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PubMed2003

Genetic analyses of putative conformation switching and cross-species inhibitory domains in Microviridae external scaffolding proteins.

Putative conformational switching and inhibitory regions in the Microviridae external scaffolding protein were investigated. Substitutions for glycine 61, hypothesized to promote a postdimerization conformational switch, have dominant lethal phenotypes. In previous studies, chimeric alpha3/phiX174 proteins for structures alpha-helix 1 and loop 6/alpha-helix 7 inhibited phiX174 morphogenesis when expressed from high copy number plasmids. To determine if inhibition was due to overexpression, chimeric genes were constructed into the phiX174 genome. In coinfections with wild-type, protein ratios would be 1:1. The helix 1 chimera has a recessive lethal phenotype; thus, overexpression confers inhibition. In single infections, the mutant cannot form procapsids, suggesting that helix 1 mediates the initial recognition of structural proteins. The lethal chimeric helix 7 protein has a dominant phenotype. Alone, the mutant forms defective procapsids, suggesting a later morphogenetic defect. The results of second-site genetic analyses indicate that the capsid-external scaffolding protein interface is larger than revealed in the crystal structure.

Amino Acid Sequence↗
PubMed2006

[Intraoperative planning and inset principles of fibula osteoseptocutaneous flap in compound or composite oromandibular defect reconstruction].

OBJECTIVES: The use of free fibular osteocutaneous flap was evaluated in the reconstruction of compound and composite mandibular defects. PATIENTS AND METHODS: The study included 30 patients (27 males, 3 females, mean age 52.6 years; range 42 to 66 years) who received free osteoseptocutaneous fibular flap for the reconstruction of compound or composite oromandibular defects following surgical tumor ablation. Five patients with extensive skin defects accompanying lateral mandible and oral defects also received free anterolateral thigh perforator flap. Other patients were treated with conventional fibular osteocutaneous flap or its chimeric form. The mean follow-up period was 19.4 months (range 8 to 38 months). RESULTS: With the applied technique, a successful functional and aesthetic restoration was achieved without total flap failure and with minimal donor site morbidity. Infection and fascial abscess encountered in one patient were treated with debridement and antibiotic therapy. In one patient who developed osteonecrosis in the neomandibula, the plate was removed and debridement was performed in the 13th month. CONCLUSION: By appropriate flap planning and placement, reconstruction of large oromandibular tumors with osteocutaneous fibular flaps provides successful functional and aesthetic restoration.

Adult↗
PubMed2005

Versatility of the lateral arm free flap in various anatomic defect reconstructions.

The free lateral arm flap may be harvested as a fascial, fasciocutaneous, or osteofasciocutaneous flap. Simultaneous flap elevation with preparation of the recipient site, easy dissection, minimal donor-site morbidity, and a constant vascular anatomy with long pedicle are advantages of the flap. In this study, the authors present 18 patients operated on between January, 2002 and August, 2003 in whom 18 free lateral arm flaps were utilized. There were four women and 14 men, and the mean patient age was 40 years. Thirteen fasciocutaneous, three fascial, and two osteofasciocutaneous flaps were used. Flaps were employed for the reconstruction of the lower extremity in five patients, upper extremity in nine patients, and head and neck in four patients. Thirteen flaps were elevated under axillary block and five flaps under general anesthesia. Aspirin, dipirydamol, dextran, and chlorpromazine were administered postoperatively. Venous insufficiency developed in two lower-extremity reconstructions on postoperative day 1. Venous thromboses were detected, anastomoses were re-done, and flaps healed uneventfully. No other postoperative complication was observed in the other patients. The free lateral arm flap may be used in various anatomic defects with various indications. It may be elevated under axillary block for extremity reconstructions.

Adolescent↗
PubMed1994

Acute hemodynamic effects of adjustable atrial septal defect closure in the lateral tunnel Fontan procedure.

