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Sample records for mysterium ligamentum alare

  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. Calcification inhibitors in human ligamentum flavum.

    PubMed

    Maruta, K; Ichimura, K; Matsui, H; Yamagami, T; Sano, A; Tsuji, H

    1993-01-01

    To examine the presence of substances which inhibit calcification in human ligamentum flavum, the inhibitory effect of an Na2HPO4 extract of the flavum was determined in terms of the in vitro calcium uptake of the ligamentum flavum matrix. Additionally, grafts of extracted and non-extracted dry ligamentum flavum matrices were transplanted into the dorsal muscles of rats, and calcification in the grafts was examined radiologically and histochemically. In order to determine if component cells of human ligamentum flavum produce calcification inhibitors, ligamentum flavum cells were cultured, and the crystal inhibitor activity of the culture medium was measured by a seed test which used hydroxyapatite as the nucleus of precipitation. The calcification reaction system demonstrated that the ligamentum flavum extract contains an inhibitory factor for calcium uptake by the ligamentum flavum matrix. The seed test revealed that human ligamentum flavum cells produce calcification inhibitor activity.

  3. "mysterium Cosmographicum", for Orchestra, Narrator/actor, and Computer Music on Tape. (with Original Composition)

    NASA Astrophysics Data System (ADS)

    Keefe, Robert Michael

    Mysterium Cosmographicum is a musical chronicle of an astronomy treatise by the German astronomer Johannes Kepler (1571-1630). Kepler's Mysterium Cosmographicum (Tubingen, 1596), or "Secret of the Universe," was a means by which he justified the existence of the six planets discovered during his lifetime. Kepler, through flawless a priori reasoning, goes to great lengths to explain that the reason there are six and only six planets (Mercury, Venus, Earth, Mars, Jupiter, and Saturn) is because God had placed one of the five regular solids (tetrahedron, cube, octa-, dodeca-, and icosahedron) around each orbiting body. Needless to say, the publication was not very successful, nor did it gain much comment from Kepler's peers, Galileo Galilei (1564-1642) and Tycho Brahe (1546-1601). But hidden within the Mysterium Cosmographicum, almost like a new planet waiting to be discovered, is one of Kepler's three laws of planetary motion, a law that held true for planets discovered long after Kepler's lifetime. Mysterium Cosmographicum is a monologue with music in three parts for orchestra, narrator/actor, and computer music on tape. All musical data structures are generated via an interactive Pascal computer program that computes latitudinal and longitudinal coordinates for each of the nine planets as seen from a fixed point on Earth for any given time frame. These coordinates are then mapped onto selected musical parameters as determined by the composer. Whenever Kepler reads from his treatise or from a lecture or correspondence, the monologue is supported by orchestral planetary data generated from the exact place, date, and time of the treatise, lecture, or correspondence. To the best of my knowledge, Mysterium Cosmographicum is the first composition ever written that employs planetary data as a supporting chronology to action and monologue.

  4. Cervical Ligamentum Flavum Hematoma: A Case Report.

    PubMed

    Haghnegahdar, Ali; Sedighi, Mahsa; Rahmanian, Abdolkarim; Baghban, Fahim

    2016-02-01

    Study Design Case report. Objective To report the first case of ligamentum flavum hematoma after cervical spine instrumentation 11 years after the index surgery. Methods After performing bilateral C3 and C4 laminectomy, we observed a dark greenish discoloration over the ligamentum flavum, which was opened. We evacuated 15 mL of subacute hematoma. Results The first ligamentum flavum hematoma of the cervical spine that occurred after spinal instrumentation with sublaminar hooks. Conclusion Ligamentum flavum hematoma might happen even after a long delay (in our case, 11 years) from spinal instrumentation (sublaminar hooks). In symptomatic patients, evacuation is the treatment of choice. In cases of instrument adhesion to the surrounding intracanal tissues, removal should be done meticulously after performing a complete release.

  5. Cervical Ligamentum Flavum Hematoma: A Case Report

    PubMed Central

    Haghnegahdar, Ali; Sedighi, Mahsa; Rahmanian, Abdolkarim; Baghban, Fahim

    2015-01-01

    Study Design Case report. Objective To report the first case of ligamentum flavum hematoma after cervical spine instrumentation 11 years after the index surgery. Methods After performing bilateral C3 and C4 laminectomy, we observed a dark greenish discoloration over the ligamentum flavum, which was opened. We evacuated 15 mL of subacute hematoma. Results The first ligamentum flavum hematoma of the cervical spine that occurred after spinal instrumentation with sublaminar hooks. Conclusion Ligamentum flavum hematoma might happen even after a long delay (in our case, 11 years) from spinal instrumentation (sublaminar hooks). In symptomatic patients, evacuation is the treatment of choice. In cases of instrument adhesion to the surrounding intracanal tissues, removal should be done meticulously after performing a complete release. PMID:26835213

  6. Anatomic Variations of Cervical and High Thoracic Ligamentum Flavum

    PubMed Central

    Yoon, Sang Pil; Kim, Hyun Jung

    2014-01-01

    Background Epidural blocks are widely used for the management of acute and chronic pain. The technique of loss of resistance is frequently adopted to determine the epidural space. A discontinuity of the ligamentum flavum may increase the risk of failure to identify the epidural space. The purpose of this study was to investigate the anatomic variations of the cervical and high thoracic ligamentum flavum in embalmed cadavers. Methods Vertebral column specimens of 15 human cadavers were obtained. After vertebral arches were detached from pedicles, the dural sac and epidural connective tissue were removed. The ligamentum flavum from C3 to T6 was directly examined anteriorly. Results The incidence of midline gaps in the ligamentum flavum was 87%-100% between C3 and T2. The incidence decreased below this level and was the lowest at T4-T5 (8%). Among the levels with a gap, the location of a gap in the caudal third of the ligamentum flavum was more frequent than in the middle or cephalic portion of the ligamentum flavum. Conclusions The cervical and high thoracic ligamentum flavum frequently has midline intervals with various features, especially in the caudal portion of the intervertebral space. Therefore, the ligamentum flavum is not always reliable as a perceptible barrier to identify the epidural space at these vertebral levels. Additionally, it may be more useful to insert the needle into the cephalic portion of the intervertebral space than in the caudal portion. PMID:25317280

  7. 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

  8. 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.

  9. Structural Properties of the Native Ligamentum Teres

    PubMed Central

    Philippon, Marc J.; Rasmussen, Matthew T.; Turnbull, Travis Lee; Trindade, Christiano A.C.; Hamming, Mark G.; Ellman, Michael B.; Harris, Matthew; LaPrade, Robert F.; Wijdicks, Coen A.

    2014-01-01

    Background: A majority of studies investigating the role of the ligamentum teres (LT) have focused primarily on anatomical and histological descriptions. To date, however, the structural properties of the LT have yet to be fully elucidated. Purpose: To investigate the structural properties of the native LT in a human cadaveric model. Study Design: Descriptive laboratory study. Methods: A total of 12 human cadaveric hemipelvises (mean age, 53.6 years; range, 34-63 years) were dissected free of all extra-articular soft tissues to isolate the LT and its acetabular and femoral attachments. A dynamic tensile testing machine distracted each femur in line with the fibers of the LT at a displacement-controlled rate of 0.5 mm/s. The anatomic dimensions, structural properties, and modes of failure were recorded. Results: The LT achieved a mean yield load of 75 N and ultimate failure load of 204 N. The LT had mean lengths of 38.0 and 53.0 mm at its yield and failure points, respectively. The most common (75% of specimens) mechanism of failure was tearing at the fovea capitis. On average, the LT had a linear stiffness of 16 N/mm and elastic modulus of 9.24 MPa. The mean initial length and cross-sectional area were 32 mm and 59 mm2, respectively. Conclusion: The human LT had a mean ultimate failure load of 204 N. Therefore, the results of this investigation, combined with recent biomechanical and outcomes studies, suggest that special consideration should be given to preserving the structural and corresponding biomechanical integrity of the LT during surgical intervention. Clinical Relevance: The LT may be more important as a static stabilizer of the hip joint than previously recognized. Further studies are recommended to investigate the appropriate indications to perform surgical repair or reconstruction of the LT for preservation of hip stability and function. PMID:26535290

  10. 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 instrument which recorded general…

  11. Progressive relapse of ligamentum flavum ossification following decompressive surgery.

    PubMed

    Ando, Kei; Imagama, Shiro; Ito, Zenya; Kobayashi, Kazuyoshi; Ukai, Junichi; Muramoto, Akio; Shinjo, Ryuichi; Matsumoto, Tomohiro; Nakashima, Hiroaki; Ishiguro, Naoki

    2014-12-01

    Thoracic ossification of the ligamentum flavum (T-OLF) is a relatively rare spinal disorder that generally requires surgical intervention, due to its progressive nature and the poor response to conservative therapy. The prevalence of OLF has been reported at 3.8%-26%, which is similar to that of cervical ossification of the posterior longitudinal ligament (OPLL). The progression of OPLL after cervical laminoplasty for the treatment of OPLL is often shown in long-term follow-up. However, there have been no reports on the progression of OLF following surgery. We report a case of thoracic myelopathy secondary to the progressive relapse of OLF following laminectomy. PMID:25558329

  12. Haemorrhagic Lumbar Juxtafacet Cyst with Ligamentum Flavum Involvement

    PubMed Central

    Ghent, Finn; Davidson, Trent; Mobbs, Ralph Jasper

    2014-01-01

    Juxtafacet cysts are an uncommon cause of radiculopathy. They occur most frequently in the lumbar region, and their distribution across the spine correlates with mobility. Haemorrhagic complications are rare and may occur in the absence of any provocation, although there is some association with anticoagulation and trauma. We present a case of acute radiculopathy due to an L5/S1 juxtafacet cyst with unprovoked haemorrhage which was found to extend into ligamentum flavum. The patient underwent uncomplicated microscope assisted decompression with excellent results. The demographics, presentation, aetiology, and management of juxtafacet cysts are discussed. PMID:25580330

  13. Centrifugal force induces human ligamentum flavum fibroblasts inflammation through activation of JNK and p38 pathways.

    PubMed

    Chao, Yuan-Hung; Tsuang, Yang-Hwei; Sun, Jui-Sheng; Sun, Man-Ger; Chen, Ming-Hong

    2012-01-01

    Inflammation has been proposed to be an important causative factor in ligamentum flavum hypertrophy. However, the mechanisms of mechanical load on inflammation of ligamentum flavum remain unclear. In this study, we used an in vitro model of human ligamentum flavum fibroblasts subjected to centrifugal force to elucidate the effects of mechanical load on cultured human ligamentum flavum fibroblasts; we further studied its molecular and biochemical mechanisms. Human ligamentum flavum fibroblasts were obtained from six patients undergoing lumbar spine surgery. Monolayer cultures of human ligamentum flavum fibroblasts were subjected to different magnitudes of centrifugal forces. Cell viability, cell death, biochemical response, and molecular response to centrifugal forces were analyzed. It was found that centrifugal stress significantly suppressed cell viability without inducing cell death. Centrifugal force at 67.1 g/cm(2) for 60 min significantly increases the production of prostaglandin E2 and nitric oxide as well as gene expression of proinflammatory cytokines, including interleukin (IL)-1α, IL-1β and IL-6, showed that centrifugal force-dependent induction of cyclooxygense-2 and inducible NO synthase required JNK and p38 mitogen-activated protein kinase, but not ERK 1/2 activities. This study suggested that centrifugal force does induce inflammatory responses in human ligamentum flavum fibroblasts. The activation of both JNK and p38 mitogen-activated protein kinase mechanotransduction cascades is a crucial intracellular mechanism that mediates cyclooxygense-2/prostaglandin E2 and inducible NO synthase/nitric oxide production.

  14. Tissue transglutaminase is involved in mechanical load-induced osteogenic differentiation of human ligamentum flavum cells.

    PubMed

    Chao, Yuan-Hung; Huang, Shih-Yung; Yang, Ruei-Cheng; Sun, Jui-Sheng

    2016-07-01

    Mechanical load-induced osteogenic differentiation might be the key cellular event in the calcification and ossification of ligamentum flavum. The aim of this study was to investigate the influence of tissue transglutaminase (TGM2) on mechanical load-induced osteogenesis of ligamentum flavum cells. Human ligamentum flavum cells were obtained from 12 patients undergoing lumbar spine surgery. Osteogenic phenotypes of ligamentum flavum cells, such as alkaline phosphatase (ALP), Alizarin red-S stain, and gene expression of osteogenic makers were evaluated following the administration of mechanical load and BMP-2 treatment. The expression of TGM2 was evaluated by real-time PCR, Western blotting, and enzyme-linked immunosorbent assay (ELISA) analysis. Our results showed that mechanical load in combination with BMP-2 enhanced calcium deposition and ALP activity. Mechanical load significantly increased ALP and OC gene expression on day 3, whereas BMP-2 significantly increased ALP, OPN, and Runx2 on day 7. Mechanical load significantly induced TGM2 gene expression and enzyme activity in human ligamentum flavum cells. Exogenous TGM2 increased ALP and OC gene expression; while, inhibited TG activity significantly attenuated mechanical load-induced and TGM2-induced ALP activity. In summary, mechanical load-induced TGM2 expression and enzyme activity is involved in the progression of the calcification of ligamentum flavum.

  15. Repair of right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum.

    PubMed

    Chen, C L

    1990-07-01

    A case of right aortic arch with an aberrant left subclavian artery arising from a Kommerell's diverticulum of the descending thoracic aorta with a left ligamentum arteriosum completing a vascular ring about the trachea and esophagus is presented. A posterolateral left thoracotomy alone is sufficient to provide an excellent exposure for the division of the ligamentum arteriosum and the resection of the Kommerell's diverticulum. Furthermore, the development of a subclavian steal syndrome is prevented by the reimplantation of the divided left subclavian artery into the left common carotid artery through this same incision.

  16. 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

  17. 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

  18. Tissue engineering and the future of hip cartilage, labrum and ligamentum teres

    PubMed Central

    Stubbs, Allston J.; Howse, Elizabeth A.; Mannava, Sandeep

    2016-01-01

    As the field of hip arthroscopy continues to evolve, the biological understanding of orthopaedic tissues, namely articular cartilage, labral fibro-cartilage and the ligamentum teres continues to expand. Similarly, the need for biological solutions for the pre-arthritic and early arthritic hip continues to be a challenge for the sports medicine surgeon and hip arthroscopist. This article outlines existing biological and tissue-engineering technologies, some being used in clinical practice and other technologies being developed, and how these biological and tissue-engineering principals may one day influence the practice of hip arthroscopy. This review of hip literature is specific to emerging biological technologies for the treatment of chondral defects, labral tears and ligamentum teres deficiency. Of note, not all of the technologies described in this article have been approved by the United States Food and Drug Administration and some of the described uses of the approved technologies should be considered ‘off-label’ uses. PMID:27026815

  19. Tissue engineering and the future of hip cartilage, labrum and ligamentum teres.

    PubMed

    Stubbs, Allston J; Howse, Elizabeth A; Mannava, Sandeep

    2016-04-01

    As the field of hip arthroscopy continues to evolve, the biological understanding of orthopaedic tissues, namely articular cartilage, labral fibro-cartilage and the ligamentum teres continues to expand. Similarly, the need for biological solutions for the pre-arthritic and early arthritic hip continues to be a challenge for the sports medicine surgeon and hip arthroscopist. This article outlines existing biological and tissue-engineering technologies, some being used in clinical practice and other technologies being developed, and how these biological and tissue-engineering principals may one day influence the practice of hip arthroscopy. This review of hip literature is specific to emerging biological technologies for the treatment of chondral defects, labral tears and ligamentum teres deficiency. Of note, not all of the technologies described in this article have been approved by the United States Food and Drug Administration and some of the described uses of the approved technologies should be considered 'off-label' uses.

  20. Tissue engineering and the future of hip cartilage, labrum and ligamentum teres.

    PubMed

    Stubbs, Allston J; Howse, Elizabeth A; Mannava, Sandeep

    2016-04-01

    As the field of hip arthroscopy continues to evolve, the biological understanding of orthopaedic tissues, namely articular cartilage, labral fibro-cartilage and the ligamentum teres continues to expand. Similarly, the need for biological solutions for the pre-arthritic and early arthritic hip continues to be a challenge for the sports medicine surgeon and hip arthroscopist. This article outlines existing biological and tissue-engineering technologies, some being used in clinical practice and other technologies being developed, and how these biological and tissue-engineering principals may one day influence the practice of hip arthroscopy. This review of hip literature is specific to emerging biological technologies for the treatment of chondral defects, labral tears and ligamentum teres deficiency. Of note, not all of the technologies described in this article have been approved by the United States Food and Drug Administration and some of the described uses of the approved technologies should be considered 'off-label' uses. PMID:27026815

  1. [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. PMID:7878229

  2. Editorial Commentary: Ligamentum Teres Tears and Femoroacetabular Impingement: Complex Coexistence of Impingement and Instability.

    PubMed

    Larson, Christopher M

    2016-07-01

    In a large Level IV case series of 2,213 hip arthroscopies with the diagnosis of femoroacetabular impingement, the intraoperative status of the ligamentum teres (LT) was recorded as normal in 11%, frayed and/or partially torn in 88%, and completely torn in 1.5% of hips. Although specific physical examination maneuvers for detecting LT tears were not available early in the study period, thus limiting a detailed assessment of such tests, the authors identified that female gender, a lower lateral center edge angle, a higher Tonnis angle, and capsular laxity were all associated with complete LT tears. This study further supports the complex coexistence of impingement and instability.

  3. Smooth dissection of ligamentum flavum for lumbar microdiscectomy. Preliminary report of this personal technique.

    PubMed

    Nicoletti, Giovanni F; Platania, Nunzio; Albanese, Vincenzo

    2005-09-01

    A newly designed technique for preservation of the ligamentum flavum (LF) during the lumbar discectomy is presented. This technique allows the evacuation of the lumbar herniated disk, without removal or laminar disinsertion of the LF. This ligament is smoothly dissected longitudinally in its more lateral portion, obtaining, after discectomy, the contact of the 2 margins with restoration of its functional integrity. Forty-five patients were operated on with this technique. We feel that this technique could offer advantages in reduction of epidural fibrosis and of decreased risk of dural injury, and is helpful to the surgeon in the case of recurrence of discal herniation. PMID:16099252

  4. 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.

  5. The capsular ligaments provide more hip rotational restraint than the acetabular labrum and the ligamentum teres

    PubMed Central

    van Arkel, R. J.; Amis, A. A.; Cobb, J. P.; Jeffers, J. R. T.

    2015-01-01

    In this in vitro study of the hip joint we examined which soft tissues act as primary and secondary passive rotational restraints when the hip joint is functionally loaded. A total of nine cadaveric left hips were mounted in a testing rig that allowed the application of forces, torques and rotations in all six degrees of freedom. The hip was rotated throughout a complete range of movement (ROM) and the contributions of the iliofemoral (medial and lateral arms), pubofemoral and ischiofemoral ligaments and the ligamentum teres to rotational restraint was determined by resecting a ligament and measuring the reduced torque required to achieve the same angular position as before resection. The contribution from the acetabular labrum was also measured. Each of the capsular ligaments acted as the primary hip rotation restraint somewhere within the complete ROM, and the ligamentum teres acted as a secondary restraint in high flexion, adduction and external rotation. The iliofemoral lateral arm and the ischiofemoral ligaments were primary restraints in two-thirds of the positions tested. Appreciation of the importance of these structures in preventing excessive hip rotation and subsequent impingement/instability may be relevant for surgeons undertaking both hip joint preserving surgery and hip arthroplasty. Cite this article: Bone Joint J 2015; 97-B:484–91. PMID:25820886

  6. Cardiac-MRI demonstration of the ligamentum arteriosum in a case of right aortic arch with aberrant left subclavian artery.

    PubMed

    Paparo, Francesco; Bacigalupo, Lorenzo; Melani, Enrico; Rollandi, Gian Andrea; Caro, Giovanni De

    2012-05-28

    Right-sided aortic arch with aberrant left subclavian artery (RAA/ALSC) is the second most common mediastinal complete vascular ring. Adult presentation of dysphagia lusoria due to a RAA/ALSC is uncommon with fewer than 25 cases reported in the world literature. The left lateral portion of this vascular ring is not a vessel, but an atretic ductus arteriosus, the ligamentum arteriosum, which has been identified in different cases as the major cause of tracheo-esophageal impingement. Surgical division of the ligamentum arteriosum allows the vessels to assume a less constricting pattern decreasing dysphagic symptoms. Clear visualization of the ligamentum arteriosum by diagnostic imaging has not been obtained in previously reported cases. We demonstrated, using magnetic resonance imaging, the location and the complete course of a left-sided ligamentum arteriosum in a patient with adult-onset dysphagia due to a RAA/ALSC with a small Kommerell's diverticulum, providing, during the same session, a complete assessment of both mediastinal vascular abnormalities and esophageal impingement sites.

  7. MDCT of right aortic arch with aberrant left subclavian artery associated with kommerell diverticulum and calcified ligamentum arteriosum.

    PubMed

    Kanza, Rene Epunza; Berube, Michel; Michaud, Pierre

    2013-04-28

    We present a case of the right aortic arch with kommerell diverticulum (KD) and aberrant left subclavian artery in a symptomatic 50-year-old patient with a calcification in the presumed attachment site of the ligamentum arteriosum (LA) to the KD. In another 30-year-old male patient, the entire course of a calcified LA was demonstrated using multidetector row computed tomography.

  8. 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. PMID:27192642

  9. Hominoid phalanges from the middle Miocene site of Paşalar, Turkey.

    PubMed

    Ersoy, A; Kelley, J; Andrews, P; Alpagut, B

    2008-04-01

    Eleven proximal and ten intermediate partial or complete hominoid phalanges have been recovered from the middle Miocene site of Paşalar in Turkey. Based on species representation at Paşalar, it is likely that most or all of the phalanges belong to Griphopithecus alpani rather than Kenyapithecus kizili, but both species may be represented. All of the complete or nearly complete phalanges appear to be manual, so comparisons to extant and other fossil primate species were limited to manual phalanges. Comparisons were made to extant hominoid and cercopithecoid primate genera expressing a variety of positional repertoires and varying degrees of arboreality and terrestriality. The comparisons consisted of a series of bivariate indices derived from previous publications on Miocene catarrhine phalangeal morphology. The proximal phalanges have dorsally expanded proximal articular surfaces, which is characteristic of cercopithecoids and most other Miocene hominoids, and indicates that the predominant positional behaviors involved pronograde quadrupedalism. Among the extant primates, many of the proximal and intermediate phalangeal indices clearly distinguish more habitually terrestrial taxa from those that are predominantly arboreal, and especially from taxa that commonly engage in suspensory activities. For nearly every index, the values of the Paşalar phalanges occupy an intermediate position-most similar to values for Pan and, to a lesser extent, Macaca-indicating a generalized morphology and probably the use of both arboreal and terrestrial substrates. At least some terrestrial activity is also compatible with reconstructions of the Paşalar habitat. Most proximal and intermediate phalanges of other middle and late Miocene hominoids have similar index values to those of the Paşalar specimens, revealing broadly similar manual phalangeal morphology among many Miocene hominoids.

  10. Editorial Commentary: Ligamentum Teres Tears and Femoroacetabular Impingement: Complex Coexistence of Impingement and Instability.

    PubMed

    Larson, Christopher M

    2016-07-01

    In a large Level IV case series of 2,213 hip arthroscopies with the diagnosis of femoroacetabular impingement, the intraoperative status of the ligamentum teres (LT) was recorded as normal in 11%, frayed and/or partially torn in 88%, and completely torn in 1.5% of hips. Although specific physical examination maneuvers for detecting LT tears were not available early in the study period, thus limiting a detailed assessment of such tests, the authors identified that female gender, a lower lateral center edge angle, a higher Tonnis angle, and capsular laxity were all associated with complete LT tears. This study further supports the complex coexistence of impingement and instability. PMID:27373179

  11. Ossified ligamentum flavum causing spinal cord compression in a patient with acromegaly.

    PubMed

    Schmidt, Richard F; Goldstein, Ira M; Liu, James K

    2013-11-01

    Acromegaly is a relatively rare neuroendocrine disorder associated with diffuse hypertrophy of bony and soft tissues due to growth hormone hypersecretion from a pituitary adenoma. Acromegaly can also cause numerous pathological changes in the spine, including degenerative osteoarticular disease, axial arthropathy, spinal stenosis, vertebral fracture and diffuse idiopathic skeletal hyperostosis (Forestier's disease). Ossified ligamentum flavum (OLF) is a rare disorder that often presents as thoracic spinal stenosis, but to our knowledge has never been described in patients with acromegaly. Previously, no link has been established between these two entities. We present, to our knowledge, the first reported case of OLF in a patient with acromegaly who presented with thoracic spinal cord compression. OLF is a potential spinal manifestation of acromegaly and should be considered in the differential diagnosis of spinal stenosis or spinal cord compression in the context of growth hormone hypersecretion.

  12. MDCT of right aortic arch with aberrant left subclavian artery associated with kommerell diverticulum and calcified ligamentum arteriosum

    PubMed Central

    Kanza, Rene Epunza; Berube, Michel; Michaud, Pierre

    2013-01-01

    We present a case of the right aortic arch with kommerell diverticulum (KD) and aberrant left subclavian artery in a symptomatic 50-year-old patient with a calcification in the presumed attachment site of the ligamentum arteriosum (LA) to the KD. In another 30-year-old male patient, the entire course of a calcified LA was demonstrated using multidetector row computed tomography. PMID:23671755

  13. 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

  14. Effect of table tilt on ligamentum flavum length measured using ultrasonography in pregnant women*.

    PubMed

    Jones, A R; Carle, C; Columb, M

    2013-01-01

    The purpose of this study was to assess whether applying dorsal table tilt to a seated parturient positioned for neuraxial anaesthesia (i.e. facing laterally with her legs over the side of the table) increased the size of the target area for the neuraxial needle. We performed lumbar ultrasonography on 20 pregnant women with the table level (0°) and tilted 8° and 15° dorsally. For each position, the size of the 'target area', defined as the visible length of the ligamentum flavum in the longitudinal paramedian view, and the interlaminar distance, were measured at the L3-4 interspace. There were significant increases in the mean (SD) size of the target area with increasing table tilt (10.7 (1.3) mm at 0°, 11.5 (1.3) mm at 8° and 12.2 (1.7) mm at 15°; p < 0.0001). Interlaminar distances were not significantly increased. These data show that using dorsal table tilt in obstetric patients increases the target area for neuraxial needles. Additional research is required to assess whether this eases the placement of neuraxial needles in clinical practice.

  15. The thickness of the ligamentum flavum in relation to age and gender.

    PubMed

    Safak, Alp Alper; Is, Merih; Sevinc, Ozdemir; Barut, Cagatay; Eryoruk, Nesrin; Erdogmus, Besir; Dosoglu, Murat

    2010-01-01

    Hypertrophy of the ligamentum flavum (LF) can reduce the diameter of the spinal canal posteriorly. Such stenosis may significantly compress the dural sac and nerve roots, resulting in symptoms, even without a bulging anulus fibrosus or herniated nucleus pulposus. We conducted an anatomical study to determine the influence of age and gender on the thickness of the LF at the lower lumbar levels using magnetic resonance imaging (MRI). The thickness of 1,280 ligaments was determined at the L4-L5 and L5-S1 levels from MRIs. We screened 320 patients (152 males [47.5%] and 168 females [52.5%]) between 21 and 82 years of age. There were no significant differences in LF thickness with respect to gender (P > 0.05). Age was not correlated with the thicknesses of the LF. The left LF at the L4-L5 and L5-S1 levels was significantly thicker than on the right side (P < 0.05). Furthermore, the LF thicknesses at L5-S1 bilaterally were significantly greater than on the corresponding sides at L4-L5 (P < 0.05). The LF is an important anatomical structure, which might cause low back or leg pain. Therefore, the thickness of the LF should be measured and evaluated carefully in the case of spinal stenosis.

  16. Ligamentum teres injuries - an observational study of a proposed new arthroscopic classification.

    PubMed

    Porthos Salas, Antonio; O'Donnell, John M

    2015-10-01

    Ligamentum teres (LT) Injuries or tears have been said to be a common cause of groin discomfort and pain, and they have been identified in 8-51% of patients undergoing hip arthroscopy. Currently, in the literature there exist three arthroscopic classifications for LT injuries and tears: the first classification was established by Gray and Villar, Botser and Domb proposed the second one which they called a descriptive classification according to the degree of partial thickness LT tears and more recently the last classification by Cerezal et al. (RadioGraphics 2010; 30:1637-51), where they take into account the one by Gray and Villar but adding an avulsion fracture and absence of the LT. We propose a new classification, which also takes into account, observed LT pathologies, as well as the possible pathological mechanism of LT tears, and offer a guide to treatment. This classification is based on direct arthroscopic observation and dynamic rotational maneuvers of the hip under distraction. This classification incorporates those pathologies, which have been observed as a result of this more focused examination of the LT. PMID:27011847

  17. Spinal Cord Kinking in Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

    PubMed Central

    Wang, Ting; Pan, Min; Yin, Chu-Qiang; Zheng, Xiu-Jun; Cong, Ya-Nan; Wang, De-Chun; Li, Shu-Zhong

    2015-01-01

    Background: Ossification of the ligamentum flavum (OLF) is being increasingly recognized as a cause of thoracic myelopathy. This study was to describe a rare clinical entity of spinal cord kinking (SK) in thoracic myelopathy secondary to OLF. Methods: The data of 95 patients with thoracic myelopathy secondary to OLF were analyzed retrospectively. The incidence and location of SK were determined using preoperative magnetic resonance imaging (MRI). The clinical presentation and radiological characteristics in patients with SK were analyzed. Posterior en bloc laminectomy with OLF was performed, and the surgical results were evaluated. Results: SK was found in seven patients (7.4%) based on preoperative MRI. The patients included one male and six females with an average age of 55.6 years (range, 48–64 years). Five patients presented with radiculomyelopathy and two presented with typical thoracic myelopathy of spastic paraparesis. In all cases, the kinking was located just above the end of the spinal cord where the conus medullaris (CM) was compressed by the OLF. The degree of SK varied from mild to severe. The tip of the CM was located between the upper third of T11 to the lower third of L1, above the lower edge of L1. With an average follow-up of 30.4 months, the modified Japanese Orthopedic Association score significantly improved from 5.7 ± 1.8 preoperatively to 8.9 ± 1.4 postoperatively (t = 12.05; P < 0.0001) with an improvement rate of 63.1 ± 12.3%. Conclusions: SK is a rare radiological phenomenon. It is typically located at the thoracolumbar junction, where the CM is compressed by the OLF. Our findings indicate that these patients may benefit from a posterior decompressive procedure. PMID:26415796

  18. Formation of cadherin-expressing brain nuclei in diencephalic alar plate divisions.

    PubMed

    Yoon, M S; Puelles, L; Redies, C

    2000-11-01

    During the formation of brain nuclei, the vertebrate neural tube is partitioned into distinct embryonic divisions. In this study, the expression of three members of the cadherin family of adhesion molecules (cadherin-6B, cadherin-7, and R-cadherin) was mapped to study the differentiation of gray matter in the division so that diencephalic alar plate of chicken embryos from embryonic day 3 (E3) to E10. At early stages of development (E3-E4), each cadherin is expressed in restricted regions of the diencephalic wall of the neural tube. The borders of some of the expression domains coincide with divisional boundaries. As the mantle layer is formed and increases in thickness from E4 to E8, morphologically discernible aggregates of cells appear that express the three cadherins differentially. These aggregates represent the anlagen of specific diencephalic brain nuclei, e.g., the lateroanterior nucleus, the ventral geniculate nucleus, the nucleus rotundus, the perirotundic area, the principal precommissural nucleus, and the lateral spiriform nucleus. Most of the cadherin-expressing diencephalic nuclei studied in this work apparently derive from a single embryonic division and remain there. The divisional boundaries are replaced gradually by the borders of cadherin-expressing brain nuclei. The current results support the idea that cadherins confer differential adhesiveness to developing structures of gray matter in the diencephalic alar plate. Moreover, they suggest that each cadherin plays a role in the formation of specific brain nuclei within the diencephalic divisions.

  19. Formation of cadherin-expressing brain nuclei in diencephalic alar plate divisions.

    PubMed

    Yoon, M S; Puelles, L; Redies, C

    2000-06-12

    During the formation of brain nuclei, the vertebrate neural tube is partitioned into distinct embryonic divisions. In this study, the expression of three members of the cadherin family of adhesion molecules (cadherin-6B, cadherin-7, and R-cadherin) was mapped to study the differentiation of gray matter in the divisions of the diencephalic alar plate of chicken embryos from embryonic day 3 (E3) to E10. At early stages of development (E3-E4), each cadherin is expressed in restricted regions of the diencephalic wall of the neural tube. The borders of some of the expression domains coincide with divisional boundaries. As the mantle layer is formed and increases in thickness from E4 to E8, morphologically discernible aggregates of cells appear that express the three cadherins differentially. These aggregates represent the anlagen of specific diencephalic brain nuclei, e.g., the lateroanterior nucleus, the ventral geniculate nucleus, the nucleus rotundus, the perirotundic area, the principal precommissural nucleus, and the lateral spiriform nucleus. Most of the cadherin-expressing diencephalic nuclei studied in this work apparently derive from a single embryonic division and remain there. The divisional boundaries are replaced gradually by the borders of cadherin-expressing brain nuclei. The current results support the idea that cadherins confer differential adhesiveness to developing structures of gray matter in the diencephalic alar plate. Moreover, they suggest that each cadherin plays a role in the formation of specific brain nuclei within the diencephalic divisions.

  20. The Evaluation and Observation of "Hidden" Hypertrophy of Cervical Ligamentum Flavum, Cervical Canal, and Related Factors Using Kinetic Magnetic Resonance Imaging.

