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At least 271 records · Page 15Linked to original sources

The use of titanium mandibular reconstruction plates in patients with oral cancer.

A series of 21 patients, who were selected for primary mandibular stabilisation with titanium plates following excision of advanced malignant tumours, is reported. Success was defined as a plate that did not have to be removed due to fracture, exposure or infection. The overall success rate was 71%, with follow-up ranging from 7-53 months. The majority of plate losses were experienced when either anterior or large lateral defects which included the condyle were bridged and when patients were subjected to either pre- or postoperative radiotherapy.

Aged↗

Small bowel obstruction due to a paracolonic retroperitoneal hernia.

Hernias involving the retroperitoneum are unusual. The most common of these are the paraduodenal hernias. A retroperitoneal hernia occurring from a lateral defect in the colonic retroperitoneal attachments is presented. We believe that this case represents a newly recognized variant of retroperitoneal hernias.

Aged↗

[Experimental morphologic findings serving as a basis for use of xenogenic dura mater for plastic surgery of blood vessels].

Heterotransplants of the human dura mater were used to replace circular and lateral defects of the thoracic and abdominal aortas, carotid and iliac arteries in experiment. Operations were performed in 106 dogs. Observations of permeability of the vessels, morphological and histochemical studies were carried out at different periods after operation (from 1 day to 2 years). The xenogenous dura mater has well pronounced plastic properties--it is solid, elastic, characterized by low antigenicity. During transplantation there appear no hard inflammatory--destructive changes in reconstructed vessels and the surrounding tissues. The transplant is gradually substituted by recipients tissues characterized by high specialization. They are rich in elastic and smooth muscle fibres, have good blood supply and innervation. The dura mater is a good material for plastics of vascular wall defects.

Animals↗

[Midgut malrotation risk in abdominal wall defect].

BACKGROUND: Midgut malrotation has a low incidence (0.5-1% at necropsies) and it is a rare symptomatic condition. Nevertheless it is often associated to clinical situations with a high morbility and mortality and it could complicate them. Our aim is to study the patients treated for abdominal wall defects and who have suffered complications due to non-treated malrotation at first surgery. METHODS: We retrospectively studied the charts of patients diagnosed of abdominal wall defects in our hospital from 1993 to 2002. We reviewed the initial treatment, the associated morbility and any new surgical treatment needed. RESULTS: During this 10-year period, 110 abdominal wall defects were managed: 56 congenital diaphragmatic hernias, 30 onphaloceles and 14 gastroschisis; overall 79 of these 100 patients survived and were included in this study. Eleven patients had symptoms due to bowel malrotation during the follow-up period. In 1 case the clinical picture had an acute onset as a volvulus that required extensive gut resection; another patient presented as a persistent gastrocutaneous fistula after removal of a gastrostomy tube; in the remaining 9, symptoms were always of classical intestinal obstruction. The malrotation was never treated during the initial surgical procedure for abdominal wall defect; later on, Ladd procedure was always the definitive treatment. CONCLUSIONS: Due to local conditions during first abdominal wall surgery that limit the evaluation of the malrotation, we must think about it when we find obstructive symptoms any time during life.

Child, Preschool↗

Modifications to the semicircular flap technique in eyelid reconstruction.

The most common reconstructive procedure in the upper and lower eyelid is direct closure of the lid margin. When additional mobilization of tissue is needed to close a defect, lateral canthotomy and cantholysis is suggested. Mobilization of tissue beyond the lateral orbital rim is occasionally required. We have found that in the lower eyelid the mobilized tissue is much better supported if the initial incision is made vertically toward the eyebrow rather than temporally, as is suggested with the semicircular flap technique. We describe modifications to this technique, which we refer to as the vertical-temporal advancement flap, and present the results in 28 consecutive patients followed for 8 months to 3 years.

Eyelid Neoplasms↗

[Reconstruction of the wall of the canal].

In "intact" canal wall tympanoplasty, recurrent disease and retraction pockets must be avoided by repair of attic or lateral defects. Between 1983 and 1986, the authors used septal cartilage homograft in 38 cases and mastoid bone autograft in 47 cases. The uniqueness of the last technique is the preservation of fibroperiosteum with the cortical bone shaving, allowing a good adaptability in the defect. Histologic studies, clinical follow up and operative evaluation in case of second look intervention allows discussion on advantages and disadvantages of the two materials. The tolerance is good. The two procedures are variable and reliable in 80% of cases.