OBJECTIVES: This study evaluated the acute hemodynamic changes with atrial septal defect closure in the postoperative period in patients undergoing the Fontan procedure. BACKGROUND: The adjustable atrial septal defect is a modification of the Fontan procedure designed to improve cardiac output and reduce systemic venous hypertension during the postoperative period. Limited information is available on the effects of inter-atrial shunting on the physiology of direct cavopulmonary connection. METHODS: In 11 patients (aged 9 months to 14.5 years), the atrial septal defect was closed 8 h to 4.6 days (mean 1.7 days) postoperatively. Indications for closure included mean right atrial pressure < 15 mm Hg or arterial oxygen saturation < 80%, or both. RESULTS: Data presented are mean values +/- 1 SD. Mean right atrial pressure was 13.4 +/- 3.0 mm Hg on admission to the intensive care unit, 10.0 +/- 2.0 mm Hg (p = 0.02) immediately before closure and 11.4 +/- 2.8 mm Hg (p = 0.02) after closure. There was a significant decrease in cardiac output, as calculated from arteriovenous oxygen saturation difference (26 +/- 9%, p = 0.003), Doppler aortic flow (19 +/- 9%, p = 0.0002) and ventricular volumes by two-dimensional echocardiography (20 +/- 8%, p = 0.0001). Arterial oxygen saturation increased from 82 +/- 5% to 94 +/- 4% (p = 0.0001), and arteriovenous oxygen saturation difference increased from 25 +/- 8% to 33 +/- 9% (p = 0.0001). Systemic oxygen delivery decreased from 727 +/- 354 to 655 +/- 325 ml/min per m2 (p = 0.02). One patient required reopening of the atrial septal defect. CONCLUSIONS: These data demonstrate that a controlled right to left atrial shunt improves cardiac output and systemic oxygen delivery and facilitates the postoperative management of patients after the Fontan procedure. Atrial septal defect closure increases systemic saturation to normal values and prevents potential systemic embolization but significantly decreases oxygen delivery and might limit exercise tolerance.

Adolescent↗
PubMed1996

Comparative evaluation of function after surgery for cancer of the alveolobuccal complex.

PURPOSE: The current study was undertaken to assess the functional deficit after hemiresection of the mandible and to determine whether lateral segment resection with reconstruction was a functionally superior alternative in the management of patients suffering from alveolobuccal cancer. PATIENTS AND METHODS: Eighty-three patients were assigned to one of two main groups: Group I, hemiresection of the mandible (n = 47), and group II, lateral segment defects (n = 36). Functional assessment of patients included subjective evaluation of overall well-being, feeding, and cosmesis, as well as objective assessment of mastication, speech, and cosmesis. Mean scores for each of these categories were compared across groups using the Duncan Multiple Range Test with .01 confidence intervals. RESULTS: Subjective assessment of overall well-being, feeding, and cosmesis did not yield statistically significant differences between groups. Objective evaluation of mastication showed significantly better function after hemiresection in dentate patients as compared with their edentulous counterparts. However, masticatory scores for hemimandibulectomy patients with intact residual dentition were not significantly different from those for patients whose lateral segmental defects had been reconstructed. Although objective cosmetic scores for reconstruction of lateral segment defects were significantly better than those for hemiresection of the mandible, most patients in the latter group accepted the resultant deformity as a consequence of their treatment and did not let it affect their routine activities. CONCLUSION: Until functional results in patients undergoing lateral segmental resection for alveolobuccal cancer can be improved by better prosthetic techniques, hemiresection of the mandible remains a simple, safe, reliable, and cost-effective option that produces acceptable postoperative function.

Adult↗
PubMed1997

Does an early neonatal diagnosis of a later spontaneously closed ventricular septal defect impair quality of life?

The hypothesis that early diagnosis of a ventricular septal defect (VSD) with spontaneous closure later on may impair the parental-infant bonding process, with consequences for the child's quality of life in the longer term, was tested in 51 children born in 1986-1991 (gestational age > or = 37-42 weeks) with VSDs diagnosed in the early neonatal period and closing spontaneously during the first 24 months of life. The results were compared to 83 healthy controls matched for gestational age, time and place of birth. A method (questionnaire) taking into consideration the quality of life spheres of external living conditions and the interpersonal and personal conditions of the child was used. Except for a lower satisfaction with family network in the VSD group (p < 0.05), no differences were found between the VSD group and the controls for any of the parameters tested or for overall quality of life (p>0.05).

Heart Murmurs↗
PubMed2004

Drosophila melanogaster Prat, a purine de novo synthesis gene, has a pleiotropic maternal-effect phenotype.

