Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “laterality defects”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources
PubMed2002

Velopharyngeal function after microsurgical reconstruction of lateral and superior oropharyngeal defects.

OBJECTIVES/HYPOTHESIS: Defects of the lateral and superior oropharyngeal wall are difficult to reconstruct because of their complicated anatomy and the possibility of causing velopharyngeal incompetence. The objective was to investigate problems of reconstruction and postoperative velopharyngeal function. STUDY DESIGN: Defects were classified into three types (I, II, and III) according to their extent. Four operative procedures were performed: the Patch, Jump, Denude, and Gehanno methods, which include a lateral-posterior pharyngeal advancement flap. Speech intelligibility, velopharyngeal function, and wound dehiscence between the flap and the remaining soft palate were evaluated. METHODS: Forty patients who had undergone resection of the lateral and superior oropharyngeal walls and subsequent reconstruction were reviewed. RESULTS: Most patients with type I or II defects had satisfactory velopharyngeal function. However, in patients with type III defects, speech function was worse and severe velopharyngeal incompetence was more common. The type of defect and the presence of wound dehiscence were related to postoperative function. The rates of wound dehiscence were lower with the Patch and Gehanno methods. CONCLUSIONS: Postoperative function in patients with type III defects can be affected by various factors. We suggest that the Gehanno method be the treatment of choice for reconstruction of extensive defects of the oropharynx. However, patients in whom more than two-thirds of the superior and posterior oropharyngeal walls has been resected are poor candidates for reconstruction because of the difficulty of maintaining both nasal airway patency and velopharyngeal function.

Adult↗
PubMed1999

The "facelift" flap for reconstruction of cheek, lateral orbit, and temple defects.

BACKGROUND: Large defects of the cheek, lateral orbit, zygomatic arch, or the lower temple pose challenges for reconstruction. These defects can be elegantly reconstructed using the "facelift" flap. OBJECTIVE: The facelift flap is a large advancement flap with a rotational component based on rhytidectomy principles. METHODS: Redundant skin from the lower cheek is used as the donor tissue, which is advanced cephalad and posteriorly. Flap design varies slightly for men and women depending on characteristics of the external ear and ear lobe as well as the position and density of the preauricular hairline. Extensive undermining is critical to reduce tension on the flap and allow for complete closure. Traction provided by an assistant aids in the undermining. Specialized instruments are helpful when performing this flap. Rhytidectomy scissors, multipronged skin rakes, hand-held fiberoptic lighted retractor, and insulated forceps are particularly useful. Correct trimming of the flap and ear lobe placement without tension on the lobe are essential for a good cosmetic result. A large standing cone is excised retroauricularly such that the scar is hidden primarily behind the ear. RESULTS AND CONCLUSION: The facelift flap gives superior and elegant results for reconstruction of large cutaneous defects involving the cheek, lateral orbit, zygomatic arch, and lower temple.

Cheek↗
PubMed2002

[Closure of atrial septal defect via small lateral thoracotomies, partial and full length sternotomies].

Surgical closure of atrial septal defect is considered a low risk procedure. Various minimally invasive surgical techniques spread over the conventional full-length sternotomy. But the risk profile and complication rates of the minimally invasive closure of atrial septal defect are not revealed sufficiently. We present the results of atrial septal defect surgery via small thoracotomies: right anterolateral, right posterolateral, partial sternotomies and full-length median sternotomies. Ninety four patients underwent surgical closure of atrial septal defect via minimal approaches through the period from February 1999 to December 2001. Via median sternotomies were operated 85 patients. Right anterolateral group consisted of 17 patients, right posterolateral - 68, partial sternotomies - 9. The intracardiac period of operation was performed on electrical fibrillation under mild hypothermia. Median bypass time was 33 min. in right anterolateral, 31 min. - right posterolateral, 32 min. - partial sternotomies, 37 min. - median sternotomies. Median fibrillation time was 21 min. in right anterolateral, 18 min. - right posterolateral, 15 min. - partial sternotomies, 21 min. - median sternotomies. There were no technical procedure related complications in minimally invasive group. Intrahospital morbidity consisted of 6 pneumonias, 4 pleural effusions. There were 3 pneumonias, 2 pleural and 2 pericardial effusions in median sternotomies group.

Adolescent↗
PubMed2005

Cytoskeletal defects in amyotrophic lateral sclerosis (motor neuron disease).

