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Results for “laterality defects”

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PubMed1981

[Practolol test for adrenergic beta receptor blockade in veterinary electrocardiographic diagnosis].

The receptor theory of the action of catecholamines as well as the synthesis and production of beta-adrenolytics gave new perspectives for the treatment of circulatory diseases and enabled to use the beta-adrenergic blockade in electrocardiographic diagnosis. The aim of this work was to study whether it is possible to modify the oral method of administration used in human beings, into intravenous one, and what an information could be obtained as to actual heart condition after practolol injection. The results can be summarized as follows:--Practolol-Polfa injected intravenously in amounts of 30-50 mg for horse or cow and 3-10 mg for dog in ten minutes deviates the curve evoked by sympathectomy;--after the administration of the drug functional changes of final ventricular complex disappear which is the result of adrenergic system prevalence;--repolarization disturbances observed after the blockade indicate a myocardial defect and later, a partial decrease of changes in T wave shows that a vegetative factor is involved;--increased disturbances of the repolarisation phase after the practolol test indicate of myocardial defect due to compensatory mechanism of adrenergic system in relation to serious hemodynamic disturbances of the heart;--practolol test gives wider possibilities of interpretation, not only from the diagnostic point of view, but therapeutic as well.

Animals↗
PubMed1996

Automated determination of the left ventricular long axