anjos, Gustavo Coelho; Patrocinio, Lucas Gomes; Barreto, Jose M; Cortes, Jorge; Quessep, Suad H

    2006-01-01

    To present and evaluate outcomes with the seagull wing technique, which was designed to replace the lower lateral cartilages and to reconstruct the nasal tip. The seagull wing technique is illustrated and described in detail. Sixty patients who underwent surgery 1981 and 2002 were retrospectively evaluated. A preoperative diagnosis of tip deformities was made based on photographs, which were compared with the postoperative results. Patient satisfaction was subjectively evaluated. The postoperative results showed a significant statistical improvement in the following tip deformities: underprojected tip (P<.001), poorly defined tip (P<.001), alar retraction (P<.001), alar pinch (P<.001), overrotated tip (P<.001), and tip ptosis (P<.01). The average follow-up period was 14.6 months. Fifty-five patients (92%) stated that they were very satisfied with the surgical results; they required no additional revision surgery. The seagull wing technique is a safe and efficient reconstructive treatment for the aesthetic and functional problems that were caused by the overresection of the nasal tip cartilaginous framework. The outcomes were pleasing, and the results were stable during the follow-up period. Patient satisfaction was high.

  17. Aesthetic and functional restoration using dorsal saddle shaped Medpor implant in secondary rhinoplasty.

    PubMed

    Turegun, Murat; Acarturk, Tahsin Oguz; Ozturk, Serdar; Sengezer, Mustafa

    2008-06-01

    Functional disorders due to alar valve collapse and cosmetic unsatisfactory results can be seen after rhinoplasty operation in some patients. Because of overresection of the upper and lower lateral cartilages, nasal lateral walls may collapse during inspiration pressing against the septum and obstructing airway. On the other hand, overresection may result in several cosmetic deformities. Fourteen patients presenting with nasal deformation and functional insufficiency, were treated using thin sheet porous polyethylene (Medpor). Cottle sign was positive in all patients. On examination, collapse during inspiration, depression at the supratip area, and asymmetry were common findings. Saddle shaped implants, 1.2 x 40 mm in dimension, were introduced into pouches prepared via bilateral rim incision. After suturing incisions, bandage and cast were applied. In the mean 14-month follow-up period, 1 implant malposition was seen in a patient because of larger planning the pocket that was corrected by a subsequent shaving of the implant. Asymmetries of the noses were totally corrected. No exposition was found. Alar collapse and respiration impairment had disappeared in all patients. Although, autologous tissue is known as the best material, Medpor can be used safely regarding its low complication rate because of its porotic architecture and low morbidity in donors. Medpor implant provides functional improvement by its strength body. Its smooth surface helps to correct the asymmetry by filling the defects. Using a saddle shape enabled us to treat different components of the postrhinoplasty deformity with a single implant.

  18. Evidence that tRNA synthetase-directed proton transfer stops mistranslation.

    PubMed

    Waas, William F; Schimmel, Paul

    2007-10-30

    To prevent mistranslation, aminoacyl-tRNA synthetases (AARSs) discriminate against noncognate amino acids and cellular metabolites. Defects in specificity produce statistical proteins which, in mammalian cells, lead to activation of the unfolded protein response and cell death. Because of inherent limitations in amino acid discrimination by a single active site, AARSs evolved a separate domain to clear mischarged amino acids. Although the structure of a widely distributed editing domain for ThrRS and AlaRS is known, the mechanism of amino acid clearance remains elusive. This domain has two motifs that together have four conserved residues in the pocket used to clear serine from mischarged tRNAs. Here, using ThrRS as an example, rapid single-turnover kinetics, mutagenesis, and solvent isotope analysis show that a strictly conserved histidine (between ThrRS and AlaRS) extracts a proton in the chemical step of the editing reaction. Three other conserved residues, and two additional residues in the editing pocket, are not directly implicated in the chemical step. These results are relevant to the previously reported mutagenesis of the homologous editing pocket of alanyl-tRNA synthetase, where even a mild defect in editing causes neurodegeneration in the mouse. Thus, a single proton-transfer event needed to prevent mistranslation can have profound implications for disease.

  19. External rhinoplasty: a critical analysis of 500 cases.

    PubMed

    Foda, Hossam M T

    2003-06-01

    The study presents a comprehensive statistical analysis of a series of 500 consecutive rhinoplasties of which 380 (76 per cent) were primary and 120 (24 per cent) were secondary cases. All cases were operated upon using the external rhinoplasty technique; simultaneous septal surgery was performed in 350 (70 per cent) of the cases. Deformities of the upper two-thirds of the nose that occurred significantly more in the secondary cases included; dorsal saddling, dorsal irregularities, valve collapse, open roof and pollybeak deformities. In the lower third of the nose; secondary cases showed significantly higher incidences of depressed tip, tip over-rotation, tip asymmetry, retracted columella, and alar notching. Suturing techniques were used significantly more in primary cases, while in secondary cases grafting techniques were used significantly more. The complications encountered intra-operatively included; septal flap tears (2.8 per cent) and alar cartilage injury (1.8 per cent), while post-operative complications included; nasal trauma (one per cent), epistaxis (two per cent), infection (2.4 per cent), prolonged oedema (17 per cent), and nasal obstruction (0.8 per cent). The overall patient satisfaction rate was 95.6 per cent and the transcolumellar scar was found to be unacceptable in only 0.8 per cent of the patients.

  20. Topological analysis of the brain stem of the frogs Rana esculenta and Rana catesbeiana.

    PubMed

    Opdam, R; Kemali, M; Nieuwenhuys, R

    1976-02-01

    The ventricular sulcal pattern and the cytoarchitectonic organization of the brain stem of the frogs Rana esculenta and Rana catesbeiana have been studied in transversely cut, Nissl stained serial sections. Four longitudinal sulci, the sulcus medianus inferior, the sulcus intermedius ventralis, the sulcus limitans and the sulcus medianus superior could be distinguished in both species. A fifth longitudinal groove, the sulcus intermedius dorsalis, was found only in Rana esculenta. With the aid of the usual cytoarchitectonic criteria 25 cell masses have been delineated in Rana esculenta and 27 in Rana catesbeiana. These cell masses can be distributed over the following categories (numbers added in brackets for Rana catesbeiana, if different from those in Rana esculenta): primary efferent or motor, 8; primary afferent or sensory, 4(6); "relay" centers, 7. Contrary to statements in the literature the reticular formation can be divided into six separate cell groups. The majority of the nuclei form part of the central gray, which constitutes a rather wide zone in anurans; three reticular nuclei lie partly within the stratum griseum and partly within the stratum album; six nuclei are entirely embedded in the stratum album. The morphological pattern of the cell masses and their relationship to the ventricular sulci were studied with the aid of a graphical reconstruction procedure termed topological analysis (cf. Nieuwenhuys, '74 and figs. 15, 16). This analysis yielded the following results: The sulcus limitans extends throughout the rhombencephalon, dividing this brain part into a basal plate and an alar plate. The cell masses in the basal plate fit into two longitudinal zones, a medial area ventralis and a lateral area intermedioventralis. The area ventralis contains three somatic motor nuclei (IV, VI and XII) and the rhombencephalic medial reticular zone. The latter may be primarily considered as a somatic motor coordinating center. The area intermedioventralis contains

  1. Quantifying Optimal Columellar Strut Dimensions for Nasal Tip Stabilization After Rhinoplasty via Finite Element Analysis.

    PubMed

    Gandy, Jessica R; Manuel, Cyrus T; Leary, Ryan P; Wong, Brian J F

    2016-05-01

    The contribution of columellar strut grafts (CSGs) to nasal tip support has not been determined via structural mechanics. Optimal graft dimensions have yet to be objectively determined. To use a finite element model (FEM) of the human nose to (1) determine the effect of the CSG on nasal tip support and (2) identify how suture placement contributes to tip support. A multiple-component FEM of the human nose consisting of bone, skin/soft tissue, and cartilage was rendered from a computed tomographic scan. Then, CSGs of varying sizes were created, ranging from 15 × 4 × 1 mm to 25 × 8 × 1 mm, and placed in the model between the medial crura. Two FEMs were constructed for each strut size: (1) CSGs that were physically attached to the nasal spine, medial crura, and caudal septum and (2) CSGs that were not in direct contact with these structures and free to move within the soft tissue. A control model was also constructed wherein no graft was placed. Nasal tip support for each model was assessed, and the resultant distribution of von Mises stress, reaction force, and strain energy density with respect to the alar cartilages were calculated. Compared with the control, the reaction force increased with increasing strut volume, while the strain energy density (calculated over the alar cartilages) generally decreased with increasing CSG volume. Simulations with struts that had suture attachments along the entire length of the graft generated a larger reaction force than the models without any suture attachments. Models with anteriorly placed sutures generated reaction forces similar to that of the fully sutured model, whereas the models with posterior sutures showed reaction forces similar to the fully disconnected model. Insertion of CSGs does effect the amount of force the nasal tip can withstand post rhinoplasty. Moreover, anteriorly placed sutures incur reaction forces similar to struts that are fully connected to the alar cartilage. Thus, our

  2. Integration and Testing of a Disjunct Eddy Accumulation VOC Flux Measurement System in a Research Aircraft

    NASA Astrophysics Data System (ADS)

    Garman, K.; Everly, M.; Wyss, P.; Carlsen, M.; Zimmerman, J.; Stirm, B.; Carney, T.; Santini, R.; Shepson, P.

    2005-12-01

    Biogenic Volatile Organic Compound (BVOC) fluxes can now be measured using Disjunct Eddy Accumulation (DEA). This method is primarily applied from fixed towers above forest canopies to study biosphere-atmosphere exchange processes. To expand these tower-based BVOC measurements to spatial scales beyond the tower footprint, an aircraft-based DEA platform is required. Among the significant challenges to such an approach is the capability to determine the vertical component of atmospheric wind from the aircraft with adequate precision and accuracy. The design of a suitable airborne sampling system is another significant challenge. The development of the Airborne Laboratory for Atmospheric Research (ALAR) is described herein. We describe the DEA design and installation along with calibration results which characterize the uncertainties of the vertical wind component measurement. We also describe initial tests of the DEA sampling system, the capabilities of the final installation, and the expected flux uncertainties.

  3. Computed tomography of the craniocervical junction in rheumatoid arthritis.

    PubMed

    Castor, W R; Miller, J D; Russell, A S; Chiu, P L; Grace, M; Hanson, J

    1983-02-01

    Thirty-three patients with rheumatoid arthritis had computed tomographic examination of the craniocervical junction. This demonstrated soft tissue features which have not previously been described in published reports. A low attenuation lesion between the odontoid and the transverse ligament shown in 11 patients was considered a premonitory sign of rupture of the transverse ligament or a manifestation of active disease. Computed tomography revealed spinal cord compression in 3 patients and ligamentous changes in the transverse ligament and the alar and spinal ligaments in 26 patients. Erosion of the odontoid was shown in 19 patients and subluxation in 20 patients. No relationship could be found between the clinical signs and symptoms and the radiological abnormalities except in the case of cord compression.

  4. Value of cephalic part of lateral crus in functional rhinoplasty.

    PubMed

    Sazgar, Amir A; Amali, Amin; Peyvasty, Mina Najarzad

    2016-12-01

    Reshaping of the nasal tip is the most difficult part of rhinoplasty. Over the years, there have been many advances in the field of rhinoplasty, including tip plasty. The goal of these continuous refinements in existing procedures has been to improve both aesthetic and functional outcomes. The cephalic part of the lateral crus of the lower lateral cartilage is what mainly contributes to nasal tip deformity. Various surgical techniques have been reported that used the cephalic part of lateral crus to refine the nasal tip and preserve alar integrity and nasal breathing function. In this review article, we have attempted to show the evolution of these methods while focusing on development of approaches that are basic for "modern rhinoplasty" and presenting our personal preferences. We have also endeavored to categorize these methods and clarify some misconceptions and inaccuracies in their descriptions.

  5. Nasal reconstruction using porous polyethylene implants.

    PubMed

    Romo, T; Sclafani, A P; Jacono, A A

    2000-01-01

    Nasal reconstruction presents a significant challenge to the facial plastic surgeon. The dual goals of reconstruction are restoration of the desired aesthetic nasal contour and an improved nasal airway. Autologous cartilage and bone are considered optimal grafting material, but their supply is often limited and harvesting entails additional morbidity. Many synthetic materials have been introduced in nasal reconstruction, but high infection and extrusion rates limited their use. Porous high density polyethylene implants present an alternative to autologous material as they allow for fibrovascular ingrowth, leading to stability of the implant and decreased rates of infection. Herein we describe the use of porous high density polyethylene implants for reconstruction of the platyrrhine nose and in revision rhinoplasty. The use of preformed nasal-dorsal tip and alar batten implants are described, as well as the use of columellar strut and premaxillary plumper implants. We believe that porous high density polyethylene implants provide a safe, desirable alternative in functional and aesthetic nasal reconstruction.

  6. A comparison of aesthetic proportions between the Oriental and Caucasian nose.

    PubMed

    Leong, S C L; White, P S

    2004-12-01

    Differences in aesthetics between the Oriental and Caucasian nose were examined from a cohort of 118 healthy volunteers of which 61 had an Oriental and 57 had a Caucasian racial origin. The oriental nose projected less from the face, and was broader at the intercanthal level (P < 0.001) and the alar base (P < 0.001), but not at the bony base. The oriental nose projected less at all levels: nasion projection (P < 0.001) and tip projection (P < 0.001). The naso-labial angles for the Orientals in this study exhibited a wider range of variation than the Caucasians, with the oriental male exhibiting the most acute angle (average 86.2 degrees ), because of the forward angulation of the upper lip. Many of the average aesthetic parameters obtained from these two cohorts of healthy subjects did not conform to the published aesthetic standards, set out as the ideal goals for rhinoplasty.

  7. Three-dimensional analysis techniques--Part 4: Three-dimensional analysis of bone and soft tissue to bone ratio of movements in 24 cleft palate patients following Le Fort I osteotomy: a preliminary report.

    PubMed

    McCance, A M; Moss, J P; Fright, W R; Linney, A D; James, D R; Coghlan, K; Mars, M

    1997-01-01

    The three-dimensional changes in the bone and the ratio of soft tissue to bone movement were investigated in a group of 24 cleft palate patients following Le Fort I osteotomy. CT scans were taken for each patient preoperatively and 1 year postoperatively. The scans were superimposed, radial measurements calculated, and the changes illustrated by two separate color scales. In all of the groups, there was a fairly consistent pattern of movement over the mandible. The soft tissues moved in a 1.25:1 ratio over the chin and canine regions, and reduced to 1:1 over the body. In the maxilla, there was a 1:1 movement in the midline increasing to 1.25:1 bilaterally over the alar bases for both the bilateral clefts and clefts of the secondary palate groups. In the unilateral cleft group, however, there was a greater degree of movement over the cleft than over the noncleft side.

  8. Expression of chick Fgf19 and mouse Fgf15 orthologs is regulated in the developing brain by Fgf8 and Shh.

    PubMed

    Gimeno, L; Martinez, S

    2007-08-01

    Fibroblast growth factors (Fgfs) constitute a family of signaling molecules that play essential roles in development. We have studied the expression pattern of mouse Fgf15 in the developing brain. Fgf19 is another member of the FGF family that has been suggested as the chick and human ortholog of mouse and rat Fgf15. Here, we compare the expression pattern during neural development of chick Fgf19 with mouse Fgf15. Unlike Fgf15, Fgf19 presents an expression in the isthmic alar plate, diencephalic and mesencephalic parabasal plates, hindbrain basal plate, as well as in the zona limitans intrathalamica (zli). Moreover, we explored the regulation between Fgf19 and the signaling molecules of the isthmic and zli organizers: Fgf8 and Shh, respectively. Considering the possibility that Fgf19 plays a similar role in humans and chicks, this finding could explain the significant diencephalic phenotypic differences between humans and mice in models and diseases where the Shh pathway is affected.

  9. Nasolabial Cyst Associated with Odontogenic Infection

    PubMed Central

    Martini, Eveline Claudia; Coppla, Fabiana Madalozzo; Campagnoli, Eduardo Bauml; Bortoluzzi, Marcelo Carlos

    2016-01-01

    The nasolabial cyst or Klestadt cyst is a relatively uncommon nonodontogenic cyst that develops in the nasal alar region; it has uncertain pathogenesis. This lesion has slow growth and variable dimensions and is characterized clinically by a floating tumefaction in the nasolabial fold area around the bridge of the nose, causing an elevation of the upper lip and relative facial asymmetry. Diagnosis is primarily made clinically; if necessary, this is complemented by imaging. This paper reports the case of a 39-year-old male patient who complained of pain in the right upper premolar region and poor aesthetics due to a firm tumor in the right wing of the nose. Initially, this was thought to be due to an odontogenic abscess; however, the differential diagnosis was that a nasolabial cyst was communicating with the apex of teeth 14 and 15. Surgical treatment was carried out, followed by histopathological examination and concomitant endodontic treatment of the teeth involved. PMID:26904312

  10. An assessment of grafts in the posterior cricoid lamina.

    PubMed

    Strome, M; Norris, C M; Joseph, M P; Brodsky, G; Eavey, R D

    1982-10-01

    Subglottic stenosis is a recognized complication of prolonged intubation. To date, there is no uniformly successful operative procedure for severe subglottic stenosis, fulfilling the criteria of decannulation and a serviceable voice. The surgical ideals for such a procedure should include the use of autogenous grafting material, avoidance of internal stenting, and limited manipulation of the mucosa. This study was intended to assess the fate of isolated hyoid and thyroid alar grafts interposed in the posterior cricoid lamina. Additionally, anterior/posterior splits with and without anterior grafting were evaluated. Seventeen dogs were used in the determinate animal model. Vocal cord mobility was evaluated by direct laryngoscopy prior to sacrifice. Graphic gross anatomical specimens depict the effects of anterior/posterior splitting on the cricoid cartilage. Clinical correlations are suggested.

  11. Infiltrating intramuscular spindle cell lipoma of the face.

    PubMed

    Mandal, Rajni V; Duncan, Lyn M; Austen, William G; Nielsen, G Petur

    2009-10-01

    Spindle cell lipoma is a benign lipomatous tumor, which usually arises on the back of the neck, shoulder or upper back of males in the third to seventh decade of life. We report herein an unusual infiltrating intramuscular spindle cell lipoma arising in the nose of a 53-year-old man. The patient presented with a 0.5-cm 'cyst' of the nose, just above the right alar crease, which was removed. Four years later, the lesion recurred and was re-excised. Histologically, a proliferation of mature adipocytes, ropey collagen fibers and spindle cells within a myxoid stroma was present in the subcutaneous tissue and infiltrated between skeletal muscle fibers. Nine cases of intramuscular spindle cell lipoma with histological examination have previously been reported and have involved the oral cavity and muscles of the extremities. To our knowledge, this is the first report of an infiltrating intramuscular spindle cell lipoma arising on the face.

  12. Intra And Extra Nasal Laser Surgery

    NASA Astrophysics Data System (ADS)

    Selking, Stuart G.

    1988-06-01

    The author describes his experience with 400 intranasal laser surgical procedures done with the carbon dioxide laser and the surgical microscope. Procedures include excision and vaporization of polyps, turbinates, tumors, telangiectasia, synechia, nasal stenosis, intranasal cysts, papillomata, and septal spurs. The author describes a suction speculum and drape of his own design which provide smoke free access to the internal nose, and protection of the alar rim and the face from laser energy. Relief of obstruction is comparable to that obtained from the more traditional means of intranasal surgery. Intraoperative and early and delayed post operative bleeding is less with laser surgery than with any other means. Avoidance of technical problems is emphasized in this manuscript, since intranasal laser surgery is in some respects difficult to perform. Included are practical suggestions about patient positioning, use of protective devices, and patient selection.

  13. [Nasal mucosa in patients with diabetes mellitus].

    PubMed

    Müller, Maciej; Betlejewski, Stanisław

    2003-01-01

    Diabetes mellitus is the most common endocrinologic disease all over the world. 150 million people suffer from this disease, in Poland about 2 million. The disease on the basis of the onset and pathophysiology may be divided into type I and type II. Pathophysiologic changes include diabetic microangiopathy, macroangiopathy and neuropathy. The most common presentations in head and neck are otitis externa, hypoacusis, vertigo, disequilibrium, xerostomia, dysphagia, fungal and recurrent infections. The changes in nasal mucosa are not very well known. Only few papers concerned the problem. The main complaints of patients regarding the nose are xeromycteria, hyposmia and various degree of decreased patency of the nose. Chronic atrophic rhinitis, septal perforation, ulceration of nasal mucosa, alar necrosis, symptoms of staphylococcal or fungal infection can be found during otolaryngologic examination. The treatment in this group of patients should consist of systemic therapy of diabetes mellitus and on the other hand focal therapy with the use of a solution to moisten the nasal mucosa.

  14. Prime Contractors with Awards Over $25,000 by Name, Location, and Contract Number, Fiscal Year 87. Part 9. Pacific Coast Sales & Service-Rockwell International Corporation.

    DTIC Science & Technology

    1987-01-01

    8217 ID W E (1 0 ~ Ecc 0 ’-’GE N4 cc cc~ c- cc c 1ALar T . 6z- -%L __ !L S :a *4m to~’) 00IN 4 m (n4 CnO WC N 0 - F - -N LC to C >c 0 ID a I > U- R) I6 L...I 44 Hot D0-D 3 o 00 00 2 0 HOMO MO M 00C 0.. C C0U 00 0*0 0 4o rF. 0 010eW 23 - ixI - - 8w~d IO 0 U)LIko0 LOO W c 0000 080W0).0000 oomo r- 0 m 5 I

  15. Humans are born too soon: impact on pediatric otolaryngology.

    PubMed

    Bluestone, Charles D

    2005-01-01

    Humans are born 12 months too early. Gestation should be 21 months. Humans evolved to become the pre-eminent animal in the world, but our big brain, bipedalism, and small female pelvic outlet have caused us to pay the price of being born too soon with all of its disadvantages. Early birth has an impact on diseases and disorders encountered by the otolaryngologist, including otitis media, laryngomalacia, tracheomalacia, congenital vocal cord paralysis, subglottic and tracheal stenosis, gastroesophageal reflux, congenital micrognathia, and congenital nasal alar collapse. Many of these conditions improve or resolve completely in the first year of life as an infant's immune system and anatomy matures. Knowledge of this evolutionary process can help us understand why some infants will grow out of certain diseases and disorders encountered in pediatric otolaryngology, while others will not.

  16. Aesthetic and functional outcome following nasal reconstruction.

    PubMed

    Mureau, Marc A M; Moolenburgh, Sanne E; Levendag, Peter C; Hofer, Stefan O P

    2007-10-01

    Few reports on outcome of aesthetic nasal reconstruction exist. Therefore, subjective and objective aesthetic and functional outcome following nasal reconstruction was assessed. Outcome was assessed in 38 consecutive patients treated for subtotal nasal defects using standardized semistructured interviews. Standardized physical examination forms and photographs were used. In six patients, one aesthetic subunit was involved; in 14, two; and in 18, three or more. Defects were classified as skin only (13 percent), skin/cartilage (21 percent), and full thickness (66 percent). Some defects (32 percent) involved adjacent aesthetic units. Inner lining was reconstructed with local mucosa or turnover skin flaps. Support was provided with regional cartilage grafts and/or composite septal flaps. Skin defects were reconstructed with forehead, nasolabial, cheek advancement, Abbé, facial artery perforator, or free radial forearm flaps. Nasal reconstructions required 116 procedures. Thirty-three patients participated in the follow-up study. Mucosal crusting was noted in 36 percent, passage difficulties in 31 percent, and worse olfaction in 16 percent. Phonation was unchanged. Eighty-one percent were very satisfied with nasal function. Flap color match was moderate to good in 97 percent; hair growth occurred in 61 percent. At critical inspection, a thicker flap (58 percent), smaller ostium nasi (77 percent), thicker alar rim (86 percent), and minor alar rim retraction (46 percent) were noted. Seventy-nine percent were very satisfied with total nasal appearance. Although objective functional and aesthetic outcome following nasal reconstruction sometimes shows impairment compared with the normal situation, it gives high subjective patient satisfaction with function and aesthetics.

  17. Functional magnetic resonance imaging--video diagnosis of soft-tissue trauma to the craniocervical joints and ligaments.

    PubMed

    Volle, E

    2000-01-01

    Patients suffering from distortion of the cervical spine after an acceleration trauma present problems with respect to the correct diagnostic recognition of the existing injuries. To define instability of the craniocervical junction, attention should be given to the position of the dens and the dimension of its subarachnoid space during the entire rotational maneuver. Our diagnosis via functional magnetic resonance imaging (fMRI) with video did not focus on injuries to the ligamentous microstructure as visualized with high-resolution MRI. Our purpose was to demonstrate the cause of instability of the craniocervical junction by direct visualization during fMRI-video technique. Between December 1997 and March 1999, 200 patients were studied using fMRI on a 0.2-Tesla Magnetom Open. Routine evaluation of the extracranial vertebral circulation by MRI angiography as an additional preinvestigative requirement is recommended. The earliest examination time from injury to MRI evaluation was 3 months and the maximum, 5 years (average, 2.6 years). Among the 200 patients investigated, 30 showed instability of the ligamentous dens complex. Of the same 200, 8 (4%) had a complete rupture and 22 (11%) an incomplete rupture of the alar ligament, with instability signs. In another 45 patients (22.5%), fMRI-video showed evidence of instability, and all these patients had coexisting intraligamentous signal pattern variation, probably due to granulation tissue. Eighty patients of the 200 (40%) had signal indifference without demonstrable video instability signs, and 43 patients (21.5%) showed no evidence of instability and no signal variation in the alar ligaments. On the basis of recognition of instability and the malfunction of the ligaments, the fibrous capsula, and the tiny dens capsula, we now can distinguish between lesions caused by rotatory trauma to the craniocervical junction and those from classic whiplash injury.

  18. MRI video diagnosis and surgical therapy of soft tissue trauma to the craniocervical junction.

    PubMed

    Volle, E; Montazem, A

    2001-01-01

    We evaluated objective diagnostic methods for patients with possible upper cervical spine instability caused by trauma and correlated them with subsequent neurosurgical findings and outcomes. Between November 1995 and May 1998, we investigated 420 patients with functional magnetic resonance imaging (MRI) of the craniocervical junction. We evaluated the extracranial vertebral circulation by MRI angiography, with focus on the position of the dens and on the subarachnoid space during entire rotational maneuvers. We documented 72 cases (17.1%) of injuries to the alar ligaments that were accompanied by signs of instability. Twenty patients (4.8%) had a complete alar ligament rupture, and 52 (12.4%) had an incomplete rupture with coexisting instability. We referred these patients to a neurosurgeon. Surgery was eventually chosen for 42 patients (10.0%) with the intention of obtaining dorsal occipitocervical stabilization. The duration of time between the MRI evaluation and surgery ranged from 1 week to 1.5 years (mean: 3.5 mo). After the fifth postoperative day, almost all symptoms had disappeared. One year following surgery, 34 of the 42 patients (80.9%) still demonstrated successful fusion and an alleviation of their sensation of instability. Twenty-five of these patients (59.5%)--all of whom were unemployed before surgery--were able to resume a professional activity. In the eight patients (19.0%) who still had a loss of stability during the second and 14th weeks, we noticed that there were some negative effects of rehabilitation. Six of these patients developed pseudarthrosis or osteolysis of their bone grafts during the first 3 months after fusion, and three required a repeat operation. We conclude that functional MRI with lateral tilting and rotatory evaluation is a useful tool for investigating craniocervical instability. For patients who are recalcitrant to following a program of conservative therapy, surgical stabilization of the craniocervical junction appears to

  19. Clone and functional analysis of Seryl-tRNA synthetase and Tyrosyl-tRNA synthetase from silkworm, Bombyx mori.

    PubMed

    Hu, Jingsheng; Tian, Jianghai; Li, Fanchi; Xue, Bin; Hu, Jiahuan; Cheng, Xiaoyu; Li, Jinxin; Shen, Weide; Li, Bing

    2017-01-30

    Aminoacyl-tRNA synthetases are the key enzymes for protein synthesis. Glycine, alanine, serine and tyrosine are the major amino acids composing fibroin of silkworm. Among them, the genes of alanyl-tRNA synthetase (AlaRS) and glycyl-tRNA synthetase (GlyRS) have been cloned. In this study, the seryl-tRNA synthetase (SerRS) and tyrosyl-tRNA synthetase (TyrRS) genes from silkworm were cloned. Their full length are 1709 bp and 1868 bp and contain open reading frame (ORF) of 1485 bp and 1575 bp, respectively. RT-PCR examination showed that the transcription levels of SerRS, TyrRS, AlaRS and GlyRS are significantly higher in silk gland than in other tissues. In addition, their transcription levels are much higher in middle and posterior silk gland than in anterior silk gland. Moreover, treatment of silkworms with phoxim, an inhibitor of silk protein synthesis, but not TiO2 NP, an enhancer of silk protein synthesis, significantly reduced the transcription levels of aaRS and content of free amino acids in posterior silk gland, therefore affecting silk protein synthesis, which may be the mechanism of phoxim-silking disorders. Furthermore, low concentration of TiO2 NPs showed no effect on the transcription of aaRS and content of free amino acids, suggesting that TiO2 NPs promotes silk protein synthesis possibly by increasing the activity of fibroin synthase in silkworm.

  20. Clone and functional analysis of Seryl-tRNA synthetase and Tyrosyl-tRNA synthetase from silkworm, Bombyx mori

    PubMed Central

    Hu, Jingsheng; Tian, Jianghai; Li, Fanchi; Xue, Bin; Hu, Jiahuan; Cheng, Xiaoyu; Li, Jinxin; Shen, Weide; Li, Bing

    2017-01-01

    Aminoacyl-tRNA synthetases are the key enzymes for protein synthesis. Glycine, alanine, serine and tyrosine are the major amino acids composing fibroin of silkworm. Among them, the genes of alanyl-tRNA synthetase (AlaRS) and glycyl-tRNA synthetase (GlyRS) have been cloned. In this study, the seryl-tRNA synthetase (SerRS) and tyrosyl-tRNA synthetase (TyrRS) genes from silkworm were cloned. Their full length are 1709 bp and 1868 bp and contain open reading frame (ORF) of 1485 bp and 1575 bp, respectively. RT-PCR examination showed that the transcription levels of SerRS, TyrRS, AlaRS and GlyRS are significantly higher in silk gland than in other tissues. In addition, their transcription levels are much higher in middle and posterior silk gland than in anterior silk gland. Moreover, treatment of silkworms with phoxim, an inhibitor of silk protein synthesis, but not TiO2 NP, an enhancer of silk protein synthesis, significantly reduced the transcription levels of aaRS and content of free amino acids in posterior silk gland, therefore affecting silk protein synthesis, which may be the mechanism of phoxim-silking disorders. Furthermore, low concentration of TiO2 NPs showed no effect on the transcription of aaRS and content of free amino acids, suggesting that TiO2 NPs promotes silk protein synthesis possibly by increasing the activity of fibroin synthase in silkworm. PMID:28134300

  1. The Structural, Functional, and Molecular Organization of the Brainstem

    PubMed Central

    Nieuwenhuys, Rudolf

    2011-01-01

    According to His (1891, 1893) the brainstem consists of two longitudinal zones, the dorsal alar plate (sensory in nature) and the ventral basal plate (motor in nature). Johnston and Herrick indicated that both plates can be subdivided into separate somatic and visceral zones, distinguishing somatosensory and viscerosensory zones within the alar plate, and visceromotor and somatomotor zones within the basal plate. To test the validity of this “four-functional-zones” concept, I developed a topological procedure, surveying the spatial relationships of the various cell masses in the brainstem in a single figure. Brainstems of 16 different anamniote species were analyzed, and revealed that the brainstems are clearly divisible into four morphological zones, which correspond largely with the functional zones of Johnston and Herrick. Exceptions include (1) the magnocellular vestibular nucleus situated in the viscerosensory zone; (2) the basal plate containing a number of evidently non-motor centers (superior and inferior olives). Nevertheless the “functional zonal model” has explanatory value. Thus, it is possible to interpret certain brain specializations related to particular behavioral profiles, as “local hypertrophies” of one or two functional columns. Recent developmental molecular studies on brains of birds and mammals confirmed the presence of longitudinal zones, and also showed molecularly defined transverse bands or neuromeres throughout development. The intersecting boundaries of the longitudinal zones and the transverse bands appeared to delimit radially arranged histogenetic domains. Because neuromeres have been observed in embryonic and larval stages of numerous anamniote species, it may be hypothesized that the brainstems of all vertebrates share a basic organizational plan, in which intersecting longitudinal and transverse zones form fundamental histogenetic and genoarchitectonic units. PMID:21738499

  2. The effect of Le Fort I maxillary impaction on nasal airway resistance.

    PubMed

    Guenthner, T A; Sather, A H; Kern, E B

    1984-04-01

    To evaluate the effect of maxillary superior movement via Le Fort I osteotomy on nasal airway resistance, eleven Caucasian patients whose surgical orthodontic treatment included Le Fort I impaction (range 2 to 8 mm, mean 5.3 mm) were selected. Nasal airway resistance in these patients was determined a few days before and approximately 8 weeks after the Le Fort I surgical procedure. Nasal airway resistance was determined by means of a uninasal active mask rhinomanometric technique. Contrary to the predicted negative effects of maxillary superior movement on nasal airway function, there was a statistically significant improvement in nasal airway resistance (P less than 0.01) after maxillary superior movement. This rather unexpected finding can be explained by examining the effect of maxillary superior movement on the nasal valve area in the anterior nose. The nasal valve area is a teardrop-shaped area bordered by the nasal septum, the caudal end of the upper lateral nasal cartilage, the floor of the nose, and the soft fibrofatty tissue on the lateral aspect of the nose. The apex of the teardrop-shaped area (the angle between the nasal septum and the upper lateral cartilage) is called the nasal valve. In the Caucasian type of nose, the nasal valve accounts for most of the inspiratory resistance to airflow. Maxillary superior movement increases the alar width. It is proposed that this increase in alar width is transmitted at least partially to the nasal valve angle, causing it to widen slightly, paradoxically reducing nasal airway resistance while reducing skeletal intranasal dimensions.