Cartilage↗

Effect of early and late postnatal hypoxia on subcellular synaptosomal fractions from cerebral cortex of rats. I. An electron-microscopical and biochemical study.

Synaptosomal fractions of brain cortex of rats exposed to moderate intermittent hypobaric hypoxic conditions during the first or second decade of the postnatal life were investigated electron microscopically one day or up to one week after the hypoxia experiment. Mitochondria and synaptosomes with impaired morphology were observed to occur more frequently in fractions obtained from hypoxic animals. Synaptosomes showed lesions of the outer membrane and loss of the synaptoplasmatic content, or condensation of the synaptosomal content with increasing electron density, deformation of the synaptosomes in size and shape, disappearance of structural details, degeneration of intrasynaptosomal mitochondria in form of strong condensation and, finally, formation of intrasynaptosomal vacuoles with dense core inclusions. The mitochondrial reaction was characterized by two antagonistic configurations: condensation of the matrix with secondary enlargement of the intracistal spaces and of the outer compartment and, finally, the decay of the matrix condensate in several crumbs. On the other hand, swelling of the matrix with strong enlargement of the whole mitochondrium, later defects in the outer membrane and the degeneration into empty mitochondrial ghosts, appearing in the upper fractions. Some characteristic marker enzymes were tested in the fractions. The results hint at an elevated vulnerability of synaptosomes obtained from animals exposed to postnatal hypoxia, as indicated by the lowered quotient of LDH activities after and before addition of Triton X-100. Furthermore, there are clues to a decrease in the number of synaptic connections within the cortex of hypoxia exposed animals, as is concluded from the diminished AChE activity in the subcellular fractions of these animals. However, no different effect of early or late postnatal hypoxia exposition was evident in the biochemical parameters.

Acetylcholinesterase↗

[Traumatic myocardial infarction. Apropos of 2 cases].

Two cases of anterior transmural myocardial infarction occurring after closed chest injuries in young adults (26 and 29 years) are reported. In one case, the infarct was detected after 42 days when the patient gradually developed left ventricular failure after thoracic injury (fracture of the left 9th rib). In the other case, the diagnosis was made during the initial evaluation of a patient with multiple injuries by routine electrocardiography. Radio-isotopic investigations showed an antero-septo-apical and lateral defect with akinetic wall motion in the first case, and apical hypofixation with limited akinesis in the second one. Coronary angiography with left ventriculography was performed after 2 and 3 months respectively, and showed a prolonged non-atheromatous stenosis of the proximal left anterior descending artery with anterior wall hypokinesia, apical akinesia and mitral incompetence (Case n 1) and slight changes of the distal part of the left anterior descending artery with apical hypokinesia (Case n 2). These two cases bring the number of documented reported cases to 37 and illustrate the two possible mechanisms of myocardial infarction after closed chest trauma: direct trauma to the coronary arteries with vascular lesions and secondary myocardial infarction associated with a poor prognosis, and myocardial contusion resulting in random myocardial lesions which usually carry a better prognosis.

Adult↗

Platelet survival in streptozotocin-induced diabetic rats.

Platelet survival in diabetes mellitus may be decreased or normal, and it is not clear whether altered platelet survival is due to a platelet or to a non-platelet defect. Therefore, platelet survival studies were performed at intervals up to 28 days in streptozotocin-induced diabetic and normal rats, using washed platelets from diabetic or normal animals. When compared to platelets from control rats, there was a significant decrease in platelet survival when platelets from 7 and 14 day diabetic rats were injected into normal controls or into diabetic rats. After 28 days of diabetes, platelet survival in diabetic rats was significantly lengthened, whether the platelets came from control or diabetic rats. Conclusions. Shortened platelet survival in the diabetic rat is caused initially by a platelet defect. Later, non-platelet factors become dominant. These findings may help explain reported discrepancies in results of platelet survival in diabetes mellitus.

Animals↗

Spindle membranes in mitosis and meiosis of the heteropteran insect Dysdercus intermedius. A study of the interrelationship of spindle architecture and the kinetic organization of chromosomes.