    PubMed

    Zeng, Cheng; Xiong, Jian; Wang, Jeffrey C; Inoue, Hirokazu; Tan, Yanlin; Tian, Haijun; Aghdasi, Bayan

    2016-03-01

    Study Design Retrospective cohort study. Objective The objective was to measure the change of flavum ligament diameter during positional changes of the cervical spine using kinetic magnetic resonance imaging (MRI) and to examine the correlational diameter changes of the flavum ligament, disk bulging, and the spinal canal from extension to flexion positions. Methods One hundred eight-nine patients underwent kinetic MRI in neutral, extension, and flexion positions. The diameters of cervical ligamentum flavum, disk bulging, and cervical spinal canal and the disk degeneration grade and Cobb angles were measured from C2-C3 to C7-T1. Results In all, 1,134 cervical spinal segments from 189 patients were included. There was a 0.26 ± 0.85-mm average increase in the diameter of the ligamentum flavum from flexion to extension, and 62.70% of the segments had increased ligamentum flavum diameter from flexion to extension. For all segments of the 189 patients, the cervical spinal canal diameters had an average decrease at the disk level of 0.56 ± 1.21 mm from flexion to extension. For all segments with cervical spinal canal narrowing ≥1 mm from flexion to extension view, the ligamentum flavum diameters at C3-C4 to C5-C6 had significant increases compared with patients with spinal canal narrowing < 1 mm (p < 0.05). For patients with ligamentum flavum hypertrophy of ≥1 mm from the flexion to extension view, the cervical spinal canal diameters at C2-C3, C4-C5, and C5-C6 had significant decreases compared with patients with ligamentum flavum hypertrophy of <1 mm (p < 0.05). Conclusion The "hidden" hypertrophy of ligamentum flavum was significant at C4-C5 and C5-C6 and significantly contributes to the stenosis of cervical spinal canal in the extension position. PMID:26933617

  1. 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

  2. Iatrogenic Spinal Cord Injury during Removal of the Inferior Articular Process in the Presence of Ossification of the Ligamentum Flavum

    PubMed Central

    Burke, Shane M.; Hwang, Steven W.; Safain, Mina G.; Riesenburger, Ron I.

    2016-01-01

    Ossified ligamentum flavum (OLF) is a condition of heterotopic lamellar bone formation within the yellow ligament. Some patients with OLF can be asymptomatic. However, asymptomatic OLF may not be obvious on preoperative MRI and could increase the risk of iatrogenic injury during treatments for unrelated spinal conditions. This report describes a case of spinal cord injury caused by the indirect transmission of force from an osteotome to an asymptomatic OLF during the resection of a thoracic inferior articular process (IAP). To prevent this outcome, we urge careful review of CT imaging in the preoperative setting and advocate the use of a high-speed drill instead of an osteotome during bone removal in the setting of an adjacent area of OLF. PMID:26885431

  3. [The surgical correction of the right aortic arch with aberrant left subclavian artery and left ligamentum arteriosum--a rare case from clinical practice].

    PubMed

    Baev, B; Nachev, G; Chirkov, A

    1995-01-01

    Reports on the surgical management of the vascular ring formed by the right aortic arch with aberrant retroesophageal left subclavian artery and left ligamentum arteriosum are relatively few. The authors present a case of a thirty-three-year old woman with cough, dysphonia and stridor without dysphagia. Surgical management which was performed through a bilateral thoracotomy with transversal sternotomy, included division of the ligamentum arteriosum and of the aberrant left subclavian artery and suture of the latter. There was no need to resect the Kommerell's diverticulum, because of lack of any dysphagia despite of the well documented severe compression of the esophagus. The authors experience proved that in difficult cases the bilateral thoracotomy and transversal sternotomy is an useful approach to perform complete surgical repair of this abnormality.

  4. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery

    PubMed Central

    Rustagi, Shaifaly Madan; Sharma, Mona; Singh, Nidhi; Mehta, Vandana; Suri, Rajesh K; Rath, Gayatri

    2015-01-01

    The intercostobrachial nerve (ICBN) is often encountered during axillary dissection for axillary lymph node dissection (ALND) for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side, the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures. PMID:25802820

  5. Peripheral communications of intercostobrachial nerve Peripheral communications of the intercostobrachial nerve in relation to the alar thoracic artery.

    PubMed

    Rustagi, Shaifaly Madan; Sharma, Mona; Singh, Nidhi; Mehta, Vandana; Suri, Rajesh K; Rath, Gayatri

    2015-01-01

    The intercostobrachial nerve (ICBN) is often encountered during axillary dissection for axillary lymph node dissection (ALND) for diagnostic and therapeutic surgery for mastectomy. The present report is a case observed in the Department of Anatomy at Vardhman Mahavir Medical College, Delhi during routine dissection of the upper extremity of a male cadaver for first year undergraduate medical students. On the right side, the medial cord of brachial plexus gave two medial cutaneous nerves of arm. Both the nerves were seen communicating with the branches of the ICBN. The ICBN and one of its branches were surrounding the termination of an alar thoracic artery. These peripheral neural connections of the ICBN with the branches of the medial cord can be a cause of sensory impairment during axillary procedures done for mastectomy or exploration of long thoracic nerves. The alar thoracic artery found in relation to the ICBN could further be a cause of vascular complications during such procedures.

  6. The deciduous dentition of Griphopithecus alpani from Paşalar, Turkey.

    PubMed

    Mortzou, Georgia; Andrews, Peter

    2008-04-01

    Seventy-four hominoid primary teeth have been recovered from the middle Miocene site of Paşalar, Turkey, constituting the largest sample of deciduous teeth for any species of fossil ape. Morphological features that characterize the permanent teeth of Griphopithecus alpani from the site have also been identified in some of these deciduous teeth, including a lingual pillar on the di(1)s. These features plus the overwhelming preponderance of G. alpani permanent teeth at the site suggest that all of the deciduous teeth belong to this species. Contrary to the situation in the permanent teeth, nothing in the morphology of the primary dentition suggests the representation of a second species. The age profile of the non-adult hominoids was reconstructed based on the degree and type of wear recorded on the dp4s, the most abundant deciduous tooth in the sample, assuming a similar eruption chronology to that of Pan troglodytes. This analysis indicates underrepresentation of very young individuals in the sample and high mortality for individuals belonging to the 3-5-years age cohort, a situation that could be due to the effects of stress related to weaning. The coefficient of variation and range-index values obtained for the majority of tooth types are equal to or greater than the comparable values in a sample of P. troglodytes, in some cases at much smaller sample sizes. One possible explanation for this is that there was greater sexual dimorphism in the G. alpani deciduous dentition than in Pan, which would mirror the condition of the permanent dentition.

  7. Evaluating Osteogenic Potential of Ligamentum Flavum Cells Cultivated in Photoresponsive Hydrogel that Incorporates Bone Morphogenetic Protein-2 for Spinal Fusion.

    PubMed

    Chiang, Chih-Wei; Chen, Wei-Chuan; Liu, Hsia-Wei; Wang, I-Chun; Chen, Chih-Hwa

    2015-01-01

    Regenerative medicine is increasingly important in clinical practice. Ligamentum flava (LF) are typically removed during spine-related surgeries. LF may be a source of cells for spinal fusion that is conducted using tissue engineering techniques. In this investigation, LF cells of rabbits were isolated and then characterized by flow cytometry, morphological observation, and immunofluorescence staining. The LF cells were also cultivated in polyethylene (glycol) diacrylate (PEGDA) hydrogels that incorporated bone morphogenetic protein-2 (BMP-2) growth factor, to evaluate their proliferation and secretion of ECM and differentiation in vitro. The experimental results thus obtained that the proliferation, ECM secretion, and differentiation of the PEGDA-BMP-2 group exceeded those of the PEGDA group during the period of cultivation. The mineralization and histological staining results differed similarly. A nude mice model was utilized to prove that LF cells on hydrogels could undergo osteogenic differentiation in vivo. These experimental results also revealed that the PEGDA-BMP-2 group had better osteogenic effects than the PEGDA group following a 12 weeks after transplantation. According to all of these experimental results, LF cells are a source of cells for spinal fusion and PEGDA-BMP-2 hydrogel is a candidate biomaterial for spinal fusion by tissue engineering. PMID:26426006

  8. Evaluating Osteogenic Potential of Ligamentum Flavum Cells Cultivated in Photoresponsive Hydrogel that Incorporates Bone Morphogenetic Protein-2 for Spinal Fusion

    PubMed Central

    Chiang, Chih-Wei; Chen, Wei-Chuan; Liu, Hsia-Wei; Wang, I-Chun; Chen, Chih-Hwa

    2015-01-01

    Regenerative medicine is increasingly important in clinical practice. Ligamentum flava (LF) are typically removed during spine-related surgeries. LF may be a source of cells for spinal fusion that is conducted using tissue engineering techniques. In this investigation, LF cells of rabbits were isolated and then characterized by flow cytometry, morphological observation, and immunofluorescence staining. The LF cells were also cultivated in polyethylene (glycol) diacrylate (PEGDA) hydrogels that incorporated bone morphogenetic protein-2 (BMP-2) growth factor, to evaluate their proliferation and secretion of ECM and differentiation in vitro. The experimental results thus obtained that the proliferation, ECM secretion, and differentiation of the PEGDA-BMP-2 group exceeded those of the PEGDA group during the period of cultivation. The mineralization and histological staining results differed similarly. A nude mice model was utilized to prove that LF cells on hydrogels could undergo osteogenic differentiation in vivo. These experimental results also revealed that the PEGDA-BMP-2 group had better osteogenic effects than the PEGDA group following a 12 weeks after transplantation. According to all of these experimental results, LF cells are a source of cells for spinal fusion and PEGDA-BMP-2 hydrogel is a candidate biomaterial for spinal fusion by tissue engineering. PMID:26426006

  9. Congenital stridor and wheezing as harbingers of the del22q11.2 syndrome presenting cardiovascular malformations of right aortic arch, aberrant left subclavian artery, Kommerell's diverticulum, and left ligamentum arteriosum.

    PubMed

    Lee, Meng-Luen; Chen, Ming; Tsao, Lon-Yen; Chiu, Han-Yao; Chiu, Ing-Sh; Yang, Albert D; Tsai, Pei-Ling

    2011-01-01

    A complete vascular ring composed of right aortic arch, aberrant left subclavian artery with Kommerell's diverticulum, and left ligamentum arteriosum was diagnosed by barium esophagography, echocardiography, angiography, and multidetector computed tomography of chest in an 18-day-old male neonate who presented with remarkable inspiratory stridor, expiratory wheezing, postprandial vomiting, and dysphagia since birth, and survived surgical division of the left ligamentum arteriosum, resection of the Kommerell's diverticulum, and reimplanation of the left subclavian artery to the left common carotid artery. Cytogenetic analysis and fluorescence in situ hybridization study of his blood revealed chromosome 22q11.2 deletion, with a karyotype of 46,XY.ish del(22)(q11.2 q11.2). A constellation of right aortic arch, aberrant left subclavian artery with Kommerell's diverticulum, and left ligamentum arteriosum in neonates may cause refractory stridor, wheezing, vomiting, and dysphagia, which can serve as harbingers of the del22q11.2 syndrome.

  10. 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

  11. Interproximal wear facets and tooth associations in the Paşalar hominoid sample.

    PubMed

    Gençturk, Insaf; Alpagut, Berna; Andrews, Peter

    2008-04-01

    Interproximal wear facets were examined on hominoid teeth from the middle Miocene site at Paşalar, Turkey. The aim was to find matches between adjacent premolar and molar teeth from single individuals that were collected in the field as isolated teeth and use them to reconstruct tooth rows. These were then used to investigate: (1) the wear gradient on the molar teeth; (2) the dispersal of teeth from single mandibles and maxillae; (3) the size ratios among the molars; and (4) the number of individuals represented by the hominoid sample. Facets were scored for size and shape and were assessed visually using photographs and superimposed outline drawings on acetate transparencies. Out of a sample of approximately 1,500 teeth collected between 1983 and 1996, 532 molars and 258 premolars produced apparent matches making up 160 tooth rows. These were then examined rigorously for morphological consistency and state of wear, and, employing the criterion that only the most unequivocal associations should be used, the final number was reduced to 48 tooth rows-31 mandibular and 17 maxillary. The tooth associations represent a minimum of 21 individuals and probably as many as 34. Molar wear was rapid, with M1s having almost twice as much wear as M3s, as measured by a wear-gradient index. The M2s are intermediate but generally closer to M1s in degree of wear, as are P4s. This wear pattern suggests either delayed eruption of M3s or extremely abrasive diets causing rapid, heavy wear. There is some indication that the wear patterns in Griphopithecus alpani and Kenyapithecus kizili are different, with the latter perhaps having a lower wear gradient, but the K. kizili sample is very small. In both species, the M2 is the largest molar and the M1 is the smallest. Separation of individual teeth in the 48 tooth associations varied from widely separated-up to 8.5m apart-to within a few centimeters of each other. One tooth row (D922) was found with the teeth in contact but the maxillary

  12. 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

  13. Human Lumbar Ligamentum Flavum Anatomy for Epidural Anesthesia: Reviewing a 3D MR-Based Interactive Model and Postmortem Samples.

    PubMed

    Reina, Miguel A; Lirk, Philipp; Puigdellívol-Sánchez, Anna; Mavar, Marija; Prats-Galino, Alberto

    2016-03-01

    The ligamentum flavum (LF) forms the anatomic basis for the loss-of-resistance technique essential to the performance of epidural anesthesia. However, the LF presents considerable interindividual variability, including the possibility of midline gaps, which may influence the performance of epidural anesthesia. We devise a method to reconstruct the anatomy of the digitally LF based on magnetic resonance images to clarify the exact limits and edges of LF and its different thickness, depending on the area examined, while avoiding destructive methods, as well as the dissection processes. Anatomic cadaveric cross sections enabled us to visually check the definition of the edges along the entire LF and compare them using 3D image reconstruction methods. Reconstruction was performed in images obtained from 7 patients. Images from 1 patient were used as a basis for the 3D spinal anatomy tool. In parallel, axial cuts, 2 to 3 cm thick, were performed in lumbar spines of 4 frozen cadavers. This technique allowed us to identify the entire ligament and its exact limits, while avoiding alterations resulting from cutting processes or from preparation methods. The LF extended between the laminas of adjacent vertebrae at all vertebral levels of the patients examined, but midline gaps are regularly encountered. These anatomical variants were reproduced in a 3D portable document format. The major anatomical features of the LF were reproduced in the 3D model. Details of its structure and variations of thickness in successive sagittal and axial slides could be visualized. Gaps within LF previously studied in cadavers have been identified in our interactive 3D model, which may help to understand their nature, as well as possible implications for epidural techniques.

  14. Analysis of the Relationship between Hypertrophy of the Ligamentum Flavum and Lumbar Segmental Motion with Aging Process

    PubMed Central

    Yoshiiwa, Toyomi; Kawano, Masanori; Ikeda, Shinichi; Tsumura, Hiroshi

    2016-01-01

    Study Design Retrospective cross-sectional study. Purpose To investigate the relationship between ligamentum flavum (LF) hypertrophy and lumbar segmental motion. Overview of Literature The pathogenesis of LF thickening is unclear and whether the thickening results from tissue hypertrophy or buckling remains controversial. Methods 296 consecutive patients underwent assessment of the lumbar spine by radiographic and magnetic resonance imaging (MRI). Of these patients, 39 with normal L4–L5 disc height were selected to exclude LF buckling as one component of LF hypertrophy. The study group included 27 men and 12 women, with an average age of 61.2 years (range, 23–81 years). Disc degeneration and LF thickness were quantified on MRI. Lumbar segmental spine instability and presence of a vacuum phenomenon were identified on radiographic images. Results The distribution of disc degeneration and LF thickness included grade II degeneration in 4 patients, with a mean LF thickness of 2.43±0.20 mm; grade III in 10 patients, 3.01±0.41 mm; and grade IV in 25 patients, 4.16±1.12 mm. LF thickness significantly increased with grade of disc degeneration and was significantly correlated with age (r=0.55, p<0.01). Logistic regression analysis identified predictive effects of segmental angulation (odds ratio [OR]=1.55, p=0.014) and age (OR=1.16, p=0.008). Conclusions Age-related increases in disc degeneration, combined with continuous lumbar segmental flexion-extension motion, leads to the development of LF hypertrophy. PMID:27340534

  15. Human Lumbar Ligamentum Flavum Anatomy for Epidural Anesthesia: Reviewing a 3D MR-Based Interactive Model and Postmortem Samples.

    PubMed

    Reina, Miguel A; Lirk, Philipp; Puigdellívol-Sánchez, Anna; Mavar, Marija; Prats-Galino, Alberto

    2016-03-01

    The ligamentum flavum (LF) forms the anatomic basis for the loss-of-resistance technique essential to the performance of epidural anesthesia. However, the LF presents considerable interindividual variability, including the possibility of midline gaps, which may influence the performance of epidural anesthesia. We devise a method to reconstruct the anatomy of the digitally LF based on magnetic resonance images to clarify the exact limits and edges of LF and its different thickness, depending on the area examined, while avoiding destructive methods, as well as the dissection processes. Anatomic cadaveric cross sections enabled us to visually check the definition of the edges along the entire LF and compare them using 3D image reconstruction methods. Reconstruction was performed in images obtained from 7 patients. Images from 1 patient were used as a basis for the 3D spinal anatomy tool. In parallel, axial cuts, 2 to 3 cm thick, were performed in lumbar spines of 4 frozen cadavers. This technique allowed us to identify the entire ligament and its exact limits, while avoiding alterations resulting from cutting processes or from preparation methods. The LF extended between the laminas of adjacent vertebrae at all vertebral levels of the patients examined, but midline gaps are regularly encountered. These anatomical variants were reproduced in a 3D portable document format. The major anatomical features of the LF were reproduced in the 3D model. Details of its structure and variations of thickness in successive sagittal and axial slides could be visualized. Gaps within LF previously studied in cadavers have been identified in our interactive 3D model, which may help to understand their nature, as well as possible implications for epidural techniques. PMID:26891398

  16. Ligamentum flavum hematomas: Why does it mostly occur in old Asian males? Interesting point of reported cases: Review and case report

    PubMed Central

    Ozdemir, Bulent; Kanat, Ayhan; Batcik, Osman Ersegun; Gucer, Hasan; Yolas, Coskun

    2016-01-01

    Hematoma of the ligamentum flavum (LF) is a rare cause of neural compression and sciatica. Currently, the etiology and epidemiological characteristics of ligamentum flavum hematoma (LFH) are unknown and epidemiological investigations using rewieving of reported cases have not been performed. We report the case of a 63-year-old man with a LFH compressing the spinal canal at the left L2–L3 level, rewieved relevant literature. In Medline research, wefound a total of 50 reported cases with LFHs, and the interesting point of these cases were analyzed. Many of cases were old males. Interestingly, 39 of the 50 cases were reported from Asian countries. The ages of 42 patients could be verified. The youngest age was 45 years, oldest age was 81 years, and mean age was 66.07 years. Thirty-three out of these 42 patients (78.53%) were older than 60 years. An important aspect of the present review is to bring attention for occurrence in older Asian males. With an increasing number of elderly people in the general population, there is a need to investigate risk factors such as sexual gender, age, and geographic location for LFH. PMID:27041879

  17. MiR-132-3p Regulates the Osteogenic Differentiation of Thoracic Ligamentum Flavum Cells by Inhibiting Multiple Osteogenesis-Related Genes

    PubMed Central

    Qu, Xiaochen; Chen, Zhongqiang; Fan, Dongwei; Sun, Chuiguo; Zeng, Yan

    2016-01-01

    Ossification of the ligamentum flavum (OLF) is a disorder of heterotopic ossification of spinal ligaments and is the main cause of thoracic spinal canal stenosis. Previous studies suggested that miR-132-3p negatively regulates osteoblast differentiation. However, whether miR-132-3p is involved in the process of OLF has not been investigated. In this study, we investigated the effect of miR-132-3p and its target genes forkhead box O1 (FOXO1), growth differentiation factor 5 (GDF5) and SRY-box 6 (SOX6) on the osteogenic differentiation of ligamentum flavum (LF) cells. We demonstrated that miR-132-3p was down-regulated during the osteogenic differentiation of LF cells and negatively regulated the osteoblast differentiation. Further, miR-132-3p targeted FOXO1, GDF5 and SOX6 and down-regulated the protein expression of these genes. Meanwhile, FOXO1, GDF5 and SOX6 were up-regulated after osteogenic differentiation and the down-regulation of endogenous FOXO1, GDF5 or SOX6 suppressed the osteogenic differentiation of LF cells. In addition, we also found FOXO1, GDF5 and SOX6 expression in the ossification front of OLF samples. Overall, these results suggest that miR-132-3p inhibits the osteogenic differentiation of LF cells by targeting FOXO1, GDF5 and SOX6. PMID:27556448

  18. 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.

  19. Technique and nuances of an S-2 alar iliac screw for lumbosacral fixation in patients with transitional and normal anatomy.

    PubMed

    Ohya, Junichi; Vogel, Todd D; Dhall, Sanjay S; Berven, Sigurd; Mummaneni, Praveen V

    2016-07-01

    S-2 alar iliac (S2AI) screw fixation has recently been recognized as a useful technique for pelvic fixation. The authors demonstrate two cases where S2AI fixation was indicated: one case was a sacral insufficiency fracture following a long-segment fusion in a patient with a transitional S-1 vertebra; the other case involved pseudarthrosis following lumbosacral fixation. S2AI screws offer rigid fixation, low profile, and allow easy connection to the lumbosacral rod. The authors describe and demonstrate the surgical technique and nuances for the S2AI screw in a case with transitional S-1 anatomy and in a case with normal S-1 anatomy. The video can be found here: https://youtu.be/Sj21lk13_aw . PMID:27364429

  20. Ossification of the cervical ligamentum flavum and osseous brown tumor: late manifestations of primary hyperparathyroidism misdiagnosed in a case of parathyroid carcinoma

    PubMed Central

    Sampanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Vasileiou, Sotirios

    2016-01-01

    Summary Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations. Herein we aimed at presenting an unique case of a young patient with late manifestations of parathyroid cancer and reviewing the relevant literature. A 45-year-old male patient presented in the Outpatient Clinic with an episode of nephrolithiasis. His personal medical history includes: recurrent episodes of nephrolithiasis, laminectomy in the cervical spine due to ossification of the cervical ligamentum flavum and surgical resection of a giant cell tumor of the brain. Laboratory testing revealed findings of primary hyperparathyroidism (serum calcium 16,0 mmol/l phosphorus 1,46 mg/dl and parathyroid hormone/PTH 8560 pg/ml). Neck ultrasound and technetium-99 m sestamibi scan were performed showing a parathyroid tumor. Due to the persistently high serum calcium and PTH levels, the high alkaline phosphatase levels (440 IU/L) and the late manifestations of HPT, surgical excision of the tumor was performed. The tumor was identified as parathyroid carcinoma. Immediately after surgery serum calcium and phosphorus levels were normalized. The patient is on a regular follow-up program with no signs of recurrence or metastasis one year after the excision. We describe the coexistence of rare late manifestations of HPT, which had not been adequately investigated at their onset in this young patient. Therefore, increased awareness is needed in order to recognize and further investigate signs or symptoms of HPT. PMID:27252748

  1. Ossification of the cervical ligamentum flavum and osseous brown tumor: late manifestations of primary hyperparathyroidism misdiagnosed in a case of parathyroid carcinoma.

    PubMed

    Sampanis, Nikolaos; Gavriilaki, Eleni; Paschou, Eleni; Kalaitzoglou, Asterios; Vasileiou, Sotirios

    2016-01-01

    Parathyroid carcinoma represents an extremely rare neoplasm with diverse clinical manifestations. Herein we aimed at presenting an unique case of a young patient with late manifestations of parathyroid cancer and reviewing the relevant literature. A 45-year-old male patient presented in the Outpatient Clinic with an episode of nephrolithiasis. His personal medical history includes: recurrent episodes of nephrolithiasis, laminectomy in the cervical spine due to ossification of the cervical ligamentum flavum and surgical resection of a giant cell tumor of the brain. Laboratory testing revealed findings of primary hyperparathyroidism (serum calcium 16,0 mmol/l phosphorus 1,46 mg/dl and parathyroid hormone/PTH 8560 pg/ml). Neck ultrasound and technetium-99 m sestamibi scan were performed showing a parathyroid tumor. Due to the persistently high serum calcium and PTH levels, the high alkaline phosphatase levels (440 IU/L) and the late manifestations of HPT, surgical excision of the tumor was performed. The tumor was identified as parathyroid carcinoma. Immediately after surgery serum calcium and phosphorus levels were normalized. The patient is on a regular follow-up program with no signs of recurrence or metastasis one year after the excision. We describe the coexistence of rare late manifestations of HPT, which had not been adequately investigated at their onset in this young patient. Therefore, increased awareness is needed in order to recognize and further investigate signs or symptoms of HPT. PMID:27252748

  2. TGF-β1, in association with the increased expression of connective tissue growth factor, induce the hypertrophy of the ligamentum flavum through the p38 MAPK pathway

    PubMed Central

    Cao, Yan-Lin; Duan, Yang; Zhu, Li-Xin; Zhan, Ye-Nan; Min, Shao-Xiong; Jin, An-Min

    2016-01-01

    Hypertrophy of the ligamentum flavum (LF) is one of the key pathomechanisms of lumbar spinal stenosis (LSS). Transforming growth factor (TGF)-β1 is abundantly expressed in hypertrophied degenerative LF tissues from LSS. However, the molecular mechanisms underling the association between TGF-β1 and LF hypertrophy have not yet been fully elucidated. In this study, we investigated the important role of the mitogen-activated protein kinase (MAPK) pathway in the pathogenesis of LSS by analyzing the expression of connective tissue growth factor (CTGF) and extracellular matrix (ECM) components (collagen I and collagen III) in TGF-β1-treated LF cells. Cell growth assay revealed that TGF-β1, in association with CTGF, enhanced the the proliferation of LF cells, and we found that TGF-β1 also elevated CTGF expression and subsequently enhanced the mRNA expression of collagen I and collagen III. The increased mRNA expression levels of CTGF, collagen I and collagen III were abolished by p38 inhibitors. Both immunofluorescence imaging and western blot analysis of p38 and p-p38 revealed the increased expression and phosphorylation of p38. Silencing the expression of p38 by siRNA in LF cells decreased the protein expression of p38, p-p38 and CTGF, as well as the mRNA expression of CTGF, collagen I and collagen III. Taken together, our findings indicate that TGF-β1, in association with the increased expression of CTGF, contribute to the homeostasis of the ECM and to the hypertrophy of LF through the p38 MAPK pathway. PMID:27279555

  3. Differential utilization of pyrrolizidine alkaloids by males of a danaid butterfly, Parantica sita, for the production of danaidone in the alar scent organ.

    PubMed

    Honda, Keiichi; Honda, Yasuyuki; Yamamoto, Satoshi; Omura, Hisashi

    2005-04-01

    Males of the chestnut tiger butterfly, Parantica sita, secrete danaidone as a major component from the alar androconial organ (sex brand). Since danaidone has been postulated to be derived from various pyrrolizidine alkaloids (PAs), which males ingest as adults from PA-containing plants, we conducted oral administration tests of several PAs to examine their availability for danaidone production by P. sita males. Males fed with a mixture of intermedine (80%) and lycopsamine (20%) produced danaidone at an average of 25.7 microg per individual, which was comparable to that found in field-caught males. In contrast, a smaller amount of danaidone (5.7 to 7.0 microg/ male) was formed when males ingested retronecine or heliotrine, and those fed with an HCI salt of monocrotaline or retrorsine produced only traces of danaidone (<0.5 microg/male). In addition, males showed a strong feeding response to intermedine/lycopsamine, whereas the other PAs elicited no positive feeding behavior. These results indicate that, unlike the arctiid moths, P. sita males can only successfully convert limited chemical types of PAs into danaidone, and further suggest that in the field, males selectively ingest particular PAs that are readily transformable into danaidone.

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

    PubMed

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

    2015-12-01

    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

  5. 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

  6. [Histological changes of the lumbar ligamentum flavum with age].

    PubMed

    Kashiwagi, K

    1993-04-01

    The present author investigated morphometrically the changes associated with age in 137 ligamenta flava of the lumbar spine obtained from 79 patients with lumbar diseases and obtained the following results. The predominant changes were decrease of elastic fibers and increase of collagen fibers. The area of type II collagen fibers increased with age in the dorsal and central portions. Those were followed by proliferation of cartilage cells and calcification. The proliferation of cartilage cells was marked in the cranial and caudal insertion portions, and the layer of cartilage cells widened with age. Two types of calcification, deposition of calcium pyrophosphate dihydrate (CPPD) and deposition of hydroxyapatite (HAP), were observed. HAP deposits were small and frequently found in the dorsal portion, while CPPD deposits were larger and widely distributed.

  7. [The correction of one cause of the short nose: how to bring the retracted alar rim downwards?].

    PubMed

    Levet, Y

    2009-10-01

    The author reports a genuine procedure called the "sliding flap" used to correct the retraction of the rim of the nostril upward. The new position of the rim is stabilized by a simple resorbable thread through the skin fixing the rim in the new situation. This technique is efficient in both primary and secondary cases.

  8. Kepler's Use of Archetypes in his defence against Aristotelian Scepticism

    NASA Astrophysics Data System (ADS)

    Martens, Rhonda M.

    In 1621, looking back over an impresive career, Johannes Kepler commented that "almost every book on astronomy which I have published since that time could be referred to one or another of the important chapters set out in this little book (the Mysterium Cosmographicum) and would contain either an illustration or a completion of it". Kepler viewed the Mysterium, his first book, as the genesis of hist later works; Here the author is focusing on the conceptual foundations it provided for his approach to physical astronomy and the Aristotelian dominant during his time. It turns out that despite Kepler's arowedly Platonic and Pythagorean sympathies, his physical astronomy comports with Aristotle's directives in the Posterior Analytics. Perhaps paradoxically, his arhetypal cosmology as expressed in the Mysterium enabled the merging Platonic and Aristotelian intuitions in his construction of the new astronomy.

  9. After liber novus.

    PubMed

    Shamdasani, Sonu

    2012-06-01

    This paper reflects on the conference question concerning the clinical and theoretical significance of Jung's Liber Novus, two years after its initial publication, and looks at how Jung himself reflected upon it and how it informed his turn to alchemy, with particular attention to the theme of opposites and their reconciliation in Liber Novus, later taken up in Mysterium Coniunctionis. PMID:22724599

  10. Effects of Conducting Plane on Band and Choral Musicians' Perceptions of Conductor and Ensemble Expressivity

    ERIC Educational Resources Information Center

    Silvey, Brian A.; Fisher, Ryan A.

    2015-01-01

    The purpose of this study was to examine whether one aspect of conducting technique, the conducting plane, would affect band and/or choral musicians' perceptions of conductor and ensemble expressivity. A band and a choral conductor were each videotaped conducting 1-min excerpts from Morten Lauridsen's "O Magnum Mysterium" while using a…

  11. Vascular ring

    MedlinePlus

    ... with aberrant subclavian and left ligamentum ateriosus; Congenital heart defect - vascular ring; Birth defect heart - vascular ring ... accounts for less than 1% of all congenital heart problems. The condition occurs as often in males ...

  12. Mästlin, Michael (1550-1631)

    NASA Astrophysics Data System (ADS)

    Murdin, P.

    2000-11-01

    Born in Göppingen, Germany, taught by, and an assistant to, PETER APIAN, became professor of astronomy at Tubingen, where he taught the Copernican as well as the Ptolemaic system. He taught KEPLER, and helped him to publish his first work, Mysterium Cosmographicum (1596). He made his own astronomical instruments. He was one of the first three or four astronomers to see in Cassiopeia what is now ...

  13. Application of the Flexible CO2 Laser in Minimally Invasive Laminectomies: Technical Note.

    PubMed

    Hussain, Namath S; Perez-Cruet, Mick

    2016-06-02

    Background Minimally invasive laminectomy is a very effective surgical method for treating lumbar stenosis. However, this technique can be technically difficult, especially in patients suffering from severe stenosis. The contralateral decompression from a unilateral approach can result in durotomy during removal of the hypertrophied ligamentum flavum. This complication can be difficult to treat through a small working channel. Objective To detail our group's operative experience with the CO2 laser and discuss our results and previous studies in the literature reporting results.  Methods The CO2 laser (Omniguide, Boston, MA) was investigated in the surgical ablation of the contralateral ligamentum flavum during minimally invasive laminectomies. Forty levels have been investigated thus far. The amount of voltage needed to adequately desiccate and remove the ligamentum flavum safely as well as the effectiveness of this technique were investigated. Results The contralateral ligamentum flavum could be removed effectively using the 9 to 11 watt continuous wavelength (10,600 nanometer) power setting on the CO2 laser. Shrinkage of the contralateral ligamentum flavum facilitated its removal using a number 2 Kerrison Punch. No durotomies occurred, and the use of the laser did not significantly lengthen operative times.  Conclusions The CO2 laser appears to be a useful tool in the armamentarium of instruments available to the minimally invasive spine surgeon and may help to reduce the incidence of durotomies when performing minimally invasive laminectomies.

  14. Application of the Flexible CO2 Laser in Minimally Invasive Laminectomies: Technical Note

    PubMed Central

    Perez-Cruet, Mick

    2016-01-01

    Background Minimally invasive laminectomy is a very effective surgical method for treating lumbar stenosis. However, this technique can be technically difficult, especially in patients suffering from severe stenosis. The contralateral decompression from a unilateral approach can result in durotomy during removal of the hypertrophied ligamentum flavum. This complication can be difficult to treat through a small working channel. Objective To detail our group’s operative experience with the CO2 laser and discuss our results and previous studies in the literature reporting results.  Methods The CO2 laser (Omniguide, Boston, MA) was investigated in the surgical ablation of the contralateral ligamentum flavum during minimally invasive laminectomies. Forty levels have been investigated thus far. The amount of voltage needed to adequately desiccate and remove the ligamentum flavum safely as well as the effectiveness of this technique were investigated. Results The contralateral ligamentum flavum could be removed effectively using the 9 to 11 watt continuous wavelength (10,600 nanometer) power setting on the CO2 laser. Shrinkage of the contralateral ligamentum flavum facilitated its removal using a number 2 Kerrison Punch. No durotomies occurred, and the use of the laser did not significantly lengthen operative times.  Conclusions The CO2 laser appears to be a useful tool in the armamentarium of instruments available to the minimally invasive spine surgeon and may help to reduce the incidence of durotomies when performing minimally invasive laminectomies. PMID:27433407

  15. Johannes Kepler and David Fabricius: Their Discussion on the Nova of 1604

    NASA Astrophysics Data System (ADS)

    Granada, Miguel A.

    David Fabricius (1564-1617) was one of the most important astronomers in the period between 1596, the year of publication of Kepler's Mysterium cosmographicum, and 1609, the year of publication of the Astronomia nova.1 Kepler praised Fabricius as the most accurate observational astronomer after Tycho Brahe's death in 1601.2 Fabricius was a Reformed pastor in Ostfriesland (East Frisia), his remote natal region, and a vocational astronomer. He published nothing in the field of astronomy except for the short treatises between 1604 and 1606 concerning the nova that appeared in October 1604 in Serpentarius.