There is growing evidence for the involvement of cytoskeletal defects in the pathogenesis of motor neuron disease and especially in components of the microtubule-based transport system. Here we will review our recent work aiming to elucidate the role of peripherin in amyotrophic lateral sclerosis (ALS) and to address the mechanism of disease caused by deletions in the ALS2 gene that cause recessive forms of juvenile ALS and primary lateral sclerosis (PLS). Peripherin is an intermediate filament protein detected in spheroids, a hallmark of ALS, and increased levels of peripherin mRNA have been found in some ALS cases. Our transgenic mouse and cell culture studies support the view of a peripherin involvement in ALS. However, a gene knockout approach demonstrated that peripherin is not a key contributor of motor neuron disease caused by mutant superoxide dismutase linked to familial ALS. A recent breakthrough in the field of ALS came with the discovery of frameshift deletions in the ALS2 gene coding for Alsin. Our transfection experiments in cultured cells suggest that Alsin is a cytoskeletal protein with dual endosomal and centrosomal localizations. We have generated a mouse knockout for Alsin that develops progressive motor dysfunction during ageing. Thus, it is anticipated that this mouse model will be useful to investigate the pathogenic pathways linked to Alsin gene mutations.

Amyotrophic Lateral Sclerosis↗
PubMed2005

Autologous osteochondral mosaicplasty for treatment of a posttraumatic defect of the lateral tibial plateau: a case report with two-year follow-up.

Posttraumatic osteochondral defects following a tibial plateau fracture are common and a serious complication that may lead to the development of posttraumatic arthrosis. Successful reconstruction of the tibial plateau must include restoration of limb alignment, repair of bone defects, restoration of the articular cartilage, and preservation of the menisci. When osteochondral defects are present, the use of bulk bone grafts to restore the original articular surface anatomy of the tibial plateau is difficult due to incongruity between the graft and the original joint surface. Recognizing this, an autologous osteochondral transplantation utilizing the mosaic technique was performed successfully on a 32-year-old male alpine skier with a posttraumatic osteochondral defect following a tibial plateau fracture. At 2 years postsurgery, the patient had regained the capacity to perform most activities of daily living and to participate in sports. Clinical examination revealed an improvement of the Lysholm score from 48 points to 72 points.

Adult↗
PubMed2002

[Spontaneous defects of the lateral cranial base. 1. Clinical aspects, diagnosis and therapy].

BACKGROUND: Spontaneous cerebrospinal fluid otorrhea (SCFO) or rhinorrhea originating from laterobasal defects is uncommon. An immediate closure of the defect is mandatory due to the risk of life-threatening meningitis. The purpose of this paper is to review the literature and to present two additional case reports with emphasis on diagnostic problems and surgical techniques. PATIENTS AND METHODS: Two adults have been treated for SCFO in our clinic. A 62-year-old woman was complaining of pertinent otorrhea after placement of a ventilation tube and conservative treatment of serous otitis for 1 year elsewhere. A 66-year-old male patient had been treated for acute pneumococcal meningitis. He presented with unilateral deafness and vertigo 3 months later. High-Resolution-Computer-Tomography (HRCT) revealed a unilateral defect in the female and a bilateral defect in the male patient. A transmastoidal approach was used to amputate the meningoencephalocele and modified (Mini-Craniotomy) in the second (male) patient. The defect was closed in two layers using allogenic material and fibrin glue. RESULTS: One year after surgery both patients were free of symptoms and defect closure remained stable in HRCT and under microscopic view. CONCLUSIONS: SCFO from tegment defects is an uncommon cause of otorrhea and even rhinorrhea. History and clinical presentation of our patients can be regarded as typical for adults with SCFO. Evaluation of history, HRCT and a high index of suspicion is a prerequisite for correct diagnosis. The approach (transmastoidal, transtemporal, Mini-Craniotomy) to repair leaks of the tegmen should be related to the extent of the defect.

Aged↗
PubMed1997

Autosomal recessive lateralization and midline defects: blastogenesis recessive 1.

In this report, we present 2 sibships in which midline and lateralization anomalies are demonstrated. Because midline and lateralization processes are early embryological events, we suggest calling this sequence Blastogenesis Recessive 1 (BGR1). Since connexin 43 gene mutations were demonstrated in some polyasplenia patients and according to connexin 43 temporospatial tissue expression, we hypothesize that this gene could bear mutations responsible for the anomalies reported in these two sibships.

Abnormalities, Multiple↗
PubMed1981

Agreement in human interpretation of analog thallium myocardial perfusion images.