  3. Biomechanical characterisation of the human nasal cartilages; implications for tissue engineering.

    PubMed

    Griffin, M F; Premakumar, Y; Seifalian, A M; Szarko, M; Butler, P E M

    2016-01-01

    Nasal reconstruction is currently performed using autologous grafts provides but is limited by donor site morbidity, tissue availability and potentially graft failure. Additionally, current alternative alloplastic materials are limited by their high extrusion and infection rates. Matching mechanical properties of synthetic materials to the native tissue they are replacing has shown to be important in the biocompatibility of implants. To date the mechanical properties of the human nasal cartilages has not been studied in depth to be able to create tissue-engineered replacements with similar mechanical properties to native tissue. The young's modulus was characterized in compression on fresh-frozen human cadaveric septal, alar, and lateral cartilage. Due to the functional differences experienced by the various aspects of the septal cartilage, 16 regions were evaluated with an average elastic modulus of 2.72 ± 0.63 MPa. Furthermore, the posterior septum was found to be significantly stiffer than the anterior septum (p < 0.01). The medial and lateral alar cartilages were tested at four points with an elastic modulus ranging from 2.09 ± 0.81 MPa, with no significant difference between the cartilages (p < 0.78). The lateral cartilage was tested once in all cadavers with an average elastic modulus of 0.98 ± 0.29 MPa. In conclusion, this study provides new information on the compressive mechanical properties of the human nasal cartilage, allowing surgeons to have a better understanding of the difference between the mechanical properties of the individual nasal cartilages. This study has provided a reference, by which tissue-engineered should be developed for effective cartilage replacements for nasal reconstruction.

  4. Airborne Observations of Urban-Derived Water Vapor and Potential Impacts on Chemistry and Clouds

    NASA Astrophysics Data System (ADS)

    Salmon, O. E.; Shepson, P. B.; Grundman, R. M., II; Stirm, B. H.; Ren, X.; Dickerson, R. R.; Fuentes, J. D.

    2015-12-01

    Atmospheric conditions typical of wintertime, such as lower boundary layer heights and reduced turbulent mixing, provide a unique environment for anthropogenic pollutants to accumulate and react. Wintertime enhancements in water vapor (H2O) have been observed in urban areas, and are thought to result from fossil fuel combustion and urban heat island-induced evaporation. The contribution of urban-derived water vapor to the atmosphere has the potential to locally influence atmospheric chemistry and weather for the urban area and surrounding region due to interactions between H2O and other chemical species, aerosols, and clouds. Airborne observations of urban-derived H2O, carbon dioxide (CO2), methane, nitrogen dioxide (NO2), ozone, and aerosols were conducted from Purdue University's Airborne Laboratory for Atmospheric Research (ALAR) and the University of Maryland's (UMD) Twin Cessna research aircraft during the winter of 2015. Measurements were conducted as part of the collaborative airborne campaign, Wintertime INvestigation of Transport, Emissions, and Reactivity (WINTER), which investigated seasonal trends in anthropogenic emissions and reactivity in the Northeastern United States. ALAR and the UMD aircraft participated in mass balance experiments around Washington D.C.-Baltimore to determine total city emission rates of H2O and other greenhouse gases. Average enhancements in H2O mixing ratio of 0.048%, and up to 0.13%, were observed downwind of the urban centers on ten research flights. In some cases, downwind H2O concentrations clearly track CO2 and NO2 enhancements, suggesting a strong combustion signal. Analysis of Purdue and UMD data collected during the WINTER campaign shows an average urban-derived H2O contribution of 5.3%, and as much as 13%, to the local boundary layer from ten research flights flown in February and March of 2015. In this paper, we discuss the potential chemical and physical implications of these results.

  5. The conserved barH-like homeobox-2 gene barhl2 acts downstream of orthodentricle-2 and together with iroquois-3 in establishment of the caudal forebrain signaling center induced by Sonic Hedgehog.

    PubMed

    Juraver-Geslin, Hugo A; Gómez-Skarmeta, José Luis; Durand, Béatrice C

    2014-12-01

    In this study, we investigated the gene regulatory network that governs formation of the Zona limitans intrathalamica (ZLI), a signaling center that secretes Sonic Hedgehog (Shh) to control the growth and regionalization of the caudal forebrain. Using loss- and gain-of-function, explants and grafting experiments in amphibians, we demonstrate that barhl2 acts downstream of otx2 and together with the iroquois (irx)-3 gene in establishment of the ZLI compartment initiated by Shh influence. We find that the presumptive (pre)-ZLI domain expresses barhl2, otx2 and irx3, whereas the thalamus territory caudally bordering the pre-ZLI expresses barhl2, otx2 and irx1/2 and early on irx3. We demonstrate that Barhl2 activity is required for determination of the ZLI and thalamus fates and that within the p2 alar plate the ratio of Irx3 to Irx1/2 contributes to ZLI specification and size determination. We show that when continuously exposed to Shh, neuroepithelial cells coexpressing barhl2, otx2 and irx3 acquire two characteristics of the ZLI compartment-the competence to express shh and the ability to segregate from anterior neural plate cells. In contrast, neuroepithelial cells expressing barhl2, otx2 and irx1/2, are not competent to express shh. Noteworthy in explants, under Shh influence, ZLI-like cells segregate from thalamic-like cells. Our study establishes that Barhl2 activity plays a key role in p2 alar plate patterning, specifically ZLI formation, and provides new insights on establishment of the signaling center of the caudal forebrain.

  6. When Aesthetics, Surgery, and Psychology Meet: Aesthetic Nasal Proportions in Patients Having Rhinoplasty and Normal Adults.

    PubMed

    Naraghi, Mohsen; Atari, Mohammad; Asadollahi, Hossein

    2016-03-01

    The aesthetic nasal proportions have played a significant role in rhinoplasty practice. On the other hand, psychological variables also play a crucial role in rhinoplasty. It is of paramount importance for facial plastic surgeons to consider both sides to achieve a more satisfactory outcome. The present study aimed to compare aesthetic nasal proportions between primary rhinoplasty candidates and a demographically matched control group to determine whether patients having rhinoplasty have different aesthetic nasal proportions compared with healthy adults who are not interested in rhinoplasty. Sixty patients having rhinoplasty were selected consecutively from a surgical clinic. A control group ( n  = 60) with the same demographic characteristics was selected. Photographs were taken using a digital camera on a fixed zoom setting. All images were captured at a distance of 1.5 m. Frontal and right lateral views were used to compare nasolabial angle, nasofrontal angle, nasofacial angle, alar width, intercanthal distance, nasal length, and width-to-length ratio. Independent t tests were used for comparisons. Independent t tests verified that nasofrontal angle, nasal length, and width-to-length ratio were significantly different between the two groups ( p  < 0.01). Effect sizes ranged between 0.11 and 0.69. Aesthetic proportions were not significantly different in four factors. Nasolabial angle, nasofacial angle, alar width, and intercanthal distance were not different ( p  > 0.05). Four major aesthetic nasal proportions were statistically similar in a group of patients having rhinoplasty and a control group with no interest in rhinoplasty. Surprisingly, the patients having rhinoplasty showed a mean width-to-length ratio closer to aesthetic ideal. Therefore, applying for rhinoplasty may have strong psychological reasons (e.g., body dysmorphic symptoms) compared with realistic aesthetic appraisals.

  7. When Aesthetics, Surgery, and Psychology Meet: Aesthetic Nasal Proportions in Patients Having Rhinoplasty and Normal Adults

    PubMed Central

    Naraghi, Mohsen; Atari, Mohammad; Asadollahi, Hossein

    2016-01-01

    The aesthetic nasal proportions have played a significant role in rhinoplasty practice. On the other hand, psychological variables also play a crucial role in rhinoplasty. It is of paramount importance for facial plastic surgeons to consider both sides to achieve a more satisfactory outcome. The present study aimed to compare aesthetic nasal proportions between primary rhinoplasty candidates and a demographically matched control group to determine whether patients having rhinoplasty have different aesthetic nasal proportions compared with healthy adults who are not interested in rhinoplasty. Sixty patients having rhinoplasty were selected consecutively from a surgical clinic. A control group ( n  = 60) with the same demographic characteristics was selected. Photographs were taken using a digital camera on a fixed zoom setting. All images were captured at a distance of 1.5 m. Frontal and right lateral views were used to compare nasolabial angle, nasofrontal angle, nasofacial angle, alar width, intercanthal distance, nasal length, and width-to-length ratio. Independent t tests were used for comparisons. Independent t tests verified that nasofrontal angle, nasal length, and width-to-length ratio were significantly different between the two groups ( p  < 0.01). Effect sizes ranged between 0.11 and 0.69. Aesthetic proportions were not significantly different in four factors. Nasolabial angle, nasofacial angle, alar width, and intercanthal distance were not different ( p  > 0.05). Four major aesthetic nasal proportions were statistically similar in a group of patients having rhinoplasty and a control group with no interest in rhinoplasty. Surprisingly, the patients having rhinoplasty showed a mean width-to-length ratio closer to aesthetic ideal. Therefore, applying for rhinoplasty may have strong psychological reasons (e.g., body dysmorphic symptoms) compared with realistic aesthetic appraisals. PMID:28824980

  8. Eppur Si Muove: Evidence for an External Granular Layer and Possibly Transit Amplification in the Teleostean Cerebellum

    PubMed Central

    Biechl, Daniela; Dorigo, Alessandro; Köster, Reinhard W.; Grothe, Benedikt; Wullimann, Mario F.

    2016-01-01

    The secreted signaling factor Sonic Hedgehog (Shh) acts in the floor plate of the developing vertebrate CNS to promote motoneuron development. In addition, shh has dorsal expression domains in the amniote alar plate (i.e., in isocortex, superior colliculus, and cerebellum). For example, shh expressing Purkinje cells act in transit amplification of external granular layer (EGL) cells of the developing cerebellum. Our previous studies had indicated the presence of an EGL in anamniote zebrafish, but a possible role of shh in the zebrafish cerebellar plate remained elusive. Therefore, we used an existing zebrafish transgenic line Tg(2.4shha-ABC-GFP)sb15; Shkumatava et al., 2004) to show this gene activity and its cellular localization in the larval zebrafish brain. Clearly, GFP expressing cells occur in larval alar zebrafish brain domains, i.e., optic tectum and cerebellum. Analysis of critical cerebellar cell markers on this transgenic background and a PH3 assay for mitotic cells reveals that Purkinje cells and eurydendroid cells are completely non-overlapping postmitotic cell populations. Furthermore, shh-GFP cells never express Zebrin II or parvalbumin, nor calretinin. They are thus neither Purkinje cells nor calretinin positive migrating rhombic lip derived cells. The shh-GFP cells also never correspond to PH3 positive cells of the ventral cerebellar proliferative zone or the upper rhombic lip-derived EGL. From this marker analysis and the location of shh-GFP cells sandwiched between calretinin positive rhombic lip derived cells and parvalbumin positive Purkinje cells, we conclude that shh-GFP expressing cells qualify as previously reported olig2 positive eurydendroid cells, which are homologous to the amniote deep cerebellar nuclei. We confirm this using double transgenic progeny of shh-GFP and olig2-dsRed zebrafish. Thus, these zebrafish eurydendroid cells may have the same role in transit amplification as Purkinje cells do in amniotes. PMID:27199681

  9. Fifteen-Year Follow-Up Results of Presurgical Orthopedics Followed by Primary Correction for Unilateral Cleft Lip Nose in Program SEHATI in Indonesia.

    PubMed

    Sulaiman, Farida Kamil; Haryanto, Inge Gustiningsih; Hak, Syafrudin; Nakamura, Norifumi; Sasaguri, Masaaki; Ohishi, Masamichi

    2013-03-01

    Objective : To assess long-term effects of nasal correction in infancy on nasal form and growth in patients with unilateral cleft lip, alveolus, and palate (UCLP). Design : Retrospective longitudinal study. Patients : Seventeen patients with complete UCLP treated in Program SEHATI in Harapan Kita Children and Maternity Hospital, Indonesia, and followed for approximately 15 years were enrolled. Interventions : Subjects received presurgical orthopedics using a Hotz's plate and simultaneous primary lip and nose repair in which the lower lateral cartilage was repositioned through a reverse-U incision. Main Outcome Measures : Preoperative and postoperative nasal forms, including the nostril height and width ratio, the ratio of the height of the top of the alar groove, and the ratio of nostril surface areas were analyzed using color photos taken serially. One-way analysis of variance was used for statistical analyses. Results : The nostril height and width ratio and the height of the alar groove were significantly improved postoperatively and maintained for 15 years. The mean ratio of nostril surface areas was 1.01 ± 0.12 fifteen years postoperatively, and there was no significant difference from the ratio 1 year postoperatively. The major persistent deformities were septal deviation and a small skin web on the nostril rim. Conclusions : Our primary cleft lip nose correction has provided an acceptable nose form and absence of disturbance of the nasal growth in patients with UCLP. However, the repositioning of the nasal cartilage at infancy might not eliminate the need for secondary correction after puberty.

  10. Presurgical nasoalveolar moulding in unilateral cleft lip and palate.

    PubMed

    Zuhaib, Mohammed; Bonanthaya, Krishnamurthy; Parmar, Renu; Shetty, Pritham N; Sharma, Pradeep

    2016-01-01

    Presurgical nasoalveolar moulding (PNAM) is a non-surgical method of reshaping the cleft lip, alveolus, palate and the nose to minimize the severity of the cleft deformity, before primary cheiloplastyand palatoplasty. In this context, PNAM proves to be an invaluable asset in the management of unilateral cleft lip and palate. The study was conducted to evaluate the efficacy of PNAM in the management of unilateral cleft lip and palate with the following objectives: (1) To assess and compare the degree of reduction in the size of cleft palate and alveolus (pre-PNAM and post-PNAM). (2) To evaluate and compare the improvement in columellar length and correction of columellar deviation (pre-PNAM and post-PNAM). (3) To assess the changes in the position of the alar base and the alar cartilages. Prospective study. A prospective study consisting of, which included 20 patients with complete unilateral cleft lip and palate was conducted. The age at the start of PNAM treatment of the infants ranged from 2 to 44 days of age reporting to our institute between December 2011 and August 2013. All the patients underwent PNAM therapy before primary cheiloplasty at 6 months of age; clinical parameters were assessed pre- and post-therapy using photographs and dental study models of the maxilla. Student's t-test for paired comparisons. Results of the study showed a promising reduction in the cleft size before the surgery, significant improvement in nasal symmetry, including the columellar length on the cleft side. PNAM is a valuable adjunct to our surgical armamentarium in dealing with the challenges of primary closure of unilateral cleft lip and palate thereby enhancing the overall surgical outcome. The advantages of this method include the simplicity of the procedure and improving the quality of surgical repair, particularly in obtaining tension free muscle closure in unilateral clefts.

  11. Cognitive deficits and ALA-D-inhibition in children exposed to multiple metals.

    PubMed

    do Nascimento, Sabrina N; Barth, Anelise; Göethel, Gabriela; Baierle, Marília; Charão, Mariele F; Brucker, Natália; Moro, Angela M; Bubols, Guilherme B; Sobreira, Johanna S; Sauer, Elisa; Rocha, Rafael; Gioda, Adriana; Dias, Ana Cristina; Salles, Jerusa F; Garcia, Solange C

    2015-01-01

    Children are especially vulnerable to adverse effects of multiple metals exposure. The aim of this study was to assess some metals concentrations such as lead (Pb), arsenic (As), chromium (Cr), manganese (Mn) and iron (Fe) in whole blood, serum, hair and drinking water samples using inductively coupled plasma-mass spectrometry (ICP-MS) in rural and urban children. In addition, evaluate the adverse effects of multiple metals exposure on cognitive function and δ-aminolevulinate dehydratase (ALA-D) activity. The cognitive ability assessment was performed by the Raven's Colored Progressive Matrices (RCPM) test. The ALA-D activity and ALA-D reactivation index (ALA-RE) activity with DTT and ZnCl2 also were determined. Forty-six rural children and 23 urban children were enrolled in this study. Rural children showed percentile IQ scores in the RCPM test significantly decreased in relation to urban children. According to multiple linear regression analysis, the Mn and Fe in hair may account for the cognitive deficits of children. Manganese and Fe in hair also were positively correlated with Mn and Fe in drinking water, respectively. These results suggest that drinking water is possibly a source of metals exposure in children. ALA-D activity was decreased and ALA-RE with DTT and ZnCl2 was increased in rural children in comparison to urban children. Moreover, ALA-D inhibition was correlated with Cr blood levels and ALA-RE/DDT and ALA-RE/ZnCl2 were correlated with levels of Cr and Hg in blood. Thus, our results indicated some adverse effects of children's exposure to multiple metals, such as cognitive deficits and ALA-D inhibition, mainly associated to Mn, Fe, Cr and Hg. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Palynostratigraphical correlation of the excavated Miocene lignite seams of the Yataǧan basin (Muǧla Province, south-western Turkey)

    NASA Astrophysics Data System (ADS)

    Bouchal, Johannes Martin; Grímsson, Friðgeir; Denk, Thomas

    2016-04-01

    The excavated main lignite seams and overlying lacustrine sediments of the opencast mines Eskihisar, Salihpaşalar, and Tı naz, Muǧla Province, south-western Turkey were investigated using a high taxonomic resolution palynological approach. The Eskihisar section comprises 47m and 56 samples of which 30 were usable for palynological analysis. The Tı naz section comprises 75 m and 29 samples of which 15 were usable for palynological analysis. Finally, the Salihpaşalar section comprises 25 m and 26 samples of which 16 were usable for palynological analysis. The age of the palynological sections is middle to late Miocene based on radiometric dating and vertebrate fossils. In order to investigate dispersed pollen and spores and their botanical affinities a combined light microscopy and scanning electron microscopy approach was used. The rich palynoflora comprises: seven types of algal cysts (Botryococcus, Zygnemataceae), seventeen spore types belonging to Lycopsida (club mosses), Marsileaceae (water-clover), Osmundaceae, Pteridaceae (brake), and Polypodiaceae; 14 types of gymnosperm pollen belonging to Ephedraceae (Mormon tea), Cupressaceae, Pinaceae (Cathaya, cedar, hemlock, pine, spruce); five types of monocotyledone pollen belonging to Poaceae (grasses, common reed), and Typhaceae (bulrush, bur-reed); ca 90 dicotyledone pollen types belonging to Altingiaceae (sweet gum), Amaranthaceae (goosefoot), Anacardiaceae (sumac family), Apiaceae (parsley family), Aquifoliaceae (holly), Asteraceae (sunflower family), Betulaceae (alder, birch, hazel, hophornbeam, hornbeam), Campanulaceae (bellflower family), Cannabaceae (hackberries), Caprifoliaceae (honeysuckle, teasel family), Caryophyllaceae (pink family), Ericaceae (heather family), Eucommiaceae, Euphorbiaceae (spurge family), Fabaceae (bean family), Fagaceae (beech, oak), Geraniaceae (storkbills), Juglandaceae (hickory, walnut, wingnut), Lamiaceae (bagflower), Linaceae (flax), Lythraceae (waterwillow), Malvaceae

  13. Wetter and cooler: pronounced temperate climate conditions in western Anatolia during the Middle Miocene Climatic Optimum

    NASA Astrophysics Data System (ADS)

    Güner, Tuncay H.; Bouchal, Johannes M.; Köse, Nesibe; Denk, Thomas

    2017-04-01

    proposed that has only a weak seasonality in precipitation (lower precipitation in winter). The findings of our study provide valuable information for inferring palaeoenvironments of middle Miocene rich ungulate faunas in western Turkey (e.g. Paşalar), for which seasonal tropical and subtropical forest communities have been proposed (Andrews, 1990). The fossil floras of the Tınaz and Salihpaşalar lignite mines, representing the Tınaz sub-basin and the main basin of the wider Yataǧan Basin, are investigated at the moment, and a synthesis paper combining and comparing evidence from the macro floral and palynological data is soon to be submitted. Andrews. (1990) Palaeoecology of the Miocene fauna from Paşalar, Turkey. Journal of Human evolution 19:569-582.

  14. Middle Miocene dispersals of apes.

    PubMed

    Andrews, Peter; Kelley, Jay

    2007-01-01

    The earliest record of fossil apes outside Africa is in the latest early Miocene of Turkey and eastern Europe. There were at least 2, and perhaps 4, species of ape, which were found associated with subtropical mixed environments of forest and more open woodland. Postcranial morphology is similar to that of early Miocene primates and indicates mainly generalized arboreal quadrupedal behaviours similar to those of less specialized New World monkeys such as Cebus. Robust jaws and thick enamelled teeth indicate a hard fruit diet. The 2 best known species of fossil ape are known from the site of Paşalar in Turkey. They have almost identical molar and jaw morphology. Molar morphology is also similar to that of specimens from Germany and Slovakia, but there are significant differences in the anterior teeth of the 2 Paşalar species. The more common species, Griphopithecus alpani, shares mainly primitive characters with early and middle Miocene apes in Africa, and it is most similar phenetically to Equatorius africanus from Maboko Island and Kipsaramon. The second species is assigned to a new species of Kenyapithecus, an African genus from Fort Ternan in Kenya, on the basis of a number of shared derived characters of the anterior dentition, and it is considered likely that there is a phylogenetic link between them. The African sites all date from the middle Miocene, similar in age to the Turkish and European ones, and the earliest emigration of apes from Africa coincides with the closure of the Tethys Sea preceding the Langhian transgression. Environments indicated for the African sites are mixtures of seasonal woodlands with some forest vegetation. The postcrania of both African taxa again indicate generalized arboreal adaptation but lacking specialized arboreal function. This middle Miocene radiation of both African and non-African apes was preceded by a radiation of arboreal catarrhine primates in the early Miocene, among which were the earliest apes. The earliest

  15. Electronic spectroscopy and excited state dynamics of the Al-N 2 complex

    NASA Astrophysics Data System (ADS)

    Yang, Xin; Gerasimov, Irina; Dagdigian, Paul J.

    1998-12-01

    The weakly bound Al⋯N 2 complex was prepared in a pulsed supersonic beam and studied with laser fluorescence excitation spectroscopy. Transitions to bound vibrational levels in electronic states correlating with the Al(5s, 4d)+N 2 asymptotes have been observed. Resonance fluorescence from the excited levels could not be detected. These excited levels decay nonradiatively, and the excitation spectrum was obtained by monitoring emission from the lower Al atomic levels. The band systems were dominated by progressions in the excited state Al-N stretch vibrational mode. Vibrational assignments were made through analysis of nitrogen isotope shifts. The rotational contours were obscured by Lorentzian line broadening from the nonradiative decay. However, for excitation to the Al(5s)⋯N 2 state the rotational structure of bands with small linewidths was consistent with a 2Σ+- 2Π electronic transition of a linear molecule, in accord with the previously calculated linear structure of the ground state [G. Chaban, M.S. Gordon, J. Chem. Phys. 107 (1997) 2160]. The excited state binding energies were estimated to be 1218±10 cm -1 for the Al(5s)⋯N 2 state [ 2Σ+ symmetry] and 2705±165 cm -1 for the Al(4d)⋯N 2 state of 2Δ symmetry. From the threshold for formation of Al(5s) from the nonradiative decay of Al(4d)⋯N 2, an upper bound to the ground state dissociation energy D0″≤354±2 cm -1 was obtained. For comparison with high-resolution scans over Al⋯N 2 bands, we have also recorded and analyzed similar scans over several bands of the AlAr H 2Σ+-X 2Π1/2 transition, which correlates with the Al 5s←3p atomic transition. Excited-state rotational constants were derived and employed to obtain Be'=0.1128±0.0020 cm -1, and hence Re'=3.05±0.03 Å. A weak predissociation, leading to formation of Al(3d), was observed for AlAr( H 2Σ+).

  16. 3D dentofacial photogrammetry reference values: a novel approach to orthodontic diagnosis.

    PubMed

    Masoud, Mohamed I; Bansal, Neetu; C Castillo, Jose; Manosudprasit, Amornrut; Allareddy, Veerasathpurush; Haghi, Arshan; Hawkins, Hannah C; Otárola-Castillo, Erik

    2017-04-01

    Orthodontic diagnostic standards generally use the cranial base as a reference and rely on samples selected by orthodontists. The purpose of this study was to provide male and female standards for a novel non-radiographic approach for orthodontic diagnosis that utilizes 3D dentofacial photogrammetry using the eyes and natural head orientation as references instead of the cranial base. One hundred and eighty females and 200 males between the ages of 18 and 35 years from 2 modeling agencies were orthodontically screened for near ideal occlusion. Subjects that met the inclusion criteria were rated by a sample of 40 lay people for attractiveness on a visual analogue scale. The final sample that had 3D facial and dental imaging included 49 subjects 25 males and 24 females with near ideal occlusion and considered attractive by the public. Inter and Intra-examiner ICC were greater than 0.8 for both landmarking and indexing. Relative to a coronal plane contacting the pupils (MC), the mean sagittal position of the alar curvature (representing the nasomaxillary complex) was 14.36 ± 3.08 mm in males and 12.4 ± 3.58 mm in females. The sagittal position of soft tissue pogonion relative to the pupils was 14.84 ± 3.63 mm in males and 12.78 ± 5.68 mm in females. The angle between the alar curvature and pogonion relative to the pupils was 9° in males and 10° in females. With the exception of the occlusal plane which was steeper in females, no ratios or angular facial measurements showed a significant gender difference. Relative to MC, males had more proclined upper incisors (20° vs 16°) and more retroclined Lower incisors (27° vs 31°; P > 0.05). A Procrustes ANOVA and permutation test showed that the shapes of males and females are different enough to be considered two distinct populations. 1. When using the proposed method for orthodontic diagnosis, male and female patients should be compared to their respective dentofacial standards. 2. Validation of the proposed method

  17. A comparison of aesthetic proportions between the healthy Caucasian nose and the aesthetic ideal.

    PubMed

    Leong, Samuel C L; White, Paul S

    2006-01-01

    The aim of septorhinoplasty is to create a nose that is aesthetically pleasing to the patient and to maintain nasal function. Although a small number of population cohort studies have been performed on the ethnic nose, little is known of the aesthetics standards of nasal proportions in the general Caucasian population. The aim of this study was to establish parameters of the average nose in the healthy population and to compare them with those of the aesthetic ideals. Ethical approval was obtained to recruit a cohort of staff and students from the medical school. Two photographs were taken: anterior and right lateral. The following measurements were made: intercanthal width, alar width, length of the nose (nasion-pronasion length), naso-labial angle, nasal tip projection, naso-facial angle and naso-frontal angle. These parameters were compared with published aesthetic ideals. Aesthetic nasal proportions of 50 healthy Caucasians were examined from a cohort of 57 volunteers. Results showed that the average nose did not conform to neo-classical facial canons. The alar width (average 3.6 cm) was significantly wider than the intercanthal width (average 3.0 cm, p<0.05). The nasal width-length ratio was also greater suggesting that the cohort average was shorter and wider than the aesthetic ideal. The Baum ratio was 2.5:1, indicating that the average nasal tip was more projected that the aesthetic ideal (2.8:1). The naso-frontal and naso-facial angles are both more obtuse, and in profile the average nose overall appeared more prominent, as a result of the reduced forehead projection. The only parameter where there appeared to be consistency between the average and the ideal nose was the naso-labial angle. This study shows that many aesthetic parameters from a cohort of healthy subjects differ from the widely used aesthetic standards. Rhinoplasty surgeons should, therefore, give thought to the frame of reference used when discussing aesthetic objectives with their patients.

  18. Outcome of modified turn in flaps for the lining with primary cartilage support in nasal reconstruction.

    PubMed

    Bashir, Muhammad Mustehsan; Khan, Bilal Ahmad; Abbas, Muhammad; Khan, Farid Ahmad

    2013-03-01

    Turning in adjacent skin from the residual nose to line a full-thickness defect is still a controversial option. Text books continue to perpetuate that such flaps are poorly vascularized and may not survive if longer than 1.5 cm. The rationale of our study was to challenge the traditional thoughts about the turn-in flaps for the lining and describe our modified technique of raising these flaps so that well-vascularized thin tissue can be provided for the lining. The study was conducted at the Department of Plastic Surgery, KEMU, Lahore, from January 2007 to March 2011. Eighteen patients were included. They had posttraumatic full-thickness nasal defect of variable extent, involving the lower third of the nose. In the first stage of reconstruction, the epithelialized portion and 5-mm portion of normal adjoining skin were dermabraded. The residual skin of nasal dorsum, side walls, and alae was turned in to form inner lining of 2 nostrils. These flaps were based on healthy dermabraded skin to ensure adequate blood supply. Residual septal and conchal cartilages were used for primary support. Standard ipsilateral paramedian forehead flap with slight oblique design was used for resurfacing. Final assessment of airway patency and alar rim contour was made by the patient at 6 months as satisfactory, just satisfactory, and not satisfactory. There were 12 female and 6 male patients. There was necrosis of distal portion of the forehead flap in 1 case. Partial graft loss at the donor site with bone exposure was noted in another case. There was partial dehiscence and necrosis of turndown flap in 3cases. Mean flap size was 2.05 ± 0.28 cm. As regards airway patency, 12 patients were satisfied, 4 patients were just satisfied, and 2 patients were unsatisfied. When asked about alar rim contour, 3 patients said it to be satisfactory, 9 patients found it just satisfactory, and 6 patients declared it unsatisfactory. Nasal turndown flaps provide reliable tissue for the lining and allow

  19. Anthropometric study of the caucasian nose in the city of Curitiba: relevance of population evaluation.

    PubMed

    Ballin, Annelyse Cristine; Carvalho, Bettina; Dolci, José Eduardo Lutaif; Becker, Renata; Berger, Cezar; Mocellin, Marcos

    2017-07-03

    Norms and patterns of nasal esthetics are essential for an adequate preoperative evaluation and surgical programming. The esthetic nasal patterns used are a blend of artistic beauty ideals and tracings in models and celebrities. Because they do not consider population measures, they vary according to the period, and allow a discrepancy between the surgeon's preference and the patient's real desire for rhinoplasty. Not all populations wish to obtain an esthetic result according to these values, but prefer a natural result, that is, one with some of the nasal characteristics of the population to which they belong to. The Brazilian population lacks population studies to evaluate its nose measurements. (1) To evaluate the anthropometric measures of Caucasian noses of people living in the city of Curitiba (state of Paraná), and to compare them to the ideal esthetic pattern of the literature; (2) To compare them between genders. This is a prospective cohort study involving 100 Caucasian volunteers at a tertiary hospital in Southern Brazil. Through the frontal and lateral view photos, intercanthal distance, alar distance, nasal dorsum length, nasofrontal angle, nasolabial angle, and nasal tip projection (Goode's method) were obtained. A statistical analysis was performed to compare the measures obtained between genders and with the ideal patterns. Comparing the results obtained with those predicted by the esthetic ideals, the sample presented: similar nasolabial angle (p=0.07), alar width greater than intercanthal distance (p<0.001), higher nasal tip projection (p<0.001), larger width-length ratio (p<0.001), and more obtuse nasofrontal angle (p<0.001). The nasofrontal angle (p=0.0008) and the tip projection (p=0.032) were statistically different between the genders. Men had a smaller nasofrontal angle, and a larger Goode's ratio. Except for the nasolabial angle, the measures obtained in the population sample differed from the published esthetic ideals. Comparing the

  20. Investigating the case of human nose shape and climate adaptation

    PubMed Central

    Zaidi, Arslan A.; Claes, Peter; McEcoy, Brian; Shriver, Mark D.

    2017-01-01

    The evolutionary reasons for variation in nose shape across human populations have been subject to continuing debate. An import function of the nose and nasal cavity is to condition inspired air before it reaches the lower respiratory tract. For this reason, it is thought the observed differences in nose shape among populations are not simply the result of genetic drift, but may be adaptations to climate. To address the question of whether local adaptation to climate is responsible for nose shape divergence across populations, we use Qst–Fst comparisons to show that nares width and alar base width are more differentiated across populations than expected under genetic drift alone. To test whether this differentiation is due to climate adaptation, we compared the spatial distribution of these variables with the global distribution of temperature, absolute humidity, and relative humidity. We find that width of the nares is correlated with temperature and absolute humidity, but not with relative humidity. We conclude that some aspects of nose shape may indeed have been driven by local adaptation to climate. However, we think that this is a simplified explanation of a very complex evolutionary history, which possibly also involved other non-neutral forces such as sexual selection. PMID:28301464

  1. Nasolabial aesthetics.

    PubMed

    Mitchell, Cassidy; Oeltjen, John; Panthaki, Zubin; Thaller, Seth R

    2007-07-01

    Orthognathic surgery, as it relates to the maxilla, attempts to correct underlying skeletal deformities as well as improve function. In addition, it has the potential to significantly alter the central aesthetic unit of the face, the nasolabial region. A key to achieving a good functional as well as aesthetic result involves both comprehensive surgical planning and an understanding of the effects that orthognathic surgery of the maxilla will have on the soft tissues within the nasolabial region. The LeFort I osteotomy is one of the most commonly performed techniques to correct maxillary dentofacial deformities. The effects of nasal and labial changes after a LeFort I osteotomy, including widening of the alar bases of the nose, changes in the nasal tip, and flattening and thinning of the upper lip, have been previously reported by other authors. This article will discuss the nasolabial region and discuss steps involved in performing a comprehensive aesthetic evaluation, as well how the LeFort I osteotomy may produce specific changes related to the external nasal morphology. In addition, emphasis will be given to the lips, and the effects of reduction and augmentation procedures will be discussed as they relate to the nasolabial region.

  2. Interaction of an aluminum atom with a closed subshell metal atom: Spectroscopic analysis of AlZn

    NASA Astrophysics Data System (ADS)

    Behm, Jane M.; Blume, Thorsten; Morse, Michael D.

    1994-10-01

    Resonant two-photon ionization spectroscopy has been employed to investigate diatomic AlZn produced by laser vaporization of a 1:2 Al:Zn alloy target disk in a supersonic expansion of helium. Several discrete transitions are reported in the energy range from 18 400 to 19 100 cm-1. Most of these are assigned as members of the B 2Π←X 2Π system, although an isolated band has been observed and assigned as the 2-0 band of the A Ω'=0.5←X 2Π1/2 system. A pair of strongly mixed levels are identified as resulting from a homogeneous spin-orbit perturbation between the A Ω=0.5, v'=3 and the B 2Π1/2, v'=1 levels, and the perturbation matrix element has been deduced to be 8.11 cm-1 for 27Al64Zn, 8.23 cm-1 for 27Al66Zn. The ground state has been unambiguously identified as a 2Πr state with a bond length of 2.6957±0.0004 Å. Comparisons to the results of the preceding article on the spectroscopy of AlCa are also provided, along with a discussion of the chemical bonding in AlZn in relation to AlCa, AlAr, and AlKr.

  3. Safer approaches and landings: A multivariate analysis of critical factors

    NASA Astrophysics Data System (ADS)

    Heinrich, Durwood J.

    The approach-and-landing phases of flight represent 27% of mission time while resulting in 61 of the accidents and 39% of the fatalities. The landing phase itself represents only 1% of flight time but claims 45% of the accidents. Inadequate crew situation awareness (SA), crew resource management (CRM), and crew decision-making (DM) have been implicated in 51%, 63%, and 73% respectively of these accidents. The human factors constructs of SA, CRM, and DM were explored; a comprehensive definition of SA was proposed; and a "proactive defense" safety strategy was recommended. Data from a 1997 analysis of worldwide fatal accidents by the Flight Safety Foundation (FSF) Approach-and-Landing Accident Reduction (ALAR) Task Force was used to isolate crew- and weather-related causal factors that lead to approach-and-landing accidents (ALAs). Logistic regression and decision tree analysis were used on samplings of NASA's Aviation Safety Reporting System (ASRS) incident records ("near misses") and the National Transportation Safety Board's (NTSB) accident reports to examine hypotheses regarding factors and factor combinations that can dramatically increase the opportunity for accidents. An effective scale of risk factors was introduced for use by crews to proactively counter safety-related error-chain situations.