In Drosophila melanogaster, two genes, Prat and Prat2, encode the enzyme, amidophosphoribosyltransferase, that performs the first and limiting step in purine de novo synthesis. Only Prat mRNA is present in the female germline and 0- to 2-hr embryos prior to the onset of zygotic transcription. We studied the maternal-effect phenotype caused by Prat loss-of-function mutations, allowing us to examine the effects of decreased purine de novo synthesis during oogenesis and the early stages of embryonic development. In addition to the purine syndrome previously characterized, we found that Prat mutant adult females have a significantly shorter life span and are conditionally semisterile. The semisterility is associated with a pleiotropic phenotype, including egg chamber defects and later effects on embryonic and larval viability. Embryos show mitotic synchrony and/or nuclear content defects at the syncytial blastoderm stages and segmentation defects at later stages. The semisterility is partially rescued by providing Prat mutant females with an RNA-enriched diet as a source of purines. Our results suggest that purine de novo synthesis is a limiting factor during the processes of cellular or nuclear proliferation that take place during egg chamber and embryonic development.

Age Factors↗
PubMed1993

Amyotrophic lateral sclerosis and structural defects in Cu,Zn superoxide dismutase.

Single-site mutants in the Cu,Zn superoxide dismutase (SOD) gene (SOD1) occur in patients with the fatal neurodegenerative disorder familial amyotrophic lateral sclerosis (FALS). Complete screening of the SOD1 coding region revealed that the mutation Ala4 to Val in exon 1 was the most frequent one; mutations were identified in exons 2, 4, and 5 but not in the active site region formed by exon 3. The 2.4 A crystal structure of human SOD, along with two other SOD structures, established that all 12 observed FALS mutant sites alter conserved interactions critical to the beta-barrel fold and dimer contact, rather than catalysis. Red cells from heterozygotes had less than 50 percent normal SOD activity, consistent with a structurally defective SOD dimer. Thus, defective SOD is linked to motor neuron death and carries implications for understanding and possible treatment of FALS.

Amino Acid Sequence↗
PubMed1996

Lateral mandibular reconstruction using soft-tissue free flaps and plates.

OBJECTIVE: To assess the outcome of patients who are undergoing reconstruction of segmental lateral mandibular defects by using soft-tissue free flaps combined with mandibular reconstruction plates. DESIGN: Retrospective case series of 15 patients who were undergoing primary reconstruction of mandibular segments posterior to the mental foramen, resulting from treatment of head and neck cancer. All patients received either preoperative or postoperative radiation therapy. SETTING: Academic tertiary care referral center. INTERVENTIONS: Fourteen patients had mandibular continuity restored by using the titanium hollow screw reconstruction plate system, and 1 patient received a stainless steel mandibular reconstruction plate. Associated soft-tissue defects were repaired by using radial forearm (n = 11), rectus abdominis (n = 2), scapular and parascapular (n = 1), or lateral arm (n = 1) free flaps. MAIN OUTCOME MEASURES: Early and delayed complications. RESULTS: All 15 microvascular free tissue transfers were successful. Early complications were minor and occurred in 5 (33%) of 15 patients. One patient in whom the titanium hollow screw reconstruction plate system had been used experienced a fracture at 15 months after reconstruction. Three patients experienced delayed external plate exposure between 7 and 15 months after primary oromandibular reconstruction. Patients who experienced delayed external plate exposure required secondary reconstruction with a vascularized bone-containing free flap. The overall rate of delayed reconstructive failure was 40% in patients who were followed up for a minimum of 1 year. CONCLUSIONS: For patients who are undergoing free flap reconstruction of lateral mandibulectomy defects, the technique that used soft-tissue free flaps combined with mandibular reconstruction plates has been abandoned in favor of using vascularized bone-containing free flaps or a combination of free flaps to achieve optimal long-term results.

Adult↗
PubMed2006

Giant lateral shift of a light beam at the defect mode in one-dimensional photonic crystals.

It is found that when a light beam is incident on a one-dimensional photonic crystal (1DPC) containing a defect layer, the lateral shifts of both the reflected and the transmitted beams are greatly enhanced near the defect mode of the 1DPC, whose location depends on the angles at a fixed frequency. The effect was studied by use of a Gaussian beam. The giant lateral displacement is due to the localization of the electromagnetic wave.

