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At least 343 records · Page 19Linked to original sources
PubMed1994

Fresh osteochondral allografts for treatment of articular defects in osteochondritis dissecans of the lateral femoral condyle in adults.

Fresh osteochondral allografts were used to patch defects in the lateral femoral condyle in 17 patients with osteochondritis dissecans. The patients included 12 males and five females, ages 16 to 46 years. All had previously undergone other procedures including pinning (4), primary removal of osteochondral fragments (16), and abrasion arthroplasty (14). Defects up to 3 cm in diameter were treated with isotopic grafts and fixed with Herbert screws. Larger defects were treated with crescent-shaped grafts fixed with multiple Herbert screws. Follow-up time ranged from two to nine years. Pain, stiffness, swelling, buckling, and locking were ablated in 16 of the 17 patients. No graft collapse has been noted in these individuals. Verification of graft viability was achieved at periods from six weeks to six years, typically at the time of hardware removal. The only failure occurred in an individual with a 3- x 4.5-cm defect who suffered gross fragmentation which left a large crater. Osteochondritis dissecans of the lateral femoral condyle provides an ideal opportunity for evaluating osteochondral grafts. Sixteen of 17 grafts were a success at two to nine years after surgery.

Adolescent↗
PubMed2001

Clinical aspects of defects in the determination of laterality.

Of individuals in the human population, 99.99% have developed identical thoracoabdominal asymmetry with the cardiac apex, a bilobed lung, the stomach, and the spleen on the left side of the midline, and the vena cavae, a trilobed lung, the appendix, and the larger liver lobe on the right. This arrangement of organs is situs solitus. Occasionally, individuals have a complete, mirror-image reversal of this asymmetry called situs inversus, and 20-25% of those individuals have an autosomal recessive condition, Kartagener syndrome, with ciliary dyskinesia, bronchiectasis, sinusitis, and infertility. Between these extremes of situs solitus and situs inversus lies the spectrum of situs ambiguus, characterized by isomerism, heterotaxy, and multiple malformations in one or more thoracic or abdominal organs. Although most abnormal situs in humans occurs sporadically, growing evidence suggests that interference with normal genetic mechanisms and pathways may be responsible for most cases. Familial cases suggest major effects of both autosomal and X-linked genes with both dominant and recessive expression. Situs inversus and situs ambiguus (SI/SA) occurring in probands who have close relatives with "isolated," nonsyndromic birth defects suggests that some of the pathways important in situs determination may also be involved in causing sporadic malformations not obviously associated with a defect in laterality determination. Human phenotypes of interest include the association of SI/SA with short rib-polydactyly syndromes and renal-hepatic-pancreatic dysplasia, and with agnathia and holoprosencephaly. Further elucidation of the developmental pathways involved in left-right axis determination should shed light on the causes of and relationships among these human phenotypes.

Animals↗
PubMed1994

A biomechanical analysis of prophylactic fixation for pathological fractures of the distal third of the humerus.

Twenty-four matched pairs of fresh-frozen humeri from human cadavera were divided randomly into four groups, in order to determine the most biomechanically desirable construct for the prophylactic fixation of impending fractures of the distal third of the humerus. Group I comprised intact humeri and matched humeri in which a 50 per cent lateral, semicylindrical cortical defect of the distal third had been created, resulting in a reproducible model of an impending fracture due to a lytic defect involving 50 per cent cortical disruption at the distal end of the humeral medullary canal. In Group II, such a lateral defect was created in both the right and the left, matched humeri. Group III was composed of humeri in which the defect had been fixed prophylactically with a single plate and the contralateral humeri, which had been treated with double-plating. Group IV comprised specimens in which the defect had been fixed with double-plating as well as those fixed with Rush rods. The fixation of each specimen in Groups III and IV was supplemented with bone cement. Each specimen was tested in torsion to failure, and the resulting peak torque, torsional stiffness, and total energy absorbed were analyzed for each group. The Group-I specimens that had a defect had a significantly lower (p < 0.05) peak torque, torsional stiffness, and total energy absorbed than the intact specimens; all of the specimens with a defect failed at the defect, and all of the intact specimens failed proximally. In Group II, there was a high side-to-side association with respect to peak torque, torsional stiffness, and total energy absorbed.(ABSTRACT TRUNCATED AT 250 WORDS)

Biomechanical Phenomena↗
PubMed2000

Repair of cardiac defects through a shorter right lateral thoracotomy in children.

BACKGROUND: Median sternotomy is a conventional approach for correction of cardiac defects for many years; however, the cosmetic result is poor. Therefore, right lateral thoracotomy was tested as an alternative procedure with a better cosmetic outcome. METHODS: Between October 1994 and February 1999, 683 patients underwent correction of congenital cardiac malformations during a cardiopulmonary bypass through right lateral thoracotomy involving a shorter incision through the third or the fourth intercostal space. All of the patients were children. The average age was 3.26+/-1.67 years (range, 4 months to 7 years). The average weight was 13.59+/-4.37 kg (5 to 40). The patients had various cardiac defects and associated anomalies. RESULTS: Only 2 patients died after operation, 1 from low cardiac output and the other from severe pulmonary infection. The hospital morbidity was lower. The mean cardiopulmonary bypass time was 58.67+/-35.11 minutes (range, 16 to 430 minutes), the mean aortic cross-clamping time was 35.03+/-24.84 minutes (range, 3 to 205 minutes). The postoperative average mechanical ventilation time was 19.23+/-39.11 hours (range, 2 to 391 hours), and the mean postoperative stay was 8.55+/-12.54 days (range, 5 to 293 days). CONCLUSIONS: The right lateral thoracotomy incision is a safe and effective alternative to a median sternotomy for correction of cardiac defects. Advantages of this approach compared with median sternotomy are less injury, maintenance of the continuity and the integrity of the bony thorax, and prevention of the development of "pigeon-chesting." The scar is less visible, hence, the cosmetic result can meet patient expectations. This procedure is consistent with the idea of minimal invasive surgery.

Cardiopulmonary Bypass↗
PubMed1977

Congenital defects of the upper lateral incisors (ULI): condition and measurements of the other teeth, measurements of the superior arch, head and face.

We surveyed a French male population for the incidence of missing or reduced upper lateral incisors (ULI). In 5,738 subjects, we observed an incidence of 1.59% with one or two reduced ULI (the other normal) and 1.90% with one or two missing ULI (the other normal or reduced), altogether, 3.49% affected subjects. Furthermore, 250 random controls were observed. Agenesis of other teeth is more frequent in propositi. Missing thir molars were 12.4% in controls, 24.0% in propositi with reduced ULI and 39.6% in propositi with two missing ULI. Furthermore, agenesis of incisors, canines and premolars ranges from 0.4% in controls to 1.3% in propositi having reduced ULI and 5.0% in propositi with two missing ULI. So, propositi with reduced ULI are intermediate between the controls and the propositi with missing ULI with respect to the freeuency of agenesis of other teeth. On the other hand, a different ranking is observed with respect to the teeth measurements: reduction of tooth size is more marked in propositi with reduced ULI than in propositi with missing ULI. The reduction mainly affects canines, incisors and to a lesser degree, premolars. Arch length and interpremolar diameters are smaller in propositi with missing ULI, compared with controls.

Adolescent↗
PubMed1977

Congenital defects of the upper lateral incisors: multivariate analysis of measurements of the other teeth, the superior arch, head and face.

The survey of a French male population allowed us to ascertain 75 propositi with one or two missing ULI, 59 propositi with one or two reduced ULI and 99 controls on whom measurements (mesiodistal and buccolingual diameters) of all of teeth of the superior arch are available. Principal Component Analysis gave a first estimated principal component highly correlated with each of the dental measurements of arch measurements. This size factor was eliminated by observing the plane of the second and third principal components. Strikingly different clusters of MD diameters or BL diameters were observed for the controls, the propositi missing one or two fo the ULI and the propositi with reduced ULI. For the controls, the arch length is correlated with the MD molar diameters and the MD incisor diameter, the arch width being isolated from the other measurements. For the propositi with missing ULI, among the dental measurements the MD and BL diameters cluster, the arch length is isolated as are the arch widths. For the propositi with reduced ULI, the rich length is closer to the dental measurements while the widths, especially the first one, are isolated. The best discriminant measurements are the diameters of the first premolars and the canine, the first arch width and the arch length. Among controls, the arch is narrowed and shorter for the propositi with absence and wider for the propositi with reduction. Teeth measurements are always smaller in propositi.

Adolescent↗
PubMed1980

Congenital defects of the upper lateral incisors (ULI) and the morphology of other teeth in man.

A sample of 192 male propositi with at least one ULI either missing or reduced has been compared with 197 male controls in terms of the morphology of the other teeth. Every class of propositi exhibits modifications in the following characters: Significant differences between propositi and controls were found for molar cusp number and groove pattern, particularly in the lower first molar and in propositi with reduced ULI. Significant differences between propositi and controls were also found with respect to caniniform pattern of the lower first premolar. The Carabelli's cusp is rarer in propositi. A hypothesis to account for these observations is proposed.

Adolescent↗
PubMed2006

Cartilage regeneration using mesenchymal stem cells and a PLGA-gelatin/chondroitin/hyaluronate hybrid scaffold.

The study was to produce a novel hybrid poly-(lactic-co-glycolic acid) (PLGA)-gelatin/chondroitin/hyaluronate (PLGA-GCH) scaffold and evaluate its potentials in cartilage repair. The porous PLGA-GCH scaffold was developed to mimic the natural extra cellular matrix of cartilage. The differentiated mesenchymal stem cells (MSCs) seeded on PLGA-GCH or PLGA scaffold were incubated in vitro and showed that, compared to PLGA scaffold, the PLGA-GCH scaffold significantly augmented the proliferation of MSCs and GAG synthesis. Then autologous differentiated MSCs/PLGA-GCH was implanted to repair full-thickness cartilage defect in rabbit, while MSCs/PLGA for the contra lateral cartilage defect (n=30). Fifteen additional rabbits without treatment for defects were used as control. Histology observation showed the MSCs/PLGA-GCH repair group had better chondrocyte morphology, integration, continuous subchondral bone, and much thicker newly formed cartilage compared with MSCs/PLGA repair group 12 and 24 weeks postoperatively. There was a significant difference in histological grading score between these two groups, which both showed much better repair than control. The present study implied that the hybrid PLGA-GCH scaffold might serve as a new way to keep the differentiation of MSCs for enhancing cartilage repair.

Animals↗
PubMed1993

Clinically asymptomatic xeroderma pigmentosum neurological disease in an adult: evidence for a neurodegeneration in later life caused by defective DNA repair.

Xeroderma pigmentosum is a genetically heterogeneous disease caused by DNA repair defects resulting in skin cancer and, in some patients, a primary neuronal degeneration which has in all previous reports become symptomatic prior to age 21 years. A 47-year-old xeroderma pigmentosum patient is described who, although neurologically asymptomatic, has sensorineural hearing loss together with clinical signs and electrophysiologic evidence of a developing peripheral neuropathy. This case suggests that defective DNA repair may cause neurodegeneration in adults as well as in children.

Consanguinity↗
PubMed2007

The distal lateral arm flap for resurfacing of extensive defects of the digits.

The distal lateral arm flap (DLAF) was used to reconstruct six extensive defects of the digits: 2 degloving injuries of the thumb and 4 major skin losses of the fingers. Two adjacent fingers were involved in 1 patient. Flap size ranged from 3 x 7 cm to 9 x 14 cm. Four flaps were reinnervated using the posterior cutaneous nerve of the forearm. All flaps survived, though 1 showed marginal necrosis. Average follow-up was 53.4 months. Thumb opposition scored 5 according to Kapandji; finger ROM averaged 50.75%; pinch strength 72.5%. Protective sensation with touch localization was restored. Patient satisfaction for resurfaced digits averaged 8.9 on a 10-points visual analogic scale. All donor sites resulted in a painless scar with good patient satisfaction. The DLAF offers a thin, pliable skin ideal for digit reconstruction, with low rate of donor site morbidity and can be considered when toe-to-hand flap transfer is not advisable or refused by the patient.

Adult↗
PubMed1975

Geniculate hemianopias: incongruous visual defects from partial involvement of the lateral geniculate nucleus.

Quantitative perimetric studies in 4 patients with involvement of a lateral geniculate nucleus revealed strikingly incongruous defects in the corresponding homonymous fields of vision. The patterns of these hemianopias are analysed and correlated anatomically with established retinotopic projections on the six cellular laminae of the geniculate nucleus. Incongruous wedge-shaped field defects appear to be pathognomonic of focal disease in the dorsal crest of the geniculate nucleus. Other patterns typify lesions of the medical or lateral horns of the nucleus. On theoretical grounds monocular hemianopic defects should result from unilaminar geniculate lesions, but this perimetric sign awaits confirmation. In each case of geniculate disease where the retinal nerve fibre layer has been examined specifically for efidence of retrograde homonymous atrophy, typical hemiretinal signs were found to be present.

Adolescent↗
PubMed1984

Congruous and incongruous sectoral visual field defects with lesions of the lateral geniculate nucleus.

Quantitative perimetric studies in two women, each 52 years of age, with involvement of the lateral geniculate nucleus (caused by a small arteriovenous malformation in one and by an astrocytoma in the other) disclosed a striking wedge-shaped horizontal sectoranopia that was perfectly congruous in one case and incongruous in the other. Selective interruption of the dual blood supply to the lateral geniculate nucleus (with the anterior choroidal artery supplying the anterior hilus, together with the anterior and lateral nucleus and the lateral choroidal artery supplying the remainder of the nucleus) may result in a congruous visual field defect with steeply sloping borders because such a lesion must respect the anatomic boundaries produced by this vascular supply. Partial infiltration or involvement of the lateral geniculate nucleus (where uncrossed retinal projections terminate in one group of laminae, while crossed retinal projections terminate in another) provides a logical explanation for the occurrence of incongruous visual field defects. This unusual horizontal wedge-shaped defect should suggest lateral geniculate nucleus involvement, especially in the absence of trauma.

Choroid↗
PubMed2001

Ophthalmological outcome following orbital resection in anterior and anterolateral skull base surgery.

OBJECT: Partial resection of the orbital bones is not uncommon during the excision of anterior and anterolateral skull base tumors. Controversy exists regarding the need for and extent of the reconstruction necessary following this resection. The authors studied this factor in a series of patients. METHODS: The authors conducted a retrospective review of 56 patients in whom resection of 57 anterior or anterolateral skull base tumors and partial excision of the orbital bone were performed. Adverse ophthalmological outcomes were noted in 16 patients, in nine of whom adverse outcomes were believed to be directly related to resection of the orbital walls. Some degree of orbital reconstruction was performed during 23 of the 57 procedures. An adverse orbit-related outcome was strongly associated with resection of the orbital floor and with resection of two thirds or more of two or more orbital walls but not with the presence of absence or orbital reconstruction. The latter finding, however, is likely a function of selection bias. CONCLUSIONS: In most patients after partial excision of the orbital bones, elaborate reconstruction is not necessary. Isolated medial and lateral orbital wall defects or combined superior and lateral orbital wall defects, especially in cases in which the periorbita is intact, probably do not require primary reconstruction. In cases of orbital floor defects, whether isolated or part of a multiple wall resection, primary reconstruction is recommended.

Craniotomy↗
PubMed2002

Ophthalmological outcome after orbital entry during anterior and anterolateral skull base surgery.

OBJECT: Partial resection of the orbital bones is not uncommon during the excision of anterior and anterolateral skull base tumors. Controversy exists regarding the need for and extent of reconstruction after this procedure. The authors studied this factor in a series of patients. METHODS: The authors conducted a retrospective review of 56 patients in whom resection of 57 anterior or anterolateral skull base tumors and partial excision of the orbital bone were performed. Adverse ophthalmological outcomes were noted in 16 patients, in nine of whom adverse outcomes were believed to be directly related to resection of the orbital walls. Some degree of orbital reconstruction was performed during 23 of the 57 procedures. An adverse orbital outcome was strongly associated with resection of the orbital floor and resection of two thirds or more of two or more orbital walls, but not with the presence or absence of orbital reconstruction. The later finding, however, is likely a function of selection bias. CONCLUSIONS: In most patients elaborate orbital reconstruction is not necessary after partial excision of the orbital bones. Isolated medial and lateral orbital wall defects, or combined superior and lateral orbital wall defects, especially in cases in which the periorbita is intact, probably do not require primary reconstruction. In cases of orbital floor defects, whether isolated or part of a multiple-wall resection, primary reconstruction is recommended.

Female↗
PubMed2004

Combined free fibular osteocutaneous-lateral calcaneal fasciocutaneous flap for reconstruction of composite oromandibular defects.

The free fibular osteocutaneous flap is often used in the reconstruction of composite oromandibular defects. In contrast, the lateral calcaneal flap has never been used in oromandibular reconstruction. On the basis of their anatomic continuity, the authors combined the free fibular osteocutaneous flap with the lateral calcaneal skin paddle to obtain 2 adjoining flaps in different anatomic areas with the same vascular axis. The authors report their experience in 3 patients with composite oromandibular defects. In 1 patient without an outer skin defect, only a sensory lateral calcaneal skin paddle with a fibular osseus flap was harvested. The lateral calcaneal flap carried the sural nerve as a sensory flap in 2 patients, and the result was passable. Only 1 patient encountered superficial flap tip necrosis at the lateral calcaneal skin paddle, and recovered well after wound care. In conclusion, a flap with many specific features is a feasible choice for reconstruction of composite oromandibular defects.

Aged↗