To assess the agreement of human interpretation of analog thallium myocardial perfusion images, four experienced interpreters evaluated 100 images on two occasions using a form designed to limit reader variability. A high intraobserver agreement (agreement by same observer at separate times) of 89--93% was found when films were interpreted as normal or abnormal (a dichotomous decision). Interobserver agreement for a majority grouping of observers (three or four) was 75% for an abnormal and 68% for a normal interpretation. However, agreement ranged from 11--79% when interpreters were asked to read the anatomic location of defects. Posterior and lateral wall defects were interpreted with the least amount of agreement. These results indicate that caution must be taken when interpreting defect location. Using a scale of 1--10 to grade the severity of a defect, correlations of 0.82--0.86 were found when reading defects in the lateral and anterior projections. Higher correlations, from 0.86--0.94, were found in left anterior oblique views. Use of reporting forms with specific criteria, multiple observers at one occasion, and/or computer processing may improve agreement. A brief review of the agreement of cardiology testing procedures is also presented.

Angina Pectoris↗
PubMed1984

Lateral diffusion of lipids and glycophorin in solid phosphatidylcholine bilayers. The role of structural defects.

The lateral mobility of the lipid analog N-4-nitrobenzo-2-oxa-1,3 diazole phosphatidylethanolamine and of the integral protein glycophorin in giant dimyristoylphosphatidylcholine vesicles was studied by the photobleaching technique. Above the temperature of the chain-melting transition (Tm = 23 degrees C), the diffusion coefficient, Dp, of the protein [Dp = (4 +/- 2) X 10(-8) cm2/s at 30 degrees C] was within the experimental errors equal to the corresponding values DL of the lipid analog. In the P beta 1 phase the diffusion of lipid and glycophorin was studied as a function of the probe and the protein concentration. (a) At low lipid-probe content (cL less than 5 mmol/mol of total lipid), approximately 20% of the probe diffuses fast (D approximately equal to 10(-8) - 10(-9) cm2/s), while the mobility of the rest is strongly reduced (D less than 10(-10) cm2/s). At a higher concentration (cp approximately 20 mmol), all probe is immobilized (D less than 10(-10) cm2/s). (b) Incorporation of glycophorin up to cp = 0.4 mmol/mol of total lipid leads to a gradual increase of the fraction of mobile lipid probe due to the lateral-phase separation into a pure P beta 1 phase and a fraction of lipid that is fluidized by strong hydrophilic lipid-protein interaction. (c) The diffusion of the glycophorin molecules is characterized by a slow and a fast fraction. The latter increases with increasing protein content, which is again due to the lateral-phase separation caused by the hydrophilic lipid-protein interaction. The results are interpreted in terms of a fast transport along linear defects in the P beta 1 phase, which form quasi-fluid paths for a nearly one dimensional and thus very effective transport. Evidence for this interpretation of the diffusion measurements is provided by freeze-fracture electron microscopy.

Diffusion↗
PubMed2003

Up-regulation of mitochondrial uncoupling protein 3 reveals an early muscular metabolic defect in amyotrophic lateral sclerosis.

Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disorder affecting primarily motor neurons. Growing evidence suggests a mitochondrial defect in ALS. The precise molecular mechanisms underlying those defects are unknown. We studied the expression of mitochondrial uncoupling proteins (UCPs), key regulators of mitochondrial functions, in tissues from a mouse model of ALS (SOD1 G86R transgenic mice) and from muscular biopsies of human sporadic ALS. Surprisingly, in SOD1 G86R mice, UCPs, and particularly UCP3, were upregulated in skeletal muscle but not in spinal cord. Consistent with this pattern of expression, ATP levels were selectively depleted in muscle but not in neural tissues 1 month before disease onset and the respiratory control ratio of isolated mitochondria is decreased. UCP3 up-regulation was not observed in experimentally denervated muscles, suggesting that changes in muscular UCP3 expression are associated with the physiopathological processes of ALS. This is further supported by our observation of increased UCP3 levels in human ALS muscular biopsies. We propose that UCP3 up-regulation in skeletal muscle contributes to the characteristic mitochondrial damage of ALS and to the onset of the disease. Moreover, since skeletal muscle is a key metabolic tissue, our findings suggest that ALS may not solely arise from neuronal events but also from more generalized metabolic defects.

Amyotrophic Lateral Sclerosis↗
PubMed1995

Isolation of the polar and lateral flagellum-defective mutants in Vibrio alginolyticus and identification of their flagellar driving energy sources.

Vibrio alginolyticus has two types of flagella (polar and lateral) in one cell. We isolated mutants with only a polar flagellum (Pof+ Laf-) or only lateral flagella (Pof- Laf+). Using these mutants, we demonstrated that the energy sources of the lateral and polar flagellar motors in V. alginolyticus are H+ and Na+ motive forces, respectively, as in the related species V. parahaemolyticus.