Journal Article↗
PubMed2005

Retinoic acid coordinates somitogenesis and left-right patterning in vertebrate embryos.

A striking feature of the body plan of a majority of animals is bilateral symmetry. Almost nothing is known about the mechanisms controlling the symmetrical arrangement of the left and right body sides during development. Here we report that blocking the production of retinoic acid (RA) in chicken embryos leads to a desynchronization of somite formation between the two embryonic sides, demonstrated by a shortened left segmented region. This defect is linked to a loss of coordination of the segmentation clock oscillations. The lateralization of this defect led us to investigate the relation between somitogenesis and the left-right asymmetry machinery in RA-deficient embryos. Reversal of the situs in chick or mouse embryos lacking RA results in a reversal of the somitogenesis laterality defect. Our data indicate that RA is important in buffering the lateralizing influence of the left-right machinery, thus permitting synchronization of the development of the two embryonic sides.

Aldehyde Oxidoreductases↗
PubMed2003

The indications and outcomes in the use of osteocutaneous radial forearm free flap.

INTRODUCTION: Whether secondary to cancer surgery ablation or trauma, surgeons are faced with defects of the mandible or maxilla that would be best reconstructed with a thin, pliable soft tissue component and vascularized bone. A subset of these challenging wounds do not require the bicortical bone necessary to reestablish structural integrity or to retain a dental prosthesis, because the soft tissue needs are more critical than the bony needs. It is this niche that the radial forearm osteofaciocutaneous free flap (RFOFF) fulfills well. In the past, potential and real donor site morbidity has precluded the routine use of this flap. New methods to reduce this morbidity have rekindled our use of this flap. PROCEDURES USED: A retrospective review of patients with defects of the mandible or maxilla treated with the RFOFF from July 1, 1997, to December 31, 2000, was performed. After flap harvest, the donor site was rigidly fixated. A skin graft was placed, and a volar splint was applied for 7 days. The arm was then fully mobilized. Parameters examined were defect location, donor site complications, flap survival, fistula occurrence, plate fracture, and/or extrusion. RESULTS: Thirty-four patients were reconstructed with the RFOFF with a follow-up of 10-54 months. Seven patients had an anterior maxillectomy defect, and 27 patients had a lateral mandibulectomy defect with associated tongue/tonsillar fossa and/or palate defect. There were no cases of flap failure or donor site radius fracture. During the follow-up period, there were no plate fractures or intraoral exposures as evidenced by clinical and radiographic evaluation. Fistulas occurred in five patients; all healed without surgical intervention. CONCLUSION: With rigid fixation of the residual radius, donor site morbidity has been minimized, and indications for this flap have expanded. Specifically the anterior maxillary arch and the ascending ramus, angle, and posterior body of the mandible (nontooth-bearing areas) are the sites most amenable to the thin bony stock of the harvested radius. The pliable forearm skin is ideal for the soft tissue defects. We believe that the RFOFF with bone has a definite role in the reconstruction of select head and neck defects.

Aged↗
PubMed1985

Lesions of the optic radiations mimicking lateral geniculate nucleus visual field defects.

Three patients were found to have visual field defects which involved homonymous horizontal sectors of the visual fields, thus mimicking field defects associated with lesions of the lateral geniculate nucleus. Computed tomography provided anatomical evidence that the responsible lesion involved the optic radiations rather than the lateral geniculate nucleus.

Adult↗
PubMed2004

The ubiquitin ligase XBAT32 regulates lateral root development in Arabidopsis.

Ubiquitin-mediated protein modification plays a key role in many cellular signal transduction pathways. The Arabidopsis gene XBAT32 encodes a protein containing an ankyrin repeat domain at the N-terminal half and a RING finger motif. The XBAT32 protein is capable of ubiquitinating itself. Mutation in XBAT32 causes a number of phenotypes including severe defects in lateral root production and in the expression of the cell division marker CYCB1;1::GUS. The XBAT32 gene is expressed abundantly in the vascular system of the primary root, but not in newly formed lateral root primordia. Treatment with auxin increases the expression of XBAT32 in the primary root and partially rescues the lateral root defect in xbat32-1 mutant plants. Thus, XBAT32 is a novel ubiquitin ligase required for lateral root initiation.

Alleles↗
PubMed2003

Outcome of untreated traumatic articular cartilage defects of the knee: a natural history study.