The fate of cytoplasmic membranes has been traced from spermatogonial interphase to the telophase of the second meiotic division with the aid of osmium ferrocyanide staining. At prophase, the nuclear membrane is indented to a funnel shape due to microtubules which radiate from the poles. These indentations open at prometaphase admitting microtubules to the nuclear interior. Since the nuclear envelope widens at prometaphase with only few lateral defects, organelles are excluded and the spindle is essentially intranuclear. Membranes surround the spindle until late anaphase. There are no cytoplasmic vesicles within the spindle, but there is an abundance of vesicles around the spindle poles following the radiating microtubules. At telophase, small vesicles around the chromosomes contribute to the new nuclear envelope while others fuse into large blisters which disappear gradually. A new vesicle system is formed in the daughter cells. At meiosis, the nuclear membrane is not indented by the polar microtubules which follow the contour of the nucleus together with vesicles. At late diakinesis, the bivalents are individually ensheathed by vesicles and lamellae which separate them from the remainder of the nucleus. In building up the metaphase configuration, the chromosomal sheaths become interconnected with the X1/X2-pseudotetrad in the center. Lamellae from these sheaths extend to the poles following the kinetochore microtubule bundles. In contrast to mitosis, the spindle body is pervaded by a structural framework of membranes with mitochondria in between. Essentially the same spindle architecture exists in the second meiotic division with the exception of the tandemly joined X1 and X2 chromosomes which are ensheathed by endoplasmic reticulum but lie outside the autosome group as they form spindle connections to one pole only. Since the chromosomes form a holocentric group at mitosis but behave as individual telocentrics at meiosis, their ensheathment by membranes during meiosis is thought to be essential for their orientation and orderly disjunction in the absence of true kinetochore plates.

Animals↗

Deciphering the molecular genetics of congenital heart disease.

Congenital heart diseases are starting to benefit from the major advances provided by the advent of molecular biology methods. It is now possible to identify genes which are responsible for congenital heart diseases. The gene responsible for supravalvular aortic stenosis--an autosomal dominant trait--was cloned last year. It is the elastin gene. DiGeorge and Shprintzen syndromes, conotruncal anomaly face and some cardiac malformations have a common cause: a deletion of the 22q11 region resulting in a monosomy. Although the region of deletion is large, it is possible that monosomy of only one gene results in these conditions. Studies are underway to evaluate the impact of this new genetic factor on the incidence of congenital heart malformations. Studies on familial bundle branch block, and lateralization defect with midline anomalies are soon going to show a chromosomal region with the gene defect. Discovering the genes and their protein products which are implied in the cardiac morphogenesis will definitively change our understanding of these cardiac malformations.

Abnormalities, Multiple↗

Prefrontal and temporal blood flow in schizophrenia: resting and activation technetium-99m-HMPAO SPECT patterns in young neuroleptic-naive patients with acute disease.

UNLABELLED: This study assesses prefrontal and temporal regional cerebral blood flow (rCBF) changes in young, neuroleptic-naive schizophrenic patients with acute disease. METHODS: A selected population of 10 young, never-treated schizophrenic women with acute disease was studied by two hexamethylpropyleneamine oxime (HMPAO) brain SPECT sessions, performed 48 hr apart, both at rest and during a prefrontal activation task using the Wisconsin Card Sort Test (WCST). All patients met Diagnostic and Statistical Manual of Mental Disorders, 3rd edition-revised criteria for schizophrenia or schizophreniform disorder, were neuroleptic-naive and had acute symptoms. RESULTS: Under resting conditions, the schizophrenic group had significantly higher rCBF in the prefrontal regions, mainly in the left side and including the anterior cingulate, than did the controls. In addition, schizophrenic patients showed significant interhemispheric differences in prefrontal and posterior temporal index values at rest (left hyperfrontality and left hypotemporality). During WCST activation, the control group showed significant increases in prefrontal blood flow, whereas the schizophrenic group did not. CONCLUSION: These results support a physiologic dysfunction of the prefrontal cortex in schizophrenia that is present at the onset of the illness prior to neuroleptic treatment. Furthermore, both left hyperfrontality and left hypotemporality may indicate a brain lateralization defect in schizophrenia.

Acute Disease↗

[Penetrating head injury caused by weed--case report].