  16. The Kepler - Mästlin correspondence. (German Title: Der Briefwechsel zwischen Kepler und Mästlin)

    NASA Astrophysics Data System (ADS)

    Seck, Friedrich

    The correspondence between Kepler and Mästlin covers the period from 1594 to 1620. It is interrupted by year-long pauses and ends a full 10 years before Kepler's death. Initially, Mästlin is quite open to Kepler's new ideas (Mysterium Cosmographicum), but later he showed little understanding for the revolutionary innovations of the mature Kepler. Kepler's insistent wishes and the unfounded fear that Kepler might publish his letters gave rise to long periods of silence. Some passages in letters of his associates suggest that Mästlin suffered from melancholy (in today's terms: depression) induced by age.

  17. Reconstruction of the left-sided brachiocephalic trunk after vascular ring operation in left-handed child with Kommerell's diverticulum.

    PubMed

    Haponiuk, Ireneusz; Paczkowski, Konrad; Chojnicki, Maciej; Jaworski, Radosław; Steffens, Mariusz; Szofer-Sendrowska, Aneta; Kwaśniak, Ewelina; Zieliński, Jacek; Gierat-Haponiuk, Katarzyna

    2013-01-01

    We report a case of a 2-year-old girl with prenatal diagnosis of vascular ring composed of a right-sided aortic arch, a left ligamentum arteriosum, and a left subclavian artery (arteria lusoria sin) originating from a retroesophageal Kommerell's diverticulum, who was referred for surgery with symptoms related to local compression - severe dysphagia and respiratory disorders. Through the left posterolateral thoracotomy, a ligamentum arteriosum between the Kommerell's diverticulum and the left pulmonary artery was divided and because of left-handedness of the child a brachiocephalic trunk was reconstructed in the fashion of anastomosis of the left subclavian artery and the left common carotid artery, originating from the ascending aorta.

  18. A visit paid to Jung by Alwine von Keller.

    PubMed

    Bernardini, Riccardo; Quaglino, Gian Piero; Romano, Augusto

    2011-04-01

    In the winter of 1943-1944, Jung had suffered a coronary thrombosis which almost cost him his life. During his illness, Jung experienced a series of visions, described in his Memories, Dreams, Reflections, which were also to influence significantly the development of his theoretical thinking. On 27(th) September 1944, Alwine von Keller (1878-1965) paid a visit to Jung, while he was still convalescing, in Zurich and documented her meeting with him in a series of notes, recently discovered, which testify to the fact that, at the time of their meeting, Jung was engaged in writing the 'Salt' chapter of Mysterium coniunctionis and investigating the alchemistic symbolism of the 'sea'. This theme seems to testify to a continuity of interests on Jung's part with the seminar he held at Eranos the previous year on the cartographic art of Opicinus de Canistris (1296-c.1352). With its addition of many unpublished details, Alwine von Keller's notes supplement the report which Jung made of his visions experienced during his sickness in MDR. In particular, these attest to the fact that Jung had attributed the terrible experience which he had endured to the problem of the conjunctio, which was confronting him from the theoretical point of view in his writing of Mysterium coniunctionis.

  19. Structural Preservation Percutaneous Endoscopic Lumbar Interlaminar Discectomy for L5-S1 Herniated Nucleus Pulposus

    PubMed Central

    Jang, Jee-Soo; Jang, Il-Tae

    2016-01-01

    Objective. Structures such as ligamentum flavum, annulus, and lamina play an important role in the segmental function. We proposed the surgical technique for achieving the sufficient preservation of segmental structures, in spite of sufficient removal of pathologic disc in the L5-S1 using the ligamentum flavum splitting and sealing technique. Methods. We retrospectively analyzed 80 cases that underwent percutaneous endoscopic lumbar discectomy for L5-S1 herniated nucleus pulposus, using the ligamentum flavum splitting and sealing technique between January 2011 and June 2013. Outcomes were assessed using VAS (leg, back), MacNab's criteria, and the immediate postoperative MRI for all patients. Structural preservation was classified as complete, sufficient, and incomplete. Results. The surgical results are as follows: 65 cases were complete, 15 cases were sufficient, and 0 cases were incomplete. The VAS was decreased at the last follow-up (leg: from 7.91 ± 0.73 to 1.15 ± 0.62; back: from 5.15 ± 0.71 to 1.19 ± 0.75). A favorable outcome (excellent or good outcome by MacNab's criteria) was achieved in 77 patients (96.25%). During the follow-up period, 2 cases (2.5%) of recurrence have occurred. Conclusion. According to the result, we could obtain the favorable clinical and radiological outcomes while simultaneously removing pathologic discs using the ligamentum flavum splitting and annular fissure sealing technique. PMID:27803927

  20. 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.

  1. Kepler's winding Path to true Heliocentrism

    NASA Astrophysics Data System (ADS)

    Bialas, Volker

    The paper concerns the evolution of concepts by Johannes Kepler from Aristotelian conception of the Universe to Heliocentrism. Already as young Magister in Tubingen Kepler has taken an active part in Physical disputations of the candidates and has defended the doctrines of Copernik (1). In the Mysterium Cosmographicum he refers the planetary distances no longer to the center of the earth's orbit, but to the center of the true sun. But just by working out his Astronomia Nova Kepler succeeds in creating a strictly heliocentric astronomy as his handwriting Manuscripts give detailed information (2). Notes: 1) fragmentum orations de motu terrae. In Keppler Gesammelte werke Vol. 20.1, Munich 1988, p. 147-149 2) Commentaria in Theoriam Martis. Edition in: Kepler Gessamelete Werke Vol. 20.2 (in preparation)

  2. Jung's quest for the Aurora consurgens.

    PubMed

    Haaning, Aksel

    2014-02-01

    The paper focuses on the year 1929 when Jung published 'A European commentary' to Richard Wilhelm's German translation of the Taoist text The Secret of the Golden Flower. This shows that Jung had already started on the track of European alchemy by following up Conrad Waldkirch's preface in Artis Auriferae (1593); and it raises the question of whether this could be the possible missing link to Jung's subsequent research in Alchemy and Hermetic Philosophy in the years to come. It is argued that here was the beginning of Jung's quest for the Aurora consurgens, the publication of which concludes the Mysterium Conuinctionis more than twenty years later. It is further maintained that this choice of the Aurora is a profound expression of Jung's ambition to revitalize the past from within the individual, and helps explain Jung's deep concern with the welfare and future of modern society. PMID:24467350

  3. From Cosmos to Confession: Kepler and the Connection Between Astronomical and Religious Truth

    NASA Astrophysics Data System (ADS)

    Rothman, Aviva

    In October of 1595, Johannes Kepler joyfully conveyed to Tübingen the news that he had completed his first book, the Mysterium cosmographicum. "I truly desire," he wrote to Michael Maestlin, his former professor of mathematics, "that these things are published as quickly as possible for the glory of God, who wants to be known from the Book of Nature […]. I wanted to be a theologian; for a long time I was distressed: behold God is now celebrated too in my astronomical work."1 Unable to devote himself to the Book of Scripture directly,2 Kepler had turned his focus to God's other book - the Book of Nature - which, he believed, also revealed God's providential plan.

  4. Jung's quest for the Aurora consurgens.

    PubMed

    Haaning, Aksel

    2014-02-01

    The paper focuses on the year 1929 when Jung published 'A European commentary' to Richard Wilhelm's German translation of the Taoist text The Secret of the Golden Flower. This shows that Jung had already started on the track of European alchemy by following up Conrad Waldkirch's preface in Artis Auriferae (1593); and it raises the question of whether this could be the possible missing link to Jung's subsequent research in Alchemy and Hermetic Philosophy in the years to come. It is argued that here was the beginning of Jung's quest for the Aurora consurgens, the publication of which concludes the Mysterium Conuinctionis more than twenty years later. It is further maintained that this choice of the Aurora is a profound expression of Jung's ambition to revitalize the past from within the individual, and helps explain Jung's deep concern with the welfare and future of modern society.

  5. Cosmological Theories at the time of Tycho Brahe

    NASA Astrophysics Data System (ADS)

    Hadravova, Alena; Hadrava, Petr

    The basic task of astronomy till the epoch of Kepler was to create a model of the Solar system which would agree with observations and simultaneously be self -consistent. From the observational point of view the geocentric and heliocentric theories were equivalent and for a suitable choice of free parameters represented by the system of epicicles they could agree with Kepler's laws to any accuracy. The main advantage of Copernicus'system was its deeper consistency manifesting itself by smaller number of free parameters. This was achieved on behalf of intuitively accepted physical ideas. The comromising system of Tycho was able to save an essential part of these ideas and, moreover, to overcome the disageement of Copernicus's system with observational limits on stellar parallaxes. On the other hand, the Kepler's model from Mysterium cosmographicum was an attempt to derive all free parameters from very basic geometric symmetries. Such an idea provides deep motivation even for today's cosmology.

  6. A Journal of travel of an astrophysicist

    NASA Astrophysics Data System (ADS)

    Gaina, Alex B.

    2015-06-01

    The authors is descibing personal impressions from a number of scientific conferences took between 1993 and 1998 in Trieste (ICTP,with the participation of 2 Nobel Laureats Winners: Professor Abdus Salam (1926-1996) and Professor Gert t'Hooft), Catania astrophysical Observatory and University (1995-JENAM 1995), Athens Observatory and University (1996-Wide Field Spectroscopy), Prague Technicke Museum (1996- Symposium "Mysterium Cosmographicum"),Prague technical University (1998 -JENAM 1998),which in fact contained also a trip to Nicolaus Copernicus Astronomical Center in Torun (Poland). Besides,some details on trips through Ukraine, Poland, Serbia, where a kind meeting with astronomers from Belgrade took place in 1995, former Yugoslav Countries: Monetnegro, Slovenija and Croatia, Bulgaria, where another meeting with physicists from the Academy of Sciences of Bulgaria took place has been given also.

  7. Reconstruction of the left-sided brachiocephalic trunk after vascular ring operation in left-handed child with Kommerell's diverticulum

    PubMed Central

    Haponiuk, Ireneusz; Chojnicki, Maciej; Jaworski, Radosław; Steffens, Mariusz; Szofer-Sendrowska, Aneta; Kwaśniak, Ewelina; Zieliński, Jacek; Gierat-Haponiuk, Katarzyna

    2013-01-01

    We report a case of a 2-year-old girl with prenatal diagnosis of vascular ring composed of a right-sided aortic arch, a left ligamentum arteriosum, and a left subclavian artery (arteria lusoria sin) originating from a retroesophageal Kommerell's diverticulum, who was referred for surgery with symptoms related to local compression – severe dysphagia and respiratory disorders. Through the left posterolateral thoracotomy, a ligamentum arteriosum between the Kommerell's diverticulum and the left pulmonary artery was divided and because of left-handedness of the child a brachiocephalic trunk was reconstructed in the fashion of anastomosis of the left subclavian artery and the left common carotid artery, originating from the ascending aorta. PMID:24570707

  8. “Don Juan-Fracture” as a Hint to Aortic Isthmus Rupture

    PubMed Central

    Suksompong, Sirilak; von Bormann, Benno

    2014-01-01

    We report a case of thoracic aortic rupture after blunt trauma in a 23-year-old male patient. The initial investigation found no external injury or bleeding, only a slightly widened mediastinum and a broken left calcaneus. Abdominal lavage was negative, biochemistry was normal, and breathing and oxygenation were not compromised. When changing his position during diagnostics, the patient all of a sudden developed cardiac arrest and typical signs of hypovolemic shock. An immediate sternotomy was done without any further diagnostics on suspicion of aortic isthmus injury. A circular avulsion at the ligamentum arteriosum was found as assumed and repaired under cardiopulmonary bypass. The patient left the hospital for rehabilitation after 12 days in adequate health status. Biodynamics of blunt trauma after high-speed frontal impact and the relationship between calcaneus fracture, called “Don-Juan fracture,” and aortic rupture at the site of ligamentum arteriosum are discussed. PMID:25478249

  9. Kepler's Cosmos And The Lathe Of Heaven

    NASA Astrophysics Data System (ADS)

    Brecher, Kenneth

    2011-01-01

    Johannes Kepler's Mysterium Cosmographicum, published in 1596, presented his vision of the geometrical structure of the solar system. Kepler sought to account for the number of planets, thought to be six, as well as their orbital radii. He assigned orbits to the planets in three-dimensional space. Kepler proposed that the planets move on six spheres inscribed within and circumscribed around the five platonic solids. How did he arrive at his model? By his own account reported in the book, the central idea occurred to him while giving a lecture about planetary conjunctions. But was this revelation the origin of the model? In this presentation, we discuss the artistic, scientific and mathematical environment in which Kepler was immersed in late 16th century Europe. Examples will be shown of some of the readily available inscribed polyhedra that he may have seen - printed in widely circulated books, included in well-known paintings and engravings, and displayed as three dimensional ornamentally turned sculptures. It is highly likely that he saw such physical models five years later while in the employ of Rudolf II who was an avid ornamental turner. Layered polyhedral ivory turnings were made by the nobility with what were then fairly common lathes. Kepler himself wanted to have his own celestial model made into a punch bowl! Therefore, it seems plausible that Kepler had seen models of inscribed platonic solids well before 1596. Later in life Kepler reprinted the Mysterium Cosmographicum with very little fundamental change in its outlook, even after having found what we now call Kepler's three laws of planetary motion. His interest in nested polyhedra may well have preceded any astronomical evidence or geometrical reasoning, arising from artistic and aesthetic encounters that occurred early in his life. Project LITE is supported by the NSF through DUE Grant # 0715975.

  10. [An unusual complication after the partial resection of the ascending duodenum of a cow].

    PubMed

    Steiner, A; Müller, L; Pabst, B

    1989-01-01

    In a heifer portions of the ascending duodenum, which had been perforated by an obstructing phytobezoar, were resected. This resulted in an unexpected complication. The shortened ligamentum duodenocolicum exerted steady traction on the descending colon. This traction caused a kink and finally resulted in a total obstruction of the colon. The pathogenesis of this complication is illustrated. Surgical--possibly preventive--procedures are discussed.

  11. Congenital isolation of the subclavian artery in adults.

    PubMed Central

    Guinn, G A; Weathers, S

    1997-01-01

    The congenital anomaly of isolation of the subclavian artery, on the left side, is associated with a right aortic arch. The subclavian artery loses its connection with the aorta and is connected to the left pulmonary artery via the ligamentum arteriosum. Subclavian steal syndrome accompanies this anomaly in a minority of patients. We report 2 cases of adults with subclavian artery isolation, one of whom was symptomatic, and we discuss the importance of recognizing its presence. Images PMID:9068141

  12. Thoracoscopic correction of a congenital persistent right aortic arch in a young cat

    PubMed Central

    Plesman, Rhea; Johnson, Matthew; Rurak, Sarah; Ambrose, Barbara; Shmon, Cindy

    2011-01-01

    A 9-week-old kitten was diagnosed with a congenital vascular ring anomaly by means of an esophageal contrast study. At 6 mo of age, a non-selective vascular study was used to diagnose a persistent right aortic arch (PRAA). Left-sided thoracoscopic surgery was performed, using a Liga-Sure vessel sealant device to seal and transect the ligamentum arteriosum. PMID:22467970

  13. Video assisted thoracoscopic surgery cases with right-sided aortic arch aneurysm and complete vascular ring: Case report

    PubMed Central

    Nezafati, Mohammad Hassan; Nezafati, Pouya

    2014-01-01

    Introduction Right-sided aortic arch with aberrant left subclavian artery and ligamentum arteriosum, after double aortic arch, is the second most common complete vascular ring. It was traditionally treated by open surgical thoracotomy and recently video assisted thoracoscopic surgery (VATS) has been used in some cases. Presentation of case We describe the cases of two infants who presented with gastroesophageal reflux, dyspnea, dysphagia secondary to aneurysmal dilatation of the retroesophageal arch confirmed by imaging data. VATS procedure was performed through a left thoracoscopic approach. Ligamentum arteriosus compressed esophagus was clipped, sectioned and then released the esophagus in one case; also, In the second case, we clipped and sectioned aorta, distal to the origin of aberrant left subclavian artery. Discussion CT angiography and MRI are known to be the most effective available imaging methods for vascular ring detection. Also, there are several surgical approaches to vascular rings such as, thoracotomy and thoracoscopy. There is a large body of evidence confirming the safety, efficacy and convenience of VATS as a therapeutic option for congenital heart disease including right-sided aortic arch and aberrant left subclavian artery. Conclusion VATS is a less invasive and safe strategy for management of right-sided aortic arch with aberrant left subclavian artery and ligamentum arteriosum. PMID:25544489

  14. An approach to aesthetic rhinoplasty in the non-caucasian nose.

    PubMed

    Kabaker, S S

    1977-08-01

    The problem of augmenting the nasal dorsum and columella in the exaggerated Negroid or Oriental nose is presented. Augmentation of the nasal dorsum is routinely performed using polyamide mesh. The lengthening and lowering of the short and sometimes retracted columella and narrowing of the alar bases is performed by making a columellar splitting incision and extending it along the alar sills. A septal cartilage graft is sewn into the new columellar space, and the alar sills are advanced into the columella, thereby lengthening the columella and changing the axis of the nares. The columellar advancement is done after the dorsal implantation is performed, and the projection of the tip is advanced to whatever amount necessary to aesthetically match the dorsal profile line.

  15. Alanyl-tRNA synthetase genes of Vanderwaltozyma polyspora arose from duplication of a dual-functional predecessor of mitochondrial origin.

    PubMed

    Chang, Chia-Pei; Tseng, Yi-Kuan; Ko, Chou-Yuan; Wang, Chien-Chia

    2012-01-01

    In eukaryotes, the cytoplasmic and mitochondrial forms of a given aminoacyl-tRNA synthetase (aaRS) are typically encoded by two orthologous nuclear genes, one of eukaryotic origin and the other of mitochondrial origin. We herein report a novel scenario of aaRS evolution in yeast. While all other yeast species studied possess a single nuclear gene encoding both forms of alanyl-tRNA synthetase (AlaRS), Vanderwaltozyma polyspora, a yeast species descended from the same whole-genome duplication event as Saccharomyces cerevisiae, contains two distinct nuclear AlaRS genes, one specifying the cytoplasmic form and the other its mitochondrial counterpart. The protein sequences of these two isoforms are very similar to each other. The isoforms are actively expressed in vivo and are exclusively localized in their respective cellular compartments. Despite the presence of a promising AUG initiator candidate, the gene encoding the mitochondrial form is actually initiated from upstream non-AUG codons. A phylogenetic analysis further revealed that all yeast AlaRS genes, including those in V. polyspora, are of mitochondrial origin. These findings underscore the possibility that contemporary AlaRS genes in V. polyspora arose relatively recently from duplication of a dual-functional predecessor of mitochondrial origin.

  16. 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

  17. Anatomy-based image processing analysis of the running pattern of the perioral artery for minimally invasive surgery.

    PubMed

    Lee, Sang-Hee; Lee, Minho; Kim, Hee-Jin

    2014-10-01

    We aimed to elucidate the tortuous course of the perioral artery with the aid of image processing, and to suggest accurate reference points for minimally invasive surgery. We used 59 hemifaces from 19 Korean and 20 Thai cadavers. A perioral line was defined to connect the point at which the facial artery emerged on the mandibular margin, and the ramification point of the lateral nasal artery and the inferior alar branch. The course of the perioral artery was reproduced as a graph based on the perioral line and analysed by adding the image of the artery using MATLAB. The course of the artery could be classified into 2 according to the course of the alar branch - oblique and vertical. Two distinct inflection points appeared in the course of the artery along the perioral line at the ramification points of the alar branch and the inferior labial artery, respectively, and the course of the artery across the face can be predicted based on the following references: the perioral line, the ramification point of the alar branch (5∼10 mm medial to the perioral line at the level of the lower third of the upper lip) and the inferior labial artery (5∼10 mm medial to the perioral line at the level of the middle of the lower lip).

  18. 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

  19. Repair of "coup de sabre," a linear form of scleroderma.

    PubMed

    Sengezer, M; Deveci, M; Selmanpakoglu, N

    1996-10-01

    A case of coup de sabre, a linear form of scleroderma, is presented. Treatment consisted of soft-tissue expansion and autologous bone grafting to the forehead, a composite graft for alar reconstruction, and a scalp graft for eyebrow reconstruction. None of the linear scleroderma cases reported in the literature consisted of bony reconstruction.

  20. 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…

  1. A C1-2 locked facet in a child with atlantoaxial rotatory fixation. Case report.

    PubMed

    Missori, Paolo; Miscusi, Massimo; Paolini, Sergio; DiBiasi, Claudio; Finocchi, Vannina; Peschillo, Simone; Delfini, Roberto

    2005-12-01

    Conservative treatment is reported in a child with atlantoaxial rotatory fixation. Three-dimensional (3D) computerized tomography (CT) and magnetic resonance (MR) imaging demonstrated the degree of dislocation and alar ligament damage. A rigid cervical collar and muscle relaxant agents without any traction allowed full recovery. Control 3D CT scanning and MR imaging findings are reported.

  2. Hip arthroscopy.

    PubMed

    de Amorim Cabrita, Henrique Antônio Berwanger; de Castro Trindade, Christiano Augusto; de Campos Gurgel, Henrique Melo; Leal, Rafael Demura; de Souza Marques, Ricardo da Fonseca

    2015-01-01

    Hip arthroscopy is a safe method for treating a variety of pathological conditions that were unknown until a decade ago. Femoroacetabular impingement is the commonest of these pathological conditions and the one with the best results when treated early on. The instruments and surgical technique for hip arthroscopy continue to evolve. New indications for hip arthroscopy has been studied as the ligamentum teres injuries, capsular repair in instabilities, dissection of the sciatic nerve and repair of gluteal muscles tears (injuries to the hip rotator cuff), although still with debatable reproducibility. The complication rate is low, and ever-better results with fewer complications should be expected with the progression of the learning curve.

  3. Video-Assisted Thoracoscopic Division of Vascular Rings

    PubMed Central

    Lee, Jung Hee; Yang, Ji-Hyuk; Jun, Tae-Gook

    2015-01-01

    This study reports our early experience with thoracoscopic division of vascular rings. Three patients were reviewed; their ages at surgery were 25 months, 4 years, and 57 years. All patients were suffering from complete vascular rings involving combinations of the right aortic arch, left ligamentum arteriosum, Kommerell’s diverticulum, and retroesophageal left subclavian artery. The median surgical time was 180.5 minutes, and the patients showed immediate recovery. Three complications, namely chylothorax, transient supraventricular tachycardia, and left vocal cord palsy, were observed. Our early experience indicates that thoracoscopic division of a vascular ring may provide early recovery and could be a promising operative choice. PMID:25705605

  4. The Epidural Ligaments (of Hofmann): A Comprehensive Review of the Literature

    PubMed Central

    Tardieu, Gabrielle G; Loukas, Marios; Moisi, Marc; Chapman, Jens; Oskouian, Rod J; Tubbs, R. Shane

    2016-01-01

    The epidural space contains the internal vertebral venous plexus, adipose, and other connective tissues. In the anatomical literature, there are nonspecific descriptions of varying fibrous connective tissue bands in the epidural space, mainly mentioned in the lumbar region, that tether the dural sac to the posterior longitudinal ligament, the vertebral canal, and the ligamentum flavum. These ligaments have been termed as Hofmann’s ligaments. This review expands on the anatomy and function of Hofmann’s ligaments, increasing the awareness of their presence and serves as an impetus for further study of their histology, innervation, and function.  PMID:27752405

  5. Symptomatic hip plica: MR arthrographic and arthroscopic correlation.

    PubMed

    Katz, Lee D; Haims, Andrew; Medvecky, Michael; McCallum, John

    2010-12-01

    Two cases of unilateral hip pain are reported in which MR arthrography demonstrated a prominent band medial to the ligamentum teres, running in the AP direction, consistent with a hip plica. Both patients underwent hip arthroscopy with resection of the band. No labral tear or additional intra-articular pathological features was identified in either case. Both patients became asymptomatic following surgery and have remained such. The pathology report demonstrated the specimens to be a synovial band with fibroconnective tissue. This is the first MR arthrographic report of the identification and resection of a symptomatic hip plica. The symptomatic plica may represent an alternative diagnosis for mechanical hip pain.

  6. World species of the genus Platyscelio Kieffer (Hymenoptera: Platygastridae)

    PubMed Central

    Taekul, Charuwat; Johnson, Norman F.; Masner, Lubomír; Polaszek, Andrew; Rajmohana K.

    2010-01-01

    Abstract The genus Platyscelio Kieffer (Hymenoptera: Platygastridae, Scelioninae) is a widespread group in the Old World, found from West Africa to northern Queensland, Australia. The species concepts are revised and a key to world species is presented. The genus is comprised of 6 species, including 2 known species which are redescribed: Platyscelio africanus Risbec (Benin, Cameroon, Central African Republic, Ghana, Guinea, Guinea-Bissau, Ivory Coast, Kenya, Mozambique, Nigeria, Sierra Leone, South Africa, Tanzania, Togo, Uganda, Yemen, Zimbabwe); and Platyscelio pulchricornis Kieffer (Australia, Bangladesh, China, India, Indonesia, Japan, Malaysia, Papua New Guinea, Philippines, Solomon Islands, Taiwan, Thailand, Vanuatu, Vietnam). Five species-group names are considered to be junior synonyms of Platyscelio pulchricornis: Platyscelio abnormis Crawford syn. n., Platyscelio dunensis Mukerjee syn. n., Platyscelio mirabilis Dodd syn. n., Platyscelio punctatus Kieffer syn. n., and Platyscelio wilcoxi Fullaway. The following species are hypothesized and described as new taxa: Platyscelio arcuatus Taekul & Johnson, sp. n. (Western Australia); Platyscelio mysterium Taekul & Johnson, sp. n. (Zimbabwe, Botswana, South Africa); Platyscelio mzantsi Taekul & Johnson, sp. n. (South Africa); and Platyscelio striga Taekul & Johnson, sp. n. (Western Australia). PMID:21594118

  7. Kepler, Galilei, the telescope and the consequences. (German Title: Kepler, Galilei, das Fernrohr und die Folgen)

    NASA Astrophysics Data System (ADS)

    Gaulke, Karsten; Hamel, Jürgen

    The papers of this volume are dedicated to Johannes Kepler, the astronomy of his time, and the consequences of his researches. They deal with the reception on the Copernican system of the world at the court of landgrave William IV in Kassel and the use of astronomy at a princely court in the 16th century, exemplified by the Kassel residence. Two contributions discuss a text fragment in Kepler's Astronomia Nova and the dimensions of the geo- and heliocentric systems of the world in Kepler's Mysterium Cosmographicum. Other contributions deal with mathematical aspects un Kepler's exchange of letters, the biography of Kepler's discussion partner Ph. Feselius, as well as the early reception of the Tabulae Rudolphinae in the calendar literature, telescopes in Kepler's time, Chr. Scheiner's optical theory of the eye, and finally in the continuation of the heliocentric world system by Otto von Guericke's natural philosophy and science. In conclusion, the documents of the planned call of Kepler to Rostock university, as well as the first publication of a recently found, hitherto unknown letter by Kepler.

  8. New theory of uterovaginal embryogenesis

    PubMed Central

    Makiyan, Zograb

    2016-01-01

    ABSTRACT Background: The explanation of uterine and vaginal embryogenesis in humans still poses many controversies, because it is difficult to assess early stages of an embryo. The literature review revealed many disagreements in Mullerian theory, inciting some authors to propose new embryological hypotheses. In the original Mullerian theory: the paramesonephral ducts form the Fallopian tubes, uterus and vagina; the mesonephral ducts regress in female embryos. Aims: The aim of this article is to investigate the development of Mullerian ducts in humans, using comparative analysis of fundamental embryological theory and various utero-vaginal anomalies. Material and methods: Between 1998 and 2015, 434 patients with various uterovaginal malformations had been operated on at the Scientific Centre of Obstetrics Gynaecology and Perynatology in Moscow. The anatomies of the uterovaginal malformations in these patients were diagnosed with ultrasound and MRI and then verified during surgical correction by laparoscopy. Results: A systematic comparison of uterovaginal malformations to those in the literature has allowed us to formulate a new theory of embryonic morphogenesis. The new theory is significantly different: ovary, ovarian ligamentum proprium, and ligamentum teres uteri derive from gonadal ridges; Fallopian tubes and vagina completely develop from mesonephral ducts. The uterus develops in the area of intersection between the mesonephral ducts with gonadal ridges by the fusion of the two. Conclusions: The new theory may to induce future embryological studies. The hypothetic possibility that the ovary and endometrium derive from the gonadal ridges could be the key to understanding the enigmatic aetiologies of extragenital and ovarian endometriosis. PMID:26900909

  9. Palliative decompression of obstructive hilar malignancies utilizing an extrahilar biliary approach.

    PubMed

    Yilmaz, S; Kirimlioglu, V; Katz, D A; Caglikulekci, M; Yilmaz, M

    2000-08-01

    Hilar cancers carry a dismal prognosis. Palliation of obstructive jaundice in patients with hilar cancer can be achieved by either surgical or nonsurgical means. Selection of the appropriate palliative measures is a challenging problem. Segmental bilioenteric anastomosis procedures were performed on 19 patients with hilar cancer. Seventeen of the bypasses were done to the segment III duct, known as the ligamentum teres approach, and two bypasses were to the segment V duct. Five patients, who had already been stented percutaneously or endoscopically, were operated on after the stents were clogged and a duodenal obstruction ensued. There were two postoperative deaths (10.5%) and four postoperative complications (21%). All of the 17 surviving patients experienced improvement in the level of jaundice postoperatively and the levels of serum total and direct bilirubin decreased by 78.9% and 84.2%, respectively. Two patients developed late cholangitis before death and were treated by external biliary drainage; one developed duodenal obstruction and was treated by gastrointestinal anastomosis. The mean length of hospital stay was 15.2 days. Mean survival was 8.2 months and the mean period of well-being was 7.8 months. Median survival was 7 months and median period of well being was 7 months. Three patients are still alive at 8, 8, and 24 months. These data suggest that the ligamentum teres approach offers effective palliation for patients with unresectable hilar cancer.

  10. Bilateral decompression of multilevel lumbar spinal stenosis through a unilateral approach.

    PubMed

    Haba, Katsuhiko; Ikeda, Masato; Soma, Mariko; Yamashima, Tetsumori

    2005-02-01

    Lumbar canal stenosis due to hypertrophy and calcification of the facet joints and/or ligamentum flavum is a common condition in the elderly. Although a large number of individuals are symptom-free, the degenerative process, usually encroaching on both central and lateral pathways, may lead to symptoms of itself or decompensate a preexisting narrow canal. Even at an advanced age, decompression surgery is effective for symptomatic stenosis. Less invasive procedures preserving maximal bony and ligamentous structures have recently been recommended to reduce associated morbidity. This paper introduces a unilateral surgical approach for bilateral decompression by ligamentectomy, partial facetectomy and foraminal unroofing. Using a specially designed, one-side retractor, after the ipsilateral nerve root decompression the contralateral dural sac and nerve roots were approached through an 8 x 15 mm window in the interspinous ligament. The contralateral ligamentum flavum, facet joints and foraminal roof were resected, preserving the supraspinous ligament complex and much of the contralateral musculature. This technique, preserving anatomy and biomechanical function of the lumbar spine, is useful for surgery on multilevel lumbar canal stenoses.

  11. Repair of vascular ring with resection of kommerell diverticulum and transposition of aberrant left subclavian artery.

    PubMed

    Samas, John; Manetta, Frank; Meyer, David B

    2013-12-01

    A 32-year-old female presented with dysphagia. Radiographic studies revealed external compression of esophagus by a vascular ring. The anatomy was a right-sided aortic arch with aberrant retroesophageal left subclavian artery, emanating from a large Kommerell diverticulum (KD). Traditional repair with ligamentum division and adhesiolysis leaves a large KD still adjacent to the esophagus with the potential for persistent or recurrent symptoms. The objective of this study was the modification of operative technique to minimize the potential for persistent or recurrent symptoms. The operative repair included resection of KD with transposition of the left subclavian artery into the left carotid artery, in addition to the division of the ligamentum arteriosum and mobilization of the esophagus. The patient's dysphagia resolved and postoperative barium studies showed no residual compression. There were no significant perioperative complications. Resection of KD is a potential adjunct to traditional repair of vascular rings and might offer better long-term palliation by minimizing residual vascular compression of the esophagus.

  12. Repair of Vascular Ring with Resection of Kommerell Diverticulum and Transposition of Aberrant Left Subclavian Artery

    PubMed Central

    Samas, John; Manetta, Frank; Meyer, David B.

    2013-01-01

    A 32-year-old female presented with dysphagia. Radiographic studies revealed external compression of esophagus by a vascular ring. The anatomy was a right-sided aortic arch with aberrant retroesophageal left subclavian artery, emanating from a large Kommerell diverticulum (KD). Traditional repair with ligamentum division and adhesiolysis leaves a large KD still adjacent to the esophagus with the potential for persistent or recurrent symptoms. The objective of this study was the modification of operative technique to minimize the potential for persistent or recurrent symptoms. The operative repair included resection of KD with transposition of the left subclavian artery into the left carotid artery, in addition to the division of the ligamentum arteriosum and mobilization of the esophagus. The patient's dysphagia resolved and postoperative barium studies showed no residual compression. There were no significant perioperative complications. Resection of KD is a potential adjunct to traditional repair of vascular rings and might offer better long-term palliation by minimizing residual vascular compression of the esophagus. PMID:24436620

  13. Large interarcuate spaces in the cervical vertebral column of the tyrolean mountain sheep.

    PubMed

    Turkof, E; Jurasch, N; Grassberger, M; Schwendenwein, S; Habib, D; Knolle, E; Losert, U

    2003-02-01

    Large interarcual spaces have been described between the arcus vertebrae C5/C6 and C6/C7 in the cervical vertebral column of Nubian goats. This aperture enables direct access to spinal cord and rootlets without the need to perform a hemilaminectomy. The present study was performed in order to determine whether these large interarcual spaces can also be found in the vertebral column of the Tyrolean mountain sheep, as this small ruminant, which is anatomically very similar to the Nubian goat, is frequently used for experimental purposes at the Surgical University Clinic in Austria. The carcasses of 10 sheep (six females, four males; range of age: 2.5-6 years, range of weight: 52-89 kg) were dissected and the vertebral column was exposed. All 10 sheep showed elliptic openings between the fourth cervical and the first thoracal vertebrae. Three sheep had additional openings between the first and the second thoracal vertebrae. All openings were covered solitarily by the ligamentum flavum and under this ligamentum lay the spinal cord without any further osseous or ligamentous protection. These findings are not mentioned in the common textbooks of veterinary anatomy and deserve attention, as they can be a step forward towards non-traumatic experimental surgery on the spinal cord.

  14. Inflammatory changes after extradural anaesthesia may affect the spread of local anaesthetic within the extradural space.