BACKGROUND: Articular cartilage damage has been reported in 23% of knees with an acute anterior cruciate ligament (ACL) injury and 54% of those with chronic ACL laxity. Because the purpose of surgery is to reconstruct the ACL, the chondral lesion is usually an incidental finding. It is not known if any of the numerous treatments that have been recommended for chondral defects alters the natural history of the untreated lesion. We sought to determine what effect, if any, an isolated articular cartilage defect observed at the time of ACL reconstruction would have on the radiographic, subjective, and objective results after surgery if no intervention was performed on the cartilage lesion itself. METHODS: From 1987 to 1999, 2770 ACL reconstructions were performed, and 125 of them were done in patients who had an articular cartilage defect of Outerbridge grade 3 or 4 but had both menisci intact. The mean defect size was 1.7 cm (2) (range, 0.5 to 6.5 cm (2) ). Postoperative rehabilitation was not altered because of the chondral defect, and patients were allowed full weight-bearing and the full range of motion of which they were capable. A control group of patients matched on the basis of sex and age at surgery was identified from the database. No patient in the control group had a chondral defect or meniscal tear. Patients were evaluated at one, two, and five years after surgery and every five years thereafter with use of the IKDC (International Knee Documentation Committee) criteria, modified Noyes subjective questionnaire, and radiographs. RESULTS: Subjective follow-up was carried out more than two years after surgery (mean time, 8.7 years after surgery) for 101 patients. The results of objective evaluation were available for fifty-two patients, at a mean of 6.3 years. The patients in the control group had significantly higher subjective scores than did the patients with a defect in the medial compartment (mean, 95.2 points versus 94.0 points; p = 0.0451) and those with a defect in the lateral compartment (mean, 95.9 points versus 92.8 points; p = 0.0047). There was no significant correlation between larger defect size and lower subjective scores (p = 0.2543). The distribution of IKDC radiographic ratings was not significantly different between the groups. At least 79% of the patients in both groups returned to jumping, twisting, and pivoting sports at least at the recreational level. CONCLUSIONS: While statistical analysis revealed a difference in subjective scores between the defect and control groups, an average of 93 points for the patients with a lateral defect and 94 points for those with a medial defect indicates that most patients have very few symptoms. This study provides a baseline of information that can be used to compare the results of procedures designed to treat articular cartilage defects.

Adult↗
PubMed1992

Visual field defects in vascular lesions of the lateral geniculate body.

Corresponding retinal nerve fibres begin their path in the eyes and end in a single visual cortical cell. Because of this arrangement, lesions in the anterior visual pathway produce incongruent visual field defects and in the posterior pathway congruent field defects. The lateral geniculate body is on the anterior third of the visual pathway. A lesion of this nucleus produces moderately to completely congruent visual field defects. Five patients with ischaemic lesions of the lateral geniculate body are reported. Two patients had a wedge-shaped homonymous hemianopia, two other cases had congruent superior homonymous quadratic defects and the fifth a quadruple sector defect. The lateral geniculate body has a dual blood supply from the anterior choroidal artery (branch from internal carotid artery) and from the lateral choroidal artery (branch from the posterior cerebral artery). A schematic diagram has been devised which shows that a knowledge of the visual field disrupted can identify the arterial system involved.

Aged↗
PubMed2002

[Repair of the facial tissue defects with reversed narrow pedicle lateral maxillocervical fasciocutaneous flap].

OBJECTIVE: To introduce a method of repairing facial tissue defects caused by various factors. METHODS: The reverse narrow pedicle lateral maxillocervical fasciocutaneous flap was designed with its pedicle located in front of auricle. The size of the flaps ranged from 5 cm x 6 cm to 10 cm x 11 cm. The length and width of the pedicle ranged 2 cm-5 cm and 1 cm-1.5 cm. RESULTS: This fasciocutaneous flap was used in 21 cases. All flaps survived except 1 flap showing distal skin necrosis. CONCLUSION: This fasciocutaneous flap didn't include any major blood vessel. The ratio of the pedicle width to flap length broke that of traditional flap and was reverse transfer. The transposition of the narrow pedicle flap was easy. The postoperative appearance (color, texture, cosmetic aspect) was satisfactory. This method was a new design and was ideal for large facial tissue defect repair.

Adolescent↗