  4. Overview of CABINEX/PROPHET 2009

    NASA Astrophysics Data System (ADS)

    Bertman, S. B.; Carroll, M.; Shepson, P. B.; Stevens, P. S.

    2010-12-01

    CABINEX (Community Atmosphere-Biosphere INteractions Experiment) is a collaborative program consisting of field and modeling studies designed to improve our understanding of how upper Midwest forest canopies affect the chemical composition of the atmospheric boundary layer. Measurements were made from July 1 to August 8, 2009, at the PROPHET (Program for Research on Oxidants: PHotochemistry, Emissions, and Transport) site at the University of Michigan Biological Station, a nearby, experimentally disturbed forest, and aboard the Purdue Airborne Laboratory for Atmospheric Research (ALAR). The 2009 effort involved groups from 15 institutions and included measurements of meteorological parameters, gases and particles at various heights within- and above-canopy and a number of modeling studies with a shared focus on the role of biogenically-emitted volatile organic compounds (BVOCs) in near-surface HOx photochemistry and particle nucleation and growth for the current, mixed-hardwood forest. Observations and key findings from the 2009 field study are summarized and evaluated within the context of atypical meteorological conditions, which led to significantly cooler temperatures and infrequent southerly flow during July and August 2009.

  5. Studies of Arctic Tropospheric Halogen Chemistry via Field Measurements and Modeling

    NASA Astrophysics Data System (ADS)

    Pratt, K.; von Glasow, R.; Custard, K. D.; Boone, E.; Shepson, P. B.; Tanner, D.; Nenes, A.

    2013-12-01

    With surfaces covered by ice and snow, the polar regions are characterized by unique atmospheric photochemistry in the springtime, and with the rapid transformation and loss of sea ice in the Arctic, there is an urgent need to characterize these chemical interactions with the snow and sea ice surface. During the NASA Bromine, Ozone, and Mercury Experiment (BROMEX) in March 2012, we utilized chemical ionization mass spectrometry to measure the near-surface temporal variability of a variety of species (e.g., Br2, BrO, HOBr, Cl2, ClO, HO2NO2) characterized by unique photochemistry in the Arctic. To probe the roles of ozone, bromine, chlorine, and nitrogen chemistry during BROMEX, we use the one-dimensional model MISTRA with vertical mixing and aerosols described based on vertical profiles of potential temperature and size-resolved aerosol number concentrations measured aboard the Purdue University Airborne Laboratory for Atmospheric Research (ALAR) during BROMEX. Modeling is utilized to estimate the required Br2 and Cl2 fluxes necessary to explain observations, as well as examine the vertical extent of halogen chemistry. In particular, the near-surface (within 30 m) distribution of chlorine- and bromine-containing trace gases are investigated.

  6. Accessory atlantoaxial ligament avulsion fracture of the axis: Are there any clinical implications?

    PubMed Central

    Niknejad, Hamid Reza; van Calenbergh, Frank; Demaerel, Philippe; van Loon, Johannes

    2016-01-01

    Injuries to the craniocervical support structures are frequently observed in neurotrauma cases. Stability of this region is of vital importance. Literature has mainly focused on three major ligaments of the craniocervical junction: The tectorial membrane, the transverse ligament, and the alar ligaments. However, the accessory atlantoaxial ligament (ALL) also seems to be involved in craniocervical stability as shown in cadaveric specimens. Still, the biomechanical importance of this structure needs to be determined, especially in trauma settings. Here, we describe a case of isolated traumatic injury to this structure and discuss the clinical outcome. A 64-year-old polytrauma patient with a remarkable avulsion fracture at the site of the insertion of the ALL was admitted to our center. We evaluated the patient both clinical and radiological at admission, after 3 months and after 1 year. We clinically assessed the upper cervical rotational stability using the cervical flexion-rotation test. We observed no rotational instability or any other clinical repercussions at the long-term after an isolated ALL injury. This case shows that isolated traumatic damage to the ALL is possible. Unilateral damage to the ALL probably does not cause rotational instability of the craniocervical junction. In case a similar avulsion fracture is observed, we recommend performing a magnetic resonance imaging of the craniovertebral region to assess for any ligamentous lesions. PMID:27891038

  7. Functional cervical MRI within the scope of whiplash injuries: presentation of a new motion device for the cervical spine.

    PubMed

    Birnbaum, Klaus; Maus, Uwe; Tacke, Josef

    2010-02-01

    Frequently following a whiplash injury of the cervical spine, patients suffer from persistent pain symptoms. The MRI will in some of these cases show changes consistent with disk pathology or spinal stenosis, although in most instances the imaging studies will offer no adequate explanation for the described symptoms. The goal of our research was to develop and test a new MRI compatible device that will allow functional imaging of the cervical spine. A total of 30 patients with whiplash injuries were evaluated during the first 6 weeks following trauma with the functional MRI. The examination was carried out with a T2-weighted turbo spin-echo sequence utilizing a new apparatus consisting of an inflatable air bag contained in a Plexiglas housing. Thanks to a valve placed outside of the examination room, it was possible to individually regulate the amount of air used to fill the pillow, thereby obtaining a full range of motion between flexion and extension. In 25 cases no pathology was found during this examination. Two patients presented with scarring of the alar ligaments, indicative of a traumatic lesion. In two other instances the images in reclination revealed a bulging disk, while in one case a widening of the disk space was found as a sign for a rupture of the anterior longitudinal ligament. Our study was able to demonstrate the applicability of the new functional testing device, which permits a standardized, continuous and dynamic evaluation of the cervical spine in a closed MRI.

  8. Transnasal endoscopic repair of pediatric meningoencephalocele

    PubMed Central

    Keshri, Amit Kumar; Shah, Saurin R.; Patadia, Simple D.; Sahu, Rabi N.; Behari, Sanjay

    2016-01-01

    Introduction: Encephaloceles in relation to the nose are rare lesions affecting the skull base. In the pediatric population, majority are congenital lesions manifesting as nasal masses requiring surgical intervention. Materials and Methods: A retrospective study of 6 consecutive patients below 12 years of age with intranasal meningoencephalocele treated by endonasal endoscopic approach at our tertiary centre was done. The follow up period ranged from 6 months to 2 years. A detailed clinical and radiological evaluation of these cases was done. Endonasal endoscopic repair (gasket seal/fat plug) was carried out in all cases. Results: Out of 6 patients, 4 patients had post-traumatic and rest 2 cases had congenital meningo-encephaloceles. All patients were asymptomatic in post-operative follow up period. One patient had minor complication of nasal alar collapse due to intra-operative adherence of encephalocele to cartilaginous framework. Conclusion: Transnasal endoscopic repair of anterior skull base meningoencephalocele is a minimally invasive single stage surgery, and has advantage in terms of lesser hospital stay, cost of treatment, and better cosmesis. The repair technique should be tailored to the size of defect to provide a water-tight seal for better outcome. PMID:27195032

  9. La Observación Sistemática de Vecindarios: El caso de Chile y sus perspectivas para Trabajo Social

    PubMed Central

    Sanhueza, Guillermo E.; Delva, Jorge; Andrade, Fernando H.; Grogan-Kaylor, Andrew; Bares, Cristina; Castillo, Marcela

    2012-01-01

    El estudio acerca de las características de los vecindarios y sus efectos sobre las personas ha llegado a ser un área de creciente atención por parte de investigadores de diversas disciplinas en países desarrollados. Aunque actualmente existen diversas metodologías para estudiar efectos del vecindario, una de las más utilizadas es la Observación Sistemática de Vecindarios –Systematic Social Observation SSO, en inglés—porque permite recolectar información acerca de diversas características del entorno físico, social, ambiental y económico de los vecindarios donde se aplica. El objetivo de este artículo es (i) dar a conocer sumariamente algunas investigaciones influyentes sobre efectos del vecindario en Estados Unidos, ii) describir cómo se diseñó e implementó la Observación Sistemática de Vecindarios en la ciudad de Santiago de Chile, iii) señalar algunos facilitadores y obstaculizadores de la implementación del proyecto y, finalmente iv) enunciar posibles contribuciones y limitaciones que esta metodología ofrecería al trabajo social en Chile. PMID:24791060

  10. Giant Rhinophyma: A Rare Case of Total Nasal Obstruction and Restitutio Ad Integrum.

    PubMed

    Wolter, Andreas; Scholz, Till; Liebau, Jutta

    2017-03-24

    Rhinophyma is considered the end stage in the development of rosacea, accompanied by hypertrophy of the sebaceous glands, which causes an enlargement of the nose. It is an uncommon condition that often results in both functional and cosmetic impairment. A large variety of surgical and nonsurgical treatments have been published to treat it. Closure is usually obtained by wound granulating in by secondary intention, skin grafting or local flaps. Rarely these lesions can attain a giant size and pose a challenge in surgical treatment. We present a 63-year-old male with the necessity for tracheostomy at the ICU due to total nasal obstruction and recurrent episodes of pneumonia caused by a huge giant rhinophyma, which had undergone extreme growth in the last five years. The tumor was removed under general anesthesia by decortication with an electrosurgical wire loop to recreate the aesthetic units of the nose preserving the alar cartilage as well as the pilosebaceous appendages. The wounds healed in by secondary intention with a very pleasant cosmetic and improved functional result. The relevant literature is discussed. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  11. Aircraft-based measurements of the carbon footprint of Indianapolis.

    PubMed

    Mays, Kelly L; Shepson, Paul B; Stirm, Brian H; Karion, Anna; Sweeney, Colm; Gurney, Kevin R

    2009-10-15

    The quantification of greenhouse gas emissions requires high precision measurements made with high spatial resolution. Here we describe measurements of carbon dioxide (CO2) and methane (CH4) conducted using Purdue University's Airborne Laboratory for Atmospheric Research (ALAR), aimed at the quantification of the "footprints" for these greenhouse gases for Indianapolis, IN. A cavity ring-down spectrometer measured atmospheric concentrations, and flask samples were obtained at various points for comparison. Coupled with pressure, temperature, and model-derived horizontal winds, these measurements allow for flux estimation. Long horizontal transects were flown perpendicular to the wind downwind of the city. Emissions were calculated using the wind speed and the difference between the concentration in the plume and the background concentration. A kriging method is applied to interpolate the measured values to a vertical plane traced out by the flight pattern within the mixed layer. Results show the urban plume is clearly distinguishable in the downwind concentrations for most flights. Additionally, there is large variability in the measured day-to-day emissions fluxes as well as in the relative CH4 and CO2 fluxes. Uncertainties in the method are discussed, and its potential utilityin determining sector-based emission factors is shown.

  12. Evaluation of bone loss at single-stage and two-stage implant abutments of fixed partial dentures.

    PubMed

    Koczorowski, R; Surdacka, A

    2006-01-01

    Fixed partial dentures (FPDs) can be supported on implant abutments only or on single-stage and two-stage implants and teeth. The purpose of this study was a comparative analysis of bone loss at the single-stage and two-stage implant abutments of fixed partial dentures used to restore missing teeth classified as Class I or Class II according to the Kennedy classification. 32 patients were treated by using 49 FPDs supported on implants and teeth worn for 2-6 years. Bone loss at the implant abutments of FPDs was evaluated by one examiner using a special ruler with a measuring scale and images of implants. Measurements were conducted at 26 single-stage implants and 50 two-stage implant abutments based on panoramic radiographs. Statistical analysis showed that the mean bone loss at implants after 2 years was 0.70 mm +/- 0.50. The mean bone loss at implants after 6 years was 1.73 mm +/- 0.41. The bone loss of the alveolar ridge at the single-stage implants was greater than at the two-stage implants but it was not statistically significant. Prosthetic treatment of missing teeth classified as Class I or II according to the Kennedy classification with FPDs may result in bone loss less than 2 mm after 6 years. Both single-stage and two-stage intraosseous implants can be suitable for the implant-prosthetic treatment of patients with alar lack of teeth.

  13. Identification of the optic recess region as a morphogenetic entity in the zebrafish forebrain.

    PubMed

    Affaticati, Pierre; Yamamoto, Kei; Rizzi, Barbara; Bureau, Charlotte; Peyriéras, Nadine; Pasqualini, Catherine; Demarque, Michaël; Vernier, Philippe

    2015-03-04

    Regionalization is a critical, highly conserved step in the development of the vertebrate brain. Discrepancies exist in how regionalization of the anterior vertebrate forebrain is conceived since the "preoptic area" is proposed to be a part of the telencephalon in tetrapods but not in teleost fish. To gain insight into this complex morphogenesis, formation of the anterior forebrain was analyzed in 3D over time in zebrafish embryos, combining visualization of proliferation and differentiation markers, with that of developmental genes. We found that the region containing the preoptic area behaves as a coherent morphogenetic entity, organized around the optic recess and located between telencephalon and hypothalamus. This optic recess region (ORR) makes clear borders with its neighbor areas and expresses a specific set of genes (dlx2a, sim1a and otpb). We thus propose that the anterior forebrain (secondary prosencephalon) in teleosts contains three morphogenetic entities (telencephalon, ORR and hypothalamus), instead of two (telencephalon and hypothalamus). The ORR in teleosts could correspond to "telencephalic stalk area" and "alar hypothalamus" in tetrapods, resolving current inconsistencies in the comparison of basal forebrain among vertebrates.

  14. Magnetic resonance imaging in patellar lateral femoral friction syndrome (PLFFS): prospective case-control study.

    PubMed

    Barbier-Brion, B; Lerais, J-M; Aubry, S; Lepage, D; Vidal, C; Delabrousse, E; Runge, M; Kastler, B

    2012-03-01

    To describe morphologic abnormalities and signs of patellar lateral femoral friction syndrome (PLFFS) detected by magnetic resonance imaging (MRI). Prospective study of 56 knees (21 patients and 30 controls) studied by 3Tesla MRI. Comparative analysis of clinical data, quantitative and qualitative imaging criteria in a population of patients with anterior knee pain associated with an abnormal MRI signal along the lateral alar folds of the infrapatellar fat pad, a characteristic sign of PLFFS, and a control population with no anterior knee pain or abnormal signal from the infrapatellar fat pad. Patients with PLFFS have anterior and/or lateral knee pain. Their knee has anatomical predispositions for instability, primarily with patella alta (P<0.0001), patellar tilt more than 13.5° (P<0.0001), a patellar nose length less than 9 mm (P=0.0037), a patellar nose ratio less than 0.25 (P<0.0001), a TT-TG distance more than 10 mm (P<0.0001), and a trochlear prominence more than 4 mm (P=0.0056). In 35% of patients, patellar chondropathy is visible, and 48% of patients have patellar or trochlear subchondral abnormalities. Anterior, lateral, and medial knee pain may be related to PLFFS. Anatomical predispositions contributing to instability are found in these patients. There may be associated chondropathies and osteochondropathies. Copyright © 2012. Published by Elsevier Masson SAS.

  15. Prosomeric organization of the hypothalamus in an elasmobranch, the catshark Scyliorhinus canicula

    PubMed Central

    Santos-Durán, Gabriel N.; Menuet, Arnaud; Lagadec, Ronan; Mayeur, Hélène; Ferreiro-Galve, Susana; Mazan, Sylvie; Rodríguez-Moldes, Isabel; Candal, Eva

    2015-01-01

    The hypothalamus has been a central topic in neuroanatomy because of its important physiological functions, but its mature organization remains elusive. Deciphering its embryonic and adult organization is crucial in an evolutionary approach of the organization of the vertebrate forebrain. Here we studied the molecular organization of the hypothalamus and neighboring telencephalic domains in a cartilaginous fish, the catshark, Scyliorhinus canicula, focusing on ScFoxg1a, ScShh, ScNkx2.1, ScDlx2/5, ScOtp, and ScTbr1 expression profiles and on the identification α-acetylated-tubulin-immunoreactive (ir), TH-ir, 5-HT-ir, and GFAP-ir structures by means of immunohistochemistry. Analysis of the results within the updated prosomeric model framework support the existence of alar and basal histogenetic compartments in the hypothalamus similar to those described in the mouse, suggesting the ancestrality of these subdivisions in jawed vertebrates. These data provide new insights into hypothalamic organization in cartilaginous fishes and highlight the generality of key features of the prosomeric model in jawed vertebrates. PMID:25904850

  16. A new genus and species of the subtribe Thyreophorina (Diptera, Piophilidae) from Japan.

    PubMed

    Saigusa, Toyohei

    2015-12-22

    A new genus, Diacanthomyia gen. nov. assigned to the subtribe Thyreophorina of the family Piophilidae is described based on a new species, Diacanthomyia okidoi sp. nov. recently found in Honshu and Kyushu, Japan. The new genus is somewhat similar to the European Centrophlebomyia of the subtribe. However, the new genus is distinguished from the known genera of the subtribe by the following combination of characters: body extensively pollinose or pruinose, 2 pairs of strong reclinate fronto-orbital bristles, 1-2 strong subvibrissal bristles in addition to 2 strong vibrissae, prosternum setose, 1 presutural dorsocentral, 1 strong anterior postsutural intra-alar, scutellum with 2 pairs of scutellar bristles without additional setulae, extensively microtrichose wing membrane, a dark round spot at r-m crossvein and a dark stripe covering m-m crossvein, and vein CuA+CuP abruptly terminated distant from wing margin. The type species inhabits evergreen broadleaved and deciduous broadleaved forests and adults appear during the cold season from December to March. Adults are attracted to decaying carcasses of Japanese deer and wild boar and traps baited with decaying pork spareribs and chicken meat with bones. The larvae of this species feed on decaying meat and marrow of deer, take less than 2 months to grow to mature larvae, and enter into diapause in the soil until autumn.

  17. Endoscopic Endonasal Transplanum Approach to the Paraclinoid Internal Carotid Artery

    PubMed Central

    Lai, Leon T.; Morgan, Michael K.; Snidvongs, Kornkiat; Chin, David C. W.; Sacks, Ray; Harvey, Richard J.

    2013-01-01

    Abstract Objective To investigate the relevance of an endoscopic transnasal approach to the surgical treatment of paraophthalmic aneurysms. Setting Binasal endoscopic transplanum surgery was performed. Participants Seven cadaver heads were studied. Main Outcome Measures (1) Dimensions of the endonasal corridor, including the operative field depth, lateral limits, and the transplanum craniotomy. (2) The degree of vascular exposure. (3) Surgical maneuverability and access for clip placements. Results The mean operative depth was 90 ± 4 mm. The lateral corridors were limited proximally by the alar rim openings (29 ± 4 mm) and distally by the distance between the opticocarotid recesses (19 ± 2 mm). The mean posteroanterior distance and width of the transplanum craniotomy were 19 ± 2 mm and 17 ± 3 mm, respectively. Vascular exposure was achieved in 100% of cases for the clinoidal internal carotid artery (ICA), ophthalmic artery, superior hypophyseal artery, and the proximal ophthalmic ICA. Surgical access and clip placement was achieved in 97.6% of cases for vessels located anterior to the pituitary stalk (odds ratio [OR] 73.8; 95% confidence interval [CI] 7.66 to 710.8; p = 0.00). Conclusion The endoscopic transnasal approach provides excellent visualization of the paraclinoid region vasculature and offers potential surgical alternative for paraclinoid aneurysms. PMID:24436941

  18. Natural reassignment of CUU and CUA sense codons to alanine in Ashbya mitochondria

    PubMed Central

    Ling, Jiqiang; Daoud, Rachid; Lajoie, Marc J.; Church, George M.; Söll, Dieter; Lang, B. Franz

    2014-01-01

    The discovery of diverse codon reassignment events has demonstrated that the canonical genetic code is not universal. Studying coding reassignment at the molecular level is critical for understanding genetic code evolution, and provides clues to genetic code manipulation in synthetic biology. Here we report a novel reassignment event in the mitochondria of Ashbya (Eremothecium) gossypii, a filamentous-growing plant pathogen related to yeast (Saccharomycetaceae). Bioinformatics studies of conserved positions in mitochondrial DNA-encoded proteins suggest that CUU and CUA codons correspond to alanine in A. gossypii, instead of leucine in the standard code or threonine in yeast mitochondria. Reassignment of CUA to Ala was confirmed at the protein level by mass spectrometry. We further demonstrate that a predicted is transcribed and accurately processed in vivo, and is responsible for Ala reassignment. Enzymatic studies reveal that is efficiently recognized by A. gossypii mitochondrial alanyl-tRNA synthetase (AgAlaRS). AlaRS typically recognizes the G3:U70 base pair of tRNAAla; a G3A change in Ashbya abolishes its recognition by AgAlaRS. Conversely, an A3G mutation in Saccharomyces cerevisiae confers tRNA recognition by AgAlaRS. Our work highlights the dynamic feature of natural genetic codes in mitochondria, and the relative simplicity by which tRNA identity may be switched. PMID:24049072

  19. Differential requirements for Gli2 and Gli3 in the regional specification of the mouse hypothalamus

    PubMed Central

    Haddad-Tóvolli, Roberta; Paul, Fabian A.; Zhang, Yuanfeng; Zhou, Xunlei; Theil, Thomas; Puelles, Luis; Blaess, Sandra; Alvarez-Bolado, Gonzalo

    2015-01-01

    Secreted protein Sonic hedgehog (Shh) ventralizes the neural tube by modulating the crucial balance between activating and repressing functions (GliA, GliR) of transcription factors Gli2 and Gli3. This balance—the Shh-Gli code—is species- and context-dependent and has been elucidated for the mouse spinal cord. The hypothalamus, a forebrain region regulating vital functions like homeostasis and hormone secretion, shows dynamic and intricate Shh expression as well as complex regional differentiation. Here we asked if particular combinations of Gli2 and Gli3 and of GliA and GliR functions contribute to the variety of hypothalamic regions, i.e., we wanted to approach the question of a possible hypothalamic version of the Shh-Gli code. Based on mouse mutant analysis, we show that: (1) hypothalamic regional heterogeneity is based in part on differentially stringent requirements for Gli2 or Gli3; (2) another source of diversity are differential requirements for Shh of neural vs. non-neural origin; (3) the medial progenitor domain known to depend on Gli2 for its development generates several essential hypothalamic nuclei plus the pituitary and median eminence; (4) the suppression of Gli3R by neural and non-neural Shh is essential for hypothalamic specification. Finally, we have mapped our results on a recent model which considers the hypothalamus as a transverse region with alar and basal portions. Our data confirm the model and are explained by it. PMID:25859185

  20. Embryonic and early fetal period development and morphogenesis of human craniovertebral junction.

    PubMed

    Hita-Contreras, Fidel; Roda, Olga; Martínez-Amat, Antonio; Cruz-Díaz, David; Mérida-Velasco, Juan A; Sánchez-Montesinos, Indalecio

    2014-04-01

    Several studies have focused on the cartilaginous, articular, and ligamentous development of the craniovertebral joint (CVJ), but there are no unifying criteria regarding the origin and morphogenetic timetable of the structures that make up the CVJ. In our study, serial sections of 53 human embryonic (n = 27) and fetal (n = 26) specimens from O'Rahilly stages 17-23 and 9-13 weeks, respectively, have been analyzed. Our results demonstrate that the chondrification of the pars basioccipitalis and exoccipitalis becomes observable at stage 19, and all future bones in the CVJ are in their cartilaginous form except for the future odontoid process. In addition, two chondrification centers appear for the body of the axis. From stage 21, the apical, alar, and transverse atlantal ligaments begin to acquire a ligamentous structure and the odontoid process initiates its chondrogenic phase. Stage 22 witnesses the first signs of the articular cavities of the atlanto-occipital joint, and by stage 23 all joints have cavities except for the transverse-odontoid joint, which will wait until week 9. In week 10, the ossification of the basilar part of the occipital bone begins, followed by the rest of the structures except for the odontoid process, which will start at week 13, thus completing the osteogenesis of all bones in the CVJ. The results of this study could help in establishing the anatomical basis of the normally functioning CVJ and for detecting its related pathologies, abnormalities, and malformations.

  1. Assessment of the 18-month permanence of onlay tip cartilage grafts following rhinoplasty.

    PubMed

    Persichetti, Paolo; Simone, Pierfranco; Carusi, Carlo

    2013-09-01

    Augmentation rhinoplasty requires addition of materials of various natures to reshape the nasal pyramid. Onlay tip grafts are single or multilayered grafts placed horizontally over the alar domes. The aim of the present study was to assess the 18-month permanence of onlay septal cartilage grafts. Twenty-eight patients underwent rhinoplasty with onlay tip cartilage graft, between June 2008 and November 2008 at the Campus Bio-Medico University in Rome, Italy. They were reviewed and photographed 6 months and 18 months postoperatively. Comparison of 6-month and 18-month postoperative pictures was performed with Adobe Photoshop CS. Measurements on pictures were taken with AutoCAD. Comparison of photographs showed no visible difference in nasal tip projection. Comparison of the measurements of tip projection showed a mean reduction of 0.06 mm (0.19%). Considerable stability of nasal tip projection after rhinoplasty with onlay tip grafts was observed postoperatively. Comparison of standardised digital photographs is a valid procedure to assess contour alterations of various anatomical structures after plastic surgery.

  2. Evidencia de alta concentración de masa en la región nuclear de una galaxia liner

    NASA Astrophysics Data System (ADS)

    Díaz, R.; Carranza, G.; Dottori, H.; Goldes, G.

    Usando técnicas de espectroscopía bidimensional en el telescopio de 1.54 m de Bosque Alegre, se obtuvo el campo de velocidades de la región nuclear de NGC 1672, galaxia LINER con un anillo circumnuclear de regiones HII. La curva de rotación media para los 2 kpc centrales sugiere la presencia de una gran concentración de masa (ρc~ 1011Msolar /kpc3). Este resultado es respaldado por la presencia de ciertos caracteres morfológicos detectados en imágenes obtenidas con el mencionado telescopio. Según recientes simulaciones hidrodinámicas de galaxias barreadas, estos caracteres sugieren la presencia de altas densidades en las regiones nucleares. El análisis espectrofotométrico indicaría, además, la presencia de dos componentes en la emisión nuclear, con una diferencia de velocidades de ~ 200 km/s. La velocidad circular del gas ionizado a 125 pc del centro señalaría la existencia de una masa interior de ~ 7× 108Msolar .

  3. Prosomeric organization of the hypothalamus in an elasmobranch, the catshark Scyliorhinus canicula.

    PubMed

    Santos-Durán, Gabriel N; Menuet, Arnaud; Lagadec, Ronan; Mayeur, Hélène; Ferreiro-Galve, Susana; Mazan, Sylvie; Rodríguez-Moldes, Isabel; Candal, Eva

    2015-01-01

    The hypothalamus has been a central topic in neuroanatomy because of its important physiological functions, but its mature organization remains elusive. Deciphering its embryonic and adult organization is crucial in an evolutionary approach of the organization of the vertebrate forebrain. Here we studied the molecular organization of the hypothalamus and neighboring telencephalic domains in a cartilaginous fish, the catshark, Scyliorhinus canicula, focusing on ScFoxg1a, ScShh, ScNkx2.1, ScDlx2/5, ScOtp, and ScTbr1 expression profiles and on the identification α-acetylated-tubulin-immunoreactive (ir), TH-ir, 5-HT-ir, and GFAP-ir structures by means of immunohistochemistry. Analysis of the results within the updated prosomeric model framework support the existence of alar and basal histogenetic compartments in the hypothalamus similar to those described in the mouse, suggesting the ancestrality of these subdivisions in jawed vertebrates. These data provide new insights into hypothalamic organization in cartilaginous fishes and highlight the generality of key features of the prosomeric model in jawed vertebrates.

  4. Investigating the case of human nose shape and climate adaptation.

    PubMed

    Zaidi, Arslan A; Mattern, Brooke C; Claes, Peter; McEcoy, Brian; Hughes, Cris; Shriver, Mark D

    2017-03-01

    The evolutionary reasons for variation in nose shape across human populations have been subject to continuing debate. An import function of the nose and nasal cavity is to condition inspired air before it reaches the lower respiratory tract. For this reason, it is thought the observed differences in nose shape among populations are not simply the result of genetic drift, but may be adaptations to climate. To address the question of whether local adaptation to climate is responsible for nose shape divergence across populations, we use Qst-Fst comparisons to show that nares width and alar base width are more differentiated across populations than expected under genetic drift alone. To test whether this differentiation is due to climate adaptation, we compared the spatial distribution of these variables with the global distribution of temperature, absolute humidity, and relative humidity. We find that width of the nares is correlated with temperature and absolute humidity, but not with relative humidity. We conclude that some aspects of nose shape may indeed have been driven by local adaptation to climate. However, we think that this is a simplified explanation of a very complex evolutionary history, which possibly also involved other non-neutral forces such as sexual selection.

  5. Pyriform Aperture Stenosis: A Novel Approach to Stenting.

    PubMed

    Smith, Aaron; Kull, Amanda; Thottam, Prasad; Sheyn, Anthony

    2017-06-01

    Congenital nasal pyriform aperture stenosis (CNPAS) is one of several causes of neonatal respiratory distress. Congenital nasal pyriform aperture stenosis can be diagnosed by clinical presentation and evaluated by computed tomography for degree of stenosis. Surgical management of indicated cases involves drillout of pyriform aperture with placement of stents. The following case presents a novel approach to choice of stent in these patients. We report the case of an infant diagnosed with CNPAS who underwent surgical correction at 9 days of life, with placement of mometasone fuorate stents. Although relatively uncommon, CNPAS is a type of airway obstruction that causes cyclic cyanosis and failure to thrive in affected infants. If uncorrected medically, surgical interventions can successfully restore patency of the nasal cavity. While traditional stents can result in undesired complications, the use of mometasone fuorate stents presents an alternative without the typically associated risks. The use of mometasone fuorate stents may be a helpful option for otolaryngologists looking for the potential to avoid restenosis, plugging, and nasal alar necrosis in patients undergoing surgical treatment of CNPAS.

  6. Lower Lateral Cartilages: An Anatomic and Morphological Study in Noses of Black Southern Africans.

    PubMed

    McIntosh, Cameron N D; van Wyk, F Carl; Joubert, Gina; Seedat, Riaz Y

    2017-03-01

    The anatomy of the nose of different ethnic groups has been widely researched in order to facilitate a better understanding of the individual nose as a foundation for improving surgical outcomes. The only anatomical research of the lower lateral cartilages (LLCs) available to the surgeon working with an African patient is to extrapolate data from studies already published on African Americans. The aim of this descriptive cadaveric study was to assess the normal anatomy of the LLCs in noses of Black South Africans and compare this to data from studies on noses from Caucasian, Asian, Korean, and African-American populations. Ninety lower lateral cartilages of 45 cadavers of Black South Africans who did not have previous surgery or trauma to the nose were dissected. The morphological shapes and 12 standard anatomical measurements were recorded. The results were analyzed and compared to data in the literature from studies on lower lateral cartilages of Caucasian, Asian, Korean, and African-American populations. A statistically significant difference was found in terms of overall cartilage dimensions, distance from nasal rim, and morphological shapes, compared to all previously studied groups, including the African-American population. There were significant differences in cartilage dimensions between males and females. This translates to clinically significant data that is useful during reconstructive and aesthetic nasal surgery on patients with a Southern African background. This study sets norms for alar cartilages in Black Southern Africans.

  7. Nasal Morphology of the Chinese: Three-Dimensional Reference Values for Rhinoplasty.

    PubMed

    Jayaratne, Yasas S N; Deutsch, Curtis K; Zwahlen, Roger A

    2014-06-01

    To determine normative nasal measurements for Chinese young adults, conditioned on demographics. A cross-sectional descriptive study. A university hospital. Three-dimensional (3D) photographs were captured from 103 Chinese subjects between 18 and 35 years of age using a commercial stereophotographic system. Anthropometric landmarks were identified on these 3D surface images, and measurements suitable for nasal analysis were performed and contrasted against established Caucasian norms. Gender differences in anthropometric dimensions were also analyzed. Normative data for these measurements are made available. Linear nasal measurements, except those for mid-columella length, were significantly larger in men than in women; further, the nasal tip angle and nasofrontal angle were significantly larger in Chinese women. Contrasts of these new data against published Caucasian norms revealed dimensions that differ for these 2 groups. The Chinese normative mean values for morphological nose width, nasal tip angle, nasofrontal angle, and alar slope angle exceeded those reported for North American Caucasians. Gender-specific normative data for the Chinese nose were established in this study to provide a useful tool for surgeons in dealing with rhinoplasty. Moreover, the Chinese nasal anthropometric measurements in this study are broader and flatter than those reported for North American Caucasians. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  8. Upper lip lift with a "T"-shaped resection of the orbicularis oris muscle for Asian perioral rejuvenation: A report of 84 patients.

    PubMed

    Pan, Bai-Lin

    2017-03-01

    An overlong upper lip or philtrum indicates aging. In the current study, a procedure for upper lip lift to alleviate this defect is illustrated and assessed for its esthetic effects and risks. A total of 84 Chinese patients with overlong upper lip underwent surgery for upper lip lift from 2012 to 2014. Skin excision height was designed on the basis of the golden proportion of the lower region of the face. The incision was made at the subnasal (inferior border of the columella-nostril-alar) region. After undermining the tissue between the subcutis and orbicularis oris, a "T"-shaped region of the muscle was resected. Both sides of the muscular flaps were developed and suspended upward to the columella base to lift the upper lip. The incision was then sutured delicately. Of the 76 patients who were effectively followed up, recovery period, lift effect, visibility of the scar, vermilion shape, surgery-associated effects, any complications, and overall rejuvenation, among other outcomes, were evaluated at 1 week, 1 month, and 3-24 months postoperation. Assessment was performed by both objective measurements and subjective satisfaction: significant efficiency was achieved and high satisfaction, satisfaction, and dissatisfaction ratings were reported by 55 (72.4%), 18 (23.7%), and 3 (3.9%) patients, respectively. Upper lip lift yields a significant esthetic effect with few complications. This surgical intervention merits further clinical development and application. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. Influence of alveolar-bone grafting on the nasal profile: unilateral cleft lips, alveoli, and palates.

    PubMed

    Wu, Yilai; Wang, Guomin; Yang, Yusheng; Zhang, Yong

    2010-11-01

    Secondary bone grafting plays an important role in the multimodal therapy of patients with cleft lips, alveoli, or palates. Through a comparative study of the nasal profile before and after alveolar bone grafting, this article aimed to determine the appropriate timing of operation and keys to success. In the study, 38 cases (23 boys and 15 girls aged 9-13 years, with an average of 11.4 years) were examined of patients with unilateral cleft lips or palates, upon whom secondary bone grafting was performed under general anesthesia. Comparative studies are conducted on their nostril widths and heights in both the cleft side and the noncleft side as well as the widths and angles of the alar bases measured in the preoperative, postoperative, and follow-up (6 months) periods respectively. Of the 29 cases examined 6 months after the operation, 4 indicate failure as the amount of bone loss exceeds 50%, whereas in the other 25 cases, both the nostril widths of the cleft side have increased, and the nostril heights of the cleft side have decreased significantly (P < 0.01). As shown in the study, the nasal profile after alveolar bone grafting is changed obviously; thus, it is recommended that patients not receive rhinoplasty before bone grafting or have both operations at the same time.