    PubMed

    Igarashi, T; Hirabayashi, Y; Shimizu, R; Mitsuhata, H; Saitoh, K; Fukuda, H; Konishi, A; Asahara, H

    1996-09-01

    We have assessed cephalad spread of analgesia in 491 patients undergoing extradural anaesthesia at the L2-3 or L3-4 interspace. Patients were classified into one of three groups based on the number of previous lumbar extradural anaesthesia procedures: none (group I, n = 339), one (group II, n = 82), and two or more (group III, n = 70). Cephalad spread of analgesia was greater in group I than in groups II and III, regardless of the puncture site. In addition, we examined the extradural space using a flexible extraduroscope in 32 patients who were excluded from the analysis of spread. Extraduroscopy showed the extradural space to be patent in patients with no history of prior lumbar extradural anesthesia, but it was not clearly identified in patients who had received extradural anaesthesia one or more times because of aseptic inflammatory changes, including proliferation of connective tissue, adhesions between the dura mater and the ligamentum flavum, granulation and changes in the ligamentum flavum. Extradural anaesthesia may cause aseptic inflammatory changes in the extradural space which may reduce the spread of analgesia. PMID:8949808

  15. Technique in Cleft Rhinoplasty: The Foundation Graft.

    PubMed

    Gassner, Holger G; Schwan, Franziska; Haubner, Frank; Suárez, Gustavo A; Vielsmeier, Veronika

    2016-04-01

    Secondary cleft rhinoplasty represents a particular surgical challenge. The authors have identified the deficit in skeletal projection of the cleft-sided piriform rim as an important contributor to the pathology. A graft is described to augment the piriform crest on the cleft side. This foundation graft is suture fixated to the piriform crest after complete release of all soft tissue attachments to the alar base. The foundation graft is articulated with a long alar strut graft, which allows for powerful projection of the cleft-sided nasal tip. An advancement flap of vestibular skin is described to correct the vestibular stenosis. A transplant of diced cartilage in fascia is added to augment maxillary soft tissue volume. Subjective and objective measures of form and function are presented in a retrospective series of five cases, illustrating the efficacy of the techniques described. PMID:27097143

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

    PubMed

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

    2012-12-01

    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.

  17. 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

  18. Aesthetic considerations of the cleft lip operation.

    PubMed

    Onizuka, T; Keyama, A; Asada, K; Shinomiya, S; Aoyama, R

    1986-01-01

    The results of a cleft lip operation are checked from the anterior, the profile, and the caudal views and even if the deformities are minimal, for aesthetic reasons they should be repaired. Philtrum length, philtrum shape, philtrum depth, nasolabial triangular area, vermilion thickness, Cupid's bow peak, horizontal upper lip groove, vermilion border, alar size, depth of alar groove, nasal deviation, nostril shape, nasal tip, columella height, sill shape, columella width, and facial balance of the anterior, profile, and caudal views are used as aesthetic checkpoints for the results of a cleft lip operation. If deformities are found, the aesthetic plastic surgeon should repair them to achieve a more satisfactory result. In addition, augmentation rhinoplasty, augmentation mentoplasty, or other craniofacial surgery may be performed.

  19. Extending the extended V-Y flap.

    PubMed

    Prowse, Phoebe; Morton, Jonathan

    2012-06-01

    This case report demonstrates a modification of the so-called 'Extended V-Y Flap' used to simultaneously reconstruct a defect involving the upper lip, floor of nose and alar rim following tumour excision. We hope that this case serves as a reminder of the versatility of the V-Y flap in the nasolabial region, and its considerable capacity for augmentation. PMID:22018837

  20. Regionalized differentiation of CRH, TRH, and GHRH peptidergic neurons in the mouse hypothalamus.

    PubMed

    Morales-Delgado, Nicanor; Castro-Robles, Beatriz; Ferrán, José L; Martinez-de-la-Torre, Margaret; Puelles, Luis; Díaz, Carmen

    2014-05-01

    According to the updated prosomeric model, the hypothalamus is subdivided rostrocaudally into terminal and peduncular parts, and dorsoventrally into alar, basal, and floor longitudinal zones. In this context, we examined the ontogeny of peptidergic cell populations expressing Crh, Trh, and Ghrh mRNAs in the mouse hypothalamus, comparing their distribution relative to the major progenitor domains characterized by molecular markers such as Otp, Sim1, Dlx5, Arx, Gsh1, and Nkx2.1. All three neuronal types originate mainly in the peduncular paraventricular domain and less importantly at the terminal paraventricular domain; both are characteristic alar Otp/Sim1-positive areas. Trh and Ghrh cells appeared specifically at the ventral subdomain of the cited areas after E10.5. Additional Ghrh cells emerged separately at the tuberal arcuate area, characterized by Nkx2.1 expression. Crh-positive cells emerged instead in the central part of the peduncular paraventricular domain at E13.5 and remained there. In contrast, as development progresses (E13.5-E18.5) many alar Ghrh and Trh cells translocate into the alar subparaventricular area, and often also into underlying basal neighborhoods expressing Nkx2.1 and/or Dlx5, such as the tuberal and retrotuberal areas, becoming partly or totally depleted at the original birth sites. Our data correlate a topologic map of molecularly defined hypothalamic progenitor areas with three types of specific neurons, each with restricted spatial origins and differential migratory behavior during prenatal hypothalamic development. The study may be useful for detailed causal analysis of the respective differential specification mechanisms. The postulated migrations also contribute to our understanding of adult hypothalamic complexity.

  1. Further characterization of Escherichia coli alanyl-tRNA synthetase.

    PubMed

    Sood, S M; Slattery, C W; Filley, S J; Wu, M X; Hill, K A

    1996-04-15

    Selected physical and thermodynamic parameters for Escherichia coli alanyl-tRNA synthetase (AlaRS) have been determined primarily to assess the quaternary structure of this enzyme. The extinction coefficient (epsilon) at 280 nm was determined experimentally to be 0.71 ml mg-1 cm-1, and the partial specific volume (nu) was calculated from the amino acid composition to be 0.73 ml g-1. From viscosity experiments the intrinsic viscosity (eta) of AlaRS was extrapolated to be 3.4 ml g-1 and the degree of hydration (delta 1) estimated to be 0.67 gH2O g(-1)(AlaRS). Laser light-scattering studies indicated some heterogeneity; a radius of 6.3 nm was calculated for the major fraction with a diffusion coefficient (D20,W) of 3.89 x 10(-7) cm2 s-1. In 50 mM Hepes, pH 7.5, 20 mM KCl, 2 mM 2-mercaptoethanol and at a protein concentration of 4.2 mg ml-1 the sedimentation coefficient (S20,W) was 6.36 S; this value increased slightly when the protein concentration was decreased. The combination of S20,W and D20,W under these conditions yielded a molecular weight of approximately 186,000 Da, corresponding to a dimer. The S20,W was virtually independent of temperature in the range of 10-37 degrees C, while an Arrhenius plot of aminoacylation activity was biphasic. The isoelectric point was determined experimentally to be 4.9. Sedimentation equilibrium data were best fit to a decamer association complex in which dimeric AlaRS is the predominant species at 25 degrees C. PMID:8645007

  2. BASAL CELL CARCINOMA OF THE NOSE—Treatment with Chemosurgery

    PubMed Central

    Beirne, Gilbert A.; Beirne, Clinton G.

    1956-01-01

    Basal cell carcinomas of the nose probably originate from embryologic cell rests left between cartilages and bones in the fusion and migration of the nasal precursors. Some carcinomas have been found to invade to the mucosal surface between subcutaneous structures or around the alar margins. Recurrences are particularly likely to develop deep extensions due to overlying scar tissue. In many cases, chemosurgical removal has disclosed unsuspected deep and lateral extensions. It is the treatment method of choice for many such lesions. PMID:13276824

  3. Nasal bone grafts from the removed hump used as overlay grafts to camouflage concave lateral crura.

    PubMed

    Kubilay, Utku; Erdogdu, Suleyman; Sezen, Ozan Seymen

    2014-01-01

    Alar cartilage consists of a medial crus, middle crus and lateral crus. The lateral crus is an important aesthetic and functional structure of the nose. A 32-year-old male patient with concave lateral crura was operated by the authors. An open rhinoplasty with a dorsal approach to the septum is preferred. The nasal bones harvested from the hump, which is an autogenous graft trimmed and sutured on both concave lateral crura as an overlay camouflage grafts. Satisfactory result was achieved.

  4. Oral-facial-digital type 1 syndrome of Papillon-Léage and Psaume.

    PubMed

    Larralde de Luna, M; Raspa, M L; Ibargoyen, J

    1992-03-01

    A female infant was classified as having oral-facial-digital syndrome (OFDS) type 1, with oral (cleft palate, bifid uvula, lingual cleft, numerous hypertrophic frenula), facial (numerous milia on face, scalp, and ears; frontal bossing; hypertelorism; hypoplasia of nasal alar cartilage; micrognathia), and digital (bilateral brachydactyly of hands) symptoms. She also had diffuse, nonscarring alopecia with wiry, dry hair. Results of roentgenographic and ultrasound studies were normal. At her present age of 11 months, her psychomotor development is appropriate for her age.

  5. 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.

  6. Internal Nasal Valve Incompetence Is Effectively Treated Using Batten Graft Functional Rhinoplasty

    PubMed Central

    Bewick, J. C.; Buchanan, M. A.; Frosh, A. C.

    2013-01-01

    Introduction. Internal nasal valve incompetence (INVI) has been treated with various surgical methods. Large, single surgeon case series are lacking, meaning that the evidence supporting a particular technique has been deficient. We present a case series using alar batten grafts to reconstruct the internal nasal valve, all performed by the senior author. Methods. Over a 7-year period, 107 patients with nasal obstruction caused by INVI underwent alar batten grafting. Preoperative assessment included the use of nasal strips to evaluate symptom improvement. Visual analogue scale (VAS) assessment of nasal blockage (NB) and quality of life (QOL) both pre- and postoperatively were performed and analysed with the Wilcoxon signed rank test. Results. Sixty-seven patients responded to both pre- and postoperative questionnaires. Ninety-one percent reported an improvement in NB and 88% an improvement in QOL. The greatest improvement was seen at 6 months (median VAS 15 mm and 88 mm resp., with a P value of <0.05 for both). Nasal strips were used preoperatively and are a useful tool in predicting patient operative success in both NB and QOL (odds ratio 2.15 and 2.58, resp.). Conclusions. Alar batten graft insertion as a single technique is a valid technique in treating INVI and produces good outcomes. PMID:23653651

  7. Assessment of MRI as a Modality for Evaluation of Soft Tissue Injuries of the Spine as Compared to Intraoperative Assessment

    PubMed Central

    Vasu, Chembumkara; Kanthila, Mahesha; Ravichandra, Gopalakrishna; Acharya, Koteshwar Devadasa; Hussain, Mohamed Musheer

    2016-01-01

    Introduction Traumatic injuries of the spine and spinal cord are potentially devastating as they may lead to significant neurological damage as the clinical and prognostic spectrum of the effects of spinal injuries is vast. Timely imaging studies can help mitigate these possibly life threatening complications. There is a dearth of studies that directly compare MR imaging findings to surgical findings. Aim Hence, this study was undertaken to assess the sensitivity of MRI in identifying injuries to the soft tissue structures of the spine. Materials and Methods MRI scans were performed on 31 cases of acute spinal injuries that presented within 72 hours of the trauma and underwent surgical fixation by either an anterior or posterior approach. The non-osseous structures namely; Anterior Longitudinal Ligament (ALL), Posterior Longitudinal Ligament (PLL), Intervertebral Disc, Ligamentum Flavum, Interspinous Ligament (ISP) and the Spinal Cord were evaluated. They were classified as ‘True Positive’ if an injury was found to correlate with intraoperative findings and as ‘False Negative’ when diagnosed falsely as normal. The statistical sensitivity of MRI in diagnosing injuries to the non-osseous structures of the spine were thus calculated. Results Of the 31 patients, in 51.6% of patients the site of injury was to the cervical spine (n=16), thoracic spine was the next highest in occurrence of 39% (n=12) and lumbar spine accounted for the least. In correlating the imaging findings to the intraoperative findings, MRI was highly sensitive in detecting injuries to the Posterior Longitudinal Ligament (94.4%) and the Spinal cord (93%) and fairly high in detecting injuries to the Intervertebral disc. However coming to the ligamentum flavum and interspinous ligaments, the sensitivity of the MRI dropped to 62.5% and 63.6% respectively. Conclusion MRI was found to be highly sensitive in detecting injuries to the spinal cord and the posterior longitudinal ligament and

  8. Transient Paraparesis After Laminectomy in a Patient with Multi-Level Ossification of the Spinal Ligament

    PubMed Central

    Shim, Jae-Jun; Doh, Jae-Won; Yoon, Seok-Mann; Bae, Hack-Gun; Yun, Il-Gyu

    2004-01-01

    Acute neurologic deterioration is not a rare event in the surgical decompression for thoracic spinal stenosis. We report a case of transient paraparesis after decompressive laminectomy in a 50-yr-old male patient with multi-level thoracic ossification of the ligamentum flavum and cervical ossification of the posterior longitudinal ligament. Decompressive laminectomy from T9 to T11 was performed without gross neurological improvement. Two weeks after the first operation, laminoplasty from C4 to C6 and additional decompressive laminectomies of T3, T4, T6, and T8 were performed. Paraparesis developed 3 hr after the second operation, which recovered spontaneously 5 hr thereafter. CT and MRI were immediately performed, but there were no corresponding lesions. Vascular compromise of the borderlines of the arterial supply by microthrombi might be responsible for the paraparesis. PMID:15308861

  9. Ossification of thoracic ligamenta flava

    SciTech Connect

    Kudo, S.; Minoru, O.; Russell, W.J.

    1983-07-01

    Although ligamentum flavum ossification (LFO) often occurs in normal persons, there are no reports of its detection on lateral chest radiographs made during screening examinations. Review of 1,744 consecutive lateral chest radiographs identified LFO in 6.2% of males and 4.8% of females. LFO occurred mainly at the intervertebral segments from T9-T10 through T12-L1. Most prevalent was the hook-shaped LFO, protruding inferoirly from the inferior facets into the projections of the intervertabral foramina. Though LFO can cause severe neurologic symptoms, none of the affected persons in this study reported such symptoms. LFO was first visualized radiographically when the subjects were 20-40 years old, and it may be a physiologic condition. The LFO in these cases existed independent of thoracic posterior longitudinal ligament ossification, diffuse idiopathic skeletal hyperostosis, and degenerative osteoarthritis.

  10. All-arthroscopic iliotibial band autograft harvesting and labral reconstruction technique.

    PubMed

    Deshmane, Prashant P; Kahlenberg, Cynthia A; Patel, Ronak M; Han, Brian; Terry, Michael A

    2013-02-01

    The labrum is essential for stability, movement, and prevention of arthritis in the hip. In cases of labral damage where repair of a labral tear is not possible, reconstruction can be a useful alternative. Several different autografts have been used, including the iliotibial band (ITB), the ligamentum teres capitis, and the gracilis tendon. Authors have reported both open and arthroscopic techniques for reconstruction with good preliminary results. However, an all-arthroscopic labral reconstruction technique including the graft harvest and reconstruction portions of a labral reconstruction procedure using an ITB autograft has not been previously described. We describe a technique for an all-arthroscopic labral reconstruction performed using a novel method for arthroscopic harvest of the ITB. The decreased invasiveness of our described technique for labral reconstruction may potentially minimize scarring, bodily disfigurement, infection, and postoperative pain associated with the graft harvesting incision.

  11. Minimally invasive space shuttle laminotomy for degenerative lumbar spinal canal stenosis

    PubMed Central

    Asamoto, Shunji; Muto, Jun; Jimbo, Hiroyuki

    2016-01-01

    Study Design: Technical note. Objectives: To show microsurgical technique, considering the meticulous anatomy of the ligamentum flavum (LF). Background: Different methods are available for treating lumbar spinal canal stenosis (LSCS). A minimally invasive surgery, namely, space shuttle laminotomy, has recently been proposed. Here, we describe the surgical method for this novel technique. To conduct this surgery accurately, surgeons must have perfect knowledge of anatomy, especially regarding the LF. Materials and Methods and Results: We use this interlaminectomy technique for all cases of LSCS. All patients with LSCS recovered from their neurological deficits in shorter hoslital stays than regular laminectomy. Conclusion: Minimally invasive space shuttle laminotomy (MISSL), which involves a microsurgical technique, is a safe, complication-free procedure. PMID:27041887

  12. Dorsoscapularis triangularis: embryological and phylogenetic characterization of a rare variation of trapezius

    PubMed Central

    Tuli, Anita; Raheja, Shashi

    2016-01-01

    The muscle trapezius shows considerable morphological diversity. Variations include an anomalous origin and complete or partial absence of the muscle. The present study reported, a hitherto undocumented complete bilateral absence of the cervical part of trapezius. Based on its peculiar origin and insertion, it was named dorsoscapularis triangularis. The embryological, phylogenetic and molecular basis of the anomaly was elucidated. Failure of cranial migration of the trapezius component of the branchial musculature anlage to gain attachment on the occipital bone, cervical spinous processes, ligamentum nuchae between 11 mm and 16 mm stage of the embryo, resulted in this anomaly. A surgeon operating on the head and neck region or a radiologist analyzing a magnetic resonance imaging of the cervical region would find the knowledge of this morphological variation of trapezius useful in making clinical decisions. PMID:27722016

  13. Soft tissue strain and facet face interaction in the lumbar intervertebral joint--Part II: Calculated results and comparison with experimental data.

    PubMed

    Tencer, A F; Mayer, T G

    1983-08-01

    A numerical simulation of soft-tissue strain and facet face interaction in the lumbar intervertebral joint under load was performed. The results, compared with a previous experimental sectioning study, showed that disk fiber strain was the main mechanism in shear resistance, except posterior shear, where the facets were main load bearing members. In axial compression, compression of the annulus was found, with a significant decrease in compressive strain resulting from annulus bulging, but no contact was found in the facet joints. The posterior ligaments, except for the facet capsules and ligamentum flavum, were found to be active only in flexion and lateral bending, while the facets and the disk both played major roles in resisting axial torsion moments. PMID:6632823

  14. Vascular ring diagnosis following respiratory arrest

    PubMed Central

    Robson, Evie Alexandra; Scott, Alison; Chetcuti, Philip; Crabbe, David

    2014-01-01

    Vascular rings can present with non-specific respiratory and/or oesophageal symptoms. Early diagnosis requires a high index of suspicion. This case report describes an uncommon acute presentation of a vascular ring. We report a thriving 14-month-old child with a long history of recurrent wheeze and ‘noisy breathing’. He presented acutely with food bolus impaction in the oesophagus which led to a respiratory arrest. Oesophagoscopy and bronchoscopy suggested vascular ring anomaly. A contrast-enhanced CT scan demonstrated a right-sided aortic arch with left ligamentum arteriosum encircling the oesophagus and airway. The ligament was ligated and divided. At follow-up 6 months later, the infant had mild persistent stridor but was otherwise well. PMID:24895385

  15. Concomitant axial cineangiography and barium esophagography in the evaluation of vascular rings.

    PubMed

    Tonkin, I L; Elliott, L P; Bargeron, L M

    1980-04-01

    Six vascular rings were evaluated using axial biplane cineangiography and concomitant barium esophagography. Three patients had a double aortic arch, two had a right aortic arch and aberrant left subclavian artery with a foreshortened left ligamentum arteriosum, and one had a pulmonary vascular sling. Barium was administered in the esophagus of the anesthetized patient followed by cineangiography. Five patients were evaluated using both the standard and four-chamber projection, while the sixth patient with the pulmonary sling was evaluated in the standard and sitting projection. With the four-chamber view, vascular rings were exposed and atypical features such as a small right aortic arch component and branch stenoses of the brachiocephalic arteries were revealed. Axial views with an esophagogram allow easier morphologic analysis and more precise definition of the vascular abnormality than conventional views. PMID:7360983

  16. Lumbar epidural varices: An unusual cause of lumbar claudication

    PubMed Central

    Subbiah, Meenakshisundaram; Yegumuthu, Krishnan

    2016-01-01

    Lumbar epidural varices can also present with radiculopathy similar to acute intervertebral disc prolapse (IVDP). However as the magnetic resonance imaging (MRI) in these patients are usually normal without significant compressive lesions of the nerve roots, the diagnosis is commonly missed or delayed leading to persistent symptoms. We present a rare case of acute severe unilateral claudication with a normal MRI unresponsive to conservative management who was treated surgically. The nerve root on the symptomatic side was found to be compressed by large anterior epidural varices secondary to an abnormal cranial attachment of ligamentum flavum. Decompression of the root and coagulation of the varices resulted in complete pain relief. To conclude, lumbar epidural varices should be considered in the differential diagnosis of acute onset radiculopathy and claudication in the absence of significant MRI findings. PMID:27512228

  17. LUMBAR DISC HERNIATION

    PubMed Central

    Vialle, Luis Roberto; Vialle, Emiliano Neves; Suárez Henao, Juan Esteban; Giraldo, Gustavo

    2015-01-01

    Lumbar disc herniation is the most common diagnosis among the degenerative abnormalities of the lumbar spine (affecting 2 to 3% of the population), and is the principal cause of spinal surgery among the adult population. The typical clinical picture includes initial lumbalgia, followed by progressive sciatica. The natural history of disc herniation is one of rapid resolution of the symptoms (four to six weeks). The initial treatment should be conservative, managed through medication and physiotherapy, sometimes associated with percutaneous nerve root block. Surgical treatment is indicated if pain control is unsuccessful, if there is a motor deficit greater than grade 3, if there is radicular pain associated with foraminal stenosis, or if cauda equina syndrome is present. The latter represents a medical emergency. A refined surgical technique, with removal of the extruded fragment and preservation of the ligamentum flavum, resolves the sciatic symptoms and reduces the risk of recurrence over the long term. PMID:27019834

  18. 400 years astronomical observatory in Jena

    NASA Astrophysics Data System (ADS)

    Schielicke, Reinhard E.

    ``Nam cum aliquod observatorium mihi comparaverim, ... '': ``As I have equiped my observatory now'', Georg Limnaeus, professor of mathematics in Jena from 1588 to 1611, wrote on 24 April 1598, ``I have decided to make friends with some experts by letter; I know from your Prodromus that you are one of them''. The letter was addressed to Johannes Kepler and was related to his first work about the ``Mysterium cosmographicum''. Kepler sent some copies of his paper to Galileo Galilei, Tycho Brahe, Reimar Ursus and also to Limnaeus in Jena from the Frankfurt Book Fair in 1597. Limnaeus gave him - apart from the words expressing praise but which actually were meaningless concerning Kepler's ideas - the information about Brahe Kepler had asked for and which may have promoted his move to Prague. The above mentioned observatory is considered to be the first one in Jena. Astronomy had already been established as a subject since the establishment of the ``Hohe Schule'' in 1548 and since the foundation of the university ten years later. Nothing is known about the instruments and the location of the observatory. Limnaeus did not belong to the taxpaying house-owners of which there exists an index; he obviously rented a flat. To all appearances the correspondence announced was not continued either. For the following centuries the professors Heinrich Hoffmann, Erhard Weigel, Georg Albrecht and Georg Erhard Hamberger are named in the literature running the observatory in Jena. The ``Herzogliche Sternwarte'' fitted out under Goethe's overall supervision in 1813 eventually developed into the university institute of today.

  19. [Proprioceptive deficit following cruciate lesions--afferent disorder or compensatory mechanism?].

    PubMed

    Hopf, T; Gleitz, M; Hess, T; Mielke, U; Müller, B

    1995-01-01

    It was suggested that the ACL has not only mechanical functions but also acts as proprioceptive organ. In cruciate deficient knees pathological patterns of muscle control were found. These findings could be caused by a disturbed afferent signal from the disrupted ACL or by secondary changes in muscle innervation, which shall protect the instable knee against subluxation. 33 patients with unilateral operative ACL repair (21 cases with primary suture, 12 cases with autogenous ligamentum-patellae-reconstruction; average post op 36.5 yr) were examined clinically and with the KT 1000 arthrometer (MEDMETRIC Inc.). Patients history was evaluated by using the LYSHOLM score. During a cycling task the electromyographic activity was monitored from the thigh muscles (M. vastus lat. and med., lat. and med. hamstrings). In comparison to the ACL deficient patients, we tested 25 healthy subjects of same age and activity level. In the ACL group the following differences to the normals were found: the M. vastus lat. showed a significantly delayed onset, earlier end and shorter duration. M. vastus med. had the same pattern; the delayed begin of activity and the shorter duration were statistically significant. M. biceps femoris showed a significant later onset and shorter duration. So did the medial hamstrings; the differences, however, were not statistically significant. There was no significant difference between operated and healthy leg in the ACL group. By comparing the primary sutures and the ligamentum-patellae-reconstructions no significant differences were found. The instable patients (KT 1000 > 3 mm) of the ACL group showed more distinct differences in the EMG pattern than the patients with stable knee joints.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

    PubMed Central

    Nguyen, Ha Son; Doan, Ninh; Shabani, Saman; Baisden, Jamie; Wolfla, Christopher; Paskoff, Glenn; Shender, Barry; Stemper, Brian

    2016-01-01

    Background: Lumbar back pain and radiculopathy are common diagnoses. Unfortunately, conventional magnetic resonance imaging (MRI) findings and clinical symptoms do not necessarily correlate in the lumbar spine. With upright imaging, disc pathologies or foraminal stenosis may become more salient, leading to improvements in diagnosis. Materials and Methods: Seventeen adults (10 asymptomatic and 7 symptomatic volunteers) provided their informed consent and participated in the study. A 0.6T upright MRI scan was performed on each adult in the seated position. Parameters were obtained from the L2/3 level to the L5/S1 level including those pertaining to the foramen [cross-sectional area (CSA), height, mid-disc width, width, thickness of ligamentum flavum], disc (bulge, height, width), vertebral body (height and width), and alignment (lordosis angle, wedge angle, lumbosacral angle). Each parameter was compared based on the spinal level and volunteer group using two-factor analysis of variance (ANOVA). Bonferroni post hoc analysis was used to assess the differences between individual spinal levels. Results: Mid-disc width accounted for 56% of maximum foramen width in symptomatic volunteers and over 63% in asymptomatic volunteers. Disc bulge was 48% greater in symptomatic volunteers compared to asymptomatic volunteers. CSA was generally smaller in symptomatic volunteers compared to asymptomatic volunteers, particularly at the L4-L5 and L5-S1 spinal levels. Thickness of ligamentum flavum (TLF) generally increased from the cranial to caudal spinal levels where the L4-L5 and L5-S1 spinal levels were significantly thicker than the L1-L2 spinal level. Conclusions: The data implied that upright MRI could be a useful diagnostic option, as it can delineate pertinent differences between symptomatic volunteers and asymptomatic volunteers, especially with respect to foraminal geometry. PMID:27041883

  1. 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

    2013-12-01

    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. PMID:24147985

  2. 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. PMID:26147027

  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. Conserved localization of Pax6 and Pax7 transcripts in the brain of representatives of sarcopterygian vertebrates during development supports homologous brain regionalization

    PubMed Central

    Moreno, Nerea; Joven, Alberto; Morona, Ruth; Bandín, Sandra; López, Jesús M.; González, Agustín

    2014-01-01

    Many of the genes involved in brain patterning during development are highly conserved in vertebrates and similarities in their expression patterns help to recognize homologous cell types or brain regions. Among these genes, Pax6 and Pax7 are expressed in regionally restricted patterns in the brain and are essential for its development. In the present immunohistochemical study we analyzed the distribution of Pax6 and Pax7 cells in the brain of six representative species of tetrapods and lungfishes, the closest living relatives of tetrapods, at several developmental stages. The distribution patterns of these transcription factors were largely comparable across species. In all species only Pax6 was expressed in the telencephalon, including the olfactory bulbs, septum, striatum, and amygdaloid complex. In the diencephalon, Pax6 and Pax7 were distinct in the alar and basal parts, mainly in prosomeres 1 and 3. Pax7 specifically labeled cells in the optic tectum (superior colliculus) and Pax6, but not Pax7, cells were found in the tegmentum. Pax6 was found in most granule cells of the cerebellum and Pax7 labeling was detected in cells of the ventricular zone of the rostral alar plate and in migrated cells in the basal plate, including the griseum centrale and the interpeduncular nucleus. Caudally, Pax6 cells formed a column, whereas the ventricular zone of the alar plate expressed Pax7. Since the observed Pax6 and Pax7 expression patterns are largely conserved they can be used to identify subdivisions in the brain across vertebrates that are not clearly discernible with classical techniques. PMID:25147506

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

    PubMed

    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 AllaR, 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, 1 sft) 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.

  6. 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.

  7. Controversies in the Management of Patients with Cleft Lip and Palate.

    PubMed

    Rodman, Regina E; Tatum, Sherard

    2016-08-01

    Cleft lip and palate is one of the most common congenital anomalies. For many years, surgeons have been attempting to reduce the severity of the deformity before the surgical repair to achieve a better outcome. The nasoalveolar molding technique uses acrylic nasal stents attached to the vestibular shield of an oral molding plate to mold the nasal alar cartilages into a more normal form and position during the presurgical period. Proponents of nasoalveolar molding claim several benefits, including improved aesthetic outcome, reduced overall costs, and a psychosocial benefit to the family. Research on these outcomes is not conclusive. PMID:27400840

  8. Heminasal agenesis: a reconstructive challenge.

    PubMed

    Fisher, Mark; Zelken, Jonathan; Redett, Richard J

    2014-05-01

    Heminasal agenesis is a rare congenital malformation often associated with deformities of the eyes and lacrimal system, midface, and proboscis lateralis. Reconstruction is especially challenging because of missing lining, cartilage, and skin. We present a case of heminasal agenesis in a 5-year-old girl with concomitant hypertelorism, coloboma of the eyelids, and maxillary hypoplasia. The patient underwent facial bipartition for hypertelorism correction and cantilever bone graft. A forehead flap was designed using an anaplastic model from the patient's twin sister. Cartilage harvested from the conchal bowl and rib provided alar and dorsal support. Reconstructive goals, timing, and options are discussed. PMID:24777004

  9. 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.

  10. State-of-the-art three-dimensional analysis of soft tissue changes following Le Fort I maxillary advancement.

    PubMed

    Almukhtar, A; Ayoub, A; Khambay, B; McDonald, J; Ju, X

    2016-09-01

    We describe the comprehensive 3-dimensional analysis of facial changes after Le Fort I osteotomy and introduce a new tool for anthropometric analysis of the face. We studied the cone-beam computed tomograms of 33 patients taken one month before and 6-12 months after Le Fort I maxillary advancement with or without posterior vertical impaction. Use of a generic facial mesh for dense correspondence analysis of changes in the soft tissue showed a mean (SD) anteroposterior advancement of the maxilla of 5.9 (1.7) mm, and mean (SD) minimal anterior and posterior vertical maxillary impaction of 0.1 (1.7) mm and 0.6 (1.45) mm, respectively. It also showed distinctive forward and marked lateral expansion around the upper lip and nose, and pronounced upward movement of the alar curvature and columella. The nose was widened and the nostrils advanced. There was minimal forward change at the base of the nose (subnasale and alar base) but a noticeable upward movement at the nasal tip. Changes at the cheeks were minimal. Analysis showed widening of the midface and upper lip which, to our knowledge, has not been reported before. The nostrils were compressed and widened, and the lower lip shortened. Changes at the chin and lower lip were secondary to the limited maxillary impaction.

  11. Three-dimensional Nasolabial Morphologic Alterations Following Le Fort I

    PubMed Central

    DeSesa, Christopher R.; Metzler, Philip; Sawh-Martinez, Rajendra

    2016-01-01

    Background: Le Fort I osteotomy imparts significant changes to the nasolabial region. Past studies have relied on 2-dimensional data and have not delineated differences among various Le Fort I subtypes. The purpose of this study is to 3-dimensionally analyze Le Fort I–induced nasal and lip changes comparing advancement alone versus widening alone [surgically assisted maxillary expansion (SAME)] versus advancement and widening. We hypothesize that the combination of maxillary advancement with widening will result in the most profound changes. Methods: A retrospective cohort study was performed. Included Le Fort I patients were grouped as: (1) nonsegmental straight advancement, (2) widening without advancement, and (3) segmental advancement and widening. Pre- and postoperative 3-dimensional photogrammetry (Canfield) were analyzed. Anthropometric landmarks were placed and measured by 2 independent observers. Statistics involved both paired and unpaired t tests (significance = P < 0.05). Results: One hundred eight photogrammetric data sets were analyzed, including 46 single-piece, 26 SAME, and 36 segmental. Significant postoperative nasal changes were observed within each intragroup analysis. The most dramatic changes were seen after segmental Le Fort I with advancement and widening, which included alar base width, alar width, nostril width, and soft triangle angle, all P < 0.05. Conclusions: Le Fort I osteotomy results in significant alteration of the nasolabial morphology. This is the first study to 3-dimensionally analyze nasal changes that occur comparing maxillary advancement alone versus widening alone (SAME) versus advancement with widening. These objective data permit improved patient counseling and surgical planning. PMID:27622116

  12. 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.

  13. Three-dimensional Nasolabial Morphologic Alterations Following Le Fort I

    PubMed Central

    DeSesa, Christopher R.; Metzler, Philip; Sawh-Martinez, Rajendra

    2016-01-01

    Background: Le Fort I osteotomy imparts significant changes to the nasolabial region. Past studies have relied on 2-dimensional data and have not delineated differences among various Le Fort I subtypes. The purpose of this study is to 3-dimensionally analyze Le Fort I–induced nasal and lip changes comparing advancement alone versus widening alone [surgically assisted maxillary expansion (SAME)] versus advancement and widening. We hypothesize that the combination of maxillary advancement with widening will result in the most profound changes. Methods: A retrospective cohort study was performed. Included Le Fort I patients were grouped as: (1) nonsegmental straight advancement, (2) widening without advancement, and (3) segmental advancement and widening. Pre- and postoperative 3-dimensional photogrammetry (Canfield) were analyzed. Anthropometric landmarks were placed and measured by 2 independent observers. Statistics involved both paired and unpaired t tests (significance = P < 0.05). Results: One hundred eight photogrammetric data sets were analyzed, including 46 single-piece, 26 SAME, and 36 segmental. Significant postoperative nasal changes were observed within each intragroup analysis. The most dramatic changes were seen after segmental Le Fort I with advancement and widening, which included alar base width, alar width, nostril width, and soft triangle angle, all P < 0.05. Conclusions: Le Fort I osteotomy results in significant alteration of the nasolabial morphology. This is the first study to 3-dimensionally analyze nasal changes that occur comparing maxillary advancement alone versus widening alone (SAME) versus advancement with widening. These objective data permit improved patient counseling and surgical planning.