Carbonyl Cyanide m-Chlorophenyl Hydrazone↗
PubMed2005

Reconstruction of foot defects with free lateral arm fasciocutaneous flaps: analysis of fifty patients.

In this article, long-term outcomes of foot reconstruction with free lateral arm fasciocutaneous flaps were retrospectively analyzed in 50 patients. The patients, 38 men and 12 women, ranged in age from 7-73 years (mean, 43.5 years). Indications for surgery included trauma (32 patients), diabetes mellitus (7 patients), burns (7 patients), chronic ulcers (3 patients), and tumor (1 patient). The locations of defects were the dorsum (n=21), ankle (n=12), medial (n=6), lateral (n=6), posterior heel (n=2), and distal sole (n=3) Concomitant bone injury occurred in 5 cases, and the weight-bearing surface of the foot was involved in 5 patients. Defects ranged in size from 27-76 cm(2) (mean, 36.4 cm(2)). Successful reconstructions were accomplished in 46 cases (92%). Flap complications included total flap loss and below-knee amputation (1 patient) and partial flap loss (3 patients); 75% (3/4) of these cases had diabetes as a comorbid factor, and 25% (1/4) had a concomitant bone injury. Six patients with dorsum defects required debulking of the flap (11.1%). None of the patients required modified shoes. In the majority of cases, flaps provided stable coverage and a gain in protective deep-pressure sensation. In long-term follow-up (up to 4 years), patients regained their ambulation, free of pain. Even in weight-bearing areas, none of the cases experienced ulceration or skin breakdown. Free lateral arm flaps provided excellent durability, with solid bony union and successful restoration of the contour of the foot in moderate-sized foot defects.

Adolescent↗
PubMed1990

[Use of synthograft after tooth apicoectomy with extensive bone defect and marginal apical communication to periodontium].

Synthograft (beta-tricalcium phosphate) is a bioresorptive ceramic material which stimulates osteogenesis after implantation into bone defects and disappears from the site of implantation. In this study, Synthograft was used as a filling in bone defects following apicotomy of teeth with extensive periapical and lateral bone defects along the tooth root involving more than 1/3 of the root, and when an extended periodontal fissure was present in addition. The study included 13 patients with one or more teeth involved. The tricalcium phosphate powder was mixed with patient's own blood and inserted into bone cavities. The patients were followed up during 12 months after surgery by clinical and radiographic control examinations. In all the 13 cases, clinical results were very good, i.e. healing of the wound proceeded without any signs of inflammation, whereas later in the course of follow-up no signs of reaction to the foreign material were observed. Preoperatively loose teeth had gradually become firm and after 12 months were within the limits of physiological motility. Roentgenograms revealed the bone cavities to have filled with newly formed bone, and the periodontal ligament, otherwise lost, was also restored. Results of this study showed the Synthograft implant to be well tolerated by recipients, thus it can be recommended as a filling in extensive bone periapical and lateral defects after tooth apicotomy.

Adolescent↗
PubMed1981

An eye movement disorder in amyotrophic lateral sclerosis.

Defective pursuit eye movements were recorded by electrooculography (EOG) in 11 of 18 patients (61%) with amyotrophic lateral sclerosis. Pursuit defects consisted of a breakdown of smooth tracking into saccadic motions that were grossly in excess (frequencies and amplitudes) of saccadic interruptions of pursuit in normal subjects. In nine patients, defective pursuits cogwheeling) were obvious by visual inspection as well as by EOG; in two, this abnormality was seen only by EOG. In eight patients, the pursuit defect was the only abnormality of oculomotor function; in three, there were also saccadic defects (optokinetic nystagmus or conjugate gaze) discerned by EOG. Autopsy revealed neuronal degeneration in substantia nigra and demyelination in integral capsule in one patient with the pursuit defect but not in another patient without the defect. The pursuit defect may be a sign of extrapyramidal or supratentorial pyramidal involvement in ALS.

Adult↗
PubMed2002

[Spontaneous defects of the lateral skull base. 2. Etiology and review of the literature].