  10. Effects of maxillary advancement and impaction on nasal airway function.

    PubMed

    Pourdanesh, F; Sharifi, R; Mohebbi, A; Jamilian, A

    2012-11-01

    The effects of Le Fort I osteotomy on the nasal airway are controversial. This study aimed to evaluate nasal airway changes after Le Fort I. 25 patients underwent conventional Le Fort I osteotomy and were separated into three groups depending on the type of surgery they underwent. 11 patients needed maxillary impaction, 9 underwent maxillary advancement, and 5 had both maxillary impaction and advancement. Rhinological examinations, anterior rhinomanometry and acoustic rhinometry were carried out 1 week before surgery and 3 months after that. Wilcoxon and χ(2) tests were used for data analysis. The samples included 19 females and 6 males with a mean age of 22.4 ± 3.32 years. Rhinomanometric assessment showed that total nasal airflow was increased from 406 ± 202 ml/s to 543 ± 268 ml/s in all three groups. Significant decrease in nasal airway resistance was seen in all three groups. Acoustic rhinometry revealed a significant decrease in total nasal volume but an increase in the cross-sectional areas of isthmus nasi (IN) and inferior concha. The rhinomanometric measurements showed improvements in the total nasal airflow after Le Fort I osteotomy with alar base cinch suture in cases where the impaction was not higher than 5.5mm.

  11. Three-dimensional facial analysis of Chinese children with repaired unilateral cleft lip and palate

    NASA Astrophysics Data System (ADS)

    Othman, Siti Adibah; Aidil Koay, Noor Airin

    2016-08-01

    We analyzed the facial features of Chinese children with repaired unilateral cleft lip and palate (UCLP) and compared them with a normal control group using a three-dimensional (3D) stereophotogrammetry camera. This cross-sectional study examined 3D measurements of the facial surfaces of 20 Chinese children with repaired UCLP and 40 unaffected Chinese children aged 7 to 12 years old, which were captured using the VECTRA 3D five-pod photosystem and analyzed using Mirror software. Twenty-five variables and two ratios were compared between both groups using independent t-test. Intra- and inter-observer reliability was determined using ten randomly selected images and analyzed using intra-class correlation coefficient test (ICC). The level of significance was set at p < 0.0018. Intra- and inter-observers’ reliability was considered fair to excellent with an ICC value ranging from 0.54 to 0.99. Statistically significant differences (p < 0.0018) were found mainly in the nasolabial region. The cleft group exhibited wider alar base root width, flattened nose and broader nostril floor width on the cleft side. They tended to have shorter upper lip length and thinner upper vermillion thickness. Faces of Chinese children with repaired UCLP displayed meaningful differences when compared to the normal group especially in the nasolabial regions.

  12. Aesthetic septorhinoplasty in the burned nose.

    PubMed

    Hafezi, Farhad; Karimi, Hamid; Nouhi, Amirhosein

    2005-03-01

    Patients who have survived thermal injuries to the face suffer severe disfigurement from the devastating deformities of full-thickness facial burns. The nose is the prominent central organ of the face, which has crucial effect on Aesthetic appearance. The plastic surgeon's role to deal with such cases is to undertake procedures to produce a more pleasant look although the target organ could be the non-burned areas of the face. It is a common belief that surgical intervention under the scarred or grafted nose is risky and may result in skin or covering graft necrosis. For this reason, plastic surgeons are cautious and hesitate to perform Aesthetic surgery on burn scarred tissue. We present 13 cases, 10 women and three men with complete or subtotal nasal burn. Classic Aesthetic Rhinoplasty operations were performed to create a better appearance and correct any internal or external deviations. These procedures are carried out under severely burned skins, or previously grafted and reconstructed noses. Cases were followed for about a one-year period. There was no necrosis in any part of skin after surgery. We believe that Aesthetic rhinoplasty can be done safely in these victims with pleasing outcome. The problems that we encountered in these cases were irregularities of burned alar margins, multiple operations and intractable nasal deviation in severe cases.

  13. Introduction to Lumbosacral and Sacropelvic Fixation Strategies.

    PubMed

    Hsieh, Patrick C; Mummaneni, Praveen V

    2016-07-01

    We are pleased to present this Neurosurgical Focus video supplement on lumbosacral and sacropelvic fixation strategies. Despite advancement in surgical techniques and technologies in spine, achieving consistent solid fusion across the lumbosacral junction remains a major challenge. The anatomy of the lumbosacral junction allows for a higher range of motion compared to other areas of the thoracolumbar spine. The L5-S1 interspace is exposed to significant shear forces. As a result, complications such as pseudoarthrosis, screw pull-out, implant fracture, or sacral fractures can occur. Complications are particularly seen in long fusion constructs ending across the lumbosacral junction. To reduce these complications, various lumbosacral and sacropelvic fixation techniques have been developed and utilized. The current supplement is intended to provide instructional videos that illustrate several current techniques for lumbosacral and sacropelvic fixation. The collection includes techniques for anterior L5-S1 interbody fusion, minimally invasive L5-S1 interbody fusions, lumbosacral pedicle screw placement, sacroiliac fusion, and sacro-alar-iliac screw placement. The authors of the videos in the supplement have provided detailed narration and video illustration to describe the nuances of the various open and minimally invasive techniques for lumbosacral and sacral-pelvic fixation. We are pleased to have such a collection of quality video illustration from experts in the field. It's been our privilege to serve as guest editors for this supplement and we believe that you will enjoy the contents of this supplement.

  14. The complex evolutionary history of aminoacyl-tRNA synthetases

    PubMed Central

    Chaliotis, Anargyros; Vlastaridis, Panayotis; Mossialos, Dimitris; Ibba, Michael; Becker, Hubert D.

    2017-01-01

    Abstract Aminoacyl-tRNA synthetases (AARSs) are a superfamily of enzymes responsible for the faithful translation of the genetic code and have lately become a prominent target for synthetic biologists. Our large-scale analysis of >2500 prokaryotic genomes reveals the complex evolutionary history of these enzymes and their paralogs, in which horizontal gene transfer played an important role. These results show that a widespread belief in the evolutionary stability of this superfamily is misconceived. Although AlaRS, GlyRS, LeuRS, IleRS, ValRS are the most stable members of the family, GluRS, LysRS and CysRS often have paralogs, whereas AsnRS, GlnRS, PylRS and SepRS are often absent from many genomes. In the course of this analysis, highly conserved protein motifs and domains within each of the AARS loci were identified and used to build a web-based computational tool for the genome-wide detection of AARS coding sequences. This is based on hidden Markov models (HMMs) and is available together with a cognate database that may be used for specific analyses. The bioinformatics tools that we have developed may also help to identify new antibiotic agents and targets using these essential enzymes. These tools also may help to identify organisms with alternative pathways that are involved in maintaining the fidelity of the genetic code. PMID:28180287

  15. A fugacity approach for modeling the transport of airborne organic chemicals in an air/plant/soil system

    SciTech Connect

    Oliver, L.D. ); McKone, T.E. )

    1991-05-01

    An important issue facing both public and private agencies is the identification and quantification of exposures by indirect pathways to toxic chemicals released to the atmosphere. With recent public concerns over pesticides such as malathion and alar in foods, greater attention is being given to the process of chemical uptake by plants. Whether chemicals taken up by plants can accumulate and ultimately enter the human food chain are important questions for determining health risks and safe levels of toxic air-pollutant emissions and pesticide application. A number of plant-toxicokinetic, or botanicokinetic,'' models have been developed to give estimates of how chemicals are partitioned and transported within plants. In this paper, we provide a brief review of these models, describing their main features and listing some of their advantages and disadvantages. We then describe and demonstrate a five-compartment air/plant/soil model, which builds on and extends the features included in previous models. We apply this model to the steady-state chemical partitioning of perchloroethylene, hexachlorobenzene, and 2,3,7,8-tetrachlorodibenzo-p-dioxin in grass as test cases. We conclude with a discussion of the advantages and limitations of the model.

  16. A fugacity approach for modeling the transport of airborne organic chemicals in an air/plant/soil system

    SciTech Connect

    Oliver, L.D.; McKone, T.E.

    1991-05-01

    An important issue facing both public and private agencies is the identification and quantification of exposures by indirect pathways to toxic chemicals released to the atmosphere. With recent public concerns over pesticides such as malathion and alar in foods, greater attention is being given to the process of chemical uptake by plants. Whether chemicals taken up by plants can accumulate and ultimately enter the human food chain are important questions for determining health risks and safe levels of toxic air-pollutant emissions and pesticide application. A number of plant-toxicokinetic, or ``botanicokinetic,`` models have been developed to give estimates of how chemicals are partitioned and transported within plants. In this paper, we provide a brief review of these models, describing their main features and listing some of their advantages and disadvantages. We then describe and demonstrate a five-compartment air/plant/soil model, which builds on and extends the features included in previous models. We apply this model to the steady-state chemical partitioning of perchloroethylene, hexachlorobenzene, and 2,3,7,8-tetrachlorodibenzo-p-dioxin in grass as test cases. We conclude with a discussion of the advantages and limitations of the model.

  17. The area acustico-vestibularis of Discoglossus pictus. II. The primary afferent projections.

    PubMed

    Gonzalez, A; Muñoz, M

    1988-01-01

    In the present report the primary projections to the dorsal rhombencephalic alar plate (area acustico-vestibularis, AAV) of the adult anuran amphibian Discoglossus pictus have been studied by means of the anterograde transport of horseradish peroxidase (HRP). As in Alytes cisternasii, other member of the family Discoglossidae, no primary afferent fibers to the AAV were found from nerves other than the VIIIth cranial nerve. No remanent of the lateral line system in the adult stage is present. The projections of the dorsal root of nerve VIIIth distribute over the dorsal nucleus and rostrally reach the aspect of the cerebellum. Caudally projects to the large cells of the ventral nucleus and terminate caudally, in the dorsolateral neuropil, at levels coincident with the IX motor nucleus. The projection of the ventral root also reaches the cerebellum in its lateral aspect but also fibers to the nucleus cerebelli were observed. The extensive projection to the ventral nucleus is also continued caudally to the caudal nucleus and ends around the solitary tract. Main terminal fields were located in two neuropils, one subventricular and other in an intermediate position. In addition, from both nerve branches, fibers leave the AAV and reach the reticular formation. Particularly, fibers from the posterior branch enter the superior olivary nucleus. Retrograde labeled neurons in the vicinity of the VII motor nucleus are interpreted as efferent cells to the labyrinth.

  18. Crocodilian Forebrain: Evolution and Development

    PubMed Central

    Pritz, Michael B.

    2015-01-01

    Organization and development of the forebrain in crocodilians are reviewed. In juvenile Caiman crocodilus, the following features were examined: identification and classification of dorsal thalamic nuclei and their respective connections with the telencephalon, presence of local circuit neurons in the dorsal thalamic nuclei, telencephalic projections to the dorsal thalamus, and organization of the thalamic reticular nucleus. These results document many similarities between crocodilians and other reptiles and birds. While crocodilians, as well as other sauropsids, demonstrate several features of neural circuitry in common with mammals, certain striking differences in organization of the forebrain are present. These differences are the result of evolution. To explore a basis for these differences, embryos of Alligator misissippiensis were examined to address the following. First, very early development of the brain in Alligator is similar to that of other amniotes. Second, the developmental program for individual vesicles of the brain differs between the secondary prosencephalon, diencephalon, midbrain, and hindbrain in Alligator. This is likely to be the case for other amniotes. Third, initial development of the diencephalon in Alligator is similar to that in other amniotes. In Alligator, alar and basal parts likely follow a different developmental scheme. PMID:25829019

  19. The olfactory fascia: an evo-devo concept of the fibrocartilaginous nose.

    PubMed

    Jankowski, Roger; Rumeau, Cécile; de Saint Hilaire, Théophile; Tonnelet, Romain; Nguyen, Duc Trung; Gallet, Patrice; Perez, Manuela

    2016-12-01

    Evo-devo is the science that studies the link between evolution of species and embryological development. This concept helps to understand the complex anatomy of the human nose. The evo-devo theory suggests the persistence in the adult of an anatomical entity, the olfactory fascia, that unites the cartilages of the nose to the olfactory mucosa. We dissected two fresh specimens. After resecting the superficial tissues of the nose, dissection was focused on the disarticulation of the fibrocartilaginous noses from the facial and skull base skeleton. Dissection shows two fibrocartilaginous sacs that were invaginated side-by-side in the midface and attached to the anterior skull base. These membranous sacs were separated in the midline by the perpendicular plate of the ethmoid. Their walls contained the alar cartilages and the lateral expansions of the septolateral cartilage, which we had to separate from the septal cartilage. The olfactory mucosa was located inside their cranial ends. The olfactory fascia is a continuous membrane uniting the nasal cartilages to the olfactory mucosa. Its origin can be found in the invagination and differentiation processes of the olfactory placodes. The fibrous portions of the olfactory fascia may be described as ligaments that unit the different components of the olfactory fascia one to the other and the fibrocartilaginous nose to the facial and skull base skeleton. The basicranial ligaments, fixing the fibrocartilaginous nose to the skull base, represent key elements in the concept of septorhinoplasty by disarticulation.

  20. Infrared laser therapy after surgically assisted rapid palatal expansion to diminish pain and accelerate bone healing.

    PubMed

    Abreu, Marcelo Emir Requia; Viegas, Vinicius Nery; Pagnoncelli, Rogerio Miranda; de Lima, Eduardo Martinelli Santayama; Farret, Alessandro Marchiori; Kulczynski, Fernando Zugno; Farret, Marcel Marchiori

    2010-01-01

    The aim of this study was to illustrate how gallium arsenite aluminum diode laser (824 nm) irradiation can reduce postsurgical edema and discomfort and accelerate sutural osseous regeneration after surgically assisted rapid palatal expansion (SARPE). An adult patient with an 8-mm transverse maxillary discrepancy was treated with SARPE. Infrared laser therapy was started on the 7th postoperative day, with a total of eight sessions at intervals of 48 hours. The laser probe spot had a size of 0.2827 cm2 and was positioned in contact with the following (bilateral) points: infraorbital foramen, nasal alar, nasopalatine foramen, median palatal suture at the height of the molars, and transverse palatine suture distal to the second molars. The laser was run in continuous mode with a power of 100 mW and a fluency of 1.5 J/cm2 for 20 seconds at each point. Subsequently, an absence of edema and pain was observed. Further, fast bone regeneration in the median palatal suture could be demonstrated by occlusal radiographs. These findings suggest that laser therapy can accelerate bone regeneration of the median palatal suture in patients who have undergone SARPE.

  1. Pattern of calbindin-D28k and calretinin immunoreactivity in the brain of Xenopus laevis during embryonic and larval development.

    PubMed

    Morona, Ruth; González, Agustín

    2013-01-01

    The present study represents a detailed spatiotemporal analysis of the localization of calbindin-D28k (CB) and calretinin (CR) immunoreactive structures in the brain of Xenopus laevis throughout development, conducted with the aim to correlate the onset of the immunoreactivity with the development of compartmentalization of distinct subdivisions recently identified in the brain of adult amphibians and primarily highlighted when analyzed within a segmental paradigm. CR and CB are expressed early in the brain and showed a progressively increasing expression throughout development, although transient expression in some neuronal subpopulations was also noted. Common and distinct characteristics in Xenopus, as compared with reported features during development in the brain of mammals, were observed. The development of specific regions in the forebrain such as the olfactory bulbs, the components of the basal ganglia and the amygdaloid complex, the alar and basal hypothalamic regions, and the distinct diencephalic neuromeres could be analyzed on the basis of the distinct expression of CB and CR in subregions. Similarly, the compartments of the mesencephalon and the main rhombencephalic regions, including the cerebellum, were differently highlighted by their specific content in CB and CR throughout development. Our results show the usefulness of the analysis of the distribution of these proteins as a tool in neuroanatomy to interpret developmental aspects of many brain regions.

  2. Low genetic diversity in Wolbachia-Infected Culex quinquefasciatus (Diptera: Culicidae) from Brazil and Argentina.

    PubMed

    Morais, Sirlei Antunes; Almeida, Fábio de; Suesdek, Lincoln; Marrelli, Mauro Toledo

    2012-12-01

    Culex quinquefasciatus is a vector of human pathogens, including filarial nematodes and several viruses. Although its epidemiological relevance is known to vary across geographical regions, an understanding of its population genetic structure is still incipient. In light of this, we evaluated the genetic diversity of Cx. quinquefasciatus and Cx. pipiens x Cx. quinquefasciatus hybrids collected from nine localities in Brazil and one site in Argentina. We used mitochondrial genes cox1 and nd4, along with the coxA and wsp genes of the maternally-inherited Wolbachia endosymbiont. The nd4 fragment was invariant between samples, whilst cox1 exhibited four haplotypes that separated two types of Cx. quinquefasciatus, one clustered in southern Brazil. Low sequence diversity was generally observed, being discussed. Both Brazilian and Argentinian mosquitoes were infected with a single Wolbachia strain. As reported in previous studies with these populations, cox1 and nd4 diversity is not congruent with the population structure revealed by nuclear markers or alar morphology. Future Cx. quinquefasciatus research should, if possible, evaluate mtDNA diversity in light of other markers.

  3. Interdomal Suture through a Nondelivery Endonasal Approach: A New Technique

    PubMed Central

    Leibou, Lior

    2016-01-01

    Background: The use of interdomal sutures for tip refinement is common in open rhinoplasty and in endonasal rhinoplasty using a delivery technique, but there is paucity of reports in the literature regarding the use of interdomal suturing techniques when the nondelivery endonasal approach is chosen. Objective: The authors describe a technique designed to refine the nasal tip with an interdomal suture placed through a nondelivery endonasal approach. Methods: In this study, the authors retrospectively review the cases of 45 patients who underwent endonasal rhinoplasty with the authors’ interdomal suturing technique between the years 2011 and 2013. The average age of the patients was 25.3 years. Intercrural sutures (PDS 4.0 straight needle, Cincinnati, Ohio) were placed as mattress-like suture in the tip region, with the knot buried between both alar cartilages. The suture is tightened progressively according to the tip definition and narrowing sought. Results: The patients were followed for 12 months. All of the patients demonstrated a significant reduction in lobule and tip widths. This series had only 1 complication of tip asymmetry that was revised 1 year after the initial operation. There were no cases of infection, allergic reaction, or extrusion of the suture. Conclusions: Despite the lack of a large volume of patients, our study confirms that this technique is indeed an attractive and highly predictable option for achieving adequate tip refinement and definition when using a nondelivery endonasal rhinoplasty. PMID:27622086

  4. Presurgical Nasoalveolar Molding Therapy Using Figueroa's NAM Technique in Unilateral Cleft Lip and Palate Patients: A Preliminary Study.

    PubMed

    Koya, Shafees; Shetty, Sandeep; Husain, Akhter; Khader, Mustafa

    The objective of the study was to evaluate the results of nasoalveolar molding (NAM) in the treatment of patients with unilateral cleft lip and palate using a modified technique in a South Indian population. The design was a prospective study with blinded measurements. The sample constituted 10 complete unilateral cleft lip and palate (UCLP) patients who underwent NAM therapy by the same operator. Direct extra and intra oral anthropometric measurements were done using a digital vernier caliper before and after NAM therapy. A photographic evaluation was also done to rate the nasal deformity post NAM therapy. The differences between measurements were statistically analyzed using paired t tests. The extra oral measurements revealed a statistically significant increase in bi-alar width, columellar length and width. The intraoral measurements demonstrated a statistically significant reduction in anterior alveolar cleft width. There was also a significant increase in arch width and greater and lesser segments length. All cases were rated as improved by the surgeons in photographic analysis. The study has quantitatively shown that the modified NAM therapy improved nasal asymmetry by columellar lengthening and effectively molded the maxillary alveolar arch.

  5. Metschnikowia cf. typographi and other pathogens from the bark beetle Ips sexdentatus - Prevalence, histological and ultrastructural evidence, and molecular characterization.

    PubMed

    Kleespies, Regina G; Lim, Young Woon; Tkaczuk, Cezary; Wrzosek, Marta; Steinwender, Bernhardt M; Wegensteiner, Rudolf

    2017-02-01

    Ips sexdentatus (six-spined engraver beetle) from Austria and Poland were dissected and examined for the presence of pathogens. Specimens collected in Austria were found to contain the ascomycetous fungus Metschnikowia cf. typographi. Infection rates ranged from 3.6% to 26.8% at different collection sites. M. cf. typographi infected midguts were investigated by histological, ultrastructural and molecular techniques. Extraordinary ultrastructural details are shown, such as ascospores with bilateral flattened flanks resembling alar rims at both sides of their attenuating tube-like ends. These have not yet been described in other yeast species. Molecular investigations showed a close phylogenetic relationship to the fungi Metschnikowia agaves and Candida wancherniae. Presence of the entomopathogenic fungus Beauveria bassiana found in Austria was confirmed both morphologically and molecularly. The eugregarine Gregarina typographi was diagnosed most frequently. Infection rates of all I. sexdentatus specimens ranged from 21.4% to 71.9% in Austria and 54.1% to 68.8% in Poland. Other entomopathogenic protists, bacteria, or viruses were not detected. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Correction of Asian Short Nose with Lower Lateral Cartilage Repositioning and Ear Cartilage Grafting

    PubMed Central

    Kim, Kenneth K.

    2013-01-01

    Background: Asians with short nose lack the cartilage needed to extend the length of the nose. A rhinoplasty technique using lower lateral cartilage (LLC) repositioning and ear cartilage grafting allows for sufficient nasal lengthening and nasal tip mobility in the correction of short nose in Asians. Methods: Short nose was classified into 3 subtypes: type I, II, or III. During LLC repositioning, the LLC was separated from surrounding retaining structures, except at the footplate. The LLC was approximated medially and advanced with a Medpor strut. A silicone dorsal implant was inserted to suit the newly projected nasal tip. An ear cartilage onlay graft or ear cartilage extension graft was applied to further project and enhance the nasal tip and columella. Results: Of the 854 primary rhinoplasty procedures performed on Asian patients between January 2008 and December 2011, 295 were performed on patients with short nose. LLC repositioning and ear cartilage onlay grafting were performed on 228 patients. LLC repositioning and ear cartilage extension grafting with or without ear cartilage onlay grafting were performed on 67 patients. Short nasal tip, alar retraction, and columellar retraction were corrected. Wound dehiscence with marginal necrosis occurred in 7 patients. One patient developed nasal infection. Conclusions: LLC repositioning and ear cartilage grafting aid in the correction of short nose in Asians. With LLC repositioning and ear cartilage grafting, the nasal tip can be positioned in accordance with the patient’s anatomic limits. The entire nasal tip and columella can be lengthened, while the tip maintains its mobility. PMID:25289239

  7. Modified Direct-Type Septal Extension Grafts: Their Stability and Usefulness in Asian Rhinoplasty.

    PubMed

    Han, So-Eun; Han, Kihwan; Choi, Jaehoon; Yun, Tae Bin

    2017-03-01

    In Asian rhinoplasty, many autogenous cartilage grafts are required for correction of the nasal tip and columella, but the amount has limitations. A modified direct-type septal extension graft, in continuity with the entire caudal border of the septal cartilage with an edge-to-edge coaptation, can effectively and concomitantly correct the nasal tip and columella deformities using a limited amount of septal cartilage graft. The purpose of this study was to evaluate long-term cosmetic outcomes and stability from the modified direct extension grafts. Fifty-seven patients with a follow-up of more than 1 year were enrolled in the study. A total of 11 measurement items were evaluated from basal and right lateral views by photogrammetry using standardized clinical photographic techniques. The overall mean follow-up period was 20.4 months. When comparing the preoperative and postoperative values, the nasal tip projection, nasal bridge length, nasal tip angle, height of nose, and the columellar labial angle increased significantly; additionally, the soft nose width index, width between ac-ac index, nostril axis inclination, columellar length (Rt-Lt), and the alar length (Rt-Lt) decreased significantly. No resorption, buckling, or displacement of the graft was observed during the follow-up period. The modified direct extension graft demonstrated a marked aesthetic improvement in the nasal tip and columella, and it provided long-term stability. Therefore, the modified direct extension graft is useful for correction of the nasal tip and columella in Asian rhinoplasty.

  8. Clinical experience with hyaluronic acid-filler complications.

    PubMed

    Park, Tae-Hwan; Seo, Sang-Won; Kim, June-Kyu; Chang, Choong-Hyun

    2011-07-01

    Hyaluronic acid (HA) fillers have become the material of choice for soft-tissue augmentation. HA fillers are longer lasting, less immunogenic and can be broken down by hyaluronidase. These advantages make HA fillers the most common of the temporary fillers on the market. However, early and delayed complications, ranging from minor to severe, can occur following HA-filler injection. We evaluated and treated 28 cases of HA-filler-related complications that were referred to our hospital over a period of 5 years from July 2004 to October 2009. Twenty-eight patients were included in our study; 82.1% of the patients were female and 17.9% were male. Complications were roughly classified as nodular masses, inflammation, tissue necrosis and dyspigmentation. Affected locations, in descending order of frequency, were the perioral area, forehead, including glabella, nose, nasolabial fold, mentum, including marionette wrinkles, cheek area and periocular wrinkles. The most disastrous complication was alar rim necrosis following injection of the nasolabial fold. We propose two 'danger zones' that are particularly vulnerable to tissue necrosis following filler injection: the glabella and nasal ala. Although there is no definite treatment modality for the correction of HA-filler complications, we have managed them with various available treatment modalities aimed at minimising patient morbidity. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  9. The history of memory arts.

    PubMed

    Patten, B M

    1990-02-01

    Ancient humans, lacking devices to store large amounts of information, invented and developed a system of mnemonics which evolved and passed to modern times. The mnemonics, collectively known as the Ancient Art of Memory, were discovered in 447 BC by a Greek poet, Simonides, and were adequately described by Cicero, Quintilian, and Pliny. These arts fell into neglect after Alaric sacked Rome in 410 AD, but were subsequently revived in 1323 by Saint Thomas Aquinas, who transferred them from a division of rhetoric to ethics and used them to recall Catholic doctrine and versions of biblical history. In 1540 Saint Ignatius Loyola used mnemonic images to affirm the faith with his newly formed Society of Jesus and tried to convert the Ming dynasty in China by teaching these memory skills to Chinese nobles. Today, the ancient memory arts have applications in pilot training, gambling, mentalism and telepathy demonstrations, and may have a role in the rehabilitation of brain-damaged patients. Objective testing confirms that with the use of these memory skills, recall is increased, at least 10-fold, and the memory deficits of proactive and retroactive inhibition do not exist.

  10. How to Harmonize the Ethnic Nose.

    PubMed

    Grinfeld, Artur; Betelli, Rodrigo; Arruda, Guilherme; Almeida, Washington

    2016-12-01

    The demand for cosmetic surgery has significantly increased in the past few years mainly due to economic rise witnessed in Brazil. The state of Bahia has predominately Afro-descendant population with the same countrywide scenario, where the surgeon must be able to face challenges such as the specifics demands of rhinoplasty in an ethnic nose. It represents not only a different nasal variety from the Caucasoid, but also a complex anatomical feature, with its own peculiarities, as thicker and oilier skin, with bulky fibrous fatty tissue with numerous sebaceous glands. The nose tip features both inadequate projection and definition, including a short columella and underdeveloped nasal spine. The lower lateral cartilages are lower and thinner if compared with Caucasian noses. The nasal septum is short and fragile, whereas the dorsum is low and wide with deep nasion and wide obtuse angles between nasal bones. Finally, yet importantly, the nose base has increased interalar distance and excess of alar wing, with an ovoid, horizontal, and open nostril. Considering all these uniqueness, the existing challenges to approach an ethnic nose are clear. It requires skill and accurate surgical maneuvers to seek facial harmony while maintaining the characteristics that define the individual ethnicity and identity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  11. Phonetic context effects in adult listeners with cochlear implants

    NASA Astrophysics Data System (ADS)

    Aravamudhan, Radhika; Lotto, Andrew J.

    2005-09-01

    From previous studies it is known that normal-hearing (NH) listeners have the ability to compensate for the acoustic variability present in speech through context-dependent perception of speech sounds. One question of practical and theoretical interest is whether listeners with cochlear implants (CI) also show context-dependent speech perception. Because of the lack of spectral resolution in the input, the representation of speech for CI listeners may differ from NH listeners, which may interfere with perceptual compensation. In a test of this prediction, adult postlingually deafened CI listeners did not demonstrate the contrastive context effects elicited from NH listeners for either /da/-/ga/ targets and /al/-/ar/ contexts or V targets and /b-b/-/d-d/ contexts. In contrast, as predicted by the good temporal resolution of the CI signal, CI listeners showed normal effects of vowel length on preceding glide-stop categorization. CI simulations with NH listeners were also performed for some of these context effects. The results support the view that spectral content of contexts largely determines their effect on target sounds, and that phonetic content does not play an essential role. In addition, the findings predict that CI listeners will have particular difficulty with heavily coarticulated speech. [Work sponsored by NIH and NSF.

  12. The development of the thalamic motor learning area is regulated by Fgf8 expression.

    PubMed

    Martinez-Ferre, Almudena; Martinez, Salvador

    2009-10-21

    Habenular nuclei play a key role in the control of motor and cognitive behavior, processing emotion, motivation, and reward values in the brain. Thus, analysis of the molecular and cellular mechanisms underlying the development and evolution of this region will contribute to a better understanding of brain function. The Fgf8 gene is expressed in the dorsal midline of the diencephalon, close to the area in which the habenular region will develop. Given that Fgf8 is an important morphogenetic signal, we decided to investigate the role of Fgf8 signaling in diencephalic development. To this end, we analyzed the effects of altered Fgf8 expression in the mouse embryo, using molecular and cellular markers. Decreasing Fgf8 activity in the diencephalon was found to be associated with dosage-dependent alterations in the epithalamus: the habenular region and pineal gland are reduced or lacking in Fgf8 hypomorphic mice. Actually, our findings indicate that Fgf8 may be the master gene for these diencephalic domains, acting as an inductive and morphogenetic regulator. Therefore, the emergence of the habenular region in vertebrates could be understood in terms of a phylogenetic territorial addition caused by de novo expression of Fgf8 in the diencephalic alar plate. This region specializes to permit the development of adaptive control of the motor function in the vertebrate brain.

  13. Experimental infection of Didelphis marsupialis with vesicular stomatitis New Jersey virus.

    PubMed

    Trujillo, Carlos M; Rodriguez, Luis; Rodas, Juan D; Arboleda, John Jairo

    2010-01-01

    Although vesicular stomatitis has been present for many years in the Americas, many aspects of its natural history remain undefined. In this study, we challenged five adult Virginia opossums (Didelphis marsupialis) with vesicular stomatitis New Jersey serotype virus (VSNJV). Opossums had no detectable antibodies against VSNJV prior to being inoculated with 10(6.5) median tissue culture infective doses (TCID(50)) of VSNJV by two routes; intraepithelial/subepithelial (IE/SE) inoculation and scarification in the muzzle (SM). Clinical response was monitored daily and animals were tested for viral shedding. All infected animals developed vesicles and ulcers on the tongue and inflammation of the nasal alar folds. Virus was isolated from esophagus-pharynx, nasal, and from ocular swabs and lesions samples. The failure to detect viremia in these animals indicates that a source other than blood may be required for transmission to insect vectors. Our results suggest that D. marsupialis could play a role in the maintenance of VSNJV outside of domestic animal populations and could provide a model to study vesicular stomatitis virus pathogenesis.

  14. Morphogenesis of the medaka cerebellum, with special reference to the mesencephalic sheet, a structure homologous to the rostrolateral part of mammalian anterior medullary velum.

    PubMed

    Ishikawa, Yuji; Yamamoto, Naoyuki; Yasuda, Takako; Yoshimoto, Masami; Ito, Hironobu

    2010-01-01

    We have examined cerebellar morphogenesis after neural tube stage in medaka (Oryzias latipes), a ray-finned fish, by conventional histology and immunohistochemistry using anti-proliferating cell nuclear antigen (PCNA) and anti-acetylated tubulin antibodies. Our results indicate that the medaka cerebellum is formed in 4 successive stages: (1) formation and enlargement of the cerebellar primordia; (2) rostral midline fusion of the left/right halves of the cerebellar primordia; (3) formation of the cerebellar matrix zones in the midline and caudalmost regions of the primitive cerebellum, and (4) growth and differentiation of the cerebellum. Our results also show that cerebellar morphogenesis is different from that in mammals in 3 important points: the developmental origins of the primordia, directions along which cerebellar fusion proceeds, and number, locations and duration of the cerebellar matrix zones. During the course of this study, an alar-derived membranous structure between the cerebellum and the midbrain in the adult medaka brain was identified as the structure homologous to the rostrolateral part of the mammalian anterior medullary velum. We have named this structure in the adult teleostean brains as the 'mesencephalic sheet'. The present study indicates that there exists both conserved and divergent patterns in cerebellar morphogenesis in vertebrates.

  15. Lack of carcinogenicity of daminozide, alone or in combination with its contaminant 1,1-dimethylhydrazine, in a medium-term bioassay.

    PubMed

    Cabral, R; Hakoi, K; Hoshiya, T; Hasegawa, R; Ito, N

    The carcinogenicity of daminozide (succinic acid-2,2-dimethylhydrazide; Alar), a plant growth regulator used primarily in apple orchards, has been the subject of recent investigations by several national and international organizations because of contradictory study results. The aim of the present study was to assess the carcinogenicity of daminozide alone and in combination with 1,1-dimethylhydrazine (UDMH), its major contaminant, in a novel medium-term bioassay in Fischer 344 rats, the DEN-PH model. Rats were given diethylnitrosamine (DEN) at 200 mg/kg body weight intraperitoneally and then 2 weeks later were given daminozide at 20,000 ppm or daminozide plus UDMH at 75, 150, or 300 ppm in the diet for 6 weeks and were then killed; all rats underwent a partial (two-thirds) hepatectomy (PH) at week 3. Hepatocarcinogenic potential was assessed by comparing the number and area of preneoplastic foci positive for the glutathione S-transferase placental form (GST-P+) in the liver of treated rats, with those in controls given DEN alone. Daminozide, UDMH, and the combination were not carcinogenic in this model. This novel medium-term bioassay for carcinogenicity is considered to be practical for the rapid evaluation of both agrochemical formulations and contaminants found in agrochemicals and other compounds.