  14. Facial dimensions of Malay children with repaired unilateral cleft lip and palate: a three dimensional analysis.

    PubMed

    Zreaqat, M; Hassan, R; Halim, A S

    2012-06-01

    This comparative cross-sectional study assessed the facial surface dimensions of a group of Malay children with unilateral cleft lip and palate (UCLP) and compared them with a control group. 30 Malay children with UCLP aged 8-10 years and 30 unaffected age-matched children were voluntarily recruited from the Orthodontic Specialist Clinic in Hospital Universiti Sains Malaysia (HUSM). For the cleft group, lip and palate were repaired and assessment was performed prior to alveolar bone grafting and orthodontic treatment. The investigation was carried out using 3D digital stereophotogrammetry. 23 variables and two ratios were compared three-dimensionally between both groups. Statistically significant dimensional differences (P<0.05) were found between the UCLP Malay group and the control group mainly in the nasolabial region. These include increased alar base and alar base root width, shorter upper lip length, and increased nose base/mouth width ratio in the UCLP group. There were significant differences between the facial surface morphology of UCLP Malay children and control subjects. Particular surgical procedures performed during primary surgeries may contribute to these differences and negatively affect the surgical outcome. PMID:22424709

  15. Primary repair of an incomplete unilateral cleft lip: avoiding an elongated lip and achieving a straight suture line.

    PubMed

    Nakajima, T; Yoshimura, Y; Yoneda, K; Nakanishi, Y

    1998-10-01

    The methods designed for the repair of a complete cleft lip should not be used to repair an incomplete cleft lip. This results too often in the postoperative drooping of the white lip on the affected side because in most incomplete cleft lips there is more tissue on the cleft side than in complete cleft lip. We present and discuss the refinements we made in our original technique for complete cleft lip in order to adapt it to incomplete cleft lip repair. The skin design at the white skin roll follows Cronin's method with an incision perpendicular to the vermilion border. The suture that pulls the edges of the angular incisions together pushes on the white skin roll caudally. This ensures that the peak of the Cupid's bow on the cleft side does not droop postoperatively. It also ensures that it does not take on an acute angle and that the vermilion border will be a continuous line without a break. We do not create a triangular flap at the vermilion border, but we raise a triangular flap at the alar base on the cleft side and advance it to the bottom of the columella. This creates the nostril sill and corrects the flared alar base. The resulting suture line is completely straight and runs along the philtral column. In this way, the postoperative elongation of the white lip on the cleft side can be prevented.

  16. 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

  17. Quantitative use of photography in orthognathic outcome assessment.

    PubMed

    Edler, R J; Wertheim, D; Greenhill, D; Jaisinghani, A

    2011-03-01

    This study reports an independent audit of two aspects of orthognathic surgery, namely control of inter-alar width and mandibular outline asymmetry. Measurements were taken from standardized photographs of a consecutive series of 27 patients, using an on-screen digitizing program (IPTool). All patients had undergone bimaxillary osteotomies involving maxillary impaction and/or advancement, by one surgeon, using a cinch suture for nasal width control. Nine-twelve months after surgery, inter-alar width had increased by just 0.08 cm mean (SD 0.3). Four patients showed an increase of just over 2mm, whilst six showed a small reduction. Based on ratios of size (area) and shape (compactness) of the right and left mandibular segments, there was a small overall improvement in mandibular symmetry (0.019 and 0.005 respectively). Whilst in most of the patients the need for surgery was primarily the correction of antero-posterior and vertical discrepancies, five patients with demonstrable asymmetry showed a clear improvement. In three patients whose asymmetry scores were very mild pre-treatment, there was a small, measured increase in asymmetry, but not to a degree that would be clinically noticeable. At a time when 3D imaging is still unavailable to many clinicians, the results of this study suggest that appropriate measurements taken from carefully standardized conventional photographs can provide a valid and objective means of assessing treatment outcome.

  18. Contemporary Concepts for the Bilateral Cleft Lip and Nasal Repair

    PubMed Central

    Khosla, Rohit K.; McGregor, Jyoti; Kelley, Patrick K.; Gruss, Joseph S.

    2012-01-01

    The bilateral cleft lip and nasal deformity presents a complex challenge for repair. Surgical techniques continue to evolve and are focused on primary anatomic realignment of the tissues. This can be accomplished in a single-stage or two-stage repair early in infancy to provide a foundation for future growth of the lip and nasal tissue. Most cleft surgeons currently perform a single-stage repair for simplifying patient care. Certain institutions utilize presurgical orthopedics for alignment of the maxillary segments and nasal shaping. Methods for the bilateral cleft lip repair are combined with various open and closed rhinoplasty techniques to achieve improved correction of the primary nasal deformity. There is recent focus on shaping the nose for columellar and tip support, as well as alar contour and alar base position. The authors will present a new technique for closure of the nasal floor to prevent the alveolar cleft fistula. Although the alveolar fistula is closed, alveolar bone grafting is still required at the usual time in dental development to fuse the maxilla. It is paramount to try and minimize the stigmata of secondary deformities that historically have been characteristic of the repaired bilateral cleft lip. A properly planned and executed repair reduces the number of revisions and can spare a child from living with secondary deformities. PMID:24179448

  19. Secondary repair of cleft lip deformity.

    PubMed

    Tessier, P; Tulasne, J F

    1984-10-01

    A considerable number of procedures have been described for secondary improvements of the lip. They involve the scars, the Cupid's bow, the philtrum, the alar base, the vestibulum and the columella. In fact, these procedures may give a good aesthetic result in a static position, but the truly successful results occur with normal movements. A normal motion of the lip is impossible without a proper dissection and reorientation of the muscles. Satisfactory lip motion cannot be realized with a defective alveolus or piriform aperture that retracts the alar base. Consequently, a good lip or nasal base cannot be achieved without bony restoration of the alveolus and piriform aperture. A transversely short lip never has normal mobility, and it must be widened by an Abbé flap. A tight, retruded lip on a retruded maxilla cannot be improved by a prosthetic vestibular plate because a greater tension will restrict movements. The lip must be advanced with the maxilla, then widened if necessary by an Abbé flap. A thick prolapsed lip never has normal movement; it must be raised by an infranasal excision. A cleft lip has nothing to gain from being displayed under a short nose, or, still worse, under a upturned nose. The nose must be kept long enough to cast a shadow on the lip. For the same reason, a bone graft is often necessary in bilateral clefts because the nose is short and retruded.

  20. Facial dimensions of Malay children with repaired unilateral cleft lip and palate: a three dimensional analysis.

    PubMed

    Zreaqat, M; Hassan, R; Halim, A S

    2012-06-01

    This comparative cross-sectional study assessed the facial surface dimensions of a group of Malay children with unilateral cleft lip and palate (UCLP) and compared them with a control group. 30 Malay children with UCLP aged 8-10 years and 30 unaffected age-matched children were voluntarily recruited from the Orthodontic Specialist Clinic in Hospital Universiti Sains Malaysia (HUSM). For the cleft group, lip and palate were repaired and assessment was performed prior to alveolar bone grafting and orthodontic treatment. The investigation was carried out using 3D digital stereophotogrammetry. 23 variables and two ratios were compared three-dimensionally between both groups. Statistically significant dimensional differences (P<0.05) were found between the UCLP Malay group and the control group mainly in the nasolabial region. These include increased alar base and alar base root width, shorter upper lip length, and increased nose base/mouth width ratio in the UCLP group. There were significant differences between the facial surface morphology of UCLP Malay children and control subjects. Particular surgical procedures performed during primary surgeries may contribute to these differences and negatively affect the surgical outcome.

  1. Three-dimensional soft tissue change after paranasal augmentation with porous polyethylene.

    PubMed

    Kwon, T-G; Kang, S-M; Hwang, H-D

    2014-07-01

    The aim of this study was to investigate the effect of porous polyethylene (PPE) in paranasal augmentation on midfacial soft tissue architecture. This retrospective study recruited patients with midface retrusion and mandibular prognathism. Twenty adult patients who had undergone bilateral PPE augmentation (ready-made type, thickness 4.5mm, Medpor) to the piriform aperture and simultaneous mandibular setback surgery were included in this study. The soft tissue morphology and thickness of the midface were evaluated using three-dimensional reformatted images from cone beam computed tomography done before and 6 months after surgery. The soft tissue outline of the midface was augmented 1-4mm. The average increase in soft tissue outline near the peri-alar region was 3.1-3.4mm, which comprised 68-74% of the PPE thickness (P<0.01). The nasolabial angle and columellar inclination were increased significantly (2.2° and 1.4°, respectively; both P<0.05), whereas the nasal tip angle, nasal tip protrusion, columellar length, and bilateral nostril axis angle did not change. The alar base became wider on average by 2.2mm (P<0.01). The results showed that paranasal augmentation with PPE significantly increased the overlying soft tissue outline without influencing the nasal projection and could enhance paranasal aesthetics with minimal morbidity.

  2. Multifactorial approaches for correction of the drooping tip of a long nose in East asians.

    PubMed

    Park, Seong Geun; Jeong, Hoijoon; Ye, Choon Ho

    2014-11-01

    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.

  3. 400th Anniversary of Marius's Book with the First Image of an Astronomical Telescope and of Orbits of Jovian Moons

    NASA Astrophysics Data System (ADS)

    Pasachoff, Jay M.; Leich, Pierre

    2015-01-01

    Simon Mayr's (Marius's) Mundus Iovialis Anno M·DC·IX Detectus Ope Perspicilli Belgici (The World of Jupiter...) was published in Nuremberg in 1614; Marius was the Ansbach court mathematician. The frontispiece includes not only a portrait of Marius (1573-1624) himself but also, in the foreground, a long tube labelled "perspicillum," the first known image of a telescopic device used for astronomy; the name "telescope" came later. A schematic diagram of Jupiter with four moons orbiting appears at upper left; Marius, following a suggestion from Kepler, gave these Galilean satellites the names now still in use: Io, Europa. Ganymede, and Callisto. The title continues Hoc est, Quatuor Joviali cum Planetarum, cum Theoria, tum Tabulae, Propriis Observationibus Maxime Fundate.... A pair of conferences was held in Germany in 2014 to commemorate the 400th anniversary of Marius's book and to discuss Marius's work and its relation to Galileo's work (http://www.simon-marius.net; http://www.simon-marius.net/index.php?lang=en&menu=1 28 languages are available). Marius (Mayr) had independently discovered the four satellites of Jupiter, apparently one day after Galileo, on December 29 O.S., 1609; by the time he published his work four years later (a local-circulation publication had appeared in Nuremberg in 1611 in Prognosticon Astrologicum auf das Jahr 1612), Galileo had gained fame and priority, and Galileo accused Marius of plagiarism in Il Saggiatore (1623). With his Belgian telescope, Marius also noted the tilt of the orbital plane of Jupiter's moons, sunspots (1611), and the Andromeda Nebula (1612). He claimed to have worked out a system of cosmology similar to the Tychonic system in 1596, contemporaneously to Kepler's Mysterium Cosmographicum. A crater, the Marius Hills, and the Rima Marius on the Moon are named for him by the I.A.U., as well as, to celebrate the quadricentennial, a main-belt asteroid, now (7984) Marius. Acknowledgment: JMP thanks Seth Fagen, PRPH Books in

  4. On the size of the ptolemaic system of the world - a study based on two figures by Johannes Kepler. (German Title: Über die Gröszlig;e des ptolemäischen Weltsystems - Eine Studie, veranlasst durch zwei Bilder bei Johannes Kepler)

    NASA Astrophysics Data System (ADS)

    Oberschelp, Arnold

    It is well known that the geocentric system according to Ptolemy is almost twice as large as the heliocentric planetary system of Copernicus. There are, however, two pictures, given by Kepler in his «Mysterium Cosmographicum» of 1596 which - at first glance - seem to contradict this. The first picture of the heliocentric system is drawn to scale. The second picture shows a geocentric system, which seems to be too small. The puzzle about the size is solved rather trivially by the fact - which is not mentioned by Kepler and which may be overlooked - that the geocentric picture is not drawn to scale and that the angles do not correspond to the degrees noted at them. In order to get a geocentric picture drawn to scale - taking Kepler's degrees for granted - it is necessary to discuss some details of the ptolemaic system. The result is, however, a geocentric system which is too big. The solution of this new puzzle is not obvious. It turns out that one of Keplers degrees (for Mars) does not correspond to the parameters of Ptolemy. Actually, in his book of 1596, Kepler's topic is not the ptolemaic system nor the copernican distances, but his heliocentric model with the five regular polyhedra. While it is interesting to note all these facts, Kepler's pictures and degrees, for the size of the ptolemaic system, lead to a dead end. Using the parameters from the «Almagest» and the principle of nested spheres from the «Planetary Hypotheses» a distance scale (Tab. 10) for the geocentric system is derived. This distance scale, however, is somewhat different from the well known ptolemaic distance scale (Tab. 1). This puzzle is not resolved, but due to the fact that different sources («Almagest» and «Planetary Hypotheses») of Ptolemy are involved. The distances of Tab. 10 correspond better to the ptolemaic system, since the relative thickness of the spheres is computed from the rather precise parameters (eccentricities and epicycle radii) of the «Almagest». The

  5. MRI Evaluation of Lumbar Disc Degenerative Disease

    PubMed Central

    Patel, Rupal; Mehta, Chetan; Patel, Narrotam

    2015-01-01

    Introduction: Lower back pain secondary to degenerative disc disease is a condition that affects young to middle-aged persons with peak incidence at approximately 40 y. MRI is the standard imaging modality for detecting disc pathology due to its advantage of lack of radiation, multiplanar imaging capability, excellent spinal soft-tissue contrast and precise localization of intervertebral discs changes. Aims and Objective: To evaluate the characterization, extent, and changes associated with the degenerative lumbar disc disease by Magnetic Resonance Imaging. Study Design: Cross-sectional and observational study. Materials and Methods: A total 109 patients of the lumbar disc degeneration with age group between 17 to 80 y were diagnosed & studied on 1.5 Tesla Magnetic Resonance Imaging machine. MRI findings like lumbar lordosis, Schmorl’s nodes, decreased disc height, disc annular tear, disc herniation, disc bulge, disc protrusion and disc extrusion were observed. Narrowing of the spinal canal, lateral recess and neural foramen with compression of nerve roots observed. Ligamentum flavum thickening and facetal arthropathy was observed. Result: Males were more commonly affected in Degenerative Spinal Disease & most of the patients show loss of lumbar lordosis. Decreased disc height was common at L5-S1 level. More than one disc involvement was seen per person. L4 – L5 disc was the most commonly involved. Annular disc tear, disc herniation, disc extrusion, narrowing of spinal canal, narrowing of lateral recess, compression of neural foramen, ligamentum flavum thickening and facetal arthropathy was common at the L4 –L5 disc level. Disc buldge was common at L3 – L4 & L4 – L5 disc level. Posterior osteophytes are common at L3 - L4 & L5 –S1 disc level. L1- L2 disc involvement and spondylolisthesis are less common. Conclusion: Lumbar disc degeneration is the most common cause of low back pain. Plain radiograph can be helpful in visualizing gross anatomic changes in

  6. A dynamic canine model of experimental hip dysplasia. Gross and histological pathology, and the effect of position of immobilization on capital femoral epiphyseal blood flow.

    PubMed

    Schoenecker, P L; Lesker, P A; Ogata, K

    1984-10-01

    We produced a dynamic model of experimental hip dysplasia in growing puppies by cast immobilization of a single hind leg with the knee in extension. Serial roentgenographic studies demonstrated a progressive acetabular dysplasia with subluxation and eventually dislocation of the femoral head. A consistent finding in the dysplastic hip was significant hypertrophy of the ligamentum capitum femoris, both in length and in cross-sectional area. Quantitative studies of blood flow in the femoral head by the hydrogen-washout technique in normal and dysplastic hips demonstrated a significant decrease in blood flow to the dysplastic femoral heads. The dysplastic hips were then placed in various positions of immobilization and blood-flow determinations were repeated. The position of forced abduction significantly reduced circulation in the femoral head, whereas immobilization in flexion consistently resulted in the highest rate of blood flow in the femoral head. These experimental data indicate the potential ischemic hazards of immobilization in the forced abducted position in the treatment of congenital dislocation of the hip. Progressive degenerative changes developed in the articular cartilage of the dislocated joint, with severe reduction of safranin-O staining, fibrocartilaginous metaplasia, and hypocellularity. The degenerative changes in the acetabular cartilage were more severe than those in the femoral head. These findings further emphasize the importance of reducing the dislocated hip at the earliest opportunity in order to prevent irreversible degenerative changes.

  7. The Mayo Table Technique in Hip Arthroscopy.

    PubMed

    Salas, Antonio Porthos; González-Campos, Mauricio; Salas-Pérez, Alfredo D'Artagnan; Aurelio González-Bazaldua, Jose Luis

    2016-06-01

    Hip distractor devices or hip fracture tables (HFTs) are vital to perform a reliable hip arthroscopy (HA) for the treatment of femoroacetabular impingement, especially when labral tears, chondral-labral delaminations, ligamentum teres tears, and other intraarticular disorders are present. Adequate hip distractors were not available in the early days of HA; most of HFTs being used those days were rigid, cumbersome, and did not allow us to properly perform an arthroscopic dynamic impingement test to evaluate and assess the femoral head and its site of impingement. The mayo table technique was developed because of the lack of appropriate hip instrumentation and an HFT when the author (A.P.S.) started to perform HA. This easy technique allows the surgeon to control hip maximal range of motion and also to assess completely the cam deformity in the posterolateral, superolateral, anterior, and anteroinferior aspects. It also allows the surgeon to revise where the cam is impinging and afterward perform a complete bony resection and decompression. We strongly believe that with the mayo table technique HA can be performed simply and reliably in old rigid and cumbersome HFTs and also hip distractors that do not allow an adequate dynamic assessment of the hip with maximal range of motion. PMID:27656362

  8. Ozone solubilizes elastin and increases its susceptibility to elastase

    SciTech Connect

    Winters, R.S.; Johnson, D.A. )

    1991-03-11

    Ozone is a powerful oxidant gas that may contribute to lung diseases such as emphysema. Because the hallmark of emphysema is destruction of the elastin rich alveoli of the lung, ozonization of elastin was studied in vitro to examine the effects of ozone on elastin structure and susceptibility to proteolysis. Samples of bovine ligamentum nuchae elastin were suspended in 15 ml PBS and bubbled with 13.7 ppm ozone in argon at a flow rate of 3.5 ml/min. Ozone treatment resulted in the solubilization of elastin as evidenced by a visual decrease in turbidity and an increase in the 225 nm absorbance of the supernatant fraction after centrifugation to pellet the insoluble elastin. Insoluble elastin recovered from exposed suspensions was examined for proteolytic susceptibility with human neutrophil elastase (HNE), by incubating 600 {mu}g samples in 1 ml of 50 mM Tris-HCl, 200 mM NaCl, pH 8.0 with 3 {mu}g HNE for various times at room temp. Elastin proteolysis was followed by measuring the 225 nm absorbance of solubilized peptides in supernatant fractions. Ozone exposed elastin, which had been previously ozonized to 5% solubility was found to be approximately twice as susceptible to proteolysis as native elastin.

  9. 5'-nucleotidase in spinal meningeal compartments in the rat. An immuno and enzyme histochemical study.

    PubMed

    Zenker, W; Rinne, B; Bankoul, S; Le Hir, M; Kaissling, B

    1992-09-01

    The distribution of 5'-nucleotidase (5'-Nu) is reported in spinal meninges of the rat on the basis of an immunohistochemical and enzyme histochemical investigation. Strong immunoreactivity was found in the arachnoid membrane and in the sheaths of the spinal roots as well as in septa subdividing the roots. Also the superficial layer of the ligamentum denticulatum showed enzyme staining. No immunoreactivity could be detected in the pia mater or along the spinal nerve roots outside the subarachnoid space. Within the arachnoid mater the immunoreactivity was concentrated in the basal zone of the arachnoid membrane, thus appearing as a narrow fluorescent band near the border of the dura. An accentuation of immunoreactivity could be observed in areas where small dural blood vessels approach the subarachnoid space. It is well known that adenine nucleotides released from neural and glial cells of the central nervous system finally reach the cerebrospinal fluid. We presume that 5'-Nu in the arachnoid membrane and spinal root sheaths is responsible for the conversion of adenine nucleotides into adenosine and that this conversion is associated with the reabsorption process of cerebrospinal fluid which most probably also takes place in spinal meninges. Adenosine, the product of 5'-nucleotidase, could play a role in the reabsorption process by its vasodilatatory effect on dural and epidural vessels.

  10. Cervical ligamentous instability in a canine in vivo model.

    PubMed

    Whitehill, R; Moran, D J; Fechner, R E; Ruch, W W; Drucker, S; Hooper, W E; McCoig, J A

    1987-12-01

    A canine in vivo model of midcervical ligamentous instability was developed by dividing the anterior longitudinal ligament, anulus fibrosus, and all posterior ligamentous structures including the ligamentum flavum. The natural history of healing in the model, the effect on its healing by an adjacent one-level arthrodesis, and the effect of a one-level arthrodesis on normal adjacent ligamentous structures were studied radiographically, mechanically, and histologically. The authors determined that healing takes place primarily by anterior scar formation in their instability model but not to a degree sufficient to recreate normal mechanical stability. After three months, healing in the model was not affected by an adjacent arthrodesis; however, acutely, instability apparently was increased as three animals became quadriplegic between the second and fourth postoperative days. Arthrodesis did not affect adjacent normal ligamentous structures, during this period. Incomplete healing in the authors' model supports those who advocate arthrodesis as the treatment of choice for destabilizing cervical ligamentous injury. The authors previously reported the case of a patient who sustained bilateral facet dislocations adjacent to an arthrodesed segment and questioned whether this resulted from a stress-concentrating effect. This study indicates that this could well have been the case acutely. Thus, inadvertent exclusion of an unstable segment from an arthrodesis has potentially catastrophic results. Finally, the authors also have previously questioned whether arthrodesis of a midcervical segment could lead to instability of adjacent normal segments. This project does not support such a concern, at least for the three postoperative months of study. PMID:3441821

  11. Persistent right aortic arch and aberrant left subclavian artery in a white Bengal tiger (Panthera tigris).

    PubMed

    Ketz, C J; Radlinsky, M; Armbrust, L; Carpenter, J W; Isaza, R

    2001-06-01

    A 3-mo-old male white Bengal tiger (Panthera tigris) presented with the chief complaint of regurgitation of solid food since weaning at 2 mo of age. Compared with its littermates, the tiger was in poor body condition and weighed only 10.3 kg when its littermates were estimated at 20-25 kg. Thoracic radiographs showed a megaesophagus cranial to the heart base. A contrast esophagram more clearly outlined the megaesophagus, and fluoroscopy demonstrated normal motility of the caudal esophagus. Endoscopic examination revealed a structure coursing dorsally from right to left over the esophagus and a constrictive band on the left of the esophagus at the heart base. Nonselective angiography confirmed the presence of a persistent right aortic arch, as well as an aberrant left subclavian artery. A left fourth intercostal thoracotomy was performed, and the ligamentum arteriosum was double ligated and divided. The left subclavian artery did not cause significant compromise of the esophagus and was not manipulated at surgery. The tiger recovered well from anesthesia and surgery. Solid food was slowly introduced over a 2-mo period without any regurgitation. The cub gained weight rapidly after surgery.

  12. Hand and foot remains from the Gran Dolina Early Pleistocene site (Sierra de Atapuerca, Spain).

    PubMed

    Lorenzo, C; Arsuaga, J L; Carretero, J M

    1999-01-01

    We report here the study of the 22 hand and foot remains from the Early Pleistocene level TD6 of the Gran Dolina site at Sierra de Atapuerca (Burgos, Spain) recovered from 1994 to 1996. These remains are paratypes of Homo antecessor. All of the elements are briefly described and compared with other fossil hominids. The capitate has a constricted neck, well developed head, strong attachment for the ligamentum interosseum trapezoid-capitate, a palmarly placed trapezoid facet with a distinctive small dorsal trapezoid facet, a highly curved and oblique orientation of the second metacarpal facet, and a transversally oriented dorsodistal border. A hamate with a moderately projecting and lightly built hamulus; an inferred reduced styloid process on the third metacarpal base; a wide second metacarpal head; and middle phalanges with well marked insertions for the flexor digitorum superficialis muscle and wide heads. The morphology and dimensions of the pedal remains from TD6 are very similar to modern humans; but the base, proximal articular surface and shafts of the proximal hallucal phalanges are more rounded and the midshaft of the proximal toe phalanx is wider. PMID:10496998

  13. Jaw myology and bite force of the monk parakeet (Aves, Psittaciformes).

    PubMed

    Carril, Julieta; Degrange, Federico J; Tambussi, Claudia P

    2015-07-01

    Psittaciform birds exhibit novelties in jaw bone structure and musculature that are associated with strong bite forces. These features include an ossified arcus suborbitalis and the muscles ethmomandibularis and pseudomasseter. We analyse the jaw musculature of the monk parakeet (Myiopsitta monachus) to enable future studies aimed at understanding craniofacial development, morphology, function and evolution. We estimate bite force based on muscle dissections, physiological cross-sectional area and skull biomechanical modelling. We also compare our results with available data for other birds and traced the evolutionary origin of the three novel diagnostic traits. Our results indicate that, in Myiopsitta, (i) the arcus suborbitalis is absent and the orbit is ventrally closed by an elongate processus orbitalis and a short ligamentum suborbitale; (ii) the ethmomandibularis muscle is a conspicuous muscle with two bellies, with its origin on the anterior portion of the septum interorbitale and insertion on the medial aspect of the mandible; (iii) the pseudomasseter muscle consists of some fibers arising from the m. adductor mandibulae externus superficialis, covering the lateral surface of the arcus jugalis and attaches by an aponeurotic sheet on the processus orbitalis; (iv) a well-developed adductor mandibulae complex is present; (v) the bite force estimation relative to body mass is higher than that calculated for other non-psittaciform species; and (vi) character evolution analysis revealed that the absence of the arcus suborbitalis and the presence of the m. pseudomassseter are the ancestral conditions, and mapping is inconclusive about presence of one or two bellies of the m. ethmomandibularis.

  14. Degenerative Cervical Myelopathy: A Spectrum of Related Disorders Affecting the Aging Spine.

    PubMed

    Tetreault, Lindsay; Goldstein, Christina L; Arnold, Paul; Harrop, James; Hilibrand, Alan; Nouri, Aria; Fehlings, Michael G

    2015-10-01

    Cervical spinal cord dysfunction can result from either traumatic or nontraumatic causes, including tumors, infections, and degenerative changes. In this article, we review the range of degenerative spinal disorders resulting in progressive cervical spinal cord compression and propose the adoption of a new term, degenerative cervical myelopathy (DCM). DCM comprises both osteoarthritic changes to the spine, including spondylosis, disk herniation, and facet arthropathy (collectively referred to as cervical spondylotic myelopathy), and ligamentous aberrations such as ossification of the posterior longitudinal ligament and hypertrophy of the ligamentum flavum. This review summarizes current knowledge of the pathophysiology of DCM and describes the cascade of events that occur after compression of the spinal cord, including ischemia, destruction of the blood-spinal cord barrier, demyelination, and neuronal apoptosis. Important features of the diagnosis of DCM are discussed in detail, and relevant clinical and imaging findings are highlighted. Furthermore, this review outlines valuable assessment tools for evaluating functional status and quality of life in these patients and summarizes the advantages and disadvantages of each. Other topics of this review include epidemiology, the prevalence of degenerative changes in the asymptomatic population, the natural history and rates of progression, risk factors of diagnosis (clinical, imaging and genetic), and management strategies. PMID:26378358

  15. Clinical Practice of Epidural Puncture in Dogs and Cats Assisted by a Commercial Acoustic Puncture Assist Device-Epidural Locator: Preliminary Results.

    PubMed

    Ertelt, Katrin; Turković, Veljko; Moens, Yves

    2016-01-01

    The objective of this study was to compare an Acoustic Puncture Assist Device-Epidural Locator (APAD-EL) with the "pop sensation" (POP) and "lack of resistance" (LOR) commonly used to confirm penetration of the ligamentum flavum and to ensure correct epidural placement in dogs and cats. We recruited 38 dogs and cats undergoing surgery and receiving epidural analgesia. Two anesthetists performed epidural puncture using the POP and LOR signs. Simultaneously, APAD-EL was used to collect visual and acoustic confirmation during advancement and placement of the needle tip for post hoc evaluation. A positive APAD-EL sign consists of a sudden pressure drop at the needle tip visible on a display and a concomitant pitch change of an acoustic signal. Failure to record a sudden pressure drop is considered a negative APAD sign. Descriptive statistics were used. In 32 patients with positive POP and LOR, the APAD was also positive. In one patient, POP was positive with a negative LOR and APAD result. Five patients had negative POP but positive LOR. Four patients had APAD positive and one (a dog) APAD negative. The study results showed that the APAD-EL information supports the subjective signs of correct needle placement suggested by positive POP and LOR experienced by trained anesthetists. The technique can be useful to assist difficult epidural puncture and as a training and teaching tool.

  16. Unexpected death caused by rupture of a dilated aorta in an adult male with aortic coarctation.

    PubMed

    Leth, Peter Mygind; Knudsen, Peter Thiis

    2015-09-01

    Aortic coarctation (AC) is a congenital aortic narrowing. We describe for the first time the findings obtained by unenhanced post mortem computed tomography (PMCT) in a case where the death was caused by cardiac tamponade from a ruptured aneurysmal dilatation of the ascending aorta and the aortic arch without dissection combined with aortic coarctation. The patient, a 46-year-old man, was found dead at home. PMCT showed haemopericardium and dilatation of the ascending aorta and the aortic arch. This appearance led to the mistaken interpretation that the images represented a dissecting aneurysm. The autopsy showed instead a thin-walled and floppy dilatation of the ascending aorta and aortic arch with a coarctation just proximal to the ligamentum arteriosum. A longitudinal tear was found in the posterior aortic wall just above the valves. Blood in the surrounding soft tissue intersected with a large haematoma (1000ml) in the pericardial sac. Cardiac hypertrophy (556g) was observed in the patient, though no other cardiovascular abnormalities were found. Histological analysis showed cystic medial necrosis of the ascending aortic wall. A ruptured aneurysmal dilatation of the ascending aorta and the aortic arch without aortic dissection associated with AC is an uncommon cause of haemopericardium that has only been described a few times before. The case is discussed in relation to other reported cases and in the context of the present understanding of this condition.

  17. Stressing on the human femoro-patellar joint. I. Components of a vertical and horizontal tensile bracing system.

    PubMed

    Blauth, M; Tillmann, B

    1983-01-01

    Horizontal and vertical tensions act on the femoropatellar joint. In both knee joints of 60 human corpses the muscles and ligaments participating in the tensile bracing of the knee joint were studied macroscopically. While the structures acting in the vertical direction are very constant, the components participating in horizontal tensile bracing show large variations. Components of vertical tensile bracing are the quadriceps femoris muscle, the ligamentum patellae as well as the vertical patellar retinacula. The active part of horizontal tensile bracing consists of the medial and lateral vastus muscles. The passive components of this system are arranged in three layers. The superficial layer is formed by the fascia lata. The middle layer consists of the horizontal retinacula. A medial horizontal retinaculum was present in one third of our cases. It passes from the medial margin of the patella towards the medial femoral epicondyle. A lateral horizontal retinaculum is demonstrable in all cases studied. It passes horizontally from the lateral margin of the patella and inserts into the deep layer of the iliotibial tract. Insertion of the lateral horizontal retinaculum into the lateral femoral epicondyle was not observed in our material. The third layer is formed by ligaments supporting the joint capsule. These originate from the medial and lateral margin of the patella and pass towards their respective meniscus as well as variably towards the femoral or tibial condyle. These structures are found both medially and laterally in two thirds of the cases studied. PMID:6650852

  18. Prevalence and pathogenesis of some filarial nematodes infecting donkeys in Egypt

    PubMed Central

    Radwan, A. M.; Ahmed, N. E.; Elakabawy, L. M.; Ramadan, M. Y.; Elmadawy, R. S.

    2016-01-01

    Aim: The primary objective of the present study is to determine the commonness of filarial parasites in donkeys in Egypt, identification of the filarial species tainting them and the delivered pathogenic impact connected with the infestation. Materials and Methods: A total of 188 donkeys were examined for filarial infection. The blood samples and scraping of the cutaneous bleeding lesions were collected, stained, and inspected for microfilariae all through the period from March 2011 to October 2013. The adult worms were perceived in tissue samples acquired from skin scraping, testes, eyes, tendons, peritoneal and pleural cavities, and the ligamentum nuchae. Results: On the basis of morphological identification, 163 of 188 donkeys (86.70%) were infected with Onchocerca cervicalis (82.98%), Setaria equina (31.11%), Parafilaria multipapillosa (5.32%), and Onchocerca reticulata (4.26%). There was no significant effect of the sex on the incidence of all the encounteredfilarial worms except for S. equina, where the infection rate prevailed in males versus females (40.82% vs. 35.90%). In addition, age group of 5-15 years old exhibited a fundamentally higher predominance (p< 0.05) of the recognized filarial worms versus those of < 5 years old and >15 years old. Conclusion: The preliminary results add to our comprehension of filarial species infecting donkeys in Egypt, their impact on animal execution and production. Accentuation must be taken for avoidance, control of filarial disease, and improvement of the management system of donkeys.