A case of penetrating head injury caused by weed was reported. A 69-year-old man fell from a bicycle and was stuck by the hard stalk of weed through the right nasal cavity. On admission the patient was fully alert and with no neurological deficits. The weed was pulled out at an out-patient department and then he became semicomatose and hemiplegic on the left side together with an occurrence of nasal bleeding. Subsequent computed tomographic (CT) scan showed an intracerebral hematoma in the right frontal lobe. The hematoma was immediately evacuated and the dural defect, lateral to the cribriform plate, was closed. It is stressed that neuroradiological evaluation with CT scan and/or magnetic resonance imaging (MRI) is mandatory because an information about an anatomical location of penetrating objects and intracranial complications are essential to a decision-making of surgical strategy. The objects should be urgently removed in a surgical exposure of the intracranial lesion and the contused brain should be debrided with a repair of the lacerated dura mater.

Aged↗

Focal facial dermal dysplasia: report of a case with associated cardiac defects.

Focal facial dermal dysplasia is characterized by congenital scar-like depressions on both temples and a wide spectrum of associated facial abnormalities. We report a 2-month-old white boy who presented with bitemporal defects, laterally deficient eyebrows, absent lower eyelashes, periorbital puffiness, a bulbous nasal tip with prominent sebaceous hyperplasia, and down-turned corners of the mouth. In addition, he had tetralogy of Fallot, an association which previously has not been described.

Abnormalities, Multiple↗

Tympanoplasty for pars flaccida.

BACKGROUND: The formation of a retraction pocket of the pars flaccida remains a difficult problem for otologists to treat. It may lead to ossicular erosion and the development of a cholesteatoma, especially when the pocket is adherent to the malleus neck. We designed a new method of surgery for the treatment of small attic cholesteatomas. METHODS: From 1986 to 1996, 20 patients with a retraction pocket of the pars flaccida or a small attic cholesteatoma underwent surgery as described below. The complete lesion was removed after widening the posterior-superior bony external ear canal wall and placing pieces of conchal cartilage (usually less than 10 pieces, according to their scutum defect) lateral to the malleus neck or incus. The temporalis fascia was then laid. RESULTS: The average follow-up period was 32 months. The paired t-test was used to compare the results of preoperative and postoperative air conduction and air-bone gap. The preoperative average air conduction was 31.17 dB and the air-bone gap was 15.09 dB. The postoperative average air conduction was 20.66 dB and the air-bone gap was 3.09 dB. The difference between preoperative and postoperative measurements was considered significant (p < 0.05). No recurrent retraction pockets or cholesteatomas were noted during follow-up. CONCLUSIONS: Tympanoplasty for correction of a retraction pocket of the pars flaccida can prevent further attic retraction and the development of cholesteatomas. Postoperative hearing results were also encouraging.

Adolescent↗

The lateral thigh V-Y flap for the repair of ischial defects.

The lateral thigh fasciocutaneous flap described by Maruyama et al in 1984 is a useful method for the repair of ischial and trochanteric defects. We clinically re-evaluated the potential vascular territory of the nutrient artery for this flap, i.e., the first profunda perforator, and have newly designed the postero-lateral thigh V-Y flap in the area including the proximal two-thirds of the posterior thigh. This flap was applied to five difficult or recurrent ischial defects, and satisfactory results were obtained in all cases. For the reconstruction of ischial defects, the postero-lateral thigh V-Y flap has the following advantages; the proximal and well-vascularised portion of the flap is inserted into the area of the previously excised pressure sore, and this flap can potentially be readvanced if a recurrent pressure sore should develop. A Z-plasty can be performed to prevent excessive tension on the skin closure at the junction of the V-Y advancement flap. The postero-lateral thigh V-Y flap can be considered one of the first-line options for both primary and recurrent ischial pressure sores.

Adult↗

The radiographic incidence of bony defects in the lateral lamella of the cribriform plate.

The purpose of this study was to evaluate the incidence and radiographic characteristics of bony defects of the lateral lamella of the cribriform plate using a coronal computerised tomography (CT) scan. By retrospectively reviewing the coronal CT scans of 410 sinuses from 205 subjects, the overall incidence and the relationship to the subjects' age and depth of cribriform plate were analysed. Bony defects were identifiable in 59.5% of the sinuses. The incidence of a bony defect was not significantly different between the sinuses of the paediatric age group and the adult group. The sinuses having a deeper cribriform plate showed a higher incidence of bony defects in comparison with the sinuses with a less deep cribriform plate. The high incidence of radiologically detectable bony defects in this region may emphasize the particular risk of this area during endoscopic sinus surgery.

Adolescent↗