  16. Three-dimensional facial analysis of Chinese children with repaired unilateral cleft lip and palate

    PubMed Central

    Othman, Siti Adibah; Aidil Koay, Noor Airin

    2016-01-01

    We analyzed the facial features of Chinese children with repaired unilateral cleft lip and palate (UCLP) and compared them with a normal control group using a three-dimensional (3D) stereophotogrammetry camera. This cross-sectional study examined 3D measurements of the facial surfaces of 20 Chinese children with repaired UCLP and 40 unaffected Chinese children aged 7 to 12 years old, which were captured using the VECTRA 3D five-pod photosystem and analyzed using Mirror software. Twenty-five variables and two ratios were compared between both groups using independent t-test. Intra- and inter-observer reliability was determined using ten randomly selected images and analyzed using intra-class correlation coefficient test (ICC). The level of significance was set at p < 0.0018. Intra- and inter-observers’ reliability was considered fair to excellent with an ICC value ranging from 0.54 to 0.99. Statistically significant differences (p < 0.0018) were found mainly in the nasolabial region. The cleft group exhibited wider alar base root width, flattened nose and broader nostril floor width on the cleft side. They tended to have shorter upper lip length and thinner upper vermillion thickness. Faces of Chinese children with repaired UCLP displayed meaningful differences when compared to the normal group especially in the nasolabial regions. PMID:27507713

  17. [Therapeutic possibilities in refractory epilepsy in tuberous sclerosis complex].

    PubMed

    Puertas-Martin, Verónica; Carreras-Saez, Inmaculada; Marana, Ana; Ruiz-Falco Rojas, M Luz; Cantarin-Extremera, Verónica; Calleja-Gero, M Lourdes

    2014-06-16

    Introduccion. El complejo esclerosis tuberosa (CET) cursa frecuentemente con epilepsia de dificil control, lo que condiciona la calidad de vida y el nivel cognitivo de estos pacientes. Objetivo. Describir las caracteristicas epidemiologicas, clinicas y el tratamiento de los pacientes afectos de CET con epilepsia. Pacientes y metodos. Se han revisado retrospectivamente las historias clinicas de 30 pacientes menores de 18 años, diagnosticados de CET y epilepsia registrados en nuestra base de datos. Resultados. La edad de inicio de la epilepsia en los pacientes con CET en nuestra serie esta comprendida entre el primer mes de vida y los 4 años. Todos comenzaron con crisis parciales. Dos presentaron sindrome de West y cuatro, espasmos infantiles sin hipsarritmia. En 19 de los pacientes, la epilepsia se comporto como farmacorresistente. Respecto al tratamiento con farmacos antiepilepticos, 11 estan en monoterapia, 10 en biterapia, siete en triterapia y uno con cuatro farmacos. Dos recibieron ACTH, dos tienen implantado un estimulador del nervio vago, cuatro reciben tratamiento con everolimus y ocho han sido sometidos a cirugia. Conclusiones. La epilepsia es un problema muy frecuente y de inicio en los primeros años de vida en el CET. Las opciones terapeuticas actuales son muchas, sin embargo el 63,3% de los pacientes tiene una epilepsia no controlada y la mayoria de ellos presenta crisis diarias. El mal control de las crisis se correlaciona con retraso mental y trastorno del espectro autista. Señalar la respuesta positiva obtenida con otras posibilidades terapeuticas: inhibidores de la via mTOR, cirugia y el estimulador del nervio vago.

  18. Teorii spiral'noj struktury galaktik v 1969-e gody. II %t Theories of spiral structures of galaxies in the 1960s. Paper II

    NASA Astrophysics Data System (ADS)

    Pasha, I. I.

    The present paper continues the author's study of the galactic spiral density-wave developments in the 1960s. The first section considers the theory of sheared density waves that was worked out in 1963-1965 by Donald Lynden-Bell, Peter Goldreich, Alar Toomre and William Julian. This theory displayed the fundamental property of differentially rotating gravitating systems to strongly amplify the sheared waves as they pass near-radial orientations swinging from leading to trailing, and it also showed how the localised material condensations induce and fix rather extended spiral-like steady waves with the help of this amplifier. The second section analyses efforts applied in the second half of the 1960s to support the then already wide-spread spiral theory of C. C. Lin and Frank Shu. Reviewed here are Shu's works aimed at improving the theory's analytical principles; William Roberts' elaboration of the concept of galactic shocks triggering the star-formation process in the spiral arms; and the early attempts of Lin and his colleagues to compare their theory with empirical evidence. The third section is devoted to Toomre's work, who was the first to analyse the group properties of the Lin-Shu waves and show that in the course of their natural evolution they do not have enough time to make up any coherent spiral mode since they drift rather rapidly towards the galactic centre and damp there. This result logically debunked the Lin-Shu picture of "self-sustained" spiral waves and stripped the as-yet latent problem of the mechanism for maintaining the spiral structure. The last section exposes several authors' results from the late 1960s - early 1970s.

  19. Teorii spiral'noj struktury galaktik v 1960-e gody. I %t Density-wave theories in the 1960s. Paper I

    NASA Astrophysics Data System (ADS)

    Pasha, I. I.

    The late 1950s - early 1960s were a period when the winds of change blew over the entire field of the galactic dynamics. With the arrival of computers, plasma physics and several fresh investigators, understanding the spiral structure of galaxies entered a new stage of unusually vigorous activity, broadly grouped under "density-wave theory". The present paper I starts with acknowledging Bertil Lindblad, rightly regarded the main father of this whole subject, and then describes the early contributions by Donald Lynden-Bell (1960), Alar Toomre (1963-64), Christoper Hunter (1963-65) and Agris Kalnajs (1962-65), who had formulated and applied such notions as the stability of flat galaxies, the regenerative spiral phenomenon, the shearing density waves and the global spiral modes. But the foremost enthusiast and proponent of the density-wave picture was undoubtedly C. C. Lin whose 1964 and 1966 papers with Frank Shu, written in support of his working hypothesis of the quasi-stationary wave-mode spiral structure, had a big and immediate impact upon astronomers, at least as a welcome sign that genuine understanding of the spiral phenomenon seemed in some sense to be just around the corner. The original Lin-Shu theory is described in a separate chapter of the present paper. The forthcoming Paper II will show how and why it had become clear to anyone by the late 1960s that much hard work still remained to explain even the persistence, much less the dynamical origins, of the variety of spirals that we observe.

  20. Attributes of turbulence over the Arctic Ocean with partial ice cover near Barrow, Alaska during spring 2012

    NASA Astrophysics Data System (ADS)

    Fuentes, J. D.; Chamecki, M.; Bou-Zeid, E.; Stirm, B.; Caulton, D.; Cambaliza, M. L.; Shepson, P.

    2012-12-01

    Melting of the permanent ice is engendering myriad changes in the Arctic lower atmosphere. The seasonal formation and melting of the ice can produce heterogeneous surfaces with a mix of fresh ice, leads, and polynyas observed in late winter and early spring. Changes in the sea ice coverage can accelerate the exchanges of gases, particulate matter, and energy between the ocean surface and the atmosphere. As part of the BRomine, Ozone, and Mercury EXperiment (BROMEX) field campaign near Barrow, Alaska during March 2012, airborne air turbulence measurements were made using Purdue's Airborne Laboratory for Atmospheric Research (ALAR) equipped with a calibrated Best Air Turbulence Probe along several transects and as a function of altitude over the Arctic Ocean, and the frozen tundra along Alaska's North Slope. We will address two research objectives using the air turbulence measurements made over tundra snowpack, ice surfaces and leads. First, results will be presented to demonstrate how atmospheric instability and turbulence intermittency vary over the Arctic Ocean as a function of the nature of the surface. The variability of turbulence parameters (e.g., turbulent kinetic energy, isotropy, etc.), within and above the Arctic stable boundary layer, extending from 10 m (during low approaches) to about 3,500 m above the surface, will be presented and discussed. Second, results from ensembles of turbulence intermittent bursts are used to investigate whether similarity gradient-diffusion approaches can be reliably employed to determine mass and energy exchanges between the Arctic Ocean and the atmosphere. We also investigate the effects of the spatial temperature contrasts and scales of leads associated with the energy exchanges determined with the eddy covariance onboard the aircraft.

  1. Spectroscopy of Reactive Molecules and Clusters

    NASA Astrophysics Data System (ADS)

    Johnson, Matthew Stanley

    This thesis presents spectroscopic investigations of reactive molecules and clusters. The techniques of laser excited fluorescence, infrared predissociation spectroscopy, and photoelectron spectroscopy were employed to investigate systems relating to fundamental cluster chemistry, ion solvation, and atmospheric ozone depletion. An instrument was developed to investigate van der Waals complexes of refractory elements. A pulsed laser ablation cluster source harnessed the cooling power of a supersonic free jet to condense weakly bound neutral clusters. Laser excited fluorescence was used to characterize the products of the source, which included adducts of aluminum atoms with water molecules, hydrogen, and argon. The species Al(H_2O), AlAr and AlH were identified. The infrared predissociation spectra of positive and negative cluster ions were investigated using a tandem time-of-flight instrument. In this work the photofragment yield spectrum of mass-selected I^-(H _2O) and I^-(H _2O)_2 complexes was measured between 3170 and 3800 cm^{ -1}. The dominant features in the I ^-(H_2O) spectra were assigned as a hydrogen bonded OH stretch and a free OH stretch. Ab initio calculations were used to aid in spectral assignment and for geometrical information concerning I ^-(H_2O). Absorptions in the iodide water dimer cluster are attributed to a symmetric and an antisymmetric bonded OH stretch, and a free OH stretch. Chlorine nitrate is a key reservoir of stratospheric chlorine, and as such its photolysis branching ratio is crucial to partitioning of species involved with stratospheric ozone depletion. The He(I) photoelectron spectrum of chlorine nitrate was measured and assigned in order to understand the photodissociation behavior of chlorine nitrate. The results include the ionization potential of the molecule (10.86 eV), and the assignment of the first ionization peak to a nonbonding chlorine atomic orbital.

  2. Estimating Emissions Fluxes of Carbon Dioxide and Methane from Indianapolis Using an Aircraft Trace Gas and Wind Measurement Platform

    NASA Astrophysics Data System (ADS)

    Ross, K. L.; Shepson, P.; Stirm, B.; Sweeney, C.; Karion, A.; Gurney, K.

    2008-12-01

    The quantification of local to regional scale greenhouse gas emissions requires high resolution and high precision measurements. These measurements can then be examined to better describe the underlying societal drivers. In the early spring of 2008, carbon dioxide (CO2) and methane (CH4) measurements were conducted using Purdue University's Airborne Laboratory for Atmospheric Research (ALAR), a Beechcraft Duchess light aircraft, around the city of Indianapolis, Indiana. A Picarro ESP-1000 cavity ring-down CO2/CH4 spectrometer measured atmospheric trace gas concentrations with a frequency of .2 Hz. Flask samples were also obtained at various points during flight for comparison with measurements from the Picarro. Coupled with high resolution (50 Hz) turbulence and wind measurements, these trace gas measurements allow for flux estimates as well as boundary layer trace gas concentration variability estimates to be calculated for the city. By flying horizontal transects upwind and downwind of the city at several altitude levels both within and above the boundary layer, the emissions flux estimate can be calculated as the difference between the gas concentration flowing out of the city and the gas concentration flowing into the city, accounting for entrainment flux at the top of the boundary layer. Analysis involves a kriging method applied to interpolate the measured values to a two dimensional vertical plane traced out by the flight pattern. In addition, vertical profiles measured at various locations around the city allow for estimates of the variability of both CO2 and CH4 concentrations as well as the uncertainty of the mean concentrations in the mixed layer. Results show that the urban plume and associated point sources are clearly distinguishable in the downwind trace gas concentration data. We will discuss comparison of the calculated fluxes with those from available emissions inventories.

  3. Aerosol Production from the Great Lakes Surface

    NASA Astrophysics Data System (ADS)

    Slade, J. H.; Mwaniki, G.; Bertman, S. B.; Vanreken, T. M.; Shepson, P. B.

    2009-12-01

    It is well understood that oceans generate airborne particulate matter from mechanical processes such as sea spray and bubble bursting. These particles are primarily composed of salts and other nonvolatile inorganic material; however, the organic mass fraction can vary by location and the extent of biological activity. The size distributions of aerosols in these environments depend greatly on relative humidity with diameters ranging from typically several hundred nanometers to several micrometers. There has been much less discussion of particle formation from fresh water ecosystems, a hub for organic activity, and thus a more likely medium for organic aerosol production. We investigated particle formation over the Great Lakes during the summer of 2009 as a part of the Community Atmosphere-Biosphere Interactions Experiments (CABINEX) at the University of Michigan Biological Station (UMBS) in Pellston, MI. With a scanning mobility particle sizer (SMPS) aboard Purdue University’s Airborne Laboratory for Atmospheric Research (ALAR) for size-distribution analysis of accumulation-mode aerosol, we conducted vertical profiles above Lake Michigan and the UMBS deciduous forest, and transects across the peninsula between Lakes Michigan and Huron to study particle formation, transport, and deposition. Preliminary results reveal a well-mixed troposphere above the forest with a mode ~0.1 μm, while in several cases, the total particle concentration over Lake Michigan is an order of magnitude greater than over the forest. There is a consistent bimodal distribution of particle sizes over Lake Michigan the lowest of which is centered at ~0.025 μm, suggesting the possibility of new particle formation. This mode is consistent with the presence of breaking waves on the lake’s surface, and this mode and the vertical structure depend greatly on wind speed. We present here evidence for new particle production from breaking waves on fresh water lakes, and discuss the results

  4. Anatomical and Biomechanical Analyses of the Unique and Consistent Locations of Sacral Insufficiency Fractures

    PubMed Central

    Linstrom, Nathan J.; Heiserman, Joseph E.; Kortman, Keith E.; Crawford, Neil R.; Baek, Seungwon; Anderson, Russell L.; Pitt, Alan M.; Karis, John; Ross, Jeff S.; Lekovic, Gregory P.; Dean, Bruce L.

    2009-01-01

    Study Design Correlation of locations of sacral insufficiency fractures are made to regions of stress depicted by finite element analysis derived from biomechanical models of patient activities. Objective Sacral insufficiency fractures occur at consistent locations. It was postulated that sacral anatomy and sites of stress within the sacrum with routine activities in the setting of osteoporosis are foundations for determining patterns for the majority of sacral insufficiency fractures. Summary of Background Data The predominant vertical components of sacral insufficiency fractures most frequently occur bilaterally through the alar regions of the sacrum which are the thickest and most robust appearing portions of the sacrum instead of subjacent to the central sacrum which bears the downward force of the spine. Methods First, the exact locations of 108 cases of sacral insufficiency fractures were catalogued and compared to sacral anatomy. Second, different routine activities were simulated by pelvic models from CT scans of the pelvis and finite element analysis. Analyses were done to correlate sites of stress with activities within the sacrum and pelvis compared to patterns of sacral insufficiency fractures from 108 cases. Results The sites of stress depicted by the finite element analysis walking model strongly correlated with identical locations for most sacral and pelvic insufficiency fractures. Consistent patterns of sacral insufficiency fractures emerged from the 108 cases and a biomechanical classification system is introduced. Additionally, alteration of walking mechanics and asymmetric sacral stress may alter the pattern of sacral insufficiency fractures noted with hip pathology (p=.002). Conclusions Locations of sacral insufficiency fractures are nearly congruous with stress depicted by walking biomechanical models. Knowledge of stress locations with activities, cortical bone transmission of stress, usual fracture patterns, intensity of sacral stress with

  5. Surgical management of the distorted caudal septum.

    PubMed

    Palma, Pietro; Khodaei, Iman

    2014-02-01

    This article reviews the current trends in the surgical approach to the caudal septum, and its importance in rhinoplasty. The evolution of rhinoplasty techniques over the past half century has changed the emphasis from excessive cartilage resection, and a plethora of grafts and sutures, to a more conservative approach that seeks to maintain the function of the nose and create a naturally beautiful, 'not-operated' look. New anatomical studies continue to shed light on the importance of soft-tissue support, and the mechanical properties of the caudal septum. When applied to surgical techniques, these new findings emphasize the principles of adequate preoperative history and examination, nasendoscopy, and facial analysis. On the basis of these clinical findings, a unique, tailor-made rhinoplasty game plan can be created for each patient that should not be used for another operation. Several techniques have emerged from the natural evolution of rhinoplasty that produce controlled, reversible effects in a predictable, stepwise manner. The caudal septum plays a key role in nasal airflow, provides support for the nasal tip, and affects the alar-columellar relationship. Deviation at the caudal septum creates some of the commonest problems in aesthetic rhinoplasty.Through new anatomical knowledge and advances in rhinoplasty techniques, the vast majority of these problems can be approached through an endonasal/hybrid rhinoplasty approach. Hybrid rhinoplasty refers to a distillation of best of both worlds of external and endonasal surgery over the past 40 years.The key to a successful outcome relies on adequate clinical examination, nasendoscopy, detailed surgical facial analysis, and a well planned surgical game plan. SDC 1 (http://links.lww.com/COOH/A9).

  6. Use of platelet-rich plasma solution applied with composite chondrocutaneous graft technique: an experimental study in rabbit model.

    PubMed

    Sevim, Kamuran Zeynep; Yazar, Memet; Irmak, Fatih; Tekkeşin, Merva Soluk; Yildiz, Kemalettin; Sirvan, Selami Serhat

    2014-07-01

    Composite chondrocutaneous grafts have been used widely for patients with cleft lip nasal deformity, alar defects, and septal perforations; however, the graft viability can be easily compromised. The aim of the present study was to extend the safe length of the composite chondrocutaneous grafts by enhancement of angiogenesis and re-epithelialization through platelet-rich plasma (PRP) and to investigate the changes that occur when PRP is administered to the graft and the recipient site. Composite grafts of critical sizes (1.5, 2.0, and 2.5 cm) were planned on the rabbit ears on 1 side. Group A consisted of grafts pretreated with PRP, group B consisted of recipient beds pretreated with PRP, and group C was the control group in which defects 1.5, 2.0, and 2.5 cm in size were formed on the right ears of the rabbits. On postoperative day 7, matching size chondrocutaneous grafts were adapted to the defect areas without PRP. In all groups, graft viability was evaluated 7 days after graft adaptation in group C and 14 days after PRP administration in groups A and B. Wound healing was scored histopathologically and immunohistologically using hematoxylin and eosin, CD34, and smooth muscle actin staining. The terminal transferase fluorescein-dUTP nick end labeling assay was performed to quantitatively demonstrate the apoptosis ratio among the groups. In groups A, B, and C, the mean graft survival of the 2.0-cm equilateral triangle-shaped composite grafts was 65.43% ± 15.7%, 78.12% ± 12.8%, and 41.31% ± 37.4%, respectively (P = .0364). PRP pretreatment accelerated composite graft survival in the 2.0-cm equilateral triangle grafts by increasing epithelial regeneration and fibrosis, inducing neovascularization, and ameliorating apoptosis rates. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Disparidad en Salud: Un Fenómeno Multidimensional

    PubMed Central

    Urrutia, Maria-Teresa; Cianelli, Rosina

    2012-01-01

    La Disparidad en Salud (DS) ha llamado la atención pública desde el siglo pasado, ha sido analizada desde diversas perspectivas y enfoques incluso variados términos han sido utilizados como sinónimos pudiendo llevar a confusión e inequidades al momento de su operacionalización. Sin embargo es importante señalar que las publicaciones coinciden en que la DS es uno de las determinantes esenciales a considerar al momento de definir polĺticas públicas. El propósito de esta publicación es analizar la disparidad en salud incorporando; a) los aspectos claves de su conceptualización, b) la evolución histórica del concepto, c) las estrategias que se han generado para enfrentarla, d) los factores considerados determinantes, y e) los aspectos éticos y la contribución de la investigación en la disminución de la DS. Health Disparities (HD) have been at the center of public attention for the past century. They have been analyzed from diverse perspectives utilizing various terms as synonyms that can lead to confusion and inequality at the moment of operationalization. Despite this, it is important to indicate that publications agree that HD are essential determinants that must be considered in the definition of public policy. The objective of this publication is to analyze health disparities incorporating; (a) key aspects in their conceptualization, (b) the historic evolution of the concept, (c) strategies that have been generated to confront them, (d) determining factors, and (e) ethical aspects and the contribution of research in decreasing HD. PMID:22581053

  8. Introducing a Favourite Tip Definition and Projection with Tripod Suture in Rhinoplasty

    PubMed Central

    Motamed, Sadrollah; Niazi, Feizollah; Moosavizadeh, Seyed Mehdi; Motaghedi, Babak; Tizmaghz, Adnan

    2017-01-01

    Introduction Surgical manipulation of the lower lateral cartilages of nasal tip could cause subtle but significant responses to the manipulation. The suture-techniques almost always offer a reliable and dramatic method of tip reshaping without a need to break or interrupt the alar rim strip or even adding tip graft. Aim The aim of this study was to describe and assess outcomes of a new suture technique in rhinoplasty by using cephalic dome septal rotation suture for better tip definition. Materials and Methods All consecutive women (62 women) who attended our centre with nasal tip drooping and some degree of columellar retraction, underwent this technique from January 2005 to September 2009. Their ages ranged from 17 to 32 years old. Fifty one primary open and 11 secondary open rhinoplasties were performed using the conventional techniques and then the new suture technique was applied before closing the incisions on each patient. Results The patients were followed-up from 22 to 72 months (mean = 52.3). The projection and rotation was satisfactory in all patients and the final results persisted with only minimal changes over time. Conclusion It is important to say that this new suture is different from ‘tip rotation suture’ that was described by Tebbets. Our suture maintains the favorite tip definition with slight dorsal tip inclination. Indeed, it causes a two-point definition as the columellar lobular angle and the supra tip break definition. In addition, long-term follow-up has shown that this new suture (i.e., cephalic dome-septal rotation suture) is able to maintain optimal position of the nasal tip projection and definition. PMID:28273999

  9. Comparison of effects of spreader grafts and flaring sutures on nasal airway resistance in rhinoplasty.

    PubMed

    Jalali, Mir Mohammad

    2015-09-01

    Cephalic resection of the lateral crura of the alar cartilages, lateral osteotomies, and removal of the nasal hump during rhinoplasty may cause collapse of the internal nasal valve angle. This study was performed to compare preventive effects of two techniques (spreader grafts and flaring sutures) on rhinoplasty by rhinomanometry. Two hundred and forty-eight patients participated in this semi-experimental study. The patients were assigned into two groups. 28 of them were not available for follow-up. All patients had a straight nose in the midline and no severe septal deviations. 87 of 220 patients underwent the spreader grafts technique and the flaring sutures technique was performed in 133 patients. The nasal airway resistance was calculated by active anterior rhinomanometry on admission to hospital and again between 3 and 6 months following surgery. The mean of follow-up was 20.9 ± 2.9 weeks. After rhinoplasty, nasal airway resistance decreased in 46 patients (52.9 percent) of spreader grafts group and in 84 patients (63.2 percent) of flaring sutures group. The median nasal airway resistance difference (before-after surgery) of spreader grafts and flaring sutures groups was 0.027 Pa/ml/s (range -110 to 130) and 0.017 Pa/ml/s (range -0.690 to 0.790), respectively. The difference of nasal airway resistance between before and after rhinoplasty in two groups was insignificance (Mann-Whitney U test, P = 0.5). The spreader grafts and flaring sutures move the dorsal border of the upper lateral cartilage in a lateral direction and had similar preventive effect on nasal airway resistance after rhinoplasty.

  10. [Prevalence of undernutrition in hospital patients with unbalanced heart failure; subjective global assessment like prognosis sign].

    PubMed

    Guerra-Sánchez, Luis; Martinez-Rincón, Carmen; Fresno-Flores, Mar

    2015-04-01

    Introducción: Existe una gran variabilidad en los estudios sobre la prevalencia de malnutrición en pacientes con insuficiencia cardiaca crónica. La proporción de pacientes desnutridos depende del método de valoración utilizado y del momento en que se realice. Se ha descrito la relación entre desnutrición y aumento de las complicaciones, de la estancia hospitalaria, de la mortalidad y de reingreso hospitalario. Por lo que merece la pena señalar y tratar a estos pacientes. Objetivos: El objetivo fue aproximarnos a la prevalencia de la desnutrición, en los pacientes con insuficiencia cardiaca crónica ingresados por descompensación, en nuestro medio y analizar cuál de los dos métodos de valoración nutricional utilizados, era mejor predictor de mortalidad. Métodos: Estudio observacional, transversal, en el que se evaluaron mediante la Valoración Subjetiva Global y Mini Nutritional Assesment , el estado nutricional de 377 pacientes ingresados en un hospital terciario de alta complejidad con diagnósticos compatibles con descompensación de insuficiencia cardiaca crónica. Resultados: La edad media fue de 75±10. El 51,5%(n=194) fueron hombres. Según la Valoración Subjetiva Global, el 50,7% (45,6%-55,7%) estaban normonutridos, el 41,9% (37,0%-46,9%) presentaban riesgo o sospecha de desnutrición y el 7,4% (5,2%-10,5%) presentaban desnutrición franca. Conclusiones: La prevalencia de desnutrición de los pacientes hospitalizados por descompensación de Insuficiencia Cardiaca crónica en nuestro ámbito es alta. La Valoración Subjetiva Global es un buen predictor de la mortalidad.

  11. Analysis of 3D soft tissue changes after 1- and 2-jaw orthognathic surgery in mandibular prognathism patients.

    PubMed

    Kim, Bo-Ram; Oh, Kyung-Min; Cevidanes, Lucia H S; Park, Jeong-Eon; Sim, Hyoung-Seob; Seo, Sung-Kyung; Reyes, Mauricio; Kim, Yoon-Ji; Park, Yang-Ho

    2013-01-01

    Orthognathic surgery has the objective of altering facial balance to achieve esthetic results in patients who have severe disharmony of the jaws. The purpose was to quantify the soft tissue changes after orthognathic surgery, as well as to assess the differences in 3D soft tissue changes in the middle and lower third of the face between the 1- and 2-jaw surgery groups, in mandibular prognathism patients. We assessed soft tissue changes of patients who have been diagnosed with mandibular prognathism and received either isolated mandibular surgery or bimaxillary surgery. The quantitative surface displacement was assessed by superimposing preoperative and postoperative volumetric images. An observer measured a surface-distance value that is shown as a contour line. Differences between the groups were determined by the Mann-Whitney U test. The Spearman correlation coefficient was used to evaluate a potential correlation between patients' surgical and cephalometric variables and soft tissue changes after orthognathic surgery in each group. There were significant differences in the middle third of the face between the 1- and 2-jaw surgery groups. Soft tissues in the lower third of the face changed in both surgery groups, but not significantly. The correlation patterns were more evident in the lower third of the face. The overall soft tissue changes of the midfacial area were more evident in the 2-jaw surgery group. In 2-jaw surgery, significant changes would be expected in the midfacial area, but caution should be exercised in patients who have a wide alar base. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  12. Disparidad en Salud: Un Fenómeno Multidimensional.

    PubMed

    Urrutia, Maria-Teresa; Cianelli, Rosina

    2010-03-01

    La Disparidad en Salud (DS) ha llamado la atención pública desde el siglo pasado, ha sido analizada desde diversas perspectivas y enfoques incluso variados términos han sido utilizados como sinónimos pudiendo llevar a confusión e inequidades al momento de su operacionalización. Sin embargo es importante señalar que las publicaciones coinciden en que la DS es uno de las determinantes esenciales a considerar al momento de definir polĺticas públicas. El propósito de esta publicación es analizar la disparidad en salud incorporando; a) los aspectos claves de su conceptualización, b) la evolución histórica del concepto, c) las estrategias que se han generado para enfrentarla, d) los factores considerados determinantes, y e) los aspectos éticos y la contribución de la investigación en la disminución de la DS.Health Disparities (HD) have been at the center of public attention for the past century. They have been analyzed from diverse perspectives utilizing various terms as synonyms that can lead to confusion and inequality at the moment of operationalization. Despite this, it is important to indicate that publications agree that HD are essential determinants that must be considered in the definition of public policy. The objective of this publication is to analyze health disparities incorporating; (a) key aspects in their conceptualization, (b) the historic evolution of the concept, (c) strategies that have been generated to confront them, (d) determining factors, and (e) ethical aspects and the contribution of research in decreasing HD.

  13. Structural Insights into the Polyphyletic Origins of Glycyl tRNA Synthetases.

    PubMed

    Valencia-Sánchez, Marco Igor; Rodríguez-Hernández, Annia; Ferreira, Ruben; Santamaría-Suárez, Hugo Aníbal; Arciniega, Marcelino; Dock-Bregeon, Anne-Catherine; Moras, Dino; Beinsteiner, Brice; Mertens, Haydyn; Svergun, Dmitri; Brieba, Luis G; Grøtli, Morten; Torres-Larios, Alfredo

    2016-07-08

    Glycyl tRNA synthetase (GlyRS) provides a unique case among class II aminoacyl tRNA synthetases, with two clearly widespread types of enzymes: a dimeric (α2) species present in some bacteria, archaea, and eukaryotes; and a heterotetrameric form (α2β2) present in most bacteria. Although the differences between both types of GlyRS at the anticodon binding domain level are evident, the extent and implications of the variations in the catalytic domain have not been described, and it is unclear whether the mechanism of amino acid recognition is also dissimilar. Here, we show that the α-subunit of the α2β2 GlyRS from the bacterium Aquifex aeolicus is able to perform the first step of the aminoacylation reaction, which involves the activation of the amino acid with ATP. The crystal structure of the α-subunit in the complex with an analog of glycyl adenylate at 2.8 Å resolution presents a conformational arrangement that properly positions the cognate amino acid. This work shows that glycine is recognized by a subset of different residues in the two types of GlyRS. A structural and sequence analysis of class II catalytic domains shows that bacterial GlyRS is closely related to alanyl tRNA synthetase, which led us to define a new subclassification of these ancient enzymes and to propose an evolutionary path of α2β2 GlyRS, convergent with α2 GlyRS and divergent from AlaRS, thus providing a possible explanation for the puzzling existence of two proteins sharing the same fold and function but not a common ancestor.

  14. Structural Insights into the Polyphyletic Origins of Glycyl tRNA Synthetases*♦

    PubMed Central

    Valencia-Sánchez, Marco Igor; Rodríguez-Hernández, Annia; Ferreira, Ruben; Santamaría-Suárez, Hugo Aníbal; Arciniega, Marcelino; Dock-Bregeon, Anne-Catherine; Moras, Dino; Beinsteiner, Brice; Brieba, Luis G.; Grøtli, Morten

    2016-01-01

    Glycyl tRNA synthetase (GlyRS) provides a unique case among class II aminoacyl tRNA synthetases, with two clearly widespread types of enzymes: a dimeric (α2) species present in some bacteria, archaea, and eukaryotes; and a heterotetrameric form (α2β2) present in most bacteria. Although the differences between both types of GlyRS at the anticodon binding domain level are evident, the extent and implications of the variations in the catalytic domain have not been described, and it is unclear whether the mechanism of amino acid recognition is also dissimilar. Here, we show that the α-subunit of the α2β2 GlyRS from the bacterium Aquifex aeolicus is able to perform the first step of the aminoacylation reaction, which involves the activation of the amino acid with ATP. The crystal structure of the α-subunit in the complex with an analog of glycyl adenylate at 2.8 Å resolution presents a conformational arrangement that properly positions the cognate amino acid. This work shows that glycine is recognized by a subset of different residues in the two types of GlyRS. A structural and sequence analysis of class II catalytic domains shows that bacterial GlyRS is closely related to alanyl tRNA synthetase, which led us to define a new subclassification of these ancient enzymes and to propose an evolutionary path of α2β2 GlyRS, convergent with α2 GlyRS and divergent from AlaRS, thus providing a possible explanation for the puzzling existence of two proteins sharing the same fold and function but not a common ancestor. PMID:27226617

  15. Clinical assessment techniques for detecting ligament and membrane injuries in the upper cervical spine region--a comparison with MRI results.

    PubMed

    Kaale, Bertel Rune; Krakenes, Jostein; Albrektsen, Grethe; Wester, Knut

    2008-10-01

    In this study we examined whether results from a clinical test of passive mobility of soft tissue structures in the upper cervical spine, corresponded with signs of physical injuries, as judged by magnetic resonance imaging (MRI). Results were based on examinations of 122 study participants, 92 with and 30 without a diagnosis of whiplash-associated disorder, type 2. The structures considered were the alar and the transverse ligaments, and the tectorial and the posterior atlanto-occipital membranes. Ordinary and weighted kappa coefficients were used as a measure of agreement, whereas McNemar's test was used for evaluating differences in rating. The clinical classification and the MRI examination both comprised four response categories (grades 0-3), with 0 representing a normal structure, and 3 indicating a structure with pronounced abnormality. In our sample, an abnormal clinical test reflected a hyper- rather than hypo-mobility. Considering all four-response categories, the kappa coefficient indicated moderate agreement (range 0.45-0.60) between the clinical and the MRI classification. The results for the membranes appeared somewhat better than for the ligaments. When there was disagreement, the classifications obtained by the clinical test were significantly lower than the MRI grading, but mainly within one grade difference. When combining grade 0-1 (normal) and 2-3 (abnormal), the agreement improved considerably (range 0.70-0.90). Although results from the clinical test seem to be slightly more conservative than the MRI assessment, we believe that a clinical test can serve as valuable clinical tool in the assessment of WAD patients. However, further validity- and reliability studies are needed.

  16. Characterization of the hypothalamus of Xenopus laevis during development. II. The basal regions.

    PubMed

    Domínguez, Laura; González, Agustín; Moreno, Nerea

    2014-04-01

    The expression patterns of conserved developmental regulatory transcription factors and neuronal markers were analyzed in the basal hypothalamus of Xenopus laevis throughout development by means of combined immunohistochemical and in situ hybridization techniques. The connectivity of the main subdivisions was investigated by in vitro tracing techniques with dextran amines. The basal hypothalamic region is topologically rostral to the basal diencephalon and is composed of the tuberal (rostral) and mammillary (caudal) subdivisions, according to the prosomeric model. It is dorsally bounded by the optic chiasm and the alar hypothalamus, and caudally by the diencephalic prosomere p3. The tuberal hypothalamus is defined by the expression of Nkx2.1, xShh, and Isl1, and rostral and caudal portions can be distinguished by the distinct expression of Otp rostrally and Nkx2.2 caudally. In the mammillary region the xShh/Nkx2.1 combination defined the rostral mammillary area, expressing Nkx2.1, and the caudal retromammillary area, expressing xShh. The expression of xLhx1, xDll4, and Otp in the mammillary area and Isl1 in the tuberal region highlights the boundary between the two basal hypothalamic territories. Both regions are strongly connected with subpallial regions, especially those conveying olfactory/vomeronasal information, and also possess abundant intrahypothalamic connections. They show reciprocal connections with the diencephalon (mainly the thalamus), project to the midbrain tectum, and are bidirectionally related to the rhombencephalon. These results illustrate that the basal hypothalamus of anurans shares many features of specification, regionalization, and hodology with amniotes, reinforcing the idea of a basic bauplan in the organization of this prosencephalic region in all tetrapods.

  17. Analysis of nasal and labial deformities in cleft lip, alveolus and palate patients by a new rating scale: preliminary report.