BACKGROUND: Isolated cases of spontaneous cerebrospinal fluid otorrhea (SCFO) of temporal bone origin with or without meningo(encephalo)cele have been reported. Diagnosis is predicted on a high index of suspicion. Since meningitis may occur secondary to SCFO, optimal therapy with surgical closure of the defect should immediately be performed. This study was undertaken to evaluate the incidence, characteristics and type of SCFO in literature. MATERIALS AND METHODS: We reviewed the reports on SCFO in the world literature since the first description in 1897 by Escat. Clinical presentation, gender, age and surgical management were aspects of our classification. Not included were patients with cerebrospinal fluid leak following any kind of previous temporal bone surgery, head trauma or rupture of the round window membrane. RESULTS: A total of 241 CSFO in 236 patients were found to accomplish the search criteria. Gender was not found to be a risk factor. Two subtypes of SCFO exist: the majority (161 cases) developing through the tegmen tympani and a smaller number (80 cases) with a translabyrinthine SCFO. The latter group can be regarded as the childhood-type with congenital defects of the otic capsule (Mondini dysplasia) presenting with meningitis in 85% of all cases. Adulthood-type SCFO are typically located in the tegmen tympani area presenting with conductive hearing loss or otorrhea following tube placement in 86% of all cases. Recent literature recommends a combined (transmastoidal and middle fossa) approach for closure of defects in the tegmen. CONCLUSIONS: Copious otorrhea through a perforated tympanic membrane or following placement of a ventilation tube, conductive hearing loss or meningitis without impairment of cochlear or vestibular function should be regarded as warning signs for an existing SCFO in adults. Children usually present with symptoms of inner ear anomalies, meningitis and loss of cochlear-vestibular function. High-resolution computer tomography is the diagnostic procedure of choice. A follow-up of several years to disclose any recurrence of SCFO or occurrence at a different area should be considered in any patient.

Cerebrospinal Fluid Otorrhea↗
PubMed2004

Circling behavior in the Ecl mouse is caused by lateral semicircular canal defects.

The epistatic circler mouse (Ecl mouse) is a preexisting mutant, which displays a circling phenotype and hyperactivity. It has been shown that the circling phenotype in this mutant results from a complex inheritance pattern, but the vestibular pathology has not been analyzed. The present study deals with the morphological and functional basis responsible for the circling behavior in the Ecl mouse. Morphological examination of the inner ears revealed a bilateral malformation of the horizontal (lateral) semicircular canal and duct. No cochlear abnormalities were detected, and auditory brainstem response (ABR) measurements indicated that the auditory system is not affected. Investigation of the vestibuloocular reflex (VOR) in Ecl mice showed that their horizontal VOR on stimulation is virtually absent, which correlates with the morphological findings.

Animals↗
PubMed1975

[Covering of defects in the lateral head and neck regions with shoulder flaps (author's transl)].

In many situations the head and neck surgeon is forced to excise large areas of tumor bearing skin in the lateral head and neck regions. This skin, either containing primary malignancies or tumors arising from underlying structures (such as lymph nodes, the mandible or the parotid gland), often is heavily irradiated. Consequently, free full-thickness skin grafts have limited chance of survival because of the reduced blood supply of the adjacent tissue. In these cases we use the so-called shoulder flap, as first described by Conley, to cover large defects. This flap, bases between the trapezius muscle and the scapula, has a rich blood supply, closes the defects in one stage and avoids restriction of the head. In addition, the donor site can be closed transposition of adjacent skin when possible without functional defect. Nine clinical cases are presented.

Aged↗
PubMed2001

[Primary reconstruction of lateral oro-mandibular defects using titanium plates (Thorp) and revascularized non-osseous flaps: a personal experience].

Reconstruction of a particular defect is an highly complex problem, that is reflected in the number and variety of techniques proposed. This is particularly true for reconstruction of mandibular segment defects usually together with the need to repair oro-pharnygeal soft tissues defects of various size. The high rate of successes that can be obtained today using microvascular reconstruction techniques explains the reason why bone free flaps have progressively become the "gold standard" used as benchmark for all other forms of primary mandibular reconstruction. However, for selected patients (elderly patients or individuals in poor general health; the presence of lateral oro-mandibular defects or soft tissue defects significantly exceeding the bone defect) the association of non-osseous microvascular free flaps (such as forearm skin flaps or miocutaneous free flaps of the abdominal rectus muscle) with a titanium mandibular reconstruction plate (THORP) can prove a valid alternative. Indeed, in these cases reconstruction of choice would be the association of two free flaps, one osseous and the other non osseous. The use of THORP-type mandibular reconstruction plates in repairing lateral defects increases the overall risk of complications related to the reconstruction technique which is already hindered by the risks associated with the use of microvascular free flaps. The present work starts with a retrospective evaluation of 5 years series of primary mandibular reconstruction for lateral oro-mandibular defects following oncological surgery. The role of THORP-type titanium mandibular plates, used in combination with non-osseous free flaps in the treatment of selected patients, is then described and discussed.

Aged↗