  19. The “Vessel through Strait” Sign is a Signature Radiological Sign for the Diagnosis of Left Hepatic Artery Variation

    PubMed Central

    Rong, Guanghua; Wang, Zhijun; Wang, Ximing; Yu, Qiang; Zhou, Lin; Wang, Huaming; Zhang, Junhua; Dong, Jinghui; Ma, Wei; An, Weimin; Ren, Hui; Zeng, Zhen; Lu, Yinying; Li, Yongwu

    2016-01-01

    An aberrant artery (AA) can frequently be observed coursing through the fissure for the ligamentum venosum (FLV) which was termed the “vessel through strait” sign (VTSS) by us. Fundamental data including the incidence, anatomical composition and clinical significance of VTSS and the AAs composing VTSS are still lacking. We sought to give a systematic demonstration on this issue in the present study. VTSS was respectively analyzed in 2,275 patients and was observed in 357 of them. Interestingly, 319 (89.4%) out of the 357 patients exhibiting VTSS were proved to have left hepatic artery variation (LHAV) (247 with replaced left hepatic artery, 64 with accessory left hepatic artery and 8 with variant common hepatic artery). We therefore hypothesized that VTSS could be a sign that strongly associated with LHAV and could be used for its diagnosis. In the following validating analysis, VTSS gained a sensitivity of 96.3% and a specificity of 98.3% for the diagnosis of LHAV in another bicenter cohort consisted of 1,329 patients. In conclusion, VTSS is a signature radiological sign of LHAV which could be used as an easy and specific method for the diagnosis of LHAV. PMID:27040020

  20. Giant Omental Fibromatosis Presenting as Pelvic Mass

    PubMed Central

    Singh, Pradyumn; Jain, Neelesh; Jain, Jaswant; Kumar, Vijay

    2015-01-01

    Omental fibromatosis (abdominal desmoids) is a rare benign but locally aggressive neoplasm characterized by mass like or infiltrative growth of fibrous tissue. It usually arises from the abdominal wall or the extremities, however rarely it may also arise in the omentum, ileocolic mesentery, transverse or sigmoid mesocolon and ligamentum teres. Here, we present an 18-year-old male, who presented with lower abdominal pain and palpable lump in hypogastric region. Computed tomography of the abdomen showed large heterogeneous mass in lower abdomen, possibly arising from mesentery with regional adenopathy. Patient underwent exploratory laparotomy with a preoperative diagnosis of mesenteric tumour possibly gastrointestinal stromal tumour (GIST). Histopathological examination revealed the lesion as omental fibromatosis. To the best of our knowledge, very few cases of omental fibromatosis are noted in literature. Here, we describe a rare case of giant omental fibromatosis which resembled mesenteric GIST clinically but finally diagnosed as fibromatosis by histomorphology and immunohistochemistry (IHC). The present article describes fibromatosis of greater omentum and the difficulty in preoperative diagnosis, as it is frequently misdiagnosed as GIST. PMID:25859511

  1. Response of individual thoracolumbar spine ligaments under high-rate deformation.

    PubMed

    Iwaskiw, Alexander S; Armiger, Robert S; Ott, Kyle A; Wickwire, Alexis C M; Merkle, Andrew C

    2012-01-01

    Under-Body Blast (UBB) has emerged as the predominant threat to ground vehicles and Warfighter survivability. The force transference from the vehicle structure to the human body has resulted in serious injuries, with the thoracolumbar spine frequently damaged. Computational models of the human body are being generated to model human response and develop injury mitigation strategies. To effectively model the spine mechanics, the thoracolumbar ligaments, which serve varying roles in contributing to spine stability, must be characterized at relevant strains and strain rates. Adaptation of cervical spine testing methods has allowed for testing of isolated spinal ligaments including the Anterior Longitudinal Ligament (ALL), Posterior Longitudinal Ligament (PLL), and Ligamentum Flavum (LF). A high-rate servo-hydraulic test machine was used to execute a tensile test protocol for 24 complexes with loading rates ranging from 240 - 2800 mm/s and displacements of 25%, 50%, 75%, 100%, and 300% of the measured ligament length. Non-contact strain field measurements were recorded to produce a three dimensional strain field of the ligament surface. In order to provide the ligament data in a form which can be incorporated in the human computational models, analytical methods for modeling the ligament response are being investigated. Ultimately, this model will be optimized to be utilized in computational models of the lumbar spine. PMID:22846283

  2. C2 nerve dysfunction associated with C1 lateral mass screw fixation.

    PubMed

    Huang, Da-geng; Hao, Ding-jun; Li, Guang-lin; Guo, Hao; Zhang, Yu-chen; He, Bao-rong

    2014-11-01

    The C1 lateral mass screw technique is widely used for atlantoaxial fixation. However, C2 nerve dysfunction may occur as a complication of this procedure, compromising the quality of life of affected patients. This is a review of the topic of C2 nerve dysfunction associated with C1 lateral mass screw fixation and related research developments. The C2 nerve root is located in the space bordered superiorly by the posterior arch of C1 , inferiorly by the C2 lamina, anteriorly by the lateral atlantoaxial joint capsule, and posteriorly by the anterior edge of the ligamentum flavum. Some surgeons suggest cutting the C2 nerve root during C1 lateral mass screw placement, whereas others prefer to preserve it. The incidence, clinical manifestations, causes, management, and prevention of C2 nerve dysfunction associated with C(1) lateral mass screw fixation are reviewed. Sacrifice of the C2 nerve root carries a high risk of postoperative numbness, whereas postoperative nerve dysfunction can occur when it has been preserved. Many surgeons have been working hard on minimizing the risk of postoperative C2 nerve dysfunction associated with C1 lateral mass screw fixation. PMID:25430709

  3. Degenerative Cervical Myelopathy: A Spectrum of Related Disorders Affecting the Aging Spine.

    PubMed

    Tetreault, Lindsay; Goldstein, Christina L; Arnold, Paul; Harrop, James; Hilibrand, Alan; Nouri, Aria; Fehlings, Michael G

    2015-10-01

    Cervical spinal cord dysfunction can result from either traumatic or nontraumatic causes, including tumors, infections, and degenerative changes. In this article, we review the range of degenerative spinal disorders resulting in progressive cervical spinal cord compression and propose the adoption of a new term, degenerative cervical myelopathy (DCM). DCM comprises both osteoarthritic changes to the spine, including spondylosis, disk herniation, and facet arthropathy (collectively referred to as cervical spondylotic myelopathy), and ligamentous aberrations such as ossification of the posterior longitudinal ligament and hypertrophy of the ligamentum flavum. This review summarizes current knowledge of the pathophysiology of DCM and describes the cascade of events that occur after compression of the spinal cord, including ischemia, destruction of the blood-spinal cord barrier, demyelination, and neuronal apoptosis. Important features of the diagnosis of DCM are discussed in detail, and relevant clinical and imaging findings are highlighted. Furthermore, this review outlines valuable assessment tools for evaluating functional status and quality of life in these patients and summarizes the advantages and disadvantages of each. Other topics of this review include epidemiology, the prevalence of degenerative changes in the asymptomatic population, the natural history and rates of progression, risk factors of diagnosis (clinical, imaging and genetic), and management strategies.

  4. Growth characteristics of the fetal ligament of the head of femur: significance in congenital hip disease.

    PubMed Central

    Walker, J. M.

    1980-01-01

    Measurement of the length and width of the ligament of the head of femur (ligamentum teres) in 140 normal human fetuses between 12 weeks and term provides limits for growth changes in this structure. These observations provide no morphological evidence of a significant difference between males and females, or between the right and left sides, to explain the female and left hip preponderance reported in congenital hip disease. The ligament is shown to be variable in length, width, and shape, and it is not a distinctly linear structure through linearity may increase with age. Tests of femoral head mobility support the opinion that this ligament must play a role in fetal and neonatal hip joint stability. Weak correlation only was demonstrated between the ligament variables and acetabular depth, which suggests that ligament shape and socket shape are not closely related. Comparison of measurements from normal and 12 dysplastic or subluxated joints provides no evidence to support previous observations that this structure is unusually long in abnormal hip joints which are not frankly dislocated. Images FIG. 1 PMID:7445537

  5. A right-sided aortic arch with Kommerell's diverticulum of the aberrant left subclavian artery presenting with syncope.

    PubMed

    Yang, Ming-Hsun; Weng, Zen-Chung; Weng, Yu-Guo; Chang, Hsiao-Huang

    2009-05-01

    A right-sided aortic arch with an aneurysm of the aberrant subclavian artery is a rare disease. We report a case of Kommerell's diverticulum of an aberrant left subclavian artery in a patient with a right-sided aortic arch. Fewer than 50 cases have been reported in the literature. A number of operative strategies are described. Right thoracotomy provides good exposure and avoids the morbidity associated with bilateral thoracotomy or sternotomy and thoracotomy. In our patient with symptoms of dysphagia, syncope, and left subclavian steal syndrome, a left thoracotomy was used. The repair was accomplished by division of a left ligamentum arteriosum, obliteration of the Kommerell's aneurysm, and an aorto-subclavian bypass. Postoperative complications included left vocal cord palsy and Horner's syndrome. Hoarseness and left ptosis recovered spontaneously 3 months after surgery, and the patient remained symptom-free at the 1-year follow-up. We believe a left thoracotomy for direct repair of Kommerell's diverticulum is a simple and safe method without the increased morbidity found in other procedures.

  6. Vascular rings: a radiological review of anatomical variations

    PubMed Central

    Ganie, Iqbal Siddi; Amod, Khatija; Reddy, Darshan

    2016-01-01

    Summary Background The imaging modalities used to diagnose vascular rings have evolved over time, from basic radiographic studies to advanced cross-sectional imaging. The goal of preoperative imaging is to provide the surgeon with an accurate representation of the ring configuration so that the surgical approach may be planned. Methods We conducted a review of all patients with vascular rings who underwent surgery at Inkosi Albert Luthuli Central Hospital, Durban, South Africa from 1 July 2008 to 1 July 2013. Results Eight patients were diagnosed with vascular rings. Seven patients had an abnormal plain chest radiograph (right aortic arch, tracheal narrowing, or abnormal mediastinal silhouette), while in six patients the contrast oesophagogram demonstrated a fixed extrinsic oesophageal indentation. Computed tomography angiography confirmed the pathology in all cases, with six double aortic arches and two right aortic arches with aberrant left subclavian artery and left ligamentum arteriosum. Conclusions We advocate a diagnostic imaging algorithm consisting of plain chest radiography, contrast oesophagogram and computed tomography angiography prior to surgery. Magnetic resonance imaging may provide an alternative axial imaging modality depending on institutional preference. PMID:26523459

  7. A review of vascular rings 1980-1992.

    PubMed

    Ledwith, M V; Duff, D F

    1994-01-01

    Over a period of 13 years 21 patients between the ages of three weeks and 13 years presenting to this centre had a vascular ring. A double aortic arch was present in 11 cases, a right aortic arch with a retroesophageal left subclavian artery in five cases, a right aortic arch with a normal left innominate artery, a Kommerell's diverticulum and a left ligamentum arteriosum encircling the trachea and oesophagus occurred in two cases and an aberrant left pulmonary artery arising from the right pulmonary artery occurred in three cases. The majority (19/21) presented with a history of chronic stridor, although other significant associated symptoms included: recurrent respiratory infection, wheeze, cyanotic episodes and difficulty or pain on swallowing. The barium swallow was the most useful method of investigation and was diagnostic in all of the 95% of cases in which it was performed. Nineteen patients underwent surgery uneventfully although stridor often remained a problem for some time following repair. Six patients (28%) had associated congenital heart disease. Three (14%) patients who did not have surgery died.

  8. Perispinal Delivery of CNS Drugs.

    PubMed

    Tobinick, Edward Lewis

    2016-06-01

    Perispinal injection is a novel emerging method of drug delivery to the central nervous system (CNS). Physiological barriers prevent macromolecules from efficiently penetrating into the CNS after systemic administration. Perispinal injection is designed to use the cerebrospinal venous system (CSVS) to enhance delivery of drugs to the CNS. It delivers a substance into the anatomic area posterior to the ligamentum flavum, an anatomic region drained by the external vertebral venous plexus (EVVP), a division of the CSVS. Blood within the EVVP communicates with the deeper venous plexuses of the CSVS. The anatomical basis for this method originates in the detailed studies of the CSVS published in 1819 by the French anatomist Gilbert Breschet. By the turn of the century, Breschet's findings were nearly forgotten, until rediscovered by American anatomist Oscar Batson in 1940. Batson confirmed the unique, linear, bidirectional and retrograde flow of blood between the spinal and cerebral divisions of the CSVS, made possible by the absence of venous valves. Recently, additional supporting evidence was discovered in the publications of American neurologist Corning. Analysis suggests that Corning's famous first use of cocaine for spinal anesthesia in 1885 was in fact based on Breschet's anatomical findings, and accomplished by perispinal injection. The therapeutic potential of perispinal injection for CNS disorders is highlighted by the rapid neurological improvement in patients with otherwise intractable neuroinflammatory disorders that may ensue following perispinal etanercept administration. Perispinal delivery merits intense investigation as a new method of enhanced delivery of macromolecules to the CNS and related structures.

  9. Prevalence and pathogenesis of some filarial nematodes infecting donkeys in Egypt

    PubMed Central

    Radwan, A. M.; Ahmed, N. E.; Elakabawy, L. M.; Ramadan, M. Y.; Elmadawy, R. S.

    2016-01-01

    Aim: The primary objective of the present study is to determine the commonness of filarial parasites in donkeys in Egypt, identification of the filarial species tainting them and the delivered pathogenic impact connected with the infestation. Materials and Methods: A total of 188 donkeys were examined for filarial infection. The blood samples and scraping of the cutaneous bleeding lesions were collected, stained, and inspected for microfilariae all through the period from March 2011 to October 2013. The adult worms were perceived in tissue samples acquired from skin scraping, testes, eyes, tendons, peritoneal and pleural cavities, and the ligamentum nuchae. Results: On the basis of morphological identification, 163 of 188 donkeys (86.70%) were infected with Onchocerca cervicalis (82.98%), Setaria equina (31.11%), Parafilaria multipapillosa (5.32%), and Onchocerca reticulata (4.26%). There was no significant effect of the sex on the incidence of all the encounteredfilarial worms except for S. equina, where the infection rate prevailed in males versus females (40.82% vs. 35.90%). In addition, age group of 5-15 years old exhibited a fundamentally higher predominance (p< 0.05) of the recognized filarial worms versus those of < 5 years old and >15 years old. Conclusion: The preliminary results add to our comprehension of filarial species infecting donkeys in Egypt, their impact on animal execution and production. Accentuation must be taken for avoidance, control of filarial disease, and improvement of the management system of donkeys. PMID:27651679

  10. Pyloric giant Brunner's gland hamartoma as a cause of both duodenojejunal intussusception and obscure gastrointestinal bleeding.

    PubMed

    Bayan, Kadim; Tüzün, Yekta; Yilmaz, Serif; Yilmaz, Gülşen; Bilici, Aslan

    2009-03-01

    Obscure gastrointestinal bleeding is an important dilemma. Brunner's gland hamartoma is an extremely rare tumor generally localized in the duodenal bulb. We present a 34-year-old woman who had suffered from several episodes of melena for the past three years. Endoscopic examinations were normal. Computed tomography showed a large target lesion over the right abdomen and an image representing intestinal malrotation, which was supported by enteroclysis. At exploratory laparotomy, ligamentum of Treitz was located in the mid-to-right side of the columna vertebralis, and the duodenal bulb was found to be invaginated into the proximal jejunum. After longitudinal duodenotomy, a pedunculated ring-shaped large polyp originating from the pyloric ring was seen and excised. Histology was consistent with Brunner's gland hamartoma. This case with obscure bleeding was original with respect to its rarity and being a huge, ring-shaped tumor with pyloric localization. Moreover, the patient had a rare clinical presentation of duodenojejunal intussusception with accompanying intestinal malrotation.

  11. [Ultrasonography-guided identification of the lumbar epidural space].

    PubMed

    Bonazzi, M; Bianchi De Grazia, L; Di Gennaro, S; Lensi, C; Migliavacca, S; Marsicano, M; Riva, A; Laveneziana, D

    1995-05-01

    The study was designed to assess the reliability of sonographic evaluation in the prediction of the depth of the lumbar epidural space. Forty males, scheduled for epidural anesthesia for surgical repair of inguinal hernia, were prospectively studied. Patients were placed in a sitting position and sagittal scanning of the lumbar spine was performed with a 5-MHz transducer over the fourth or fifth interspace in order to identify the deeper hyperechogen interface, which represents the landmark between the ligamentum flavum and the epidural space. Ultrasound depth was measured and transducer removed. A Tuohy needle 18 G was then introduced percutaneously according to the standard technique and a rubber slide placed over it, so that it depth of insertion could be accurately measured. The potential for using ultrasounds for prediction of the distance from skin to epidural space was analyzed using a simple linear regression analysis; p values < 0.05 were considered significant. Mean values of ultrasound depth and needle depth were respectively 51 mm (SD 6.3) and 50.9 mm (SD 6.2); the correlation coefficient was 0.99. Ultrasound scanning of the lumbar spine provides an accurate measurement of the depth of the epidural space, which can facilitate the performance of the epidural anaesthesia and may decrease the complication rate, particularly in those patients in which anatomic landmarks are obscured.

  12. Fine structure of vesiculated nerve profiles in the human lumbar facet joint.

    PubMed Central

    Vandenabeele, F; Creemers, J; Lambrichts, I; Robberechts, W

    1995-01-01

    The ultrastructural features of vesiculated nerve profiles were examined within a perivascular plexus of unmyelinated nerve fibres around small arteries and arterioles in the posterior facet joint capsule. Such profiles were exclusively observed in the dense fibrous layer and the adjacent part of the subintimal layer. The ligamentum flavum lacked any type of innervation. The vesiculated nerve profiles were tentatively classified on the basis of the fine structural appearances of their vesicular content. Two major types of nerve profiles could readily be distinguished in the capsular tissue. Both displayed a variable number of mitochondria, neurotubules and neurofilaments. The first type, containing predominantly small vesicles with an electron-dense granule or core, was frequently encountered and considered to be adrenergic in function. Profiles similar in morphology were also observed in the synovial plical tissue. A second type of profile, found in the joint capsule, contained varying proportions of small agranular (clear) vesicles and mitochondria. Some of these profiles exhibited an accumulation of mitochondria and were considered to be sensory in function. Nerve profiles filled with predominantly small flattened vesicles were occasionally encountered. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 Fig. 5 Fig. 6 PMID:8586567

  13. Foraminal deposition of calcium pyrophosphate dihydrate crystals in the thoracic spine: possible relationship with disc herniation and implications for surgical planning. Report of two cases.

    PubMed

    Paolini, Sergio; Ciappetta, Pasquale; Guiducci, Antonio; Principi, Massimo; Missori, Paolo; Delfini, Roberto

    2005-01-01

    The authors report two cases of nodular calcium pyrophosphate dihydrate (CPPD) crystal deposition close to the thoracic neural foramen, which caused chronic radiculopathy. Preoperatively, the lesions were interpreted as calcified disc herniations. Both patients underwent surgery in which an extended transfacet pedicle-sparing approach was used. Incision of the posterior longitudinal ligament released soft degenerated material. In both cases, histological examination showed abundant degenerative debris along with CPPD crystals. Spinal CPPD deposition is a comparatively rare disease that almost invariably involves the posterior aspect of the spinal canal, typically the ligamentum flavum. The exceptional foraminal location of the lesions reported here, combined with the surgical findings, indicated that the CPPD crystals were deposited on a laterally herniated disc fragment. A distinctive feature in both cases was the soft consistency of the resected tissue. The consistency of the disc material and the location of the lesion in the axial plane (that is, median compared with lateral) are key factors in determining the optimal surgical approach to thoracic disc herniations. In describing consistency, terms such as "calcified" and "hard" have been used interchangeably in the literature. In the cases reported here, what appeared on computerized tomography and magnetic resonance imaging studies to be densely calcified lesions were shown intraoperatively to be soft herniations. The authors' experience underscores that not all densely calcified herniated discs are hard. Although detection of this discrepancy would have left surgical planning for the lateral disc herniations unchanged, it could have altered planning for centrally or centrolaterally located disc herniations.

  14. Persistent right aortic arch and aberrant left subclavian artery in a white Bengal tiger (Panthera tigris).

    PubMed

    Ketz, C J; Radlinsky, M; Armbrust, L; Carpenter, J W; Isaza, R

    2001-06-01

    A 3-mo-old male white Bengal tiger (Panthera tigris) presented with the chief complaint of regurgitation of solid food since weaning at 2 mo of age. Compared with its littermates, the tiger was in poor body condition and weighed only 10.3 kg when its littermates were estimated at 20-25 kg. Thoracic radiographs showed a megaesophagus cranial to the heart base. A contrast esophagram more clearly outlined the megaesophagus, and fluoroscopy demonstrated normal motility of the caudal esophagus. Endoscopic examination revealed a structure coursing dorsally from right to left over the esophagus and a constrictive band on the left of the esophagus at the heart base. Nonselective angiography confirmed the presence of a persistent right aortic arch, as well as an aberrant left subclavian artery. A left fourth intercostal thoracotomy was performed, and the ligamentum arteriosum was double ligated and divided. The left subclavian artery did not cause significant compromise of the esophagus and was not manipulated at surgery. The tiger recovered well from anesthesia and surgery. Solid food was slowly introduced over a 2-mo period without any regurgitation. The cub gained weight rapidly after surgery. PMID:12790433

  15. Experimental Characterization of the Anatomical Structures of the Lumbar Spine Under Dynamic Sagittal Bending.

    PubMed

    Bradfield, C A; Demetropoulos, C K; Luongo, M E; Pyles, C O; Armiger, R S; Merkle, A C

    2015-01-01

    Underbody blast (UBB) events transmit high-rate vertical loads through the seated occupant’s lumbar spine and have a high probability of inducing severe injury. While previous studies have characterized the lumbar spine under quasi-static loading, additional work should focus on the complex kinetic and kinematic response under high loading rates. To discern the biomechanical influence of the lumbar spine’s anatomical structures during dynamic loading, the axial force, flexion-extension moments and range of motion for lumbar motion segments (n=18) were measured during different states of progressive dissection. Pre-compression was applied using a static mass while dynamic bending was applied using an offset drop mass. Dynamic loading resulted in peak axial loads of 4,224±133 N, while maximum peak extension and flexion moments were 19.6±12.5 and -44.8±8.6 Nm in the pre-dissected state, respectively. Upon dissection, transection of the interspinous ligament, ligamentum flavum and facet capsules resulted in significantly larger flexion angles, while the removal of the posterior elements increased the total peak angular displacement in extension from 3.3±1.5 to 5.0±1.7 degrees (p=0.002). This study provides insight on the contribution of individual anatomical components on overall lumbar response under high-rate loading, as well as validation data for numerical models. PMID:25996712

  16. Age- and sex-related changes in the normal human external nose.

    PubMed

    Sforza, Chiarella; Grandi, Gaia; De Menezes, Marcio; Tartaglia, Gianluca M; Ferrario, Virgilio F

    2011-01-30

    The objective of this study was to measure: (1) normal sex-related dimensions of external nose (linear distances, ratios, angles, volume and surface area); and (2) growth changes between childhood and old age. The three-dimensional coordinates of several soft-tissue landmarks on the external nose were obtained by a non-invasive, computerized digitizer in 519 male and 340 female healthy subjects aged 4-73 years. The subjects were divided into 11 non-overlapping age groups: for children and preadolescent subjects, 2-year spans were used, while larger intervals were used for adolescent and adult subjects. From the landmarks, nasal volume and external surface area; nasal and alar base widths, nasal height, nasal bridge length, philtrum length, nasal tip protrusion, right and left nostril lengths, superior and inferior nostril widths; nasal tip protrusion-to-nasal height, and nasal width-to-nasal height ratios; nasal convexity, alar slope, and nasal tip angles were calculated, and averaged for age and sex. Comparisons were performed by factorial analysis of variance. On average, men had larger nasal external volume and area, linear distances and nasal width-to-height ratio than women (p<0.01); no sex differences were found for the angles and the nasal tip protrusion-to-nasal height ratio. Age significantly influenced all analyzed measurements (p<0.001): nasal volume, area, linear distances increased from childhood to old age, while the nasal tip angle decreased as a function of age. No consistent age related patterns were found for the ratios and the nasal convexity and alar slope angles. Men and women had different age related patterns, with significant sex by age interactions (p<0.001). Overall, in most occasions male increments in nasal dimensions were larger than female ones. Data collected in the present investigation could serve as a database for the quantitative description of human nasal morphology during normal growth, development and aging. Forensic

  17. Supramid tip implants in rhinoplasty. Review of 98 cases.

    PubMed

    Fanous, N; Webster, R

    1987-07-01

    The nasal tip procedure is the most sophisticated aspect of a rhinoplasty, particularly in certain known problem types of nasal tips. A new approach, using Supramid tip implants, is introduced. Precise guidelines for the preoperative planning and operative techniques are developed, and the so-called pocket, experience, positioning, shape and size, and incision (PEPSI) rule is outlined. A comparative discussion of the advantages and disadvantages of the Supramid implant vs cartilage grafts and/or repositioning of alar cartilages is presented. The Supramid implant was used in the tip area for nasal tip alteration in a total of 98 cases. Patients were monitored for a period of six months to four years. The results were satisfactory.

  18. Primary Nasal Reconstruction in Self-Inflicted Nasal Injury.

    PubMed

    Kapadia, Abizer; John, Jerry R; Gaba, Sunil; Sharma, Ramesh Kumar

    2015-10-01

    Self-inflicted injury of the nose is extremely rare. It may be associated with severe psychopathology and suicidal ideation. The authors report a case of a 24-year-old man, who presented with soft-tissue loss over both the alae of his nose. He had cut off the alar rims with an ordinary razor blade. He was overtly concerned about his nose being excessively broad and fat. A diagnosis of body dysmorphic disorder with nonsuicidal self-injury was made. Patient was observed during 72 hours in hospital with psychiatric support and local dressings. The authors undertook primary nasal reconstruction with nasolabial flaps on both sides for coverage. In conclusion, self-inflicted nasal injury mandates a judicious balancing of psychiatric support and surgical reconstruction. This can prevent untoward sequelae including further self-harm and suicide.

  19. 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

  20. Primary unilateral cleft lip repair

    PubMed Central

    Adenwalla, H. S.; Narayanan, P. V.

    2009-01-01

    The unilateral cleft lip is a complex deformity. Surgical correction has evolved from a straight repair through triangular and quadrilateral repairs to the Rotation Advancement Technique of Millard. The latter is the technique followed at our centre for all unilateral cleft lip patients. We operate on these at five to six months of age, do not use pre-surgical orthodontics, and follow a protocol to produce a notch-free vermillion. This is easy to follow even for trainees. We also perform closed alar dissection and extensive primary septoplasty in all these patients. This has improved the overall result and has no long-term deleterious effect on the growth of the nose or of the maxilla. Other refinements have been used for prevention of a high-riding nostril, and correction of the vestibular web. PMID:19884683

  1. Sacral insufficiency fractures: a case of mistaken identity

    PubMed Central

    Baldwin, Mathew J; Tucker, Laura J

    2014-01-01

    Introduction Sacral insufficiency fractures are an important cause of lower back pain in the elderly. Clinically and radiologically, they must be distinguished from osseous metastases, which frequently coexist. To date, no case report has comprehensively explored the full range of diagnostic hurdles and potential pitfalls. Case presentation We report the case of a 70-year-old Caucasian female who presented to our services with a short history of progressive back pain without any history of trauma. A prior history of breast cancer was noted. Bone scintigraphy was initially reported as consistent with metastatic sacral deposits. Further characterization with magnetic resonance imaging and computed tomography revealed bilateral insufficiency fractures of the sacral alar. The patient responded well to conservative management. Conclusion To avoid misdiagnosis, particularly in those who are also at risk of osseous metastases, sacral insufficiency fractures must always be considered as a cause of lower back pain. PMID:24940083

  2. 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. PMID:15627440

  3. [Accident analytics for structural traumas of the cervical spine].

    PubMed

    Hartwig, E; Elbel, M; Schultheiss, M; Kettler, A; Kinzl, L; Kramer, M

    2004-12-01

    The differentiation between degenerative syndromes of the cervical spine and post-traumatic symptoms requires accident analysis. Experiments with human subjects yield data only in the low-energy range, and there are still no accident analyses of structural traumas of the cervical spine. From 1 January 2000 to 30 April 2002, 15 patients with structural injuries to the cervical spine due to car accidents were treated in the Department of Trauma Surgery of the University of Ulm. In 11 of these cases, the DEKRA Ulm completed an appraisal of the accident process.With lateral impacts, structural injuries to the cervical spine can occur even at speeds of only ca 10 km/h. Injuries to the alar ligaments are produced by frontal collisions with substantial differences in speed. Data from accident analysis of structural injuries to the cervical spine must be taken into consideration in causality examinations of distortions of the cervical spine.

  4. Management of the cleft lip nasal deformity.

    PubMed

    Dutton, J M; Bumsted, R M

    2001-02-01

    Management of the cleft lip nasal deformity offers a unique and ongoing challenge in facial plastic surgery. Although there has been no consensus regarding the optimal timing and technique for surgical repair of this deformity, the authors have found a three-tiered approach to be satisfactory. This approach involves a primary rhinoplasty performed at the time of the initial cleft lip repair to address reconstruction of the nasal floor and sill, columellar lengthening, repositioning of the alar base, and repositioning of the skin and mucosa of the lower lateral cartilage. Following alveolar bone grafting, an intermediate rhinoplasty is often performed at 6 to 10 years of age through an open approach to correct the cartilaginous lower nasal deformity. A delayed rhinoplasty is then performed in the later teenage years to correct the bony dorsal deformity and the various causes of nasal obstruction.

  5. Post-traumatic upper cervical subluxation visualized by MRI: a case report

    PubMed Central

    Demetrious, James

    2007-01-01

    Background This paper describes MRI findings of upper cervical subluxation due to alar ligament disruption following a vehicular collision. Incidental findings included the presence of a myodural bridge and a spinal cord syrinx. Chiropractic management of the patient is discussed. Case presentation A 21-year old female presented with complaints of acute, debilitating upper neck pain with unremitting sub-occipital headache and dizziness following a vehicular collision. Initial emergency department and neurologic investigations included x-ray and CT evaluation of the head and neck. Due to persistent pain, the patient sought chiropractic care. MRI of the upper cervical spine revealed previously unrecognized clinical entities. Conclusion This case highlights the identification of upper cervical ligamentous injury that produced vertebral subluxation following a traumatic incident. MRI evaluation provided visualization of previously undetected injury. The patient experienced improvement through chiropractic care. PMID:18093309

  6. [Over projected tip].

    PubMed

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

    2014-12-01

    Overprojected tip is a pretty usual request not easy to manage. Preop analysis is crucial in order to evaluate tip support and skin thickness and ability to retract. For example, if the skin is very thick and has poor chance to retract, the surgeon should be very careful in the tip projection decreasing to avoid a skin pollybeak deformity. In such cases, he has to analyze the facial proportions, especially other areas projection (radix, dorsum and chin) and think about augmenting them to balance the profile rather than decreasing tip projection. Correction should always be conducted incrementally, starting with weakening the tip support mechanisms and, only if necessary, continue with alar cartilage interruption. This can be performed on many areas (lateral cruras, domes, medial cruras) and with several techniques (resection or interruption+overlapping).

  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. Nasolabial Cyst Associated with Odontogenic Infection.

    PubMed

    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

  9. Organization of hindbrain segments in the zebrafish embryo.

    PubMed

    Trevarrow, B; Marks, D L; Kimmel, C B

    1990-05-01

    To learn how neural segments are structured in a simple vertebrate, we have characterized the embryonic zebrafish hindbrain with a library of monoclonal antibodies. Two regions repeat in an alternating pattern along a series of seven segments. One, the neuromere centers, contains the first basal plate neurons to develop and the first neuropil. The other region, surrounding the segment boundaries, contains the first neurons to develop in the alar plate. The projection patterns of these neurons differ: those in the segment centers have descending axons, while those in the border regions form ventral commissures. A row of glial fiber bundles forms a curtain-like structure between each center and border region. Specific features of the individual hindbrain segments in the series arise within this general framework. We suggest that a cryptic simplicity underlies the eventual complex structure that develops from this region of the CNS.

  10. Evo-devo and the primate isocortex: the central organizing role of intrinsic gradients of neurogenesis

    PubMed Central

    Charvet, Christine J.; Finlay, Barbara L.

    2014-01-01

    Spatial gradients in the initiation and termination of basic processes, such as cytogenesis, cell-type specification and dendritic maturation are ubiquitous in developing nervous systems. Such gradients can produce a niche adaptation in a particular species. For example, the high density of photoreceptors and neurons in the “area centralis” of some vertebrate retinas result from the early maturation of its center relative to its periphery. Across species, regularities in allometric scaling of brain regions can derive from conserved spatial gradients: longer neurogenesis in the alar versus the basal plate of the neural tube is associated with relatively greater expansion of alar plate derivatives in larger brains. We describe gradients of neurogenesis within the isocortex and their effects on adult cytoarchitecture within and across species. Longer duration of neurogenesis in the caudal isocortex is associated with increased neuron number and density per column relative to the rostral isocortex. Later-maturing features of single neurons, such as soma size and dendritic spine numbers reflect this gradient. Considering rodents and primates, the longer duration of isocortical neurogenesis in each species, the greater the rostral-to-caudal difference in neuron number and density per column. Extended developmental duration produces substantial, predictable changes in the architecture of the isocortex in larger brains, and presumably, a progressively changed functional organization whose properties we do not yet fully understand. Many features of isocortical architecture previously viewed as species- or niche-specific adaptations can now be integrated as the natural outcomes of spatiotemporal gradients that are deployed in larger brains. PMID:25247448

  11. The structural, functional, and molecular organization of the brainstem.

    PubMed

    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

  12. 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

  13. 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.

  14. Aesthetic rhinoplasty: Avoiding unfavourable results.

    PubMed

    Bhangoo, Kulwant S

    2013-05-01

    Rhinoplasty is one of the most challenging surgical procedures in plastic surgery. It is not surprising that a significant number of patients end up with unfavourable outcomes. Many of these unfavourable outcomes could be the result of poor judgment and wrong decision making. Most frequently, the unfavourable outcome is the result of errors in surgical technique. In this paper, unfavourable outcomes resulting from errors in surgical technique are discussed under the heading of each operative step. Poor placement of intra-nasal incision can result in internal valve obstruction. Bad columellar scars can result from errors during open rhinoplasty. Unfavourable results associated with skeletonisation are mentioned. Tip plasty, being the most difficult part of rhinoplasty, can result in lack of tip projection, asymmetry and deformities associated with placement of tip grafts. Over-resection of the lower lateral cartilages during tip plasty can also result in pinched nose, alar collapse causing external valve obstruction and other alar rim deformities. Humpectomy can result in open roof deformity, inverted V deformity and over-resection resulting in saddle nose. The so-called poly beak deformity is also a preventable unfavourable outcome when dealing with a large dorsal hump. Complications resulting from osteotomies include narrowing of nasal airway, open roof deformity, inverted V deformity and asymmetry of the bony wall resulting from incomplete or green stick fractures. Judicious use of grafts can be very rewarding. By the same token, grafts also carry with them the risk of complications. Allografts can result in recurrent infection, atrophy of the overlying skin and extrusion resulting in crippling deformities. Autografts are recommended by the author. Unfavourable results from autografts include displacement of graft, visibility of the graft edges, asymmetry, warping, and resorption.