    PubMed

    Anastassov, Y; Chipkov, C

    2003-10-01

    In this study the nasal deformities in patients with cleft lip, alveolus and palate (CLAP) were analysed and the relevant role of the perinasal-perioral muscular balance, and the inborn dislocation of the alar cartilages is presented. 50 CLAP patients were analysed in whom 29 primary cheiloplasties, 12 lip revisions and 9 rhinoplasties were performed. The lip repair was done by a modification of Millard's technique, the nose by either a closed or open-sky rhinoplasty. The severity of the cleft appearance was evaluated pre- and postoperatively, according to a pre-agreed visual rating scale. There were 4 degrees of severity of the deformity preoperatively (mild, moderate, severe and very severe), and postoperatively 5 categories of outcome (excellent, very good, good, satisfactory and poor) depending on the scores obtained by summing up the points corresponding to different types of deformity. This scale is closely related to the American Cleft Palate classification of clefts. 17 excellent, 4 very good, 2 good, 5 satisfactory and 1 poor result were obtained in the group of primary cheiloplasty. Eight excellent, 4 very good results were obtained by the lip revisions. Seven excellent and 2 satisfactory results were obtained following rhinoplasty. During the primary lip repair, it is important to correct the abnormal position of ala nasi, the nasal floor and the base of the columella. When correct insertion of m. transversus nasi to the nasal spine is achieved and a good repair of m. orbicularis oris, symmetry of the alae and normal growth of lip and columella was obtained even in most severe bilateral cases. In cases of diastasis of the orbicularis and transversus nasi muscles, in combination with other soft tissue deformities or scars, a secondary musculo-periosteal revision is recommended. The defect of the soft tissue triangle of the nose is best corrected via an open rhinoplasty.

  18. Evaluation of Toxic Metals and Essential Elements in Children with Learning Disabilities from a Rural Area of Southern Brazil

    PubMed Central

    do Nascimento, Sabrina Nunes; Charão, Mariele Feiffer; Moro, Angela Maria; Roehrs, Miguel; Paniz, Clovis; Baierle, Marília; Brucker, Natália; Gioda, Adriana; Barbosa, Fernando; Bohrer, Denise; Ávila, Daiana Silva; Garcia, Solange Cristina

    2014-01-01

    Children’s exposure to metals can result in adverse effects such as cognitive function impairments. This study aimed to evaluate some toxic metals and levels of essential trace elements in blood, hair, and drinking water in children from a rural area of Southern Brazil. Cognitive ability and δ-aminolevulinate dehydratase (ALA-D) activity were evaluated. Oxidative stress was evaluated as a main mechanism of metal toxicity, through the quantification of malondialdehyde (MDA) levels. This study included 20 children from a rural area and 20 children from an urban area. Our findings demonstrated increase in blood lead (Pb) levels (BLLs). Also, increased levels of nickel (Ni) in blood and increase of aluminum (Al) levels in hair and drinking water in rural children were found. Deficiency in selenium (Se) levels was observed in rural children as well. Rural children with visual-motor immaturity presented Pb levels in hair significantly increased in relation to rural children without visual-motor immaturity (p < 0.05). Negative correlations between BLLs and ALA-D activity and positive correlations between BLLs and ALA-RE activity were observed. MDA was significantly higher in rural compared to urban children (p < 0.05). Our findings suggest that rural children were co-exposed to toxic metals, especially Al, Pb and Ni. Moreover, a slight deficiency of Se was observed. Low performance on cognitive ability tests and ALA-D inhibition can be related to metal exposure in rural children. Oxidative stress was suggested as a main toxicological mechanism involved in metal exposure. PMID:25329533

  19. Structural insights into the polyphyletic origins of glycyl tRNA synthetases

    DOE PAGES

    Valencia-Sánchez, Marco Igor; Rodríguez-Hernández, Annia; Ferreira, Ruben; ...

    2016-05-23

    Glycyl tRNA synthetase (GlyRS) provides a unique case among class II aminoacyl tRNA synthetases, with two clearly widespread types of enzymes: a dimeric (α2) species present in some bacteria, archaea, and eukaryotes; and a heterotetrameric form (α2β2) present in most bacteria. Although the differences between both types of GlyRS at the anticodon binding domain level are evident, the extent and implications of the variations in the catalytic domain have not been described, and it is unclear whether the mechanism of amino acid recognition is also dissimilar. Here, we show that the α-subunit of the α2β2 GlyRS from the bacterium Aquifexmore » aeolicus is able to perform the first step of the aminoacylation reaction, which involves the activation of the amino acid with ATP. The crystal structure of the α-subunit in the complex with an analog of glycyl adenylate at 2.8 Å resolution presents a conformational arrangement that properly positions the cognate amino acid. This work shows that glycine is recognized by a subset of different residues in the two types of GlyRS. Furthermore, a structural and sequence analysis of class II catalytic domains shows that bacterial GlyRS is closely related to alanyl tRNA synthetase, which led us to define a new subclassification of these ancient enzymes and to propose an evolutionary path of α2β2 GlyRS, convergent with α2 GlyRS and divergent from AlaRS, thus providing a possible explanation for the puzzling existence of two proteins sharing the same fold and function but not a common ancestor.« less

  20. Repositioned lateral crural flap technique for cephalic malposition in rhinoplasty

    PubMed Central

    Mohebbi, A; Azizi, A; Tabatabaiee, S

    2015-01-01

    BACKGROUND: Cephalic malposition of the lower lateral cartilage (CMLLC) is a relatively common anatomical variant, particularly in Middle Eastern patients. The characteristics of CMLLC include long alar creases, a boxy and ball-shaped nasal tip, parenthesis tip deformity and external valvular incompetence. The gold standard for correcting CMLLC is the lateral crural strut graft (Gunter graft), but many patients experience problems after this technique. OBJECTIVE: To evaluate the efficacy of the repositioned lateral crural flap (RLCF) technique in correcting CMLLC, and to discuss the cosmetic and functional results. METHODS: In the present study, 123 primary septorhinoplasty operations using the RLCF technique were performed between May 2012 and March 2013. The mean follow-up period was 11.4 months (range nine to 24 months). Four parameters were measured and compared pre- and postoperatively: the angle between the line connecting the maximum convexity of the lower lateral cartilage (LLC) to the tip-defining point and midline on each side (angle of rotation); the total distance between the maximum convexity of LLC right and left to midline (representing the size of the parenthesis deformity); satisfaction scale rating of the patients’ nasal tip appearance; and the satisfaction scale rating of patients’ breathing through their nostrils. RESULTS: The mean angle of the LLC to the midline significantly increased and the mean distance between the maximum convexities was significantly reduced, indicating correction of the malposition and reduction of the parenthesis deformity, respectively. The mean satisfactory scale ratings of nasal tip appearance and breathing quality were also significantly improved. CONCLUSION: CMLLC can be corrected using the RLCF technique, resulting in both aesthetic and functional improvements. PMID:26361626

  1. Morphogenetic and Histogenetic Roles of the Temporal-Spatial Organization of Cell Proliferation in the Vertebrate Corticogenesis as Revealed by Inter-specific Analyses of the Optic Tectum Cortex Development

    PubMed Central

    Rapacioli, Melina; Palma, Verónica; Flores, Vladimir

    2016-01-01

    The central nervous system areas displaying the highest structural and functional complexity correspond to the so called cortices, i.e., concentric alternating neuronal and fibrous layers. Corticogenesis, i.e., the development of the cortical organization, depends on the temporal-spatial organization of several developmental events: (a) the duration of the proliferative phase of the neuroepithelium, (b) the relative duration of symmetric (expansive) versus asymmetric (neuronogenic) sub phases, (c) the spatial organization of each kind of cell division, (e) the time of determination and cell cycle exit and (f) the time of onset of the post-mitotic neuronal migration and (g) the time of onset of the neuronal structural and functional differentiation. The first five events depend on molecular mechanisms that perform a fine tuning of the proliferative activity. Changes in any of them significantly influence the cortical size or volume (tangential expansion and radial thickness), morphology, architecture and also impact on neuritogenesis and synaptogenesis affecting the cortical wiring. This paper integrates information, obtained in several species, on the developmental roles of cell proliferation in the development of the optic tectum (OT) cortex, a multilayered associative area of the dorsal (alar) midbrain. The present review (1) compiles relevant information on the temporal and spatial organization of cell proliferation in different species (fish, amphibians, birds, and mammals), (2) revises the main molecular events involved in the isthmic organizer (IsO) determination and localization, (3) describes how the patterning installed by IsO is translated into spatially organized neural stem cell proliferation (i.e., by means of growth factors, receptors, transcription factors, signaling pathways, etc.) and (4) describes the morpho- and histogenetic effect of a spatially organized cell proliferation in the above mentioned species. A brief section on the OT evolution is

  2. Molecular codes defining rostrocaudal domains in the embryonic mouse hypothalamus.

    PubMed

    Ferran, José L; Puelles, Luis; Rubenstein, John L R

    2015-01-01

    The prosomeric model proposes that the hypothalamus is a rostral forebrain entity, placed ventral to the telencephalon and rostral to the diencephalon. Gene expression markers differentially label molecularly distinct dorsoventral progenitor domains, which represent continuous longitudinal bands across the hypothalamic alar and basal regions. There is also circumstantial support for a rostrocaudal subdivision of the hypothalamus into transverse peduncular (caudal) and terminal (rostral) territories (PHy, THy). In addition, there is evidence for a specialized acroterminal domain at the rostral midline of the terminal hypothalamus (ATD). The PHy and THy transverse structural units are presently held to form part of two hypothalamo-telencephalic prosomeres (hp1 and hp2, respectively), which end dorsally at the telencephalic septocommissural roof. PHy and THy have distinct adult nuclei, at all dorsoventral levels. Here we report the results of data mining from the Allen Developing Mouse Brain Atlas database, looking for genes expressed differentially in the PHy, Thy, and ATD regions of the hypothalamus at several developmental stages. This search allowed us to identify additional molecular evidence supporting the postulated fundamental rostrocaudal bipartition of the mouse hypothalamus into the PHy and THy, and also corroborated molecularly the singularity of the ATD. A number of markers were expressed in Thy (Fgf15, Gsc, Nkx6.2, Otx1, Zic1/5), but were absent in PHy, while other genes showed the converse pattern (Erbb4, Irx1/3/5, Lmo4, Mfap4, Plagl1, Pmch). We also identified markers that selectively label the ATD (Fgf8/10/18, Otx2, Pomc, Rax, Six6). On the whole, these data help to explain why, irrespective of the observed continuity of all dorsoventral molecular hypothalamic subdivisions across PHy and THy, different nuclear structures originate within each of these two domains, and also why singular structures arise at the ATD, e.g., the suprachiasmatic nuclei, the

  3. Contribution of genoarchitecture to understanding forebrain evolution and development, with particular emphasis on the amygdala.

    PubMed

    Medina, Loreta; Bupesh, Munisamy; Abellán, Antonio

    2011-01-01

    The amygdala is a forebrain center involved in functions and behaviors that are critical for survival (such as control of the neuroendocrine system and homeostasis, and reproduction and fear/escape responses) and in cognitive functions such as attention and emotional learning. In mammals, the amygdala is highly complex, with multiple subdivisions, neuronal subtypes, and connections, making it very difficult to understand its functional organization and evolutionary origin. Since evolution is the consequence of changes that occurred in development, herein we review developmental data based on genoarchitecture and fate mapping in mammals (in the mouse model) and other vertebrates in order to identify its basic components and embryonic origin in different species and understand how they changed in evolution. In all tetrapods studied, the amygdala includes at least 4 components: (1) a ventral pallial part, characterized by expression of Lhx2 and Lhx9, that includes part of the basal amygdalar complex in mammals and a caudal part of the dorsal ventricular ridge in sauropsids and also produces a cell subpopulation of the medial amygdala; (2) a striatal part, characterized by expression of Pax6 and/or Islet1, which includes the central amygdala in different species; (3) a pallidal part, characterized by expression of Nkx2.1 and, in amniotes, Lhx6, which includes part of the medial amygdala, and (4) a hypothalamic part (derived from the supraoptoparaventricular domain or SPV), characterized by Otp and/or Lhx5 expression, which produces an important subpopulation of cells of the medial extended amygdala (medial amygdala and/or medial bed nucleus of the stria terminalis). Importantly, the size of the SPV domain increases upon reduction or lack of Nkx2.1 function in the hypothalamus. It appears that Nkx2.1 expression was downregulated in the alar hypothalamus during evolution to mammals, which may have produced an enlargement of SPV and the amygdalar cell subpopulation

  4. MRI morphometric characterisation of the paediatric cervical spine and spinal cord in children with MPS IVA (Morquio-Brailsford syndrome).

    PubMed

    Solanki, Guirish A; Lo, William B; Hendriksz, Christian J

    2013-03-01

    Nearly all children with MPS IVA develop skeletal deformities affecting the spine. At the atlanto-axial spine, odontoid hypoplasia occurs. GAG deposition around the dens, leads to peri-odontoid infiltration. Transverse/alar ligament incompetence causes instability. Atlanto-axial instability is associated with cord compression and myelopathy, leading to major morbidity and mortality. Intervention is often required. Does the presence of widened bullet shaped vertebra in platyspondily encroach on the spinal canal and cause spinal stenosis in MPS IVA? So far, there have been no standardised morphometric measurements of the paediatric MPS IVA cervical spine to evaluate whether there is pre-existing spinal stenosis predisposing to compressive myelopathy or whether this is purely an acquired process secondary to instability and compression. This study provides the first radiological quantitative analysis of the cervical spine and spinal cord in a series of affected children. MRI morphometry indicates that the MPS IVA spine is narrower at C1-2 level giving an inverted funnel shape. There is no evidence of a reduction in the Torg ratio (canal-body ratio) in the cervical spine. The spinal canal does not exceed 11 mm at any level, significantly smaller than normal historical cohorts (14 mm). The sagittal diameter and axial surface area of both spinal canal and cord are reduced. C1-2 level cord compression was evident in the canal-cord ratio but the Torg ratio was not predictive of cord compression. In MPS IVA the reduction in the space available for the cord (SAC) is multifactorial rather than due to congenital spinal stenosis.

  5. [Desvenlafaxine and neuropathic pain: additional clinical benefits of a second generation serotonin-noradrenaline reuptake inhibitor].

    PubMed

    Alcantara-Montero, A

    2017-03-01

    Introduccion. La desvenlafaxina es el tercer antidepresivo incluido entre los inhibidores de la recaptacion de serotonina y noradrenalina. Las ultimas guias de practica clinica consultadas coinciden en señalar que los antidepresivos triciclicos, los duales (venlafaxina/duloxetina) y los antiepilepticos gabapentina y pregabalina constituyen los farmacos de primera linea en el tratamiento del dolor neuropatico. El tramadol, los apositos de lidocaina al 5% y los parches de capsaicina al 8% son los farmacos de segunda linea, mientras que los opioides potentes constituirian una tercera linea de tratamiento. La interaccion entre el binomio dolor y depresion es muy habitual y representa la complicacion psicologica mas frecuente en los pacientes con dolor cronico. Desarrollo. Tras una busqueda bibliografica, en este articulo se resumen los datos farmacologicos mas relevantes de la desvenlafaxina y su utilidad en la practica clinica, asi como la bibliografia especifica de este farmaco en el dolor neuropatico y el dolor cronico. Conclusiones. Aunque la evidencia de la desvenlafaxina en el dolor neuropatico es escasa, presenta unas caracteristicas farmacocineticas interesantes, como son no ser sustrato ni actuar sobre la glicoproteina P y tener un metabolismo que practicamente no depende del sistema del citocromo P450, lo que limita el riesgo de interacciones farmacocineticas y los potenciales problemas de tolerabilidad asociados cuando se administra con farmacos que sean inhibidores moderados o potentes del CYP2D6 o con otros sustratos de esta isoenzima. Estas caracteristicas hacen de la desvenlafaxina un antidepresivo distinto y especialmente util en algunos subgrupos de pacientes con dolor cronico (como polimedicados y pacientes con insuficiencia hepatica), donde la depresion comorbida es frecuente.

  6. Change in upper lip height and nostril sill after alveolar bone grafting in unilateral cleft lip alveolus patients.

    PubMed

    Kim, Suk Wha; Park, Seong Oh; Choi, Tae Hyun; Hai, Do Ten

    2012-05-01

    Alveolar bone grafting is known to reduce nasal asymmetry by supporting a defective alar base and a sunken nostril. However, there are no studies which include details of changes to the upper lip with appropriate measurements. The purpose of this study was to measure the change in the upper lip height and nostril sill after alveolar bone grafting, using photogrammetry. The study included 18 unilateral cleft lip alveolus (UCLA) patients who were diagnosed with unilateral cleft lip and palate (mean age, 9.87 years). The patients underwent alveolar bone grafting with iliac bone between June 2007 and June 2008. The average follow-up period was 16.6 months. The average bone graft volume was 2.39 cm(3). We obtained photographs of the frontal, lateral and basal views using standardised photographic techniques. We defined 14 landmarks and measured the distance of 11 points (distance items) for the determination of upper lip height, upper lip projection and nostril sill elevation. We defined the proportion index as the ratio of the cleft side to non-cleft side or reference line (R). We compared the preoperative proportion index with the postoperative proportion index for each distance items. The height of the upper lip increased significantly in four of five distance items. The projection of the upper lip was more prominent, but it was not statistically significant. The nostril sill was significantly elevated in all four distance items. The height of the upper lip was elongated and the nostril sill was elevated after alveolar bone grafting in UCLA patients. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Alveolar bone grafting with simultaneous cleft lip rhinoplasty.

    PubMed

    Kim, Young-Eun; Han, Jihyeon; Baek, Rong-Min; Kim, Baek-Kyu

    2016-11-01

    Optimal timing for cleft lip rhinoplasty is controversial. Definitive rhinoplasty is deferred until facial skeletal growth is completed. Intermediate rhinoplasty is performed after stabilization of the grafted alveolar bone, because the grafted bone tends to be absorbed over several months postoperatively, distorting the nasal profile. Here, we report our experience with simultaneous rhinoplasty during alveolar bone grafting for indicated patients, describe our surgical technique that ensures long-term bone graft survival, and report graft take rates and nasal profile changes. This retrospective chart review included a total of 54 patients; 44 underwent alveolar bone grafting only, and 10 underwent simultaneous cleft lip rhinoplasty. All surgeries were conducted with a judicious mucosal incision for tensionless wound closure. Bone graft take was evaluated with dental radiographs by the Bergland classification. Further, nasal aesthetic outcome was evaluated with medical photographs, based on nostril height and width and alar base width. In total, 96.3% of clefts showed graft success with Type I (66.7%) or Type II (27.8%) classifications; only 3.7% of clefts showed unfavorable results classified as Type III, and no clefts showed Type IV failure. The nasal shape was flatter with a decreased nostril height and increased nostril width after alveolar bone grafting, while nostril height was increased and nostril width was decreased in patients who underwent simultaneous rhinoplasty. With surgical techniques ensuring alveolar bone graft survival, simultaneous cleft lip rhinoplasty can result in nasal aesthetic improvement for patients with severe nasal deformities, decreasing the number of operations. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  8. Structural insights into the polyphyletic origins of glycyl tRNA synthetases

    SciTech Connect

    Valencia-Sánchez, Marco Igor; Rodríguez-Hernández, Annia; Ferreira, Ruben; Santamaría-Suárez, Hugo Aníbal; Arciniega, Marcelino; Dock-Bregeon, Anne-Catherine; Moras, Dino; Beinsteiner, Brice; Mertens, Haydyn; Svergun, Dmitri; Brieba, Luis G.; Grøtli, Morten; Torres-Larios, Alfredo

    2016-05-23

    Glycyl tRNA synthetase (GlyRS) provides a unique case among class II aminoacyl tRNA synthetases, with two clearly widespread types of enzymes: a dimeric (α2) species present in some bacteria, archaea, and eukaryotes; and a heterotetrameric form (α2β2) present in most bacteria. Although the differences between both types of GlyRS at the anticodon binding domain level are evident, the extent and implications of the variations in the catalytic domain have not been described, and it is unclear whether the mechanism of amino acid recognition is also dissimilar. Here, we show that the α-subunit of the α2β2 GlyRS from the bacterium Aquifex aeolicus is able to perform the first step of the aminoacylation reaction, which involves the activation of the amino acid with ATP. The crystal structure of the α-subunit in the complex with an analog of glycyl adenylate at 2.8 Å resolution presents a conformational arrangement that properly positions the cognate amino acid. This work shows that glycine is recognized by a subset of different residues in the two types of GlyRS. Furthermore, a structural and sequence analysis of class II catalytic domains shows that bacterial GlyRS is closely related to alanyl tRNA synthetase, which led us to define a new subclassification of these ancient enzymes and to propose an evolutionary path of α2β2 GlyRS, convergent with α2 GlyRS and divergent from AlaRS, thus providing a possible explanation for the puzzling existence of two proteins sharing the same fold and function but not a common ancestor.

  9. New application of three-dimensional printing biomaterial in nasal reconstruction.

    PubMed

    Park, Sun Hwa; Yun, Byeong Gon; Won, Joo Yun; Yun, Won Soo; Shim, Jin Hyung; Lim, Mi Hyun; Kim, Do Hyun; Baek, Sang A; Alahmari, Yahya Dhafer; Jeun, Jun Ho; Hwang, Se Hwan; Kim, Sung Won

    2017-05-01

    Polycaprolactone (PCL) is an U.S. Food and Drug Administration-approved synthetic biodegradable polymer and is easily fabricated into three-dimensional (3D) structures. In this study, the 3D-printed PCL implant for nasal augmentation was further evaluated for its suitability for nasal surgeries such as septoplasty and rhinoplasty. Ten New Zealand White rabbits were included and divided into study and sham groups (7 and 3, respectively). A lateral incision was made on the nasal dorsum and a pocket formed in the subperichondrial plane between the upper lateral cartilage and nasal septum. Polycaprolactone was fabricated based on 3D printing technology into a 0.8 × 0.8-cm rectangular shape for use as a nasal implant. The material was inserted as a septal extension graft and sutured with alar cartilage for nasal reshaping. The implants were harvested 4, 8, and 12 weeks after implantation and evaluated by gross morphological assessment and histological examination. The initial shape of the implant was unchanged in all cases, and no definitive postoperative complications were seen over the 3-month period. Gross morphological evaluation confirmed that implants remained in their initial location without migration or extrusion. Histologic evaluations showed that the implant architectures were maintained with excellent fibrovascular ingrowth and minimal inflammatory reactions. Polycaprolactone can be used for nasal reconstruction such as nasal augmentation. Polycaprolactone is easy to work with and will avoid the increased operative time and morbidity associated with autograft harvesting. Therefore, PCL implants designed by 3D printing can serve as clinically biocompatible materials in craniofacial reconstruction in the future. NA. Laryngoscope, 127:1036-1043, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  10. [The primary closure approach of dog bite injuries of the nose].

    PubMed

    Zieliński, Tomasz

    2010-01-01

    Biting of humans by domestic animals, especially by dogs, is common injury which causes suffering and pain, might be a cause of disability or even death. It is associated with high risk of bacterial infection of the wounds or even transfection of rabies virus. Bites are usually to the upper and lower limbs, while the face is third in a raw localization of bites. Within the face, the nose and lips are injured the most often. The goal of this paper is presentation selected methods and obtained results of primary closure of dog bite injures of the nose. There were 16 patients with dog bites injures of the nose treated in the Department of Plastic, Reconstructive and Aesthetic Surgery of the Medical University of Łódź in the years 2003-2008. The patients were 11 to 46 years old. Bites caused either superficial laceration of the skin, tearing of the nostril wing or even major defects of the tissues. In 7 patients superficial wounds a direct closure was done and antibiotic ointment was applied. In 7 patients a defect of the skin was covered with a skin graft taken from retroauricular area, but in 2 of the patients of this group repair of mucosa and alar cartilage was done. In two persons with full thickness defects of the nose reconstruction was performed with the use of a pedicled nosolabial flap. Complications occurred only in 1 patient who developed infection in the wound. In all other patients there were no complications. Good aesthetic results were obtained. Primary closure approach of bite injures with tissue defect is not associated with larger risk than in the case in secondary such approach, and should be implemented always whenever it is possible in order to avoid risk of wound and scars which require further reconstructive procedures in future.

  11. Morphogenetic and Histogenetic Roles of the Temporal-Spatial Organization of Cell Proliferation in the Vertebrate Corticogenesis as Revealed by Inter-specific Analyses of the Optic Tectum Cortex Development.

    PubMed

    Rapacioli, Melina; Palma, Verónica; Flores, Vladimir

    2016-01-01

    The central nervous system areas displaying the highest structural and functional complexity correspond to the so called cortices, i.e., concentric alternating neuronal and fibrous layers. Corticogenesis, i.e., the development of the cortical organization, depends on the temporal-spatial organization of several developmental events: (a) the duration of the proliferative phase of the neuroepithelium, (b) the relative duration of symmetric (expansive) versus asymmetric (neuronogenic) sub phases, (c) the spatial organization of each kind of cell division, (e) the time of determination and cell cycle exit and (f) the time of onset of the post-mitotic neuronal migration and (g) the time of onset of the neuronal structural and functional differentiation. The first five events depend on molecular mechanisms that perform a fine tuning of the proliferative activity. Changes in any of them significantly influence the cortical size or volume (tangential expansion and radial thickness), morphology, architecture and also impact on neuritogenesis and synaptogenesis affecting the cortical wiring. This paper integrates information, obtained in several species, on the developmental roles of cell proliferation in the development of the optic tectum (OT) cortex, a multilayered associative area of the dorsal (alar) midbrain. The present review (1) compiles relevant information on the temporal and spatial organization of cell proliferation in different species (fish, amphibians, birds, and mammals), (2) revises the main molecular events involved in the isthmic organizer (IsO) determination and localization, (3) describes how the patterning installed by IsO is translated into spatially organized neural stem cell proliferation (i.e., by means of growth factors, receptors, transcription factors, signaling pathways, etc.) and (4) describes the morpho- and histogenetic effect of a spatially organized cell proliferation in the above mentioned species. A brief section on the OT evolution is

  12. Identification of genes differentially expressed in dorsal and ventral chick midbrain during early Development

    PubMed Central

    Chittka, A; Volff, JN; Wizenmann, A

    2009-01-01

    Background During the development of the central nervous system (CNS), patterning processes along the dorsoventral (DV) axis of the neural tube generate different neuronal subtypes. As development progresses these neurons are arranged into functional units with varying cytoarchitecture, such as laminae or nuclei for efficient relaying of information. Early in development ventral and dorsal regions are similar in size and structure. Different proliferation rates and cell migration patterns are likely to result in the formation of laminae or nuclei, eventually. However, the underlying molecular mechanisms that establish these different structural arrangements are not well understood. We undertook a differential display polymerase chain reaction (DD-PCR) screen to identify genes with distinct expression patterns between dorsal and ventral regions of the chick midbrain in order to identify genes which regulate the sculpturing of such divergent neuronal organisation. We focused on the DV axis of the early chick midbrain since mesencephalic alar plate and basal plate develop into laminae and nuclei, respectively. Results We identified 53 differentially expressed bands in our initial screen. Twenty-six of these could be assigned to specific genes and we could unambiguously show the differential expression of five of the isolated cDNAs in vivo by in situ mRNA expression analysis. Additionally, we verified differential levels of expression of a selected number of genes by using reverse transcriptase (RT) PCR method with gene-specific primers. One of these genes, QR1, has been previously cloned and we present here a detailed study of its early developmental time course and pattern of expression providing some insights into its possible function. Our phylogenetic analysis of QR1 shows that it is the chick orthologue of Sparc-like 1/Hevin/Mast9 gene in mice, rats, dogs and humans, a protein involved in cell adhesion. Conclusion This study reveals some possible networks, which

  13. Expression of PLA2G6 in human fetal development: Implications for infantile neuroaxonal dystrophy.

    PubMed

    Polster, Brenda; Crosier, Moira; Lindsay, Susan; Hayflick, Susan

    2010-11-20

    Mutations in PLA2G6, which encodes calcium-independent phospholipase A(2) group VIA (iPLA2-VIA), underlie the autosomal recessive disorder infantile neuroaxonal dystrophy (INAD). INAD typically presents in the first year of life, and leads to optic atrophy and psychomotor regression. We have examined PLA2G6 expression in early human embryonic development by in situ hybridization. At Carnegie Stage (CS) 19 (approximately 7 post-conception weeks [PCW]), strong expression is evident in the ventricular zone (VZ) of midbrain and forebrain suggestive of expression in neural stem and progenitor cells. At CS23 (8PCW) expression is also detectable in the VZ of the hindbrain and the subventricular zone (SVZ) of the developing neocortex, ganglionic eminences and diencephalon. By 9PCW strong expression in the post-mitotic cells of the cortical plate can be seen in the developing neocortex. In the eye, expression is seen in the lens and retina at all stages examined. PLA2G6 expression is also evident in the alar plate of the spinal cord, dorsal root ganglia, the retina and lens in the eye and several non-neuronal tissues, including developing bones, lung, kidney and gut. These findings suggest a role for PLA2G6 in neuronal proliferation throughout the developing brain and in maturing neurons in the cortical plate and hindbrain. Although widespread PLA2G6 expression is detected in neuronal tissues, the pattern shows dynamic changes with time and indicates that INAD pathogenesis may begin prior to birth. 2010 Elsevier Inc. All rights reserved.

  14. Expression of PLA2G6 in human fetal development: Implications for infantile neuroaxonal dystrophy

    PubMed Central

    Polster, Brenda; Crosier, Moira; Lindsay, Susan; Hayflick, Susan

    2010-01-01

    Mutations in PLA2G6, which encodes calcium-independent phospholipase A2 group VIA (iPLA2-VIA), underlie the autosomal recessive disorder infantile neuroaxonal dystrophy (INAD). INAD typically presents in the first year of life, and leads to optic atrophy and psychomotor regression. We have examined PLA2G6 expression in early human embryonic development by in situ hybridization. At Carnegie Stage (CS) 19 (approximately 7 post conception weeks [PCW]), strong expression is evident in the ventricular zone (VZ) of midbrain and forebrain suggestive of expression in neural stem and progenitor cells. At CS23 (8 PCW) expression is also detectable in the VZ of the hindbrain and the subventricular zone (SVZ) of the developing neocortex, ganglionic eminences and diencephalon. By 9 PCW strong expression in the post-mitotic cells of the cortical plate can be seen in the developing neocortex. In the eye, expression is seen in the lens and retina at all stages examined. PLA2G6 expression is also evident in the alar plate of the spinal cord, dorsal root ganglia, the retina and lens in the eye and and several non-neuronal tissues, including developing bones, lung, kidney and gut. These findings suggest a role for PLA2G6 in neuronal proliferation throughout the developing brain and in maturing neurons in the cortical plate and hindbrain. Although widespread PLA2G6 expression is detected in neuronal tissues, the pattern shows dynamic changes with time and indicates that INAD pathogenesis may begin prior to birth. PMID:20813170

  15. Three-dimensional morphometric analysis of craniofacial shape in the unaffected relatives of individuals with nonsyndromic orofacial clefts: a possible marker for genetic susceptibility.

    PubMed

    Weinberg, Seth M; Neiswanger, Katherine; Richtsmeier, Joan T; Maher, Brion S; Mooney, Mark P; Siegel, Michael I; Marazita, Mary L

    2008-02-15

    Numerous studies have described altered patterns of craniofacial form in the unaffected relatives of individuals with nonsyndromic clefts. Unfortunately, results from such studies have been highly variable and have failed to provide a reliable method for differentiating "at-risk" relatives from controls. In the present study, we compared craniofacial shape between a sample of unaffected relatives (33 females; 14 males) from cleft multiplex families and an equal number of age/sex/ethnicity-matched controls. Sixteen x,y,z facial landmark coordinates derived from 3D photogrammetry were analyzed via Euclidean Distance Matrix Analysis, while 14 additional linear distances were analyzed via t tests. A subset of variables was then entered into a discriminant function analysis (DFA). Compared to controls, female unaffected relatives demonstrated increased upper facial width, midface reduction and lateral displacement of the alar cartilage. DFA correctly classified 70% of female unaffected relatives and 73% of female controls. Male unaffected relatives demonstrated increased upper facial and cranial base width, increased lower facial height and decreased upper facial height compared with controls. DFA correctly classified 86% of male unaffected relatives and 93% of male controls. In both sexes, upper facial width contributed most to group discrimination. Following DFA, unaffected relatives were assigned to risk/liability classes based on the degree of phenotypic divergence from controls. Results indicate that craniofacial shape differences characterizing unaffected relatives are partly sex-specific and are in broad agreement with previous reports. These findings further suggest that a quantitative assessment of the craniofacial phenotype may allow for the identification of susceptible individuals within nonsyndromic cleft families.

  16. Prepatterning and patterning of the thalamus along embryonic development of Xenopus laevis

    PubMed Central

    Bandín, Sandra; Morona, Ruth; González, Agustín

    2015-01-01

    Previous developmental studies of the thalamus (alar part of the diencephalic prosomere p2) have defined the molecular basis for the acquisition of the thalamic competence (preparttening), the subsequent formation of the secondary organizer in the zona limitans intrathalamica, and the early specification of two anteroposterior domains (rostral and caudal progenitor domains) in response to inducing activities and that are shared in birds and mammals. In the present study we have analyzed the embryonic development of the thalamus in the anuran Xenopus laevis to determine conserved or specific features in the amphibian diencephalon. From early embryonic stages to the beginning of the larval period, the expression patterns of 22 markers were analyzed by means of combined In situ hybridization (ISH) and immunohistochemical techniques. The early genoarchitecture observed in the diencephalon allowed us to discern the boundaries of the thalamus with the prethalamus, pretectum, and epithalamus. Common molecular features were observed in the thalamic prepatterning among vertebrates in which Wnt3a, Fez, Pax6 and Xiro1 expression were of particular importance in Xenopus. The formation of the zona limitans intrathalamica was observed, as in other vertebrates, by the progressive expression of Shh. The largely conserved expressions of Nkx2.2 in the rostral thalamic domain vs. Gbx2 and Ngn2 (among others) in the caudal domain strongly suggest the role of Shh as morphogen in the amphibian thalamus. All these data showed that the molecular characteristics observed during preparttening and patterning in the thalamus of the anuran Xenopus (anamniote) share many features with those described during thalamic development in amniotes (common patterns in tetrapods) but also with zebrafish, strengthening the idea of a basic organization of this diencephalic region across vertebrates. PMID:26321920

  17. Nasal Reconstruction and Repair of Secondary Nasal Deformities Following Treatment of Nasal Hemangiomas.

    PubMed

    Lu, Xiaona; Fan, Fei; Wang, Huan; You, Jianjun

    2017-03-01

    Secondary nasal deformities and retardation of development due to treatment of nasal hemangioma during infancy are a challenge when it comes to nasal reconstruction. In order to evaluate nasal repair and reconstruction in these patients, the authors compared the ease and outcomes of using expanded forehead, nasolabial sulcus, and medial upper arm tube flaps. According to the deformities and patients' wishes, flaps were selected; using autogeneic rib cartilage, auricle cartilage, or silica gel as a scaffold or without framework; the inner lining were made by the residual scar tissue or the distal end of transferred flap. The esthetical and functional scores were recorded by the Nasal Appearance and Function Evaluation Questionnaire score to evaluate the effectiveness of the methods. From January 2010 to December 2015, 34 patients were included. Postoperative follow-up went for 12 to 36 months. The expanded forehead flap was used in 28 patients, the nasolabial sulcus flap in 5 patients, and the medial upper arm tube flap in 1 patient. Regarding framework, 20 patients used rib cartilage, 8 patients used auricle cartilage, 1 patient used silicone, and 5 patients did not use any framework. All patients reported the increasing nasal appearance and function evaluation. Repair of secondary nasal defects following treatment of hemangiomas in infants and young children using an expanded frontal flap and autogenous cartilage framework is a reliable method with great long-term esthetic results. The nasolabial sulcus flap is a relatively simple method, especially for patients with a unilateral nasal alar defect. Supporting structure is needed and appropriate overcorrection is necessary.

  18. Nasal correction in nasomaxillary hypoplasia (Binder's syndrome): An optimised classification and treatment

    PubMed Central

    Yamani, Venkata Ramana; Ghosh, Shakuntala; Tirunagari, Shreekumar

    2016-01-01

    Background: Nasomaxillary hypoplasia is a rare congenital disorder involving the central face. It imparts a distinctive appearance to the individual face as the age advances. Severity of the disorder varies, so do the manifestations. Methods: This was a retrospective study conducted on the records and photographic data of 560 rhinoplasty cases performed between 2006 March and 2016 March. About 16 cases of nasomaxillary hypoplasia were selected from the group and they were classified based on the severity of the features. Surgical correction performed in each group was detailed. Results: Three percent of the 560 rhinoplasties performed in our centre turned out to be cases of Binder's syndrome. Nasal correction with locoregional autologous cartilage grafts was sufficient in mild cases. Loco-regional cartilage grafts along with costal cartilage grafts were needed for moderate and severe cases. Anterior nasal floor along with alar base augmentation was performed to achieve a proper aesthetic profile in moderate and severe cases. Post-operative results were excellent in mild and moderate cases and acceptable in severe cases. Discussion: We attempted to correct the deformity only after growth of the nose and maxilla was completed. We used cartilage grafts as a mainstay as cartilage has long-term stability without resorption unlike bone grafts. Instead of following en bloc technique of cartilage assembly, we have reconstructed the nasal dorsum, columella and tip separately as this principle is more functionally acceptable with less warping or stiffness of the nose. Importance was given to proper anchorage of grafts. Conclusion: We have attempted to put together the various features into three categories of mild/moderate/severe based on previous anthropometric studies of nasal anatomical parameters. The second objective of our study was to advise a logical surgical protocol for each group so that future surgeons can follow an easy surgical guideline to attain optimal

  19. Molecular codes defining rostrocaudal domains in the embryonic mouse hypothalamus

    PubMed Central

    Ferran, José L.; Puelles, Luis; Rubenstein, John L. R.

    2015-01-01

    The prosomeric model proposes that the hypothalamus is a rostral forebrain entity, placed ventral to the telencephalon and rostral to the diencephalon. Gene expression markers differentially label molecularly distinct dorsoventral progenitor domains, which represent continuous longitudinal bands across the hypothalamic alar and basal regions. There is also circumstantial support for a rostrocaudal subdivision of the hypothalamus into transverse peduncular (caudal) and terminal (rostral) territories (PHy, THy). In addition, there is evidence for a specialized acroterminal domain at the rostral midline of the terminal hypothalamus (ATD). The PHy and THy transverse structural units are presently held to form part of two hypothalamo-telencephalic prosomeres (hp1 and hp2, respectively), which end dorsally at the telencephalic septocommissural roof. PHy and THy have distinct adult nuclei, at all dorsoventral levels. Here we report the results of data mining from the Allen Developing Mouse Brain Atlas database, looking for genes expressed differentially in the PHy, Thy, and ATD regions of the hypothalamus at several developmental stages. This search allowed us to identify additional molecular evidence supporting the postulated fundamental rostrocaudal bipartition of the mouse hypothalamus into the PHy and THy, and also corroborated molecularly the singularity of the ATD. A number of markers were expressed in Thy (Fgf15, Gsc, Nkx6.2, Otx1, Zic1/5), but were absent in PHy, while other genes showed the converse pattern (Erbb4, Irx1/3/5, Lmo4, Mfap4, Plagl1, Pmch). We also identified markers that selectively label the ATD (Fgf8/10/18, Otx2, Pomc, Rax, Six6). On the whole, these data help to explain why, irrespective of the observed continuity of all dorsoventral molecular hypothalamic subdivisions across PHy and THy, different nuclear structures originate within each of these two domains, and also why singular structures arise at the ATD, e.g., the suprachiasmatic nuclei, the

  20. Preoperative lip measurement in patients with complete unilateral cleft lip/palate and its comparison with norms.

    PubMed

    Chou, Pang-Yun; Luo, Chih-Cheng; Chen, Philip Kuo-Ting; Chen, Yu-Ray; Samuel Noordhoff, M; Lo, Lun-Jou

    2013-04-01

    There is prominent lip asymmetry in patients with unilateral complete cleft lip and palate. Measurement of the lip on cleft and non-cleft sides provides appraisal of the lip deformity and information for planning of surgical correction. The purpose of this retrospective study is to evaluate the degree of lip deformity and to compare it with normative data. From 1983 to 1997, data from a total of 168 patients with unilateral complete cleft lip and palate were collected. There were no other associated craniofacial anomalies in this patient group. The measurement was performed under general anaesthesia by a senior surgeon using a calliper prior to the first lip repair. Corresponding normative data were collected from 2002 to 2003 on 50 patients who had normal facial appearance prior to hernia repair. The measurements included lip height, lip width, philtrum length and vermilion thickness. Comparisons were made between the cleft side and the non-cleft side, as well as between cleft patients and norms. Comparisons between the cleft and the non-cleft sides revealed significantly longer lip on the non-cleft side, including lip height from alar base to Cupid's bow, lip width from Cupid's bow to commissure and the vermilion thickness. The lip measurements on the norms were longer than those on the cleft side of the lip, but were similar to the non-cleft side. A wide variety of tissue growth asymmetry is observed between the non-cleft and the cleft sides, indicating a deficiency of tissue development associated with the cleft deformity. These data can provide a fundamental basis for presurgical orthopaedic treatment, surgical planning, execution of surgery, postoperative assessment and may help to predict treatment outcome. Copyright © 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. [Lacosamide and neuropathic pain, a review].

    PubMed

    Alcántara-Montero, Antonio; Sánchez-Carnerero, Clara I

    2016-03-01

    Introduccion. La mayor parte de las guias de practica clinica consultadas coinciden en señalar que los antidepresivos triciclicos, duales (venlafaxina/duloxetina), antiepilepticos gabapentina/pregabalina, apositos de lidocaina al 5% y parches de capsaicina al 8% constituyen los farmacos de primera linea en el tratamiento del dolor neuropatico periferico, y el tramadol y algunos opioides potentes (morfina, oxicodona y tapentadol) son farmacos de segunda linea. Por otra parte, la prevalencia de dolor neuropatico refractario al tratamiento se acerca al 1,5% de la poblacion, de forma que se calcula que un 50% de los pacientes no responde al tratamiento prescrito. Existen otros antiepilepticos que no tienen indicacion en el dolor neuropatico por las agencias reguladoras, como la lamotrigina, el topiramato o la oxcarbacepina, pero se utilizan en la practica clinica habitual fuera de indicacion. Desarrollo. Tras una busqueda bibliografica, se realizo una revision sobre el empleo de la lacosamida en el dolor neuropatico, tanto en distintos modelos animales como en diferentes estudios en humanos. Conclusiones. El tratamiento con lacosamida en el dolor neuropatico de diferentes etiologias podria considerarse como una alternativa efectiva para los pacientes que no respondan o no toleren los tratamientos estandares. Sin embargo, la mayor parte de la evidencia disponible, a excepcion de los ensayos clinicos en fase II/III realizados en el dolor neuropatico diabetico, corresponde a estudios abiertos y observacionales, sin grupo control y con bajo numero de pacientes, pero los resultados favorables obtenidos invitan a seguir investigando la utilidad de la lacosamida en el dolor neuropatico.

  2. Regional distribution of calretinin and calbindin-D28k expression in the brain of the urodele amphibian Pleurodeles waltl during embryonic and larval development.

    PubMed

    Joven, Alberto; Morona, Ruth; Moreno, Nerea; González, Agustín

    2013-07-01

    The sequence of appearance of calretinin and calbindin-D28k immunoreactive (CRir and CBir, respectively) cells and fibers has been studied in the brain of the urodele amphibian Pleurodeles waltl. Embryonic, larval and juvenile stages were studied. The early expression and the dynamics of the distribution of CBir and CRir structures have been used as markers for developmental aspects of distinct neuronal populations, highlighting the accurate extent of many regions in the developing brain, not observed on the basis of cytoarchitecture alone. CR and, to a lesser extent, CB are expressed early in the central nervous system and show a progressively increasing expression from the embryonic stages throughout the larval life and, in general, the labeled structures in the developing brain retain their ability to express these proteins in the adult brain. The onset of CRir cells primarily served to follow the development of the olfactory bulbs, subpallium, thalamus, alar hypothalamus, mesencephalic tegmentum, and distinct cell populations in the rhombencephalic reticular formation. CBir cells highlighted the development of, among others, the pallidum, hypothalamus, dorsal habenula, midbrain tegmentum, cerebellum, and central gray of the rostral rhombencephalon. However, it was the relative and mostly segregated distribution of both proteins in distinct cell populations which evidenced the developing regionalization of the brain. The results have shown the usefulness in neuroanatomy of the analysis during development of the onset of CBir and CRir structures, but the comparison with previous data has shown extensive variability across vertebrate classes. Therefore, one should be cautious when comparing possible homologue structures across species only on the basis of the expression of these proteins, due to the variation of the content of calcium-binding proteins observed in well-established homologous regions in the brain of different vertebrates.

  3. Bilateral cleft lip nasal deformity

    PubMed Central

    Singh, Arun Kumar; Nandini, R.

    2009-01-01

    Bilateral cleft lip nose deformity is a multi-factorial and complex deformity which tends to aggravate with growth of the child, if not attended surgically. The goals of primary bilateral cleft lip nose surgery are, closure of the nasal floor and sill, lengthening of the columella, repositioning of the alar base, achieving nasal tip projection, repositioning of the lower lateral cartilages, and reorienting the nares from horizontal to oblique position. The multiplicity of procedures in the literature for correction of this deformity alludes to the fact that no single procedure is entirely effective. The timing for surgical intervention and its extent varies considerably. Early surgery on cartilage may adversely affect growth and development; at the same time, allowing the cartilage to grow in an abnormal position and contributing to aggravation of deformity. Some surgeons advocate correction of deformity at an early age. However, others like the cartilages to grow and mature before going in for surgery. With peer pressure also becoming an important consideration during the teens, the current trend is towards early intervention. There is no unanimity in the extent of nasal dissection to be done at the time of primary lip repair. While many perform limited nasal dissection for the fear of growth retardation, others opt for full cartilage correction at the time of primary surgery itself. The value of naso-alveolar moulding (NAM) too is not universally accepted and has now more opponents than proponents. Also most centres in the developing world have neither the personnel nor the facilities for the same. The secondary cleft nasal deformity is variable and is affected by the extent of the original abnormality, any prior surgeries performed and alteration due to nasal growth. This article reviews the currently popular methods for correction of nasal deformity associated with bilateral cleft lip, it's management both at the time of cleft lip repair and also secondarily

  4. The human vertebral column at the end of the embryonic period proper. 2. The occipitocervical region.

    PubMed Central

    O'Rahilly, R; Müller, F; Meyer, D B

    1983-01-01

    The present investigation of the cervical region of the vertebral column at eight post-ovulatory weeks is the first such study based on precise reconstructions of staged embryos. At the end of the embryonic period proper, a typical vertebra is a U-shaped piece of cartilage characterized by spina bifida occulta. The notochord ascends through the centra and leaves the dens to enter the basal plate of the skull. The median column of the axis comprises three parts (designated X, Y, Z) which persist well into the fetal period. They are related to the first, second and third cervical nerves, respectively. Part X may project into the foramen magnum and form an occipito-axial joint. Part Z appears to be the centrum of the axis. The articular columns of the cervical vertebrae are twofold, as in the adult: an anterior (atlanto-occipital and atlanto-axial) and a posterior (from the lower aspect of the axis downwards). Alar and transverse ligaments are present. Cavitation is not found in the embryonic period in either the atlanto-occipital or zygapophysial joints, and is generally not present in the median atlanto-axial joint either. Most of the transverse processes exhibit anterior and posterior tubercles. An 'intertubercular lamella' may or may not be present, i.e. the foramina transversaria are being formed around the vertebral artery. The spinal ganglia are generally partly in the vertebral canal and partly on the neural arches, medial to the articular processes. During the fetal period, the articular processes shift to a coronal position and this alteration appears to be associated with a corresponding change in the location of the spinal ganglia. Images Fig. 4 Fig. 7 PMID:6833119

  5. Horizontal and vertical distribution of bromine monoxide in northern Alaska during BROMEX derived from airborne imaging-DOAS measurements

    NASA Astrophysics Data System (ADS)

    Pöhler, Denis; Stephan, General; Zielcke, Johannes; Shepson, Paul B.; Sihler, Holger; Stirm, Brian H.; Frieß, Udo; Pratt, Kerry A.; Walsh, Steve; Simpson, William R.; Platt, Ulrich

    2013-04-01

    Bromine monoxide (BrO) is a reactive halogen species (RHS) and has been known for quite a while to have a profound impact on the chemistry of the polar tropospheric boundary layer. Details of the bromine release and reaction processes are still unclear, especially the role of frost flowers, first-year sea ice, aerosols, atmospheric stability and snow. To investigate important details of the bromine release, a novel imaging DOAS instrument for the ultraviolet wavelength range (300 to 400 nm) was deployed aboard a light twin-engine aircraft (ALAR, Purdue Univ.) as part of the BRomine, Ozone, and Mercury EXperiment (BROMEX) in Barrow, Alaska, in spring 2012. This instrument utilizes (1) a scanner system in nadir direction to map trace gas distributions of the overflown area at high spatial resolution and (2) a forward-looking system, to observe the vertical trace gas distribution. Both viewing directions are equipped with digital cameras, enabling the creation of aerial maps and the comparison of spectral data with background features. We derived horizontal and vertical distribution of bromine monoxide (BrO) and other gases (e.g. NO2) over a wide variety of sea, ice and land surface conditions (first-year sea ice, frost flowers, open leads, and arctic tundra). We observed strong horizontal gradients of BrO within few km and a fast movement of BrO plumes. Distributions change significantly within few hours. The data show interesting correlations to the different surfaces. Additionally a clear anti-correlation of BrO and NO2 can be observed. Tropospheric BrO-distributions derived from satellite observations match within the satellite resolution those seen with the aircraft. Vertical gradients show a shallow layer of BrO close to the surface. These and other results from the 11 flights will be presented together with conclusions of the involved chemistry.

  6. Pertinent anatomy and analysis for midface volumizing procedures.

    PubMed

    Surek, Christopher C; Beut, Javier; Stephens, Robert; Jelks, Glenn; Lamb, Jerome

    2015-05-01

    The study was conducted to construct an anatomically inspired midfacial analysis facilitating safe, accurate, and dynamic nonsurgical rejuvenation. Emphasis is placed on determining injection target areas and adverse event zones. Twelve hemifacial fresh cadavers were dissected in a layered fashion. Dimensional measurements between the midfacial fat compartments, prezygomatic space, mimetic muscles, and neurovascular bundles were used to develop a topographic analysis for clinical injections. A longitudinal line from the base of the alar crease to the medial edge of the levator anguli oris muscle (1.9 cm), lateral edge of the levator anguli oris muscle (2.6 cm), and zygomaticus major muscle (4.6 cm) partitions the cheek into two aesthetic regions. A six-step facial analysis outlines three target zones and two adverse event zones and triangulates the point of maximum cheek projection. The lower adverse event zone yields an anatomical explanation to inadvertent jowling during anterior cheek injection. The upper adverse event zone localizes the palpebral branch of the infraorbital artery. The medial malar target area isolates quadrants for anterior cheek projection and tear trough effacement. The middle malar target area addresses lid-cheek blending and superficial compartment turgor. The lateral malar target area highlights lateral cheek projection and locates the prezygomatic space. This stepwise analysis illustrates target areas and adverse event zones to achieve midfacial support, contour, and profile in the repose position and simultaneous molding of a natural shape during animation. This reproducible method can be used both procedurally and in record-keeping for midface volumizing procedures.

  7. External rhinoplasty for the Arabian nose: a columellar scar analysis.

    PubMed

    Foda, Hossam M T

    2004-01-01

    This study aimed to evaluate columellar scar problems after external rhinoplasty in the Arabian population, and to analyze the technical factors that help prevent such problems and maximize the scar cosmesis. The investigation was conducted in university and private practice settings of the author in Alexandria, Egypt. A total of 600 Arab patients who underwent external rhinoplasty were included in the study. All the patients underwent surgery using the external rhinoplasty approach, in which bilateral alar marginal incisions were connected by an inverted V-shaped transcolumellar incision. At completion of the procedure, a two-layer closure of the columellar incision was performed. At a minimum of 1 year postoperatively, the columellar scar was evaluated subjectively by means of a patient questionnaire, and objectively by clinical examination and comparison of the close-up pre- and postoperative basal view photographs. Objectively, anything less than a barely visible, leveled, thin, linear scar was considered unsatisfactory. Subjectively, 95.5% of the patients rated the scar as unnoticeable, 3% as noticeable but acceptable, and 1.5% as unacceptable. Objectively, the scar was unsatisfactory in 7% of the cases. This was because of scar widening with or without depression (5%), hyperpigmentation (1.5%), and columellar rim notching (0.5%). The use of a deep 6/0 polydioxanon (PDS) suture significantly decreased the incidence of scar widening (p < 0.005).The columellar incision can be used safely in the Arab population regardless of their thick, dark, and oily skin. Technical factors that contributed to the favorable outcome of the columellar scar included proper planning of location and design of the incision used, precise execution, meticulous multilayered closure, and good postoperative care.

  8. Evaluation of surgically assisted rapid maxillary expansion and orthodontic treatment. Effects on dental, skeletal and nasal structures and rhinological findings.

    PubMed

    Magnusson, Anders

    2013-01-01

    . The most obvious changes were at the most lateral alar-bases. The difference in lateral displacement profoundly influenced the perception of a more rounded nose. There were no predictive correlations between the changes. Patients with narrow and constrained nostrils can benefit from these changes with respect to the subjective experience of nasal obstruction. It is questionable whether an alar-cinch suture will prevent widening at the alar-base. The 3D superimposition applied in Study II is a reliable method, circumventing projection and measurement errors. In conclusion, SARME and orthodontic treatment normalize the transverse deficiency, with long-term stability. SARME has a favourable effect on the subjective perception of nasal respiration. SARME significantly affects dental, skeletal and nasal structures.

  9. Configuration of water resources for a typical river basin in an arid region of China based on the ecological water requirements (EWRs) of desert riparian vegetation

    NASA Astrophysics Data System (ADS)

    Ling, Hongbo; Guo, Bin; Xu, Hailiang; Fu, Jinyi

    2014-11-01

    Desert riparian vegetation is a natural cover promoting the stability and development of inland river ecosystems in arid regions. Calculating the ecological water requirements (EWRs) of desert riparian vegetation is an important step in achieving reasonable water utilization. Therefore, this study examined the Tarim River, located in an extremely arid region of China, and collected relevant data on hydrology, weather and vegetation using remote sensing. Subsequently, we analyzed the spatial distribution of the desert riparian vegetation in four sections of the Tarim River and calculated the EWR of the desert riparian vegetation using the phreatic evaporation model; additionally, we determined the required runoffs at five hydrologic stations based on the water balance principle. Ultimately, the necessary protection ranges and goals for desert riparian vegetation were established according to the water resource variations in the Tarim River. Our research showed that the total area of desert riparian vegetation along the Tarim River is 16,285.3 km2; this distribution area gradually decreased as the distance from the river increased, and areas varied in the different river sections. The EWRs of desert riparian vegetation from Sections 1 to 5 are 5.698 × 108, 7.585 × 108, 4.900 × 108, 4.101 × 108 m3 and 1.078 × 108 m3, respectively. Therefore, the total EWR of the study region is 23.362 × 108 m3. In terms of the transpiration law of the "unimodal type", the peak value of EWR of natural vegetation occurs in July, and the decreasing trend appears in the other months. Based on the water balance principle, the required runoffs in Alar, Xinquman, Yingbaza, Wusiman and Qiala were determined to be 47.105 × 108, 35.174 × 108, 22.734 × 108, 15.775 × 108 and 7.707 × 108 m3, respectively. According to the water resource frequency and the EWR of the desert riparian vegetation along the Tarim River, we divided the region into three protection ranges: key protection (8

  10. Efficiency of Natural Gas Flares Associated with Shale Formation Wells

    NASA Astrophysics Data System (ADS)

    Stirm, B.; Caulton, D.; Shepson, P.; Cambaliza, M. L.; Mccabe, D. C.; Baum, E.

    2012-12-01

    Hydraulic fracturing has increased access and economic viability of shale oil reserves. Currently the Bakken Oil field in North Dakota is experiencing a rapid increase in the drilling of shale oil wells. However, this process typically results in the simultaneous release of natural gas. Low natural gas prices and the lack of local gas pipeline infrastructure have decreased the incentive for companies to capture this natural gas, with many opting to vent or flare the natural gas instead. The impact of these operations on greenhouse gas emissions has not been well characterized. An undocumented variable of interest is the destruction efficiency of methane in active oil field flares. In situ measurements of flare efficiency are difficult to obtain because of the inaccessibility of the flares. In June of 2012 we conducted flights over shale oil wells and flares in the Bakken Formation near Williston, ND using Purdue University's Airborne Laboratory for Atmospheric Research (ALAR) which is equipped with a 0.5 Hz Picarro CO2/CH4/H2O analyzer and a Best Air Turbulence (BAT) probe that measures the wind vectors. In addition, one flare in the Marcellus Formation near Washington, PA was also sampled. Flare signals were identified based on the enhancements of CO2 above the ambient background signal and the corresponding colocated CH4 concentration. Enhancements were isolated by subtracting the background concentrations of CO2 and CH4 to obtain delta CO2 and delta CH4 values. Emission factors to be reported are obtained as the ratio delta CH4 divided by delta CO2. We will report first in situ measurements of natural gas flare efficiency. We observed a variety of meteorological conditions with winds ranging from 4 to 15 m/s and will report on the relationship between wind speed and flare efficiency. We observed very high flare efficiency even under strong winds (at least 99.8% CO2 for all flares). During flare sampling, we observed a number of CH4 enhancements that were

  11. Study of Impacts of Arctic Sea Ice Reduction on Atmospheric Chemical Processes - The BROMEX 2012 Field Campaign

    NASA Astrophysics Data System (ADS)

    Nghiem, S. V.

    2012-12-01

    Arctic perennial sea ice has decreased drastically in the last decade and still remained low in spring 2012 as observed from scatterometer datasets acquired by QuikSCAT and Oceansat-2 satellites. In particular, the thinner, weaker, and saltier seasonal sea ice has dominated over the perennial ice in the Chukchi Sea and Beaufort Sea. To investigate impacts of sea ice reduction on atmospheric chemical processes, we conducted the BRomine, Ozone, and Mercury EXperiment in (BROMEX) in March-April 2012 around Barrow, extending out to a large region offshore and inland. Here we present overview results from BROMEX, which was successfully carried out by about 30 scientists, researchers, and field workers from multiple international institutions. For BROMEX, we coordinated and collected satellite data, including a number of near-real-time products, from multiple satellite instruments including MODIS, AMSR-E, GOME-2, SCIAMACHY, OMI, RADARSAT-2, Envisat ASAR, TanDEM-X, SMOS, CryoSat-2, and Oceansat-2. Over the BROMEX field region, we made measurements and collected sea ice, snow, ocean, and air samples for physical, meteorological, chemical, biological, and acoustic studies. A helicopter was used to deploy chemical and meteorological buoys in the Chukchi Sea and the Beaufort Sea. Measurements were also made with airborne sensors across sea ice, leads, lagoon, and tundra along various flight patterns of the ALAR aircraft. Furthermore, we coordinated with the NASA IceBridge P3 aircraft to collect surface temperature, surface height, snow depth, and ice thickness measurements. We set up and maintained field sites on sea ice and in the tundra to measure bromine, ozone, mercury, and other chemical species. Moreover, we obtained temperature data from many different types of temperature sensors for temperature accuracy assessment to identify potential issues that might cause errors or biases in temperature measurements. An enormous amount of in-situ snow and ice data was collected

  12. Airborne Measurements of CO2 Exchange above a Heterogeneous Northern-latitude Forest

    NASA Astrophysics Data System (ADS)

    Salmon, O. E.; Caulton, D.; Shepson, P. B.; Stirm, B. H.; Metzger, S.; Musinsky, J.; Munger, J. W.

    2014-12-01

    Northern latitude forests represent an important global sink for carbon dioxide (CO2). Estimating the landscape-scale exchange of CO2 is complicated by the heterogeneity of forested areas. Airborne eddy-covariance measurements can complement continuous tower-based measurements for determining the magnitude and spatial variability of carbon uptake in forested areas, and to assess means for scaling-up. While aircraft provide accessibility, the resulting flux measurements represent a narrow time slice, and average over a comparatively large source area. The goal of this study is to improve our ability to attribute aircraft flux data to finer spatial scales. We hypothesize that this can be achieved by (i) improving the spatial scale of the sampling method, (ii) examining inter-day variability, and (iii) relating airborne eddy-covariance flux estimates to remote sensing determinations of the land cover. For this purpose identical flight experiments were conducted on May 29 and June 1, 2014 over a 240 km2 region encompassing the Harvard University EMS eddy flux tower at Harvard Forest, MA, using the Purdue University ALAR aircraft. In the early afternoon of each day, 19 flight legs, 20 km in length, were flown over the heterogeneous forest canopy. The two replicate experiments allow assessment of inter-day variability in CO2 exchange under similar meteorological conditions. Furthermore, the experiments were coordinated with high-resolution (≤1 m) and medium-resolution (≤100 m) remote sensing retrievals of forest canopy structure and composition (NEON AOP) and soil moisture (NASA AirMOSS), respectively. This unprecedented hierarchy of observations enables evaluation of the ability of different data processing approaches to calculate finer scale CO2 exchange with the surface. Analyses of the flights conducted on May 29 and June 1 show a transect-averaged (± 1σ) CO2 uptake of 13 ± 3 µmol m-2s-1 and 11 ± 2 µmol m-2s-1, respectively. In complement to the aircraft

  13. Towards sustainable development of the environmentally degraded arid rivers of China — a case study from Tarim River

    NASA Astrophysics Data System (ADS)

    Feng, Q.; Endo, K. N.; Cheng, G. D.

    2001-11-01

    Increases in water resources development and utilization over the last 30 years have led to significant environmental and hydrological degradation of the Tarim River basin. Water discharge in the lower reaches has been seriously compromised. A total of 300 km of the lower reach has been drained between the 1950s and 1970s. The water table fell from 2-3 to 4-10 m between the years 1960 and 1980, and the annual rate of fall of the water table was 20 cm from 1980 to the present. The area populated by Populus euphtatica has declined by two thirds and the biomass has decreased by half between the years 1958 and 1978 in the Tarim River basin. From the 1950s to the 1990s, the area of P. euphtatica/ E. angustifolia forest, the main tree species of the region, declined by 3,820 km2 in the lower reaches of the Tarim River basin, while the shrub and meadow area declined by 200 km2. Such hydrological changes have resulted in a marked degradation of aquatic habitats and have caused substantial land desertification. A total of 12,300 km2 of desertified lands formed between the 1960s and 1990s. During the past 30 years, the salt content of the Tarim River has increased gradually according to observational data from the Alar Hydrological Station. The maximum salt content in 1960 was 1.28 g L-1, but in 1981-1984 it reached 4.0 g L-1, and in 1998 was 7.8 g L-1. Based on the present organic carbon content in desertified lands, total emissions of C into the atmosphere in the last 30 years have been 112.2 Tg, representing 28.3% of organic carbon in the 0-1.0 m soil layer due to the hydrological degradation. Among factors contributing to these problems, human activities are fore most. Solving these problems will require raising the level of scientific and technological expertise in the monitoring, conservation, protection, and rehabilitation of water resources and associated habitats. Presently the greatest priority is to expand and improve water conservation studies.

  14. Quantifying Methane Emissions from Shale Gas Wells in Pennsylvania

    NASA Astrophysics Data System (ADS)

    Caulton, D.; Shepson, P.; Cambaliza, M. L.; Sparks, J. P.; Santoro, R.; Sweeney, C.; Davis, K. J.; Lauvaux, T.; Howarth, R.; Stirm, B.; Sarmiento, D.; Belmecheri, S.

    2012-12-01

    A major question facing assessment of greenhouse gas sources and sinks is the impact of shale gas drilling operations on methane emissions. Estimating fugitive methane emissions is a challenge because of the temporal variability of emissions and because of the inaccessibility of the emission plumes using traditional measurement techniques. In June of 2012 we conducted flights over shale gas wells in the Marcellus Formation near Washington, PA using Purdue University's Airborne Laboratory for Atmospheric Research (ALAR) which is equipped with a 0.5 Hz Picarro CO2/CH4/H2O analyzer and a programmable flask package provided by NOAA. We calculated methane fluxes for two wells, here denoted as Well Delta and Well Tau, via the aircraft-based mass balance technique that has been previously described by Mays et al. (2009). Briefly, horizontal transects perpendicular to the prevailing wind direction were flown at different altitudes up to the top of the convective boundary layer downwind of a source. The data were interpolated to create a complete 2-d snapshot of methane concentrations derived from the source. By multiplying the background subtracted concentration by the perpendicular component of the horizontal winds and integrating over the plume dimensions the flux can be obtained. During the experiment elevated background concentrations were observed in the southwestern corner of Pennsylvania during the morning shown in Figure 1. We mapped the extent of this elevated methane region and used it to obtain an estimate of the regional enhancement of methane. Here we present our preliminary analysis, and results. Well Delta was sampled in three separate experiments; however, it was close to several other active wells. When the signal was too diffuse to obtain separate well specific fluxes, the flux for the entire area was averaged over the number of wells that may have contributed. Well Tau was sampled during one experiment and a nearby relatively large methane emission

  15. Disseminated lupus vulgaris.

    PubMed

    Garg, Taru; Ramchander; Shrihar, Rashmi; Gupta, Tanvi Pal; Aggarwal, Shilpi

    2011-01-01

    A 28-year-old woman presented with reddish raised, shiny lesions over the face and ears present for the past 3 years. Four years ago, she developed in her left axilla a nodule that became fluctuant and tender, which ruptured to discharge seropurulent material. It subsided after the patient had received antibiotics for 6 months, leaving puckered scarring. There was no history of antituberculous treatment. After 1 year, she developed papulonodular lesions on her face, nose, and ears. There was now a history of malaise, fever, dry cough, and anorexia and weight loss for the past 2 months. The patient was fully vaccinated in childhood, including against varicella infection. The general physical examination revealed lymphadenopathy involving cervical, axillary, and inguinal lymph nodes 0.5 x 0.5 cm to 1 x 1.5 cm, firm in consistency, and nontender. They were discrete except in the left axilla where multiple matted lymph nodes were present with overlying scarring and a papule. Her systemic examination was normal. Cutaneous examination showed a shiny erythematous plaque 3x2 cm with central atrophy and scarring on the face (Figure). It was comprised of multiple shiny nontender soft papules arranged in annular configuration. Similar discrete papules and nodules with adherent fine scaling were seen bilaterally on the alar prominence of the nose, lower lip, and post-auricular area. On diascopy, apple jelly nodules were seen. The hemogram, liver function tests, and renal function tests were normal, except for an elevated erythrocyte sedimentation rate. The Mantoux test showed erythema and an induration of 20 x 20 cm. A posteroanterior view on the chest x-ray showed fibrotic changes suggestive of pulmonary tuberculosis. Ultrasonography of the abdomen and pelvis showed no tubercular foci. Human immunodeficiency virus serology by enzyme-linked immunosorbent assay with 3 different kits was nonreactive. Histopathology from a nodule showed a focally thinned-out epidermis with

  16. Water resource management in river oases along the Tarim River in North-West of China

    NASA Astrophysics Data System (ADS)

    Kliucininkaite, Lina; Disse, Markus

    2013-04-01

    Tarim River is one of the longest inland rivers in the world. It flows its water in the northern part of the Taklamakan desert in Xinjiang, North-west of China, which is a very hostile region due its climatic conditions and particularly due to low precipitation and very high evaporation rates. During the past five decades intensive exploitation of water resources, mainly by agricultural activities, has changed the temporal and spatial distribution of them and caused serious environmental problems in the Tarim River Basin. The support measures for oasis management along the Tarim River under climatic and societal changes became the overarching goal of this research. The temperature has risen by nearly 1° C over the past 50 years in the Tarim River Basin so more water was available in the mountainous areas of Xinjiang, leading to an increasing trend of the headstream discharges of the Tarim Basin. Aksu, Hotan and Yarkant Rivers are three tributaries of the Tarim River, as well as its main water suppliers. However, under the condition of water increase with the volume of 25×108 m3 in headstreams in recent 10 years, the water to the mainstream has increased less than 108 m3 (in Alar hydrological station), which is less than 3% of the increased water volume of runoff. Moreover, the region is one of the biggest cotton and other cash crops producers in China. In addition, expansion of urban and, in particular, of irrigation areas have caused higher water consumption at different parts of the river, leading to severe ecological effects on rural areas, especially in the lower reaches. Moreover, it also highly affects groundwater level and quality. The aim of this research is to support decision makers, planners and engineers to find right measures in the area for the further development of the region, as well as adaptation to changing climate. Different scenarios for water resource management, as well as water distribution and allocation in a more efficient and water

  17. Photo anthropometric variations in Japanese facial features: Establishment of large-sample standard reference data for personal identification using a three-dimensional capture system.