  15. Straight line repair of unilateral cleft lip: new operative method based on 25 years experience.

    PubMed

    Nakajima, T; Tamada, I; Miyamoto, J; Nagasao, T; Hikosaka, M

    2008-08-01

    The resultant scar in the primary repair of unilateral cleft lip should ideally be straight and the mirror image of the philtrum on the non-cleft side. In 1993, we reported a new operative technique for unilateral cleft lip, in which we designed a straight line for the incision on the white lip. In order to produce the nostril floor, we used the white lip tissue in the area between the alar base and alveolus at the cleft side as a flap. We also used a small triangular flap above the white skin roll to prevent Cupid's peak from being drawn up. Unlike the rotation-advancement method, our technique does not leave a transverse scar at the alar base. Instead, it leaves a scar only along the line coincident with the natural philtral ridge. However, during observations of our patients, we noticed that the small triangular flap designed to be 1.5mm tended to become a conspicuous angular scar as the patients grew older. In addition, drooping of Cupid's peak on the cleft side was often observed with this small triangular flap. To make it less conspicuous, we made some modifications to the small flap above the white skin roll. With this new technique, we designed a semi-circular flap (1.5 x 3mm) above the white skin roll, instead of the small triangular flap. The suture line of our refined procedure draws a gentle curve, which looks almost straight because of skin elasticity. Moreover, the semi-circular flap causes less drooping of the upper lip than the triangular flap. We believe that revising the shape of the small flap on the white skin roll greatly improves patients' appearance. In this report, we present our refined techniques of primary repair of unilateral cleft lip.

  16. Efficient aminoacylation of the tRNA(Ala) acceptor stem: dependence on the 2:71 base pair.

    PubMed Central

    Beuning, Penny J; Nagan, Maria C; Cramer, Christopher J; Musier-Forsyth, Karin; Gelpí, Josep-Lluis; Bashford, Donald

    2002-01-01

    Specific aminoacylation by aminoacyl-tRNA synthetases requires accurate recognition of cognate tRNA substrates. In the case of alanyl-tRNA synthetase (AlaRS), RNA duplexes that mimic the acceptor stem of the tRNA are efficient substrates for aminoacylation in vitro. It was previously shown that recognition by AlaRS is severely affected by a simple base pair transversion of the G2:C71 pair at the second position in the RNA helix. In this study, we determined the aminoacylation efficiencies of 50 variants of the tRNA(Ala) acceptor stem containing substitutions at the 2:71 position. We find that there is not a single functional group of the wild-type G2:C71 base pair that is critical for positive recognition. Rather, we observed that base-pair orientation plays an important role in recognition. In particular, pyrimidine2:purine71 combinations generally resulted in decreased aminoacylation efficiency compared to the corresponding purine:pyrimidine pair. Moreover, the activity of a pyrimidine:purine variant could be partially restored by the presence of a major groove amino group at position 71. In an attempt to understand this result further, dielectric continuum electrostatic calculations were carried out, in some cases with additional inclusion of van der Waals interaction energies, to determine interaction potentials of the wild-type duplexAla and seven 2:71 variants. This analysis revealed a positive correlation between major groove negative electrostatic potential in the vicinity of the 3:70 base pair and measured aminoacylation efficiency. PMID:12022232

  17. 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.

  18. 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. PMID:26676857

  19. 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.

  20. Presurgical nasoalveolar moulding in unilateral cleft lip and palate

    PubMed Central

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

    2016-01-01

    Context: 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. Aims: 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. Settings and Design: Prospective study. Subjects and Methods: 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. Statistical Analysis Used: Student's t-test for paired comparisons. Results: 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. Conclusions: 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

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

    PubMed

    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

  3. Formation of pseudotachylitic breccias in the central uplifts of very large impact structures: Scaling the melt formation

    NASA Astrophysics Data System (ADS)

    Mohr-Westheide, Tanja; Reimold, Wolf Uwe

    2011-04-01

    The processes leading to formation of sometimes massive occurrences of pseudotachylitic breccia (PTB) in impact structures have been strongly debated for decades. Variably an origin of these pseudotachylite (friction melt)-like breccias by (1) shearing (friction melting); (2) so-called shock compression melting (with or without a shear component) immediately after shock propagation through the target; (3) decompression melting related to rapid uplift of crustal material due to central uplift formation; (4) combinations of these processes; or (5) intrusion of allochthonous impact melt from a coherent melt body has been advocated. Our investigations of these enigmatic breccias involve detailed multidisciplinary analysis of millimeter- to meter-sized occurrences from the type location, the Vredefort Dome. This complex Archean to early Proterozoic terrane constitutes the central uplift of the originally >250 km diameter Vredefort impact structure in South Africa. Previously, results of microstructural and microchemical investigations have indicated that formation of very small veinlets involved local melting, likely during the early shock compression phase. However, for larger veins and networks it was so far not possible to isolate a specific melt-forming mechanism. Macroscopic to microscopic evidence for friction melting is very limited, and so far chemical results have not directly supported PTB generation by intrusion of impact melt. On the other hand, evidence for filling of dilational sites with melt is abundant. Herein, we present a new approach to the mysterium of PTB formation based on volumetric melt breccia calculations. The foundation for this is the detailed analysis of a 1.5 × 3 × 0.04 m polished granite slab from a dimension-stone quarry in the core of the Vredefort Dome. This slab contains a 37.5 dm3 breccia zone. The pure melt volume in 0.1 m3 PTB-bearing granitic target rock outside of the several-decimeter-wide breccia zone in the granite slab was

  4. The Occupancy of the Components in the Cervical Spine and Their Changes with Extension and Flexion

    PubMed Central

    Sayıt, Emrah; Aghdasi, Bayan; Daubs, Michael D.; Wang, Jeffrey C.

    2015-01-01

    Study Design Retrospective case series. Objectives The kinematics of the cervical spine has been investigated by many researchers. However, the occupancy of the disk bulges, spinal cord, ligamentum flavum, and the rest of the canal as well as the changes of these structures with motion have not yet been investigated. The goal of this study is to investigate these dynamic changes. Methods The kinetic magnetic resonance images of 248 patients (124 men and 124 women) were evaluated, and the occupancy of each structure for each cervical level at neutral, flexion, and extension were calculated. Results Whole canal anteroposterior (AP) diameters showed significant differences between neutral-extension and flexion-extension at the C4–C5 and C5–C6 levels (p < 0.05). The mean disk bulges showed significant differences between neutral-flexion and flexion-extension at the C4–C5, C5–C6, C6–C7, and C7–T1 levels (p < 0.01). The mean spinal canal AP diameter showed significant differences between flexion-extension and neutral-extension at the C3–C4, C4–C5, C5–C6, and C6–C7 levels (p < 0.05). There were significant differences between neutral-flexion at the C4–C5, C5–C6, and C6–C7 levels (p < 0.05). The mean thickness of the ligamentum flavum showed significant differences between flexion-extension at the C3–C4, C4–C5, C5–C6, and C6–C7 levels (p < 0.001). There were significant differences between neutral-extension at the C3–C4 and C5–C6 levels (p < 0.05). There were significant differences between neutral-flexion at the C5–C6 and C6–C7 levels (p < 0.05). The mean thickness of the spinal cord showed significant differences between neutral-flexion at the C2–C3 and C3–C4 levels (p < 0.05). There were significant differences between flexion-extension at the C3–C4 and C4–C5 levels (p < 0.01). The rest of the canal showed significant differences between neutral-extension and flexion

  5. The Occupancy of the Components in the Cervical Spine and Their Changes with Extension and Flexion.

    PubMed

    Sayıt, Emrah; Aghdasi, Bayan; Daubs, Michael D; Wang, Jeffrey C

    2015-10-01

    Study Design Retrospective case series. Objectives The kinematics of the cervical spine has been investigated by many researchers. However, the occupancy of the disk bulges, spinal cord, ligamentum flavum, and the rest of the canal as well as the changes of these structures with motion have not yet been investigated. The goal of this study is to investigate these dynamic changes. Methods The kinetic magnetic resonance images of 248 patients (124 men and 124 women) were evaluated, and the occupancy of each structure for each cervical level at neutral, flexion, and extension were calculated. Results Whole canal anteroposterior (AP) diameters showed significant differences between neutral-extension and flexion-extension at the C4-C5 and C5-C6 levels (p < 0.05). The mean disk bulges showed significant differences between neutral-flexion and flexion-extension at the C4-C5, C5-C6, C6-C7, and C7-T1 levels (p < 0.01). The mean spinal canal AP diameter showed significant differences between flexion-extension and neutral-extension at the C3-C4, C4-C5, C5-C6, and C6-C7 levels (p < 0.05). There were significant differences between neutral-flexion at the C4-C5, C5-C6, and C6-C7 levels (p < 0.05). The mean thickness of the ligamentum flavum showed significant differences between flexion-extension at the C3-C4, C4-C5, C5-C6, and C6-C7 levels (p < 0.001). There were significant differences between neutral-extension at the C3-C4 and C5-C6 levels (p < 0.05). There were significant differences between neutral-flexion at the C5-C6 and C6-C7 levels (p < 0.05). The mean thickness of the spinal cord showed significant differences between neutral-flexion at the C2-C3 and C3-C4 levels (p < 0.05). There were significant differences between flexion-extension at the C3-C4 and C4-C5 levels (p < 0.01). The rest of the canal showed significant differences between neutral-extension and flexion-extension at the C3-C4, C4-C5, C5-C6, and C6-C7 levels (p

  6. Nitrogen dioxide reaction with proteins: Evidence for peptide bond cleavage at lysine residues

    SciTech Connect

    Hood, D.B.

    1991-01-01

    Nitrogen dioxide (NO{sub 2}), an air pollutant produced by burning fossil fuels and a component of cigarette smoke, is thought to contribute to the pathogenesis of pulmonary diseases, such as emphysema. To gain information on the mechanism by which NO{sub 2} damages the lung, in vitro exposures of {alpha}{sub 1}-proteinase inhibitor ({alpha}{sub 1}-PI), elastin, bovine serum albumin (BSA), human serum albumin (HSA) and synthetic poly-L-lysine were performed. A genetic deficiency of {alpha}{sup 1}-PI predisposes humans to emphysema and NO{sub 2} has been hypothesized to damage {alpha}{sub 1}-PI, which would leave proteases such as human neutrophil elastase, (HNE) free to attack lung structural proteins. The ability of {alpha}{sub 1}-PI to inhibit HNE declined with exposure to 50% of the control value at molar ratios of NO{sub 2}:{alpha}{sub 1}-PI of 400:1 and greater. Exposure of {alpha}{sub 1}-PI to NO{sub 2} resulted in a 50% lose of immunoreactivity with either monoclonal or polyclonal antibodies in an enzyme-linked immunosorbent assay at molar ratios of NO{sub 2}:{alpha}{sub 1}-PI of essentially 100:1 and greater. The mechanisms of these effects were investigated via ultraviolet-visible spectroscopy and amino acid analysis. The remaining target molecules were labeled by reductive methylation of amino groups with {sup 3}H-HCHO prior to treatment with NO{sub 2} in aqueous solutions at physiological pH. Time course exposure of 5 mg {sup 3}H-insoluble bovine ligamentum nuchae elastin suspensions with up to 120 {mu}moles of NO{sub 2} resulted in 90% solubilization of the label. Amino acid analysis of the soluble and insoluble fractions from these exposures confirmed that 80% of the {sup 3}H-dimethyllysine residues were in the soluble fraction.

  7. Post-traumatic avascular necrosis of the femoral head predicted by preoperative technetium-99m antimony-colloid scan: an experimental and clinical study. [Rabbits; patients

    SciTech Connect

    Turner, J.H.

    1983-07-01

    Technetium-99m antimony colloid was used to visualize the bone marrow of the head of the femur within twenty-four hours after interruption of the blood supply by subcapital osteotomy and section of the ligamentum teres in thirteen rabbits and within twenty-four hours after a subcapital fracture in thirty patients. Of the rabbits, all showed loss of marrow radioactivity over the affected femoral head. Bone-imaging with technetium-99m methylene diphosphonate, in contrast, failed to demonstrate any abnormality in the avascular head of the femur for as long as forty-eight hours after osteotomy. This difference between the marrow scan and the bone scan was attributed to earlier loss of function in the marrow cells than in the osteocytes. The thirty patients who had a preoperative scan within twenty-four hours after sustaining a subcapital fracture were treated by internal fixation with a Richards screw and plate and were followed for as long as two years, or until the patient died or radiographs showed evidence of avascular necrosis. The preoperative technetium-99m antimony-colloid activity in the head of the fractured femur was normal in sixteen patients and absent in fourteen; two of the fourteen had no activity in either hip, which precluded assessment of the fractured hip in these patients. In fifteen of the sixteen hips, preservation of the uptake in the marrow of the head of the fractured femur preoperatively predicted normal healing. Late segmental collapse developed in the remaining hip. In eleven of the twelve patients who had loss of marrow activity in the femoral head preoperatively, avascular necrosis developed within two years.

  8. Acute injury of the neck: anatomical and pathological basis of pain.

    PubMed

    Taylor, J R; Finch, P

    1993-03-01

    Headache, upper torso and upper limb pain can all originate in lesions of the cervical spine. The pain distribution is similar whether the cause is traumatic or degenerative. Nociceptive fibres are present in many cervical spine structures including the disc annulus, facet joint capsules, muscles, meninges, arteries, nerve roots and dorsal root ganglia. Such nerves are not present in the disc nucleus, facet articular cartilages and the ligamentum flavum. Central nervous connections between the trigeminal nucleus and upper cervical sensory input provide an explanation for some forms of headache and facial pain. This paper focuses on neck sprain from road traffic accidents as a cause of pain. Similar lesions are seen in the cervical spines of those who die immediately and survivors who die some years after a neck injury, from unrelated causes. Both discs and facet joints are injured. The common disc injury is a "rim lesion" or transverse tear near the anterior vertebral rim. It is caused by distraction and shearing in sudden extension. Both the posterior disc and the facets are compressed, causing disc contusion or herniation, facet haemarthroses, bruising around the C2 nerve, or fractures of articular processes. Suboccipital vascular congestion and annulus calcification are also seen in the "survivors". Chronic pain develops in 20-40% of the "survivors". The reasons include altered spinal mechanics, neural damage and vascular changes. Management must always start with an accurate diagnosis based on a history and physical examination. Simple investigations such as extension X-rays may reveal vacuum clefts in the same anatomical position as rim lesions. Nuclear scans detect increased uptake at damaged end plates or facet fractures.(ABSTRACT TRUNCATED AT 250 WORDS)

  9. Articular soft tissue anatomy of the archosaur hip joint: Structural homology and functional implications.

    PubMed

    Tsai, Henry P; Holliday, Casey M

    2015-06-01

    Archosaurs evolved a wide diversity of locomotor postures, body sizes, and hip joint morphologies. The two extant archosaurs clades (birds and crocodylians) possess highly divergent hip joint morphologies, and the homologies and functions of their articular soft tissues, such as ligaments, cartilage, and tendons, are poorly understood. Reconstructing joint anatomy and function of extinct vertebrates is critical to understanding their posture, locomotor behavior, ecology, and evolution. However, the lack of soft tissues in fossil taxa makes accurate inferences of joint function difficult. Here, we describe the soft tissue anatomies and their osteological correlates in the hip joint of archosaurs and their sauropsid outgroups, and infer structural homology across the extant taxa. A comparative sample of 35 species of birds, crocodylians, lepidosaurs, and turtles ranging from hatchling to skeletally mature adult were studied using dissection, imaging, and histology. Birds and crocodylians possess topologically and histologically consistent articular soft tissues in their hip joints. Epiphyseal cartilages, fibrocartilages, and ligaments leave consistent osteological correlates. The archosaur acetabulum possesses distinct labrum and antitrochanter structures on the supraacetabulum. The ligamentum capitis femoris consists of distinct pubic- and ischial attachments, and is homologous with the ventral capsular ligament of lepidosaurs. The proximal femur has a hyaline cartilage core attached to the metaphysis via a fibrocartilaginous sleeve. This study provides new insight into soft tissue structures and their osteological correlates (e.g., the antitrochanter, the fovea capitis, and the metaphyseal collar) in the archosaur hip joint. The topological arrangement of fibro- and hyaline cartilage may provide mechanical support for the chondroepiphysis. The osteological correlates identified here will inform systematic and functional analyses of archosaur hindlimb evolution and

  10. Epidural insertion simulator of higher insertion resistance & drop rate after puncture.

    PubMed

    Naemura, K; Sakai, A; Hayashi, T; Saito, H

    2008-01-01

    Accidents such as dural puncture remain one of the problems of epidural anesthesia, and unskilled doctors can repeat such accidents. The purpose of the current research was to provide a new simulator for epidural insertion training. No reference data regarding the resistance force used when inserting a needle into patients have been reported. A comparative study was conducted to aid in the development of a new simulator. Pork loin (n=5) were employed as a substitute for patients. Thickness was set at 2 cm so as to improve the reproducibility. The authors took the conventional simulator apart, and picked a block as an analogue of muscle and ligamentum flavum. A new simulator was made of a melamine foam resin block and a latex rubber sheet. An epidural needle fixed on a motorized stage was inserted at the speed of 2 mm per second. The reaction force was measured while the needle was inserted into each specimen. Waveform of the pork loin exhibited two slopes of different inclines up to peaks and then falls after puncture. The conventional simulator showed a simple increase up to peak and a slow fall after puncture. In contrast, the new simulator showed two slopes up to peak and then a sudden fall after puncture. The insertion resistances were 2.5 N/s for the porcine, 0.8 N/s for the conventional and 2.1 N/s for the new simulator. The drop rates were 5 N/s for the porcine, 0.6 N/s for the conventional and 24 N/s for the new simulator. The higher insertion resistance and drop rate for the new simulator than the conventional simulator will be suitable for epidural insertion training.

  11. Composite tissue flap at perforating branches of saphenous artery: a new design for repairing composite tissue defects in anterior knee

    PubMed Central

    Sun, Guangfeng; Nie, Kaiyu; Jin, Wenhu; Wei, Zairong; Qi, Jianping; Wang, Dali

    2015-01-01

    So far it has been difficult to repair and reconstruct the composite tissue defects in knee. Saphenous artery flap has been widely used to repair complex wounds, but the design and clinical application of composite tissue flap at perforating branches of saphenous artery were not reported. In this research, we design a new composite tissue flap by carrying fascial flap in the medial gastrocnemius muscle with perforators flap in saphenous artery to repair and reconstruct the composite tissue defects in knee. By anatomic observation and analysis, we find that there exists blood-supply in netty form among saphenous arteries, medial artery below the knee, intermuscular branch in high-order position of posterior tibial artery and perforating branch in medial artery of calf. We chose saphenous artery as blood-supplying artery; utilized the netty blood-supplying mode in middle-up and medial part of shank; cut the composite tissue flap at perforating branches of saphenous artery with fascial flap carried in the medial gastrocnemius muscle; reconstructed the ligamentum patellae using medial head of gastrocnemius muscle and Achilles’s tendon; and covered the wounds at front side of knee with flap. Composite tissues were survived completely, free from infection at wounds and exosmosis of joint fluid. Motion function of knee-joint proved satisfactory, and ambulatory function was recovered. There was no complication in donor site. Composite tissue flap at perforating branches of saphenous artery with fascial flap carried in the medial gastrocnemius muscle is one of the most ideal solutions for repairing the composite tissue defects at front side of knee joint. PMID:26885090

  12. Comparative transcriptional analysis of three human ligaments with distinct biomechanical properties

    PubMed Central

    Lorda-Diez, Carlos I; Canga-Villegas, Ana; Cerezal, Luis; Plaza, Santiago; Hurlé, Juan M; García-Porrero, Juan A; Montero, Juan A

    2013-01-01

    One major aim of regenerative medicine targeting the musculoskeletal system is to provide complementary and/or alternative therapeutic approaches to current surgical therapies, often involving the removal and prosthetic substitution of damaged tissues such as ligaments. For these approaches to be successful, detailed information regarding the cellular and molecular composition of different musculoskeletal tissues is required. Ligaments have often been considered homogeneous tissues with common biomechanical properties. However, advances in tissue engineering research have highlighted the functional relevance of the organisational and compositional differences between ligament types, especially in those with higher risks of injury. The aim of this study was to provide information concerning the relative expression levels of a subset of key genes (including extracellular matrix components, transcription factors and growth factors) that confer functional identity to ligaments. We compared the transcriptomes of three representative human ligaments subjected to different biomechanical demands: the anterior cruciate ligament (ACL); the ligamentum teres of the hip (LT); and the iliofemoral ligament (IL). We revealed significant differences in the expression of type I collagen, elastin, fibromodulin, biglycan, transforming growth factor β1, transforming growth interacting factor 1, hypoxia-inducible factor 1-alpha and transforming growth factor β-induced gene between the IL and the other two ligaments. Thus, considerable molecular heterogeneity can exist between anatomically distinct ligaments with differing biomechanical demands. However, the LT and ACL were found to show remarkable molecular homology, suggesting common functional properties. This finding provides experimental support for the proposed role of the LT as a hip joint stabiliser in humans. PMID:24128114

  13. Microinstability of the Hip and the Splits Radiograph.

    PubMed

    Harris, Joshua D; Gerrie, Brayden J; Lintner, David M; Varner, Kevin E; McCulloch, Patrick C

    2016-01-01

    A normal hip has a natural tendency toward stability because of both osseous and soft tissue structures. Hip motion is primarily rotational around a center of rotation. When the femoral head and its center of rotation translate, with or without rotation, the inherent stability of the femoroacetabular articulation may be lost. The spectrum of hip instability ranges from subtle microinstability to traumatic dislocation. Microinstability may be the cause or the effect of several other hip pathologies. Soft tissue contributions to stability include the static capsule, dynamic musculotendinous units, and underlying generalized connective tissue (eg, Ehlers-Danlos). Osseous contributions include multiple femoral and acetabular radiographic coverage parameters. Iatrogenic contributions include an unrepaired capsulotomy, overresection of the acetabular rim (iatrogenic dysplasia), overresection of cam osteochondroplasty, iliopsoas tenotomy, labral debridement, and ligamentum teres debridement. Patients with hip microinstability often have deep groin pain, exhibited by a C sign. These patients frequently participate in flexibility sports and activities, such as ballet, gymnastics, figure skating, and martial arts. On physical examination, generalized hypermobility syndromes should be assessed, as should loss of log-roll external rotation recoil, excessive abduction, trochanteric-pelvic impingement, and abductor fatigue. Standard imaging, including plain radiographs, magnetic resonance imaging, and computed tomography, should be analyzed for all causes of hip pain. A new plain radiograph, the splits radiograph is introduced here, consistently showing lateral femoral head translation and creation of a vacuum sign, showing hip microinstability. The splits radiograph is illustrated in a 22-year-old female dancer who presented with bilateral deep anterolateral groin pain. PMID:26730687

  14. Quantifying the Nonlinear, Anisotropic Material Response of Spinal Ligaments

    NASA Astrophysics Data System (ADS)

    Robertson, Daniel J.

    Spinal ligaments may be a significant source of chronic back pain, yet they are often disregarded by the clinical community due to a lack of information with regards to their material response, and innervation characteristics. The purpose of this dissertation was to characterize the material response of spinal ligaments and to review their innervation characteristics. Review of relevant literature revealed that all of the major spinal ligaments are innervated. They cause painful sensations when irritated and provide reflexive control of the deep spinal musculature. As such, including the neurologic implications of iatrogenic ligament damage in the evaluation of surgical procedures aimed at relieving back pain will likely result in more effective long-term solutions. The material response of spinal ligaments has not previously been fully quantified due to limitations associated with standard soft tissue testing techniques. The present work presents and validates a novel testing methodology capable of overcoming these limitations. In particular, the anisotropic, inhomogeneous material constitutive properties of the human supraspinous ligament are quantified and methods for determining the response of the other spinal ligaments are presented. In addition, a method for determining the anisotropic, inhomogeneous pre-strain distribution of the spinal ligaments is presented. The multi-axial pre-strain distributions of the human anterior longitudinal ligament, ligamentum flavum and supraspinous ligament were determined using this methodology. Results from this work clearly demonstrate that spinal ligaments are not uniaxial structures, and that finite element models which account for pre-strain and incorporate ligament's complex material properties may provide increased fidelity to the in vivo condition.

  15. A security evaluation of the Rigid-fix crosses pin system used for anterior cruciate ligament reconstruction in tibial fixation site

    PubMed Central

    Fan, Huaqiang; Wang, Jian; Fu, Yangpan; Dong, Huixiang; Wang, Jianxiong; Tang, Cong; Huang, Changming; Shi, Zhanjun

    2014-01-01

    Our study aims to evaluate the safeness and feasibility that Rigid-fix cross pin system was used for hamstring graft anterior cruciate ligament (ACL) reconstruction in the tibial fixation site. In this study, eleven adult conservative cadaver knees were performed using the Rigid-fix Cross Pin device in the tibial fixation site for modeling the ACL reconstruction. The guide rod top was put through the tibial tunnel at the three horizontal positions: equal pace to articular facet (group A), the plane 5 mm below articular facet (group B), and the plane 10 mm below articular facet (group C). We gave four rotation positions to the cross-pin guide: 0°, 30°, 45°, 60° slope, referring to the parallel line of the posterior border of tibial plateau. We recorded the iatrogenic damages incidence, in the four different slope angle in the three groups, and then compare the incidence using Chi-Square test. Our results suggested that the incidence of chondral injury of tibial plateau in group B and group C was significantly lower compared to group A (χ 2 A-B = 27.077, χ 2 A-C 45.517, P = 0.000); However, there was no significant difference for the incidence penetrating the medial condyle of tibial plateau among the three groups (χ 2 = 5.733, P = 0.057); The highest incidence of injuring ligamentum transversum is in group A with 72.7%, especially at the 60° slope angle. In summary, our study suggested that in order to achieve the satisfactory clinical effect for the Rigid-fix system used in the tibia end fixation of ACL reconstruction surgery, the guide rod top should be put at the 5 mm below articular facet with a slope that parallel to the tibial medial plane at 30°-60° slope angle. PMID:25550991

  16. MRI features of spinal Fluorosis: Results of an endemic community screening

    PubMed Central

    Ahmed, Iftekhar; Sohail, Saba; Hussain, Munawwar; Khan, Nazeer; Hameed Khan, Masood

    2013-01-01

    Objectives: Fluorosis is endemic in many parts of the world. However community studies on MRI features of fluorosis are lacking. The aim of this study was to determine MRI features of spinal changes in a community with endemic fluorosis in the Thar Desert Pakistan. Methodology: Randomly selected adults from the Village Samorindh, district Tharparker, Sindh, Pakistan, with spinal fluorosis diagnosed on plain x-rays and raised serum fluoride levels were studied from June 2008 to January 2009. MRI was carried out on 0.5 T open magnet MRI system. Features of vertebral body, spinal ligaments, intervertebral disc, facet joints, iliac wings and other incidental findings were noted. Sclerosis was defined as low signal intensity on both T1 and T2 weighted images. Results were described as mean and percentage values. Results: All the studied 27 subjects complained of back ache without neurological signs. The average age was 43.33 ± 10.45 years; 21 being male (77.8%). The most frequent findings included generalized vertebral sclerosis (24, 88.8%), ligamentum flavum hypertrophy (23, 85%), anterior (20, 74%) and lateral (17, 62.9%) disc herniation, thickened longitudinal ligaments, and narrowing of spinal foramina. Hemangioma was seen in 04(14.8%). The most commonly involved level was L1-2, L4-5 and lower dorsal spine. Conclusion: Vertebral sclerosis, a combination of premature degeneration with anterior disc herniation and an unusually high frequency of vertebral hemangioma formed the spectrum of MRI findings in subjects with spinal fluorosis having back ache but no neurological findings. PMID:24353535

  17. Complex Primary Total Knee Replacement (TKR) Using Prophylactic Gastrocnemius Flap and Rotating-Hinge Knee in Post-traumatic, Infective Arthritis of the Knee – A Case Report

    PubMed Central

    Patnaik, Sanjeev; Nayak, Biswaranjan; Mishra, Laxmikanta; Sahoo, Akshaya Kumar

    2015-01-01

    Introduction: Prophylactic gastrocnemius flap with primary rotating hinge knee is technically demanding in a case of neglected post-traumatic, infective arthritis of the knee, with challenges of compromised skin and soft tissues, articular bone defect, limb mal-alignment, gross instability, retained hardware and a contracted extensor mechanism with the patella fixed in the lateral gutter all in combination, is rarely reported. We report such a complex case in this study. Case Report: We report a 48 year male patient with a history of fracture lateral femoral condyle of right knee due to road traffic accident 10 years back, for which he got operated with open reduction and internal fixation with cancellous screws, which subsequently got infected. Primary procedure undertaken was removal of implants, debridement, placement of antibiotic-cement spacer followed by prophylactic medial gastrocnemius flap and a temporary joint spanning external fixator. Definitive procedure undertaken, after clearance of infection in 12 weeks was conversion to a rotating hinge TKR using a lateral para-patellar arthrotomy & tibial tubercle osteotomy to address the challenges of fixed patella in the lateral gutter and contracted ligamentum patellae. At one year follow up, the knee was painless, stable, with satisfactory range of motion and improved function without any infection or aseptic lysis. Conclusion: Prophylactic Gastrocnemius flap cover along with rotating hinge knee arthroplasty using a lateral para-patellar approach and tibial tubercle osteotomy in a case of neglected post-traumatic, infective arthritis of knee with the complexities of limb mal-alignment, compromised skin and soft tissue, articular bone loss and ligamentous instability is a satisfactory bail out option in such a highly complex joint scenario. PMID:27299096

  18. 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

  19. 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

  20. Is alveolar cleft reconstruction still controversial? (Review of literature).

    PubMed

    Seifeldin, Sameh A

    2016-01-01

    Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material. PMID:26792963

  1. 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.

  2. Pythiosis in the Nasal Cavity of Horses.

    PubMed

    Souto, E P F; Maia, L A; Olinda, R G; Galiza, G J N; Kommers, G D; Miranda-Neto, E G; Dantas, A F M; Riet-Correa, F

    2016-01-01

    Two cases of nasal pythiosis are reported in horses from the semi-arid region of northeastern Brazil. From January 1986 to December 2015, the Laboratory of Animal Pathology, Federal University of Campina Grande received 830 equine samples, 156 (18.79%) of which were diagnosed with pythiosis. Of these, two horses (1.28%), a male and a female adult cross-breed, had lesions in the nasal cavity. Both horses had access to water reservoirs. Clinically, they had swelling in the rhinofacial region and a serosanguineous nasal discharge. Macroscopically, in case 1, the lesion affected the nasal vestibule, extending to the alar cartilage and nasal septum. In case 2, the lesion extended through the turbinates and the meatuses of the nasal cavity, as well as the ethmoid region. In both cases, the lesions were characterized by having a yellow-grey granular surface with cavitations of different sizes containing coral-like masses of necrotic tissue (kunkers). Histologically, multifocal necrotizing eosinophilic rhinitis associated with hyphae (2-8 μm) similar to Pythium insidiosum were observed. In case 2, the lesions extended to the muscle, cartilage and bone adjacent to the nasal cavity and lungs. The diagnosis was confirmed by immunohistochemistry. It is concluded that nasal pythiosis occurs sporadically in horses in the semi-arid region of northeastern Brazil where cutaneous pythiosis is prevalent. PMID:27406311

  3. 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. PMID:23547534

  4. 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

  5. Mistranslation and its control by tRNA synthetases

    PubMed Central

    Schimmel, Paul

    2011-01-01

    Aminoacyl tRNA synthetases are ancient proteins that interpret the genetic material in all life forms. They are thought to have appeared during the transition from the RNA world to the theatre of proteins. During translation, they establish the rules of the genetic code, whereby each amino acid is attached to a tRNA that is cognate to the amino acid. Mistranslation occurs when an amino acid is attached to the wrong tRNA and subsequently is misplaced in a nascent protein. Mistranslation can be toxic to bacteria and mammalian cells, and can lead to heritable mutations. The great challenge for nature appears to be serine-for-alanine mistranslation, where even small amounts of this mistranslation cause severe neuropathologies in the mouse. To minimize serine-for-alanine mistranslation, powerful selective pressures developed to prevent mistranslation through a special editing activity imbedded within alanyl-tRNA synthetases (AlaRSs). However, serine-for-alanine mistranslation is so challenging that a separate, genome-encoded fragment of the editing domain of AlaRS is distributed throughout the Tree of Life to redundantly prevent serine-to-alanine mistranslation. Detailed X-ray structural and functional analysis shed light on why serine-for-alanine mistranslation is a universal problem, and on the selective pressures that engendered the appearance of AlaXps at the base of the Tree of Life. PMID:21930589

  6. Molecular Marker Differences Relate to Developmental Position and Subsets of Mesodiencephalic Dopaminergic Neurons

    PubMed Central

    Smits, Simone M.; von Oerthel, Lars; Hoekstra, Elisa J.; Burbach, J. Peter H; Smidt, Marten P.

    2013-01-01

    The development of mesodiencephalic dopaminergic (mdDA) neurons located in the substantia nigra compacta (SNc) and ventral tegmental area (VTA) follow a number of stages marked by distinct events. After preparation of the region by signals that provide induction and patterning, several transcription factors have been identified, which are involved in specifying the neuronal fate of these cells. The specific vulnerability of SNc neurons is thought to root in these specific developmental programs. The present study examines the positions of young postmitotic mdDA neurons to relate developmental position to mdDA subset specific markers. MdDA neurons were mapped relative to the neuromeric domains (prosomeres 1-3 (P1-3), midbrain, and hindbrain) as well as the longitudinal subdivisions (floor plate, basal plate, alar plate), as proposed by the prosomeric model. We found that postmitotic mdDA neurons are located mainly in the floorplate domain and very few in slightly more lateral domains. Moreover, mdDA neurons are present along a large proportion of the anterior/posterior axis extending from the midbrain to P3 in the diencephalon. The specific positions relate to some extent to the presence of specific subset markers as Ahd2. In the adult stage more of such subsets specific expressed genes are present and may represent a molecular map defining molecularly distinct groups of mdDA neurons. PMID:24116087

  7. Three-dimensional facial analysis of Chinese children with repaired unilateral cleft lip and palate.

    PubMed

    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

  8. 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

  9. 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. PMID:27364425

  10. Facial emphysema after sinus lift.

    PubMed

    Sakakibara, Akiko; Suzuki, Hiroaki; Yamashita, Atsuya; Hasegawa, Takumi; Minamikawa, Tsutomu; Furudoi, Shungo; Komori, Takahide

    2015-01-01

    An 80-year-old man with a history of en bloc resection of squamous cell carcinoma of the hard palate (T4aN0M0) was performed a lateral-window sinus lift of the edentulous area of the left maxillary molar region to facilitate future placement of dental implants.Two hours after the surgery, the patient complained of sudden malar swelling. Marked swelling was present from the left infraorbital region to the buccal region. The swelling was associated with air pockets at the alar base and in the angulus oculi medialis region and subcutaneous malar tissue. Emphysema appeared after the patient blew his nose. Therefore, the mucous membrane of the maxillary sinus might have had a small hole, and air might have entered the subcutaneous tissue via the bone window when the air pressure in the maxillary sinus increased with nose blowing. It is important to advise patients to avoid increasing the intraoral pressure after sinus-lift procedure. PMID:26088054

  11. 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.