    PubMed

    Ogawa, Y; Wada, B; Taniguchi, K; Miyasaka, S; Imaizumi, K

    2015-12-01

    This study clarifies the anthropometric variations of the Japanese face by presenting large-sample population data of photo anthropometric measurements. The measurements can be used as standard reference data for the personal identification of facial images in forensic practices. To this end, three-dimensional (3D) facial images of 1126 Japanese individuals (865 male and 261 female Japanese individuals, aged 19-60 years) were acquired as samples using an already validated 3D capture system, and normative anthropometric analysis was carried out. In this anthropometric analysis, first, anthropological landmarks (22 items, i.e., entocanthion (en), alare (al), cheilion (ch), zygion (zy), gonion (go), sellion (se), gnathion (gn), labrale superius (ls), stomion (sto), labrale inferius (li)) were positioned on each 3D facial image (the direction of which had been adjusted to the Frankfort horizontal plane as the standard position for appropriate anthropometry), and anthropometric absolute measurements (19 items, i.e., bientocanthion breadth (en-en), nose breadth (al-al), mouth breadth (ch-ch), bizygomatic breadth (zy-zy), bigonial breadth (go-go), morphologic face height (se-gn), upper-lip height (ls-sto), lower-lip height (sto-li)) were exported using computer software for the measurement of a 3D digital object. Second, anthropometric indices (21 items, i.e., (se-gn)/(zy-zy), (en-en)/(al-al), (ls-li)/(ch-ch), (ls-sto)/(sto-li)) were calculated from these exported measurements. As a result, basic statistics, such as the mean values, standard deviations, and quartiles, and details of the distributions of these anthropometric results were shown. All of the results except "upper/lower lip ratio (ls-sto)/(sto-li)" were normally distributed. They were acquired as carefully as possible employing a 3D capture system and 3D digital imaging technologies. The sample of images was much larger than any Japanese sample used before for the purpose of personal identification. The

  18. Pax6 regulates the formation of the habenular nuclei by controlling the temporospatial expression of Shh in the diencephalon in vertebrates.

    PubMed

    Chatterjee, Mallika; Guo, Qiuxia; Weber, Sabrina; Scholpp, Steffen; Li, James Yh

    2014-02-14

    The habenula and the thalamus are two critical nodes in the forebrain circuitry and they connect the midbrain and the cerebral cortex in vertebrates. The habenula is derived from the epithalamus and rests dorsally to the thalamus. Both epithalamus and thalamus arise from a single diencephalon segment called prosomere (p)2. Shh is expressed in the ventral midline of the neural tube and in the mid-diencephalic organizer (MDO) at the zona limitans intrathalamica between thalamus and prethalamus. Acting as a morphogen, Shh plays an important role in regulating cell proliferation and survival in the diencephalon and thalamic patterning. The molecular regulation of the MDO Shh expression and the potential role of Shh in development of the habenula remain largely unclear. We show that deleting paired-box and homeobox-containing gene Pax6 results in precocious and expanded expression of Shh in the prospective MDO in fish and mice, whereas gain-of-function of pax6 inhibits MDO shh expression in fish. Using gene expression and genetic fate mapping, we have characterized the expression of molecular markers that demarcate the progenitors and precursors of habenular neurons. We show that the thalamic domain is shifted dorsally and the epithalamus is missing in the alar plate of p2 in the Pax6 mutant mouse. Conversely, the epithalamus is expanded ventrally at the expense of the thalamus in mouse embryos with reduced Shh activity. Significantly, attenuating Shh signaling largely rescues the patterning of p2 and restores the epithalamus in Pax6 mouse mutants, suggesting that Shh acts downstream of Pax6 in controlling the formation of the habenula. Similar to that found in the mouse, we show that pax6 controls the formation of the epithalamus mostly via the regulation of MDO shh expression in zebrafish. Our findings demonstrate that Pax6 has an evolutionarily conserved function in establishing the temporospatial expression of Shh in the MDO in vertebrates. Furthermore, Shh mediates

  19. Spatiotemporal Development of the Orexinergic (Hypocretinergic) System in the Central Nervous System of Xenopus laevis.

    PubMed

    López, Jesús M; Morales, Lorena; González, Agustín

    2016-01-01

    The present immunohistochemical study represents a detailed spatiotemporal analysis of the localization of orexin-immunoreactive (OX-ir) cells and fibers throughout development in the brain of the anuran amphibian Xenopus laevis, a model frequently used in developmental studies. Anurans undergo remarkable physiological changes during the early life stages, and very little is known about the ontogeny and the localization of the centers that control functions such as appetite and feed ingestion in the developing brain. We examined the onset of the orexinergic system, demonstrated to be involved in appetite regulation, using antibodies against mammalian orexin-A and orexin-B peptides. Simultaneous detection of orexins with other territorial markers was used to assess the precise location of the orexinergic cells in the hypothalamus, analyzed within a segmental paradigm. Double staining of orexins and tyrosine hydroxylase served to evaluate possible interactions with the catecholaminergic systems. At early embryonic stages, the first OX-ir cells were detected in the hypothalamus and, soon after, long descending projections were observed through the brainstem to the spinal cord. As brain development proceeded, the double-staining techniques demonstrated that this OX-ir cell group was located in the suprachiasmatic nucleus within the alar hypothalamus. Throughout larval development, the number of OX-ir cells increased notably and a widespread fiber network that innervated the main areas of the forebrain and brainstem was progressively formed, including innervation in the posterior tubercle and mesencephalon, the locus coeruleus, and the nucleus of the solitary tract where catecholaminergic cells are present. In addition, orexinergic cells were detected in the preoptic area and the tuberal hypothalamus only at late prometamorphic stages. The final distribution pattern, largely similar to that of the adult, was achieved through metamorphic climax. The early expression of

  20. Site-selective chemical modification of chymotrypsin using peptidyl derivatives bearing optically active diphenyl 1-amino-2-phenylethylphosphonate: Stereochemical effect of the diphenyl phosphonate moiety.

    PubMed

    Ono, Shin; Nakai, Takahiko; Kuroda, Hirofumi; Miyatake, Ryuta; Horino, Yoshikazu; Abe, Hitoshi; Umezaki, Masahito; Oyama, Hiroshi

    2016-11-04

    Diphenyl (α-aminoalkyl)phosphonates act as mechanism-based inhibitors against serine proteases by forming a covalent bond with the hydroxy group of the active center Ser residue. Because the covalent bond was found to be broken and replaced by 2-pyridinaldoxime methiodide (2PAM), we employed a peptidyl derivative bearing diphenyl 1-amino-2-phenylethylphosphonate moiety (Phe(p) (OPh)2 ) to target the active site of chymotrypsin and to selectively anchor to Lys175 in the vicinity of the active site. Previously, it was reported that the configuration of the α-carbon of phosphorus in diphenyl (α-aminoalkyl)phosphonates affects the inactivation reaction of serine proteases, i.e., the (R)-enantiomeric diphenyl phosphonate is comparable to l-amino acids and it effectively reacts with serine proteases, whereas the (S)-enantiomeric form does not. In this study, we evaluated the stereochemical effect of the phosphonate moiety on the selective chemical modification. Epimeric dipeptidyl derivatives, Ala-(R or S)-Phe(p) (OPh)2 , were prepared by separation with RP-HPLC. A tripeptidyl (R)-epimer (Ala-Ala-(R)-Phe(p) (OPh)2 ) exhibited a more potent inactivation ability against chymotrypsin than the (S)-epimer. The enzyme inactivated by the (R)-epimer was more effectively reactivated with 2PAM than the enzyme inactivated by the (S)-epimer. Finally, N-succinimidyl (NHS) active ester derivatives, NHS-Suc-Ala-Ala- (R or S)-Phe(p) (OPh)2 , were prepared, and we evaluated their action when modifying Lys175 in chymotrypsin. We demonstrated that the epimeric NHS derivative that possessed the diphenyl phosphonate moiety with the (R)-configuration effectively modified Lys175 in chymotrypsin, whereas that with the (S)-configuration did not. These results demonstrate the utility of peptidyl derivatives that bear an optically active diphenyl phosphonate moiety as affinity labeling probes in protein bioconjugation. © 2015 Wiley Periodicals, Inc. Biopolymers (Pept Sci) 106: 521-530, 2016.

  1. Isthmus-to-midbrain transformation in the absence of midbrain-hindbrain organizer activity.

    PubMed

    Jászai, József; Reifers, Frank; Picker, Alexander; Langenberg, Tobias; Brand, Michael

    2003-12-01

    In zebrafish acerebellar (ace) embryos, because of a point mutation in fgf8, the isthmic constriction containing the midbrain-hindbrain boundary (MHB) organizer fails to form. The mutants lack cerebellar development by morphological criteria, and they appear to have an enlarged tectum, showing no obvious reduction in the tissue mass at the dorsal mesencephalic/metencephalic alar plate. To reveal the molecular identity of the tissues located at equivalent rostrocaudal positions along the neuraxis as the isthmic and cerebellar primordia in wild-types, we undertook a detailed analysis of ace embryos. In ace mutants, the appearance of forebrain and midbrain specific marker genes (otx2, dmbx1, wnt4) in the caudal tectal enlargement reveals a marked rostralized gene expression profile during early somitogenesis, followed by the lack of early and late cerebellar-specific gene expression (zath1/atoh1, gap43, tag1/cntn2, neurod, zebrin II). The Locus coeruleus (LC) derived from rostral rhombomere 1 is also absent in the mutants. A new interface between otx2 and epha4a suggests that the rostralization stops at the caudal part of rhombomere 1. The mesencephalic basal plate is also affected in the mutant embryos, as indicated by the caudal expansion of the diencephalic expression domains of epha4a, zash1b/ashb, gap43 and tag1/cntn2, and by the dramatic reduction of twhh expression. No marked differences are seen in cell proliferation and apoptotic patterns around the time the rostralization of gene expression becomes evident in the mutants. Therefore, locally distinct cell proliferation and cell death is unlikely to be the cause of the fate alteration of the isthmic and cerebellar primordia in the mutants. Dil cell-lineage labeling of isthmic primordial cells reveals that cells, at the location equivalent of the wild-type MHB, give rise to caudal tectum in ace embryos. This suggests that a caudalto-rostral transformation leads to the tectal expansion in the mutants. Fgf8

  2. Chicken sternal cartilage for simulated septal cartilage graft carving: a rhinoplasty educational model.

    PubMed

    Weinfeld, Adam Bryce

    2010-01-01

    In rhinoplasty, cartilage is often harvested from the nasal septum and meticulously carved into delicate grafts designed to reshape and strengthen the nasal osteocartilaginous framework. Proficiency at this task develops with experience in the clinical setting. The author offers a simulated educational model designed to provide rhinoplasty surgeons with increased preclinical experience in cartilage graft carving. This model relies on inexpensive, food-grade chickens, which may be purchased at any grocery store. Four whole chickens were dissected to expose and harvest the sternal (breast/keel) cartilage. A technique was developed for preparing the cartilage to approximate the shape and dimensions of human septal cartilage. Measurements were made to demonstrate similarities between the model material and the human septum. The average weight of the chickens was 4.27 lb. The average cartilage height, length, and thickness were 2.36 cm, 6.13 cm, and 3.4 mm, respectively. This size compared favorably with typical septal harvest pieces, which had both heights and lengths of 2.5 cm and thicknesses of 3.25 mm. The author found that one sternal cartilage piece could be employed to carve two spreader grafts, a columellar strut graft, a tip graft, and two alar rim cartilage grafts. The performance of the avian cartilage was subjectively very similar to that of septal cartilage. Furthermore, two pieces of the sternal cartilage could be glued together and fastened within a model of a human skull to replicate the cartilaginous septum in situ. This construct was employed for demonstrations of actual septal cartilage harvest. Carving septal cartilage into grafts is a difficult process. Precision and improved results increase with clinical experience on human patients, but this cadaveric avian (chicken) model provides an opportunity for simulated surgical training on a very similar tissue type at a very low cost. This model has the potential to improve human outcomes by providing

  3. [Nasal septum cartilage-silica gel complex for repairing nasal deformities of unilateral cleft lip].

    PubMed

    Li, Qingwei; Sheng, Zunqi; Tang, Shengjian; Yang, Biaobing; Yu, Xiaohua

    2009-07-01

    To evaluate the operative methods and therapeutic effects of nasal septum cartilage-silica gel complex for two-stage repair of nasal deformities of unilateral cleft lip. From June 2001 to June 2007, 38 cases of secondary nasal deformity and septum deviation of cleft lip were treated with transplanting nasal septum cartilage-silica gel complex. Among of them, there were 21 males and 17 females, aging 14-23 years with an average of 17.6 years. All cases were with nasal deformities of unilateral cleft lip, including 21 cases of complete cleft lip and 17 cases of incomplete cleft lip. The locations were left side in 26 cases and right side in 12 cases. Nasal deformities were columella nasi deflexion, flattened nasal tip, pteleorrhine and alanasi collapse. The patients received 1-4 times operations, and the interval of two operations was 3-10 years (mean 5.5 years). According to nasal deformity, the nasal septum cartilage of 1.8 cm x 1.2 cm was cut, and transplanted into the nose point phantom surface forming "the shield" to extend nose column and to raise the tip of the nose. At the same time the nasal tip fat-connective tissue flap graft with fat knot was given. After fixation, the nasal alar cartilage and soft tissues were reduced to normal position. Primary healing of the incisions was achieved in all cases. The nasal deformity was corrected. The postoperative follow-up period was 12-18 months with an average of 15.6 months. All the patients of regional cartilage scars had no complication. The figure of nose was slinky, the height of apex of nose and the shape of nose was natural, the apex of nose, nasal ala, nostrils and nasal columella were satisfactory [(the results were satisfactory in 30 cases (78.9%), general in 8 cases (21.1%)]. The nose department overall esthetics shape was improved in all the patients, no complications of the phantom sliding, shifting and exposure, hemorrhage and infection occurred. The nasal septum cartilage-silica gel complex to repair

  4. Crystal structures of three protozoan homologs of tryptophanyl-tRNA synthetase.

    PubMed

    Merritt, Ethan A; Arakaki, Tracy L; Gillespie, Robert; Napuli, Alberto J; Kim, Jessica E; Buckner, Frederick S; Van Voorhis, Wesley C; Verlinde, Christophe L M J; Fan, Erkang; Zucker, Frank; Hol, Wim G J

    2011-05-01

    Tryptophanyl-tRNA synthetase (TrpRS) is an essential enzyme that is recognizably conserved across all forms of life. It is responsible for activating and attaching tryptophan to a cognate tRNA(Trp) molecule for use in protein synthesis. In some eukaryotes this original core function has been supplemented or modified through the addition of extra domains or the expression of variant TrpRS isoforms. The three TrpRS structures from pathogenic protozoa described here represent three illustrations of this malleability in eukaryotes. The Cryptosporidium parvum genome contains a single TrpRS gene, which codes for an N-terminal domain of uncertain function in addition to the conserved core TrpRS domains. Sequence analysis indicates that this extra domain, conserved among several apicomplexans, is related to the editing domain of some AlaRS and ThrRS. The C. parvum enzyme remains fully active in charging tRNA(Trp) after truncation of this extra domain. The crystal structure of the active, truncated enzyme is presented here at 2.4Å resolution. The Trypanosoma brucei genome contains separate cytosolic and mitochondrial isoforms of TrpRS that have diverged in their respective tRNA recognition domains. The crystal structure of the T. brucei cytosolic isoform is presented here at 2.8Å resolution. The Entamoeba histolytica genome contains three sequences that appear to be TrpRS homologs. However one of these, whose structure is presented here at 3.0Å resolution, has lost the active site motifs characteristic of the Class I aminoacyl-tRNA synthetase catalytic domain while retaining the conserved features of a fully formed tRNA(Trp) recognition domain. The biological function of this variant E. histolytica TrpRS remains unknown, but, on the basis of a completely conserved tRNA recognition region and evidence for ATP but not tryptophan binding, it is tempting to speculate that it may perform an editing function. Together with a previously reported structure of an unusual Trp

  5. Frontal soft tissue analysis using a 3 dimensional camera following two-jaw rotational orthognathic surgery in skeletal class III patients.

    PubMed

    Choi, Jong Woo; Lee, Jang Yeol; Oh, Tae-Suk; Kwon, Soon Man; Yang, Sung Joon; Koh, Kyung Suk

    2014-04-01

    Although two dimensional cephalometry is the standard method for analyzing the results of orthognathic surgery, it has potential limits in frontal soft tissue analysis. We have utilized a 3 dimensional camera to examine changes in soft tissue landmarks in patients with skeletal class III dentofacial deformity who underwent two-jaw rotational setback surgery. We assessed 25 consecutive Asian patients (mean age, 22 years; range, 17-32 years) with skeletal class III dentofacial deformities who underwent two-jaw rotational surgery without maxillary advancement. Using a 3D camera, we analyzed changes in facial proportions, including vertical and horizontal dimensions, facial surface areas, nose profile, lip contour, and soft tissue cheek convexity, as well as landmarks related to facial symmetry. The average mandibular setback was 10.7 mm (range: 5-17 mm). The average SNA changed from 77.4° to 77.8°, the average SNB from 89.2° to 81.1°, and the average occlusal plane from 8.7° to 11.4°. The mid third vertical dimension changed from 58.8 mm to 57.8 mm (p = 0.059), and the lower third vertical dimension changed from 70.4 mm to 68.2 mm (p = 0.0006). The average bigonial width decreased from 113.5 mm to 109.2 mm (p = 0.0028), the alar width increased from 34.7 mm to 36.1 mm (p-value = 0.0002), and lip length was unchanged. Mean mid and lower facial surface areas decreased significantly, from 171.8 cm(2) to 166.2 cm(2) (p = 0.026) and from 71.23 cm(2) to 61.9 cm(2) (p < 0.0001), respectively. Cheek convexity increased significantly, from 171.8° to 155.9° (p = 0.0007). The 3D camera was effective in frontal soft tissue analysis for orthognathic surgery, and enabled quantitative analysis of changes in frontal soft tissue landmarks and facial proportions that were not possible with conventional 2D cephalometric analysis.

  6. Airborne Imaging-DOAS measurements of the horizontal and vertical distribution of bromine monoxide during the BROMEX campaign in spring 2012 around Barrow, AK

    NASA Astrophysics Data System (ADS)

    Zielcke, J.; Pöhler, D.; General, S.; Shepson, P.; Stirm, B.; Friess, U.; Pratt, K. A.; Caulton, D.; Cambaliza, M. L.; Perez Perez, L.; Halfacre, J. W.; Walsh, S. J.; Simpson, W. R.; Platt, U.

    2012-12-01

    During the past few decades, the amount of multi-year sea ice in the Arctic has decreased dramatically, and this loss is predicted to continue due to the warming climate. This means a shift of the dominance from perennial to seasonal ice, which implies that vast regions of the Arctic are being occupied by seasonal, saltier ice. This younger and also thinner seasonal ice is also more susceptible to formation of leads, polynyas and frost flowers, which are saltier compared to perennial ice, and can facilitate chemical processes leading to bromine enhancement in the Arctic. Bromine monoxide (BrO) is a reactive halogen species (RHS) and has been known for quite a while to have a profound impact on the chemistry of the polar tropospheric boundary layer. Especially during springtime, BrO regularly causes the complete depletion of ozone in the lowermost ~1000m through autocatalytic photochemistry during so called Ozone Depletion Events (ODEs). Despite numerous advances during the last few years, details of the bromine release and reaction processes are still unclear, especially the role of frost flowers, first-year sea ice, atmospheric stability and snow. To investigate these important details of this process, a novel imaging DOAS instrument for the ultraviolet wavelength range (300 to 400 nanometer) was deployed aboard a light twin-engine aircraft (ALAR, Purdue Univ.) as part of the BRomine, Ozone, and Mercury EXperiment (BROMEX) in Barrow, Alaska, in spring 2012. This instrument utilizes (1) a whisk broom scanner system in nadir direction to map trace gas distributions of the overflown area at high spatial resolution. In addition, (2) a forward-looking system, observes the vertical trace gas distribution in 31 different viewing directions simultaneously (push broom scanning). Both viewing directions are equipped with digital cameras, enabling the creation of aerial maps and the comparison of spectral data with background features. This system was used for measurements

  7. Frontal-view nasolabial soft tissue alterations after bimaxillary orthognathic surgery in Class III patients.

    PubMed

    Hemmatpour, Siamak; Kadkhodaei Oliadarani, Fatemeh; Hasani, Ali; Rakhshan, Vahid

    2016-11-01

    The aim of this before-after clinical trial was to evaluate nasolabial soft tissue changes in the frontal plane after bimaxillary surgery. A total of 20 skeletal Class III Iranian patients needing bimaxillary Le Fort I osteotomy plus mandibular setback surgery were enrolled in this trial. Patients underwent 4.02 ± 1.02 mm of maxillary advancement (Le Fort I osteotomy, 4.33 ± 1.21 mm in men, 3.81 ± 0.86 mm in women) and 7.13 ± 1.74 mm of mandibular setback (intraoral vertical ramus osteotomy, 7.71 ± 2.33 mm in men, and 6.74 ± 1.16 mm in women). Data were acquired via 2D frontal photographs. We compared pretreatment baseline (T 1), preoperative postorthodontic treatment (T 2), and postoperative (T 3) anthropometric measurements using repeated-measures ANOVA and Bonferroni tests (α = 0.05). The 20 patients (12 men, 8 women) were aged 21.85 ± 1.75 years. Between T 1 and T 2, nasal width, cutaneous upper labial heights increased overall; cutaneous lower labial height decreased (P < 0.05). Between T 2 and T 3, nasal width, widths of the philtrum and mouth, cutaneous upper-lip height, vermilion height of the lower lip, lateral upper-lip height increased; the upper-lip vermilion height and cutaneous lower lip height decreased (P < 0.05). The changes ranged between 0.5 and 5 mm. The applied orthognathic surgery procedures might widen the alar base and mouth width. It might increase the lateral upper-lip height, vermilion height of the lower lip, and cutaneous and overall upper-lip heights while reducing upper-lip vermilion height and shortening the overall lower-lip height.

  8. Seasonal changes of whole root system conductance by a drought-tolerant grape root system.

    PubMed

    Alsina, Maria Mar; Smart, David R; Bauerle, Taryn; de Herralde, Felicidad; Biel, Carme; Stockert, Christine; Negron, Claudia; Save, Robert

    2011-01-01

    The role of root systems in drought tolerance is a subject of very limited information compared with above-ground responses. Adjustments to the ability of roots to supply water relative to shoot transpiration demand is proposed as a major means for woody perennial plants to tolerate drought, and is often expressed as changes in the ratios of leaf to root area (A(L):A(R)). Seasonal root proliferation in a directed manner could increase the water supply function of roots independent of total root area (A(R)) and represents a mechanism whereby water supply to demand could be increased. To address this issue, seasonal root proliferation, stomatal conductance (g(s)) and whole root system hydraulic conductance (k(r)) were investigated for a drought-tolerant grape root system (Vitis berlandieri×V. rupestris cv. 1103P) and a non-drought-tolerant root system (Vitis riparia×V. rupestris cv. 101-14Mgt), upon which had been grafted the same drought-sensitive clone of Vitis vinifera cv. Merlot. Leaf water potentials (ψ(L)) for Merlot grafted onto the 1103P root system (-0.91±0.02 MPa) were +0.15 MPa higher than Merlot on 101-14Mgt (-1.06±0.03 MPa) during spring, but dropped by approximately -0.4 MPa from spring to autumn, and were significantly lower by -0.15 MPa (-1.43±0.02 MPa) than for Merlot on 101-14Mgt (at -1.28±0.02 MPa). Surprisingly, g(s) of Merlot on the drought-tolerant root system (1103P) was less down-regulated and canopies maintained evaporative fluxes ranging from 35-20 mmol vine(-1) s(-1) during the diurnal peak from spring to autumn, respectively, three times greater than those measured for Merlot on the drought-sensitive rootstock 101-14Mgt. The drought-tolerant root system grew more roots at depth during the warm summer dry period, and the whole root system conductance (k(r)) increased from 0.004 to 0.009 kg MPa(-1) s(-1) during that same time period. The changes in k(r) could not be explained by xylem anatomy or conductivity changes of individual root

  9. Biomechanical comparison of lumbosacral fixation using Luque-Galveston and Colorado II sacropelvic fixation: advantage of using locked proximal fixation.

    PubMed

    Early, Sean; Mahar, Andrew; Oka, Richard; Newton, Peter

    2005-06-15

    Biomechanical evaluation of sacropelvic fixation strategies as they apply to neuromuscular scoliosis. The primary objective was to compare the rigidity of 2 methods of sacropelvic fixation (Galveston vs. Colorado II). The secondary objective was to evaluate the effect on construct rigidity by adding a pair of L1 pedicle screws to a Luque wire construct. The Galveston modification to the Luque rodding system has become standard for treating childhood and adolescent neuromuscular scoliosis. The Galveston method provides reasonable lumbo-pelvic fixation with a relatively simple method of insertion. Clinical reviews of sagittal plane stability in neuromuscular patients with Galveston fixations performed at our institution have led to concerns regarding the technique's ability to maintain proper lumbar lordosis. This concern has generated interest in evaluating biomechanical stability of more rigid fixation methods in these long spino-pelvic constructs. As such, the following biomechanical study evaluated lumbosacral stability of 2 sacropelvic fixation methods: the standard Luque-Galveston method and the Colorado II sacropelvic fixation method using the Chopin plate-screw block. As a secondary interest, evaluations of the rigidity of the proximal construct when using pedicle screw fixation were completed. It was hypothesized that one additional point of rigid fixation at the thoracolumbar junction may make substantial improvement in rigidity to the otherwise Luque construct. Lumbo-pelvic segments of human cadaveric specimens were instrumented with L1 pedicle screws, sublaminar wires between L2 and L5, and sacropelvic fixation with either Galveston rods or Colorado II sacropelvic plates using S1 screws, S2 alar screws, and iliac screws. Tests were conducted for physiologic flexion-extension and torsional loading. Construct stiffness between L1-S1 was determined for each specimen. Motion measurement data were collected between L1-L5 and L5-S1 using a noncontact marker

  10. Seasonal changes of whole root system conductance by a drought-tolerant grape root system

    PubMed Central

    Alsina, Maria Mar; Smart, David R.; Bauerle, Taryn; de Herralde, Felicidad; Biel, Carme; Stockert, Christine; Negron, Claudia; Save, Robert

    2011-01-01

    The role of root systems in drought tolerance is a subject of very limited information compared with above-ground responses. Adjustments to the ability of roots to supply water relative to shoot transpiration demand is proposed as a major means for woody perennial plants to tolerate drought, and is often expressed as changes in the ratios of leaf to root area (AL:AR). Seasonal root proliferation in a directed manner could increase the water supply function of roots independent of total root area (AR) and represents a mechanism whereby water supply to demand could be increased. To address this issue, seasonal root proliferation, stomatal conductance (gs) and whole root system hydraulic conductance (kr) were investigated for a drought-tolerant grape root system (Vitis berlandieri×V. rupestris cv. 1103P) and a non-drought-tolerant root system (Vitis riparia×V. rupestris cv. 101-14Mgt), upon which had been grafted the same drought-sensitive clone of Vitis vinifera cv. Merlot. Leaf water potentials (ψL) for Merlot grafted onto the 1103P root system (–0.91±0.02 MPa) were +0.15 MPa higher than Merlot on 101-14Mgt (–1.06±0.03 MPa) during spring, but dropped by approximately –0.4 MPa from spring to autumn, and were significantly lower by –0.15 MPa (–1.43±0.02 MPa) than for Merlot on 101-14Mgt (at –1.28±0.02 MPa). Surprisingly, gs of Merlot on the drought-tolerant root system (1103P) was less down-regulated and canopies maintained evaporative fluxes ranging from 35–20 mmol vine−1 s−1 during the diurnal peak from spring to autumn, respectively, three times greater than those measured for Merlot on the drought-sensitive rootstock 101-14Mgt. The drought-tolerant root system grew more roots at depth during the warm summer dry period, and the whole root system conductance (kr) increased from 0.004 to 0.009 kg MPa−1 s−1 during that same time period. The changes in kr could not be explained by xylem anatomy or conductivity changes of individual root

  11. Use of Adipose-Derived Mesenchymal Stem Cells to Increase Viability of Composite Grafts.

    PubMed

    Yucel, Ergin; Alagoz, Murat Sahin; Eren, Guler Gamze; Yasar, Emrah Kagan; Izmirli, Hakki Hayrettin; Duruksu, Gokhan; Isgoren, Serkan; Muezzinoglu, Bahar; Karaoz, Erdal

    2016-07-01

    Chondrocutaneous composite grafts figure among the reconstruction alternatives for alar rim defects resulting from tumor resection and trauma. The major problem with composite grafts is the limited graft survival area. In the present study, the authors aimed to increase the survival area of composite grafts by utilizing the ability of stem cells to promote neovascularization which is crucial in composite graft viability. The study included 36 adult Wistar Albino rats, which were allocated to 6 groups. Groups 1, 2, and 3 were the groups in which the grafts were implanted immediately after the defect was formed, and Groups 4, 5, and 6 were those in which grafts were adapted 4 days after the defect was formed. Composite grafts of 1 × 1 cm containing both the cartilage and the skin were prepared from 1 ear, and after forming punctures and incisions on the cartilage, the grafts were adapted to the 1 × 1 cm defects on the back. The backs of the rats in groups 1 and 4 were injected with adipose-derived stem cell (ADSC), those in groups 2 and 5 with medium solution, while the rats in Groups 3 and 6 did not receive any injection. The procedures were followed by histopathological and scintigraphic evaluations. An evaluation of the statistical results showed that composite graft survival areas of the group treated with stem cells increased significantly, in comparison with control and medium groups. When scintigraphic evaluations were considered, it was seen that the group treated with stem cells had significantly higher radioactive substance retention than the control group. Histopathological examination demonstrated that microscopic survival rates in the stem cell group were higher than those in the control group. Green fluorescent protein (GFP) was used in the experiment to tag adipose tissue-derived stem cells. Immunofluorescence staining studies showed less apoptosis and fewer GFP (+) stem cells in the composite grafts of the stem cell group. However

  12. Toward a W4-F12 approach: Can explicitly correlated and orbital-based ab initio CCSD(T) limits be reconciled?

    NASA Astrophysics Data System (ADS)

    Sylvetsky, Nitai; Peterson, Kirk A.; Karton, Amir; Martin, Jan M. L.

    2016-06-01

    In the context of high-accuracy computational thermochemistry, the valence coupled cluster with all singles and doubles (CCSD) correlation component of molecular atomization energies presents the most severe basis set convergence problem, followed by the (T) component. In the present paper, we make a detailed comparison, for an expanded version of the W4-11 thermochemistry benchmark, between, on the one hand, orbital-based CCSD/AV{5,6}Z + d and CCSD/ACV{5,6}Z extrapolation, and on the other hand CCSD-F12b calculations with cc-pVQZ-F12 and cc-pV5Z-F12 basis sets. This latter basis set, now available for H-He, B-Ne, and Al-Ar, is shown to be very close to the basis set limit. Apparent differences (which can reach 0.35 kcal/mol for systems like CCl4) between orbital-based and CCSD-F12b basis set limits disappear if basis sets with additional radial flexibility, such as ACV{5,6}Z, are used for the orbital calculation. Counterpoise calculations reveal that, while total atomization energies with V5Z-F12 basis sets are nearly free of BSSE, orbital calculations have significant BSSE even with AV(6 + d)Z basis sets, leading to non-negligible differences between raw and counterpoise-corrected extrapolated limits. This latter problem is greatly reduced by switching to ACV{5,6}Z core-valence basis sets, or simply adding an additional zeta to just the valence orbitals. Previous reports that all-electron approaches like HEAT (high-accuracy extrapolated ab-initio thermochemistry) lead to different CCSD(T) limits than "valence limit + CV correction" approaches like Feller-Peterson-Dixon and Weizmann-4 (W4) theory can be rationalized in terms of the greater radial flexibility of core-valence basis sets. For (T) corrections, conventional CCSD(T)/AV{Q,5}Z + d calculations are found to be superior to scaled or extrapolated CCSD(T)-F12b calculations of similar cost. For a W4-F12 protocol, we recommend obtaining the Hartree-Fock and valence CCSD components from CCSD-F12b/cc-pV{Q,5}Z-F12

  13. Solid waste management in primary healthcare centers: application of a facilitation tool.

    PubMed

    Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

    2016-08-18

    -30%, alcanzó 30-38% un año más tarde. el instrumento se mostró fácil de usar, evita pasar por una gama compleja de disposiciones normativas existentes, permitió identificar posibles casos de incumplimiento, señalar medidas correctivas puntuales y evaluar el desempeño de la gestión de residuos. En este sentido, contribuye a la toma de decisiones y a prácticas de gestión relativas a los residuos, tareas normalmente asignadas a los enfermeros. Se recomienda la aplicación del instrumento en unidades de salud similares para estudios comparativos, y las adaptaciones necesarias para otros servicios de salud.

  14. Nursing diagnoses in patients with immune-bullous dermatosis.

    PubMed

    Brandão, Euzeli da Silva; Santos, Iraci Dos; Lanzillotti, Regina Serrão; Ferreira, Adriano Menis; Gamba, Mônica Antar; Azulay-Abulafia, Luna

    2016-08-15

    ón de los fenómenos relacionados con los clientes en cuestión, se sugiere la inclusión de dos factores de riesgo/relacionados en tres diagnósticos de esta taxonomía. Vale la pena señalar la contribución de los hallazgos para el cuidado/educación/investigación en enfermería en dermatología.

  15. Speaking, writing, and memory span in children: output modality affects cognitive performance.

    PubMed

    Grabowski, Joachim

    2010-02-01

    franceses quiénes compararon la ejecución en la capacidad de retención en la memoria oral y escrita. Las dificultades observadas en niños, pero no en adultos, en procesos de bajo nivel en la escritura pueden derivarse de la inadecuación grafomotriz u ortográfica. Informamos sobre cinco experimentos diseñados para replicar y ampliar los resultados originales. Primero, los resultados franceses fueron replicados con éxito para alemanes en tercer curso y para estudiantes universitarios. Después, los cambios evolutivos en costes cognitivos en la escritura fueron estudiados durante la educación primaria, comparando la ejecución de los alumnos del segundo y cuarto curso. Posteriormente, demostramos que las formas de escribir no practicadas, que se han inducido experimentalmente, conducen a la disminución de la ejecución en la memoria también en adultos, lo cual apoya la hipótesis de que la falta de la automatización grafomotriz es la responsable de los efectos encontrados en niños. Sin embargo, la escritura a mano muestra resultados más claros que la escritura a máquina. Por último, hemos intentado separar la influencia de la grafomotricidad frente a las dificultades ortográficas componiendo las palabras señalando en una "pizarra de ortografía". Este intento, sin embargo, no ha tenido éxito, probablemente porque señalar letras ha introducido otros costes de bajo nivel. Resumiendo, a lo largo de los cuatro años de la educación primaria, los niños alemanes muestran peor ejecución en retención en memoria en la escritura, en comparación con el recuerdo oral, con un incremento general en ambas modalidades. Por tanto, al final de la educación primaria, la escritura no ha igualado todavía el habla en cuanto a los costes cognitivos. Por consiguiente, las conclusiones están relacionadas con la cuestión de cómo evaluar cualquier tipo de conocimiento o habilidades mediante la producción de lenguaje. Les processus de bas niveau de la production du langage