  12. Infection in the Nasal Tip Caused by Acellular Dermal Matrix.

    PubMed

    Lee, Kun Hee

    2015-12-01

    A 19-year-old female patient visited our clinic for rhinoplasty. She complained about her low take-off point, which was apparent in profile view, and wanted slight tip projection. She refused additional cartilage harvesting from ears or ribs but consented to the use of homologous tissue, including acellular dermal matrix, for her dorsum and tip. Septoturbinoplasty was performed, and only a very small amount of septal cartilage could be harvested. It was used as both the columellar strut and the alar rim graft. Nasal dorsum and tip were augmented with acellular dermal matrix. Three months postoperatively, she experienced a few episodes of edema and redness on her nasal tip, followed by pus exudation from the nasal skin. Six months postoperatively, she underwent revision rhinoplasty for removal of inflamed grafts, and onlay tip graft with homologous rib cartilage was performed. Nasal dorsum or tip grafts are an integral part of Asian rhinoplasty. Autogenous tissue is the gold standard for grafting materials. However, the limited availability of autogenous tissue and the preference of patients and surgeons for artificial surgical implants make Asian rhinoplasty challenging. Unavailability of autogenous cartilage and patient refusal of artificial implants led to the use of acellular dermal matrix (ADM) in the nasal dorsum and tip for this case. This is the first report of postoperative complication because of infection rather than absorption after ADM use.

  13. The surgical repair of half-nose.

    PubMed

    da Silva Freitas, Renato; Alonso, Nivaldo; de Freitas Azzolini, Thais; Busato, Luciano; Dall'Oglio Tolazzi, André Ricardo; Azor de Oliveira E Cruz, Gilvani; Goldenberg, Dov

    2010-01-01

    Absence of half-nose is an extremely rare congenital malformation, which has a devastating impact on the patient and the family. A review of indexed English-language literature found 91 cases of half-nose, including 50 patients with proboscis lateralis. Pathogenesis is not clear, and the reported cases have sporadically occurred. Many aspects must be considered when reconstructing a congenital half-nose, such as timing of surgery, type of tissue to be used and the need to reconstruct nasal airway. The aim of this article is to present personal experience in seven cases of half-nose reconstruction, in order to review the literature regarding to this rare entity, highlighting aspects of incidence, pathogenesis and surgical treatment. Nasal reconstruction was performed at ages of 5-7 years to minimise psychological trauma. Forehead skin demonstrated to be an excellent donor site to re-surface the nose. For the inner lining, contralateral cutaneous nasal flap was our preference. Concerning the nasal framework reconstruction, alar contour was restored using a cartilage graft from the lower portion of ear tragus and concha. PMID:19046661

  14. Nasal reconstruction in heminasal deficiency (proboscis lateralis): two case reports, with airway reconstruction in one case.

    PubMed

    Fischer, Helmut; Eppstein, Ron Julius; von Gregory, Henning Freiherr; Gubisch, Wolfgang

    2014-06-01

    Proboscis lateralis is a very rare congenital malformation with heminasal hypoplasia or aplasia. The affected side is represented by a trunk (proboscis) which can be positioned from the upper eyelid down to the alar base. We present two cases of proboscis lateralis, one in which we reconstructed an airway. The first case is a 16-year-old male patient who presented with heminasal aplasia. Immediately after birth, a proboscis lateralis was resected from the right upper eyelid as primary treatment elsewhere. We reconstructed the nose using costal cartilage as framework. A paramedian forehead flap was transposed to give the patient a nose with adult dimensions. We made no attempt to reconstruct an airway in this case as unilateral nasal breathing appeared adequate. The second case is a 14-year-old male patient who presented with heminasal aplasia on his right side, where a nodule-like appendix was existent with a fistula underneath. A computed tomographic scan revealed an existing hypoplastic posterior nasal airway and a complete ventilated sinus system. The fact that there was an existing posterior airway encouraged us to construct an anterior airway to create an airflow passage. Costal cartilage was taken for framework reconstruction and nasal skin was completely replaced by a paramedian forehead flap. The reconstructed airflow passage was stable. PMID:24918715

  15. 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.

  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. 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.

  18. Molecular characterization of prosomeric and intraprosomeric subdivisions of the embryonic zebrafish diencephalon.

    PubMed

    Lauter, Gilbert; Söll, Iris; Hauptmann, Giselbert

    2013-04-01

    During development of the early neural tube, positional information provided by signaling gradients is translated into a grid of transverse and longitudinal transcription factor expression domains. Transcription factor specification codes defining distinct histogenetic domains within this grid are evolutionarily conserved across vertebrates and may reflect an underlying common vertebrate bauplan. When compared to the rich body of comparative gene expression studies of tetrapods, there is considerably less comparative data available for teleost fish. We used sensitive multicolor fluorescent in situ hybridization to generate a detailed map of regulatory gene expression domains in the embryonic zebrafish diencephalon. The high resolution of this technique allowed us to resolve abutting and overlapping gene expression of different transcripts. We found that the relative topography of gene expression patterns in zebrafish was highly similar to those of orthologous genes in tetrapods and consistent with a three-prosomere organization of the alar and basal diencephalon. Our analysis further demonstrated a conservation of intraprosomeric subdivisions within prosomeres 1, 2, and 3 (p1, p2, and p3). A tripartition of zebrafish p1 was identified reminiscent of precommissural (PcP), juxtacommissural (JcP), and commissural (CoP) pretectal domains of tetrapods. The constructed detailed diencephalic transcription factor gene expression map further identified molecularly distinct thalamic and prethalamic rostral and caudal domains and a prethalamic eminence histogenetic domain in zebrafish. Our comparative gene expression analysis conformed with the idea of a common bauplan for the diencephalon of anamniote and amniote vertebrates from fish to mammals.

  19. Triple Plane Dissection in Open Primary Rhinoplasty in Middle Eastern Noses

    PubMed Central

    Elshahat, Ahmed

    2013-01-01

    Objective: Rhinoplasty started as a closed technique and then the open technique gained popularity. Open technique gave surgeons the opportunity to visualize and manipulate the cartilaginous skeleton at the tip of the nose precisely. The dissection planes in open rhinoplasty technique may be subcutaneous, submuscular (under the superficial musculoaponeurotic system), or subpericondrial subperiosteal. Each plane has advantages and disadvantages. The aim of this study was to combine planes to get the maximal benefit of each plane. Method: The study was performed on 38 Middle Eastern patients, among whom 23 were females and 15 were males. All patients presented for primary rhinoplasty. They were divided into 5 groups on the basis of their skin thickness. Dissection started subcutaneous at the area of the lower lateral cartilages and then shifted subsuperficial musculoaponeurotic system over the upper lateral cartilages and ended subperiosteal over the bony skeleton. Results: This triple plane of dissection gave acceptable results without any complication. Subcutaneous dissection allowed thinning of the thick sebaceous skin at the tip and alar region, subsuperficial musculoaponeurotic system dissection allowed direct exposure of the upper lateral cartilage without thinning skin at an area where it is thin, and subperiosteal dissection helped masking any bony irregularities resulted from osteotomies. Conclusion: The triple plane dissection in open primary rhinoplasty in Middle Eastern patients maximized the advantages of each plane and minimized the disadvantages and resulted in safe cosmetic results. PMID:23967367

  20. 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.

  1. Projection of the retinal ganglion cells to the tectum differentiated from the prosencephalon.

    PubMed

    Nakamura, H; Matsui, K A; Takagi, S; Fujisawa, H

    1991-08-01

    The alar plate of the prosencephalon differentiates into a tectum-like structure when transplanted into the mesencephalon around the 10-somite stage. Here, we report on the projection pattern of the retinal ganglion cells to the transplants. Optic nerve fibers were labeled with horseradish peroxidase (HRP) and 3H-proline, and the innervation of the optic nerve fibers to the chimeric tectum was analyzed by HRP histochemistry on whole-mounted specimens, by autoradiography and by electron microscopy on embryonic day 16. In the chimeric tectum, the transplant was distinguished from the host by difference in nuclear structure between the quail and the chick cells. It was shown that the transplant had the laminar pattern of the optic tectum when the transplant was integrated into the host mesencephalon. The whole-mount HRP histochemistry showed that the optic nerve fibers extend to the transplants. Autoradiography showed that the distribution pattern of silver grains was similar in both the host and the transplant. These results may indicate that the optic nerve fibers turn to the transplant and terminate on the transplant. Electron microscopy further confirmed that optic nerve fibers ended by making synaptic contacts with the dendrites in the transplant region of the tectum. These results indicate that the transplant with the laminar pattern of the optic tectum is a true tectum receiving input from the eye. PMID:1661870

  2. 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.

  3. Infection in the Nasal Tip Caused by Acellular Dermal Matrix.

    PubMed

    Lee, Kun Hee

    2015-12-01

    A 19-year-old female patient visited our clinic for rhinoplasty. She complained about her low take-off point, which was apparent in profile view, and wanted slight tip projection. She refused additional cartilage harvesting from ears or ribs but consented to the use of homologous tissue, including acellular dermal matrix, for her dorsum and tip. Septoturbinoplasty was performed, and only a very small amount of septal cartilage could be harvested. It was used as both the columellar strut and the alar rim graft. Nasal dorsum and tip were augmented with acellular dermal matrix. Three months postoperatively, she experienced a few episodes of edema and redness on her nasal tip, followed by pus exudation from the nasal skin. Six months postoperatively, she underwent revision rhinoplasty for removal of inflamed grafts, and onlay tip graft with homologous rib cartilage was performed. Nasal dorsum or tip grafts are an integral part of Asian rhinoplasty. Autogenous tissue is the gold standard for grafting materials. However, the limited availability of autogenous tissue and the preference of patients and surgeons for artificial surgical implants make Asian rhinoplasty challenging. Unavailability of autogenous cartilage and patient refusal of artificial implants led to the use of acellular dermal matrix (ADM) in the nasal dorsum and tip for this case. This is the first report of postoperative complication because of infection rather than absorption after ADM use. PMID:26894006

  4. Three-dimensional nasal morphology in cleft lip and palate operated adult patients.

    PubMed

    Ferrario, Virgilio F; Sforza, Chiarella; Dellavia, Claudia; Vizzotto, Laura; Carù, Armando

    2003-10-01

    Nasal morphology was assessed three-dimensionally in 18 cleft lip and palate operated patients aged 19 to 27 years, and in 161 sex- and age-matched control subjects. Comparisons were performed by Student t and Watson-Williams' tests. No differences were found in nasal volume or surface. Nasal width, alar base width, and inferior width of the nostrils were significantly larger in male patients than in the reference men. The nasal bridge was shorter. Similar differences were found in the female patients. In addition, the right nostril was larger and the nasal height shorter. In men, the nasolabial and the nasal tip angles were smaller in the patients than in the reference subjects, whereas the facial convexity angle was larger in the patients. In conclusion, the nose of adult operated cleft lip and palate patients differed from that of normal control subjects. Surgical corrections of the cleft lip and palate failed to provide a completely normal appearance. The methods might be used to indicate where additional procedures might be performed to approximate a reference population.

  5. Investigation of DNA synthesis in experimentally induced Long-Evans rat myeloschisis by the BrdU/antiBrdU technique.

    PubMed

    Chono, Y; Abe, H; Iwasaki, Y; Nagashima, K

    1994-04-01

    The volume and DNA synthesis of the neuroepithelium in induced myeloschisis in Long-Evans rats as shown by hematoxylin-eosin and BrdU/antiBrdU immunohistochemical staining patterns were examined at different stages of embryonal development. On day 14 of gestation, control animals contained BrdU-incorporating cells mainly at the alar plate of the closed neural tube. On the same day, the everted neural plate of rats with myeloschisis showed active, diffuse uptake of BrdU in the cells of the matrix layer, although an increase in the volume of the everted neural plate was not yet identifiable. On day 21 of gestation, rats with myeloschisis showed a marked increase in the volume of the neuroepithelium compared with controls. Our investigations suggest that, in myeloschisis, more neuroepithelial cells than normal retain their capability for DNA synthesis on day 14 of gestation, and the overgrowth of the neuroepithelium found on day 21 is possibly a secondary effect of failure of neural tube closure.

  6. Outcomes following V-Y advancement flap reconstruction of large upper lip defects

    PubMed Central

    Griffin, Garrett R.; Weber, Stephen; Baker, Shan R.

    2016-01-01

    Objective To characterize revision surgery following V-Y subcutaneous tissue pedicle advancement flap repair of large upper lip skin defects. Methods Retrospective review of upper lip skin defects ≥3.0 cm2 that were reconstructed with a V-Y subcutaneous tissue pedicle advancement flap at an academic tertiary care center. Depth and area of the defect, as well as involvement of the vermilion and nasal ala, were recorded as independent variables. Revision techniques were analyzed to identify patterns. Results Thirty patients were identified with upper lip skin defects ranging from 3.0 to 14.0 cm2 (mean 7.0 cm2, median 6.25 cm2). The defect involved the nasal ala in four cases and the vermilion in three cases. At least one revision surgery was performed in 14/30 (47%) patients. Alar or vermilion involvement was a significant factor in revision by chi-square analysis (p=0.026). Larger defect size did not predict a need for revision, even among cases where the defect did not involve the ala or vermilion (p=0.68). Conclusion Reconstruction of large upper lip skin defects with a V-Y subcutaneous tissue pedicle advancement flap is associated with a 47% revision rate, and when the defect involves the ala or vermilion, the revision rate is increased. Defect size alone cannot be used to predict the need for revision surgery. Revision techniques are demonstrated. PMID:22801764

  7. Evaluation of nasal tip surgery.

    PubMed

    Friedman, W H; Biller, H F

    1975-09-01

    Nasal tip surgery has been evaluated with respect to correction of the lower lateral cartilages. Indications, techniques, results, and complications related to three generic approaches to the lower lateral cartilages are described. In 673 consecutive rhinoplasties the commonest type of nasal tip surgery was excisional, utilizing either a marginal or cartilage splitting technique. These techniques were utilized: 1. to accomplish debulking, and 2. to accomplish the installation of facets. The excisional technique found its greatest utility in primary rhinoplasties. The version technique, utilizing a change of direction of the thrust of the lower lateral cartilages was utilized in a variety of situations, particularly for the correction of moderately congenitally hypoplastic tip cartilages. It also found great utility in surgery of the Negro or cleft palate nose, increasing tip projection, correcting unacceptable bifidity, and in revision rhinoplasty. Augmentation rhinoplasty, utilizing conchal cartilage as an elastic strut was particularly useful for severe hypoplastic cartilage deficits, the Negro nose, columellar retraction, and alar rim deficits. The overall complication rate of lower lateral rhinoplasty was 17.4 percent. The rate of unacceptable complications related to lower lateral rhinoplasty was 2.7 percent.

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

    PubMed

    Saigusa, Toyohei

    2015-01-01

    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.

  9. Secondary rhinoplasty of the Asian nose: correction of the contracted nose.

    PubMed

    Jung, Dong-Hak; Moon, Hyoung-Jin; Choi, Seung-Ho; Lam, Samuel M

    2004-01-01

    The contracted nose is a unique entity that follows primary rhinoplasty in the Asian patient. The proposed reasons for this complication are capsular contraction from a silicone nasal implant, pressure necrosis of the lower lateral cartilage resulting from the nasal implant, and infection after alloplastic implantation. The two principal anatomic constituents that must be addressed at the time of secondary rhinoplasty are the lower lateral cartilages and the skin envelope. The lower lateral cartilages should be derotated, projected, and transfixed with an extended spreader graft. Additional onlay grafting may be required to provide greater nasal tip derotation and projection. A transcolumellar incision situated at the columellar-labial angle permits undermining of the upper lip skin to release tension on the incision. If the nasal tip retraction is severe, then the skin envelope may be insufficient to provide coverage to the new cartilaginous framework. In this case, a paramedian forehead flap is recommended to provide adequate tissue coverage. Correction of alar-columellar disparity should be undertaken with composite grafting only after 6 months have transpired to gauge the ultimate relation between the alae and columella. Infection that arises after correction of the contracted nose can be devastating. It should be treated aggressively, but tailored to the severity of the infection. Wound tension along the columella may predispose to skin necrosis and consequent cartilage exposure, which should be managed in turn with prostaglandin emollients to accelerate wound healing and to prevent infection. PMID:15037957

  10. 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

  11. 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

  12. Is alveolar cleft reconstruction still controversial? (Review of literature)

    PubMed Central

    Seifeldin, Sameh A.

    2015-01-01

    Cleft lip and palate (CL/P) is a frequent congenital malformation that manifests in several varieties including unilateral or bilateral and complete or incomplete. Alveolar cleft reconstruction remains controversial with regard to timing, graft materials, surgical techniques, and methods of evaluation. Many studies have been conducted addressing these points to develop an acceptable universal protocol for managing CL/P. The primary goal of alveolar cleft reconstruction in CL/P patients is to provide a bony bridge at the cleft site that allows maxillary arch continuity, oronasal fistula repair, eruption of the permanent dentition into the newly formed bone, enhances nasal symmetry through providing alar base support, orthodontic movement and placement of osseointegrated implants when indicated. Other goals include improving speech, improvement of periodontal conditions, establishing better oral hygiene, and limiting growth disturbances. In order to rehabilitate oral function in CL/P patients alveolar bone grafting is necessary. Secondary bone grafting is the most widely accepted method for treating alveolar clefts. Autogenous bone graft is the primary source for reconstructing alveolar cleft defects and is currently the preferred grafting material. PMID:26792963

  13. 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.

  14. 'Un chant d'appel amoureux': acoustic communication in moths

    PubMed

    Conner

    1999-07-01

    Tympanal sound receptors in moths evolved in response to selective pressures provided by echolocating insectivorous bats. The presence of these ultrasound detectors also set the stage for the later evolution of ultrasonic courtship signals in the tympanate moth families. Male moths have repeatedly exploited the bat-detection mechanisms in females for the purpose of finding, identifying and obtaining mates. Ultrasonic courtship has been described in several members of the moth families Arctiidae, Noctuidae and Pyralidae, and ultrasound is predicted to play a significant role in the courtship of other tympanate moths including the Sphingidae, Lymantriidae, Notodontidae and Geometridae. Ultrasonic signals are involved in species recognition, in male-male competition for mates and in female mate-choice systems. Pre-existing motor systems, including those involved in bat defence, have also been exploited for the purpose of generating high-frequency courtship signals. Sound production mechanisms in moths include thoracic tymbals, tegular tymbals, alar castanets and genital stridulatory organs. Thus, in both their sensory and motor aspects, the weapons of bat/moth warfare have frequently evolved into components of courtship systems. PMID:10359675

  15. Arthroscopic Treatment of FAI in Adolescent Athletes

    PubMed Central

    Byrd, J. W. Thomas; Jones, Kay S.

    2015-01-01

    Objectives: Athletic activities are implicated in the development of symptomatic FAI in adolescents as reflected by a high prevalence of sports participation among young individuals who present with this problem. The purpose of this study is to report the outcomes of arthroscopic treatment. Methods: All patients undergoing arthroscopy are prospectively assessed with a modified Harris hip score. 104 athletes (117 hips) were identified among 108 consecutive adolescents (122 hips) less than 18 years of age who had undergone arthroscopic surgery for FAI and had achieved minimum one-year follow-up. This cohort of athletes represents the substance of this report. Results: Follow-up averaged 28 months (range 12-60 months). Average age was 16 years (range 12-17 years). There were 47 males and 57 females. The average improvement was 22 points (preop 73; postop 95) with 113 hips (97 %) improved with 112 (96%) good & excellent results. Eighty-eight athletes (84%) returned to their sport. Among the 16 that did not return to sports, 5 were unable, 6 chose not, and 5 had completed their high school athletic careers. Most common sports were football 15, soccer 13, basketball 13, dance 11, volleyball 7, cross-country 7, swim 7, gymnastics 5, baseball 4, softball 4, and lacrosse 4. FAI correction was performed for 33 cam, 17 pincer, and 67 combined lesions. 107 labral tears underwent 82 refixations and 24 debridements. There were 99 acetabular chondral lesions (42 Grade I, 18 Grade II, 34 Grade III, 5 Grade IV) with four microfractures. There were 3 femoral chondral lesions (1 Grade II, 2 Grade III). Seven loose bodies were removed and 19 lesions of the ligamentum teres were debrided. Concomitant extra-articular procedures included 13 iliopsoas tendon releases, two iliotibial band tendoplasties, and one trochanteric bursectomy. There were two complications, transient pudendal neurapraxias, that resolved within two weeks. Four patients underwent repeat arthroscopy and one a PAO

  16. [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.

  17. 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

  18. 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

  19. PMP-22 expression in the central nervous system of the embryonic mouse defines potential transverse segments and longitudinal columns.

    PubMed

    Parmantier, E; Braun, C; Thomas, J L; Peyron, F; Martinez, S; Zalc, B

    1997-02-10

    PMP-22, a major constituent of peripheral nervous system (PNS) myelin, is also present in the central nervous system (CNS), in motoneurons of the cranial nerve motor nuclei and spinal cord (Parmantier et al. [1995] Eur. J. Neurosci. 7:1080-1088). The expression of PMP-22 in the CNS during embryonic and early postnatal development was investigated and showed a biphasic spatio-temporal pattern. The expression of PMP-22 started at embryonic day (E)11.5, in restricted longitudinal and transverse domains, in the ventricular zone of the spinal cord, rhombencephalon, mesencephalon and prosencephalon. In the mid- and forebrain, the PMP-22 signal was detectable in a longitudinal domain that followed ventrally the basal/alar boundary but could no longer be detected dorsally at some distance from the roof plate. Along the caudo-rostral axis, the territory in which PMP-22 was detected spanned the mesencephalon and the prosencephalon, extending caudally from the limit between the isthmus and the mesencephalon, and rostrally to the boundary between prosomeres 4 and 5 (p4/p5). In agreement with the prosomeric model of forebrain organization proposed by Puelles and Rubenstein ([1993] TINS 16:472-479), differences in the level of PMP-22 expression in p2, p3, and p4 clearly defined the p2/p3 and p3/p4 neuromeric boundaries. By E17.5, PMP-22 was no longer detected in the ventricular zone, but at E18.5 it began to be expressed in motoneurons of cranial nerve motor nuclei and, after birth, following a rostro-caudal gradient, in the ventral spinal cord.

  20. 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

  1. 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.

  2. 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

    2016-07-01

    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.

  3. [Is it enough to recommend to patients take a walk? Importance of the cadence].

    PubMed

    Cristi-Montero, Carlos

    2013-01-01

    Introducción: Existe fuerte evidencia científica sobre los beneficios que conlleva seguir un estilo de vida activo. La actividad física más característica e inherente al ser humano es la marcha, la que hoy en día es promovida por diversos profesionales para mejorar el estado de salud de la población. No obstante, al parecer no solo basta con sugerir “salga a caminar” pues es necesario alcanzar cierta cantidad de pasos y cadencia con la finalidad de inducir en el organismo una serie de efectos beneficiosos. Objetivos: El objetivo del presente trabajo es dar a conocer los últimos avances relacionados con esta materia, con el propósito de poder entregar a la población y pacientes recomendaciones más detalladas a la hora de prescribir y sugerir caminar. Métodos: Se realizó una búsqueda bibliográfica en Pubmed y Scielo, así como una búsqueda manual entre las referencias de los estudios seleccionados. Resultados: Tras analizar la literatura se puede señalar que no solo parece ser importante cumplir cierta cantidad de pasos durante el día con la finalidad de mejorar el estado de salud de las personas, además parece ser indispensable sugerir la cadencia a la que se debiera caminar. Conclusiones: “Salga a caminar” es una efectiva y contrastada recomendación para lograr beneficios en la salud de la población, no obstante lo anterior, los profesionales de la salud podrían además sugerir alcanzar cierta cadencia o intensidad mínima para asegurarse de que sus pacientes logren dichos efectos favorables en el organismo.

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. Objective tools to analyze the lower lateral cartilage in unilateral cleft lip nasal deformities.

    PubMed

    Saleh, Mohamed A; Elshahat, Ahmed; Emara, Maher; Hussein, Heba; Gould, Lisa; Smith, David; Awad, Mostafa A

    2011-07-01

    Correction of cleft lip nasal deformity is an elusive goal. A controversy exists regarding the cause of the deformity, and therefore, there is a controversy of how to correct the deformity. Extrinsic theory is based on the presence of deformational forces from outside. The intrinsic theory is associated with deficiency of the lower lateral cartilage. The aim of this study was to use new objective tools to compare morphologically and histologically between the lower lateral cartilages of cleft and noncleft sides in patients with unilateral cleft lip nasal deformity. This study included 16 patients. They were operated on to correct unilateral cleft lip nasal deformity. Length, width, and thickness of lateral crura of the lower lateral cartilages of cleft and noncleft sides were measured. Punch biopsies from the middle part of the caudal ends of lateral crura were taken and sent for histologic and immunohistochemical studies. The lateral crura of the cleft side were significantly wider and shorter and tend to be thinner than those of the noncleft side. There was no significant difference in the chondroblast, chondrocyte, and total cellular number in the lower lateral cartilage of the cleft and noncleft sides. There was significantly less glycosaminoglycan content in the ground matrix of the lower lateral cartilage of cleft side. In conclusion, the use of digital sliding caliber in measuring the diminutions of the lower lateral cartilage and image analyzer to quantify the proteoglycans, glycosaminoglycans, fibroblast growth factor 18, and collagen content is very effective objective tools to compare the cleft and noncleft alar cartilage. PMID:21772161

  10. 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.

  11. Comparative microanatomy of the orbicularis oris muscle between chimpanzees and humans: evolutionary divergence of lip function.

    PubMed

    Rogers, Carolyn R; Mooney, Mark P; Smith, Timothy D; Weinberg, Seth M; Waller, Bridget M; Parr, Lisa A; Docherty, Beth A; Bonar, Christopher J; Reinholt, Lauren E; Deleyiannis, Frederic W-B; Siegel, Michael I; Marazita, Mary L; Burrows, Anne M

    2009-01-01

    The orbicularis oris muscle plays a role in the production of primate facial expressions and vocalizations, nutrient intake, and in some non-human primates it is used as a prehensile, manipulative tool. As the chimpanzee (Pan troglodytes) is the closest living relative of humans, a comparison of the orbicularis oris muscle between these species may increase our understanding of the morphological specializations related to the differing functional demands of their lips and the factors responsible for their divergent evolution. To this end, this study compares the microanatomy of the mid-line upper fibers of the orbicularis oris muscle between chimpanzees and humans. A mid-line portion of the orbicularis oris muscle was harvested from the upper lips of three chimpanzee and five human cadavers. The sampled blocks included the area between the lateral borders of the nasal alar cartilages in both species. Each sample was processed for paraffin histology, sectioned and stained with a variety of protocols. Sections were examined for fiber direction and relative thickness of muscle layers. Ratios of cross-sectional connective tissue area vs. cross-sectional muscle tissue area, muscle fiber diameter and relative dermal thickness were calculated for each species. In both species, a clear pars marginalis layer was recognized, contrary to previous reports that only humans possess this layer. In chimpanzees, the relative fiber diameter and relative amount of muscle tissue (i.e. based on ratio of connective tissue area : muscle tissue area) were significantly (P < 0.05) greater than in humans. In contrast, measurements of relative dermal thickness showed that humans have a greater average dermal thickness of the upper lip than chimpanzees. Taken together, these results suggest that both human and chimpanzee orbicularis oris muscle upper fibers meet the specific functional demands associated with their divergent vocal and facial display repertoires, the development of human

  12. 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

    2016-11-01

    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.

  13. 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

  14. [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.

  15. Sedimentology of tufa facies and continental microbialites from the Palaeogene of Mallorca Island (Spain)

    NASA Astrophysics Data System (ADS)

    Arenas, C.; Cabrera, L.; Ramos, E.

    2007-04-01

    The Middle Eocene and Oligocene basins in northwestern half of Mallorca are filled by detrital rocks (conglomerates, calcarenites and lutites) and carbonates deposited in alluvial, fluvial, palustrine and lacustrine settings. The sediment supplied to these continental basins was transported by alkaline, bicarbonate-rich waters. As a consequence, these non-marine carbonate deposits display extensive developments of diverse kinds of organosedimentary facies. The sedimentary record from three localities (Peguera, Alaró and Sineu) enabled one to characterize well-preserved Eocene tufa deposits as well as Eocene and Oligocene stromatolites and oncolites. A total of ten carbonate facies are described and interpreted. The facies related to tufa deposits are diverse types of boundstones, rudstones and packstones of bryophytes, in situ stems s.l., phytoclasts, etc. and associated oncolite rudstones and bioclastic mudstones-to-packstones. These facies deposited in littoral lacustrine and fluvio-lacustrine environments. Oncolites and stromatolites present a great variety of shapes and sizes (oncolites from centimetres to several meters in diameter) that somehow were conditioned by environmental conditions within shallow lacustrine and fluvial settings. Three types of lamination apparently dependent on the type of microorganisms responsible for calcite precipitation are distinguished (fan-shaped and bush-shaped grouped filaments and isolated to loosely grouped filaments). The δ 13C and δ 18O composition of these deposits agrees with carbonate precipitation in freshwater, hydrologically open systems with similar carbon sources throughout the Eocene and Oligocene. However, Eocene and Oligocene samples are set apart by the δ 18O. Oligocene facies present lower δ 18O values, which might indicate deposition from isotopically less evolved waters, perhaps under slightly greater precipitation/evaporation conditions. Tufa facies have the highest δ 13C composition and show some

  16. 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

  17. 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

  18. [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.

  19. 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

  20. 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

  1. 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

  2. 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

  3. 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

  4. 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.

  5. 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

  6. 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

  7. 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

  8. Systematics within Gyps vultures: a clade at risk

    PubMed Central

    Johnson, Jeff A; Lerner, Heather RL; Rasmussen, Pamela C; Mindell, David P

    2006-01-01

    molecular phylogenies strongly support the treatment of indicus and tenuirostris as separate species, as does morphological data showing that these two taxa of similar overall size differ in proportions, especially in rostral, alar, and pedal characters. In addition, grouping of bengalensis and africanus together in the genus Pseudogyps, as historically proposed, is not upheld based on mitochondrial data. Conclusion Both molecular and morphological data provide strong support for considering the "Long-billed" Vulture to be comprised of two species (G. indicus and G. tenuirostris), and further analysis is warranted to determine the taxonomic distinctiveness of G. f. fulvescens. Our phylogenetic analyses and conservative estimates suggest the diversification of Gyps taxa to be within the past 6 million years. Diclofenac susceptibility has been previously demonstrated for four Gyps species (G. indicus, G. fulvus, G. africanus, G. bengalensis), and the phylogenetic position of these species each forming a sister relationship with at least one of the remaining species, support concern that other Gyps taxa may be susceptible as well. Determining genetic and evolutionary distinctiveness for Gyps lineages is increasingly important as a breeding program is being established to prevent extinction.

  9. The Turkish delight: a pliable graft for rhinoplasty.

    PubMed

    Erol, O O

    2000-05-01

    In nose surgery, carved or crushed cartilage used as a graft has some disadvantages, chiefly that it may be perceptible through the nasal skin after tissue resolution is complete. To overcome these problems and to obtain a smoother surface, the authors initiated the use of Surgicel-wrapped diced cartilage. This innovative technique has been used by the authors on 2365 patients over the past 10 years: in 165 patients with traumatic nasal deformity, in 350 patients with postrhinoplasty deformity, and in 1850 patients during primary rhinoplasty. The highlights of the surgical procedure include harvested cartilage (septal, alar, conchal, and sometimes costal) cut in pieces of 0.5 to 1 mm using a no. 11 blade. The fine-textured cartilage mass is then wrapped in one layer of Surgicel and moistened with an antibiotic (rifamycin). The graft is then molded into a cylindrical form and inserted under the dorsal nasal skin. In the lateral wall and tip of the nose, some overcorrection is performed depending on the type of deformity. When the mucosal stitching is complete, this graft can be externally molded, like plasticine, under the dorsal skin. In cases of mild-to-moderate nasal depression, septal and conchal cartilages are used in the same manner to augment the nasal dorsum with consistently effective and durable results. In cases with more severe defects of the nose, costal cartilage is necessary to correct both the length of the nose and the projection of the columella. In patients with recurrent deviation of the nasal bridge, this technique provided a simple solution to the problem. After overexcision of the dorsal part of deviated septal cartilage and insertion of Surgicel-wrapped diced cartilage, a straight nose was obtained in all patients with no recurrence (follow-up of 1 to 10 years). The technique also proved to be highly effective in primary rhinoplasties to camouflage bone irregularities after hump removal in patients with thin nasal skin and/or in cases when

  10. 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

  11. Toward a W4-F12 approach: Can explicitly correlated and orbital-based ab initio CCSD(T) limits be reconciled?

    PubMed

    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

  12. Exciting Message from a Dying Monster Star

    NASA Astrophysics Data System (ADS)

    1996-03-01

    SEST Discovers First Extra-galactic SiO Maser With the help of a new and more sensitive receiver, recently installed on the 15-metre Swedish-ESO Submillimetre Telescope (SEST) at the European Southern Observatory on the La Silla mountain in Chile, a team of European astronomers [1] has succeeded in discovering the first extra-galactic silicon-monoxide (SiO) maser . It is located in the atmosphere of the largest known star in the Large Magellanic Cloud, a satellite galaxy to the Milky Way. This observational feat now opens new, exciting possibilities for the study of individual stars in other galaxies in the Local Group. The continued search for extra-galactic SiO masers is a joint project of European and Australian astronomers, to be carried on with even more advanced instruments that will become available in the near future. What is a maser ? The fact that masers exist in the Universe is one of the most unexpected discoveries made by astronomers in this century. They function according to the same principles as the better known lasers . Lasers (Light Amplified Stimulated Emission Radiators) are becoming more and more common in our daily life, for instance to read discs in CD players and to cut steel plates. Inside a laser, molecules act as an enormously powerful amplifier for light of a specific wavelength (`colour') [2]. However, this only happens when we subject the molecules to special conditions, much unlike those they would normally experience in nature. Nevertheless, exotic places do exist in the Universe where conditions are similar to those in lasers. In the 1960s, astronomers discovered that some celestial objects emit abnormally strong radio waves at a particular wavelength. In the beginning, they thought that this emission was coming from an unknown molecule they called `Mysterium'. Later it turned out that it originated in already known, and rather ordinary, OH-molecules of oxygen and hydrogen. In some places in space, these molecules experience the

  13. 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

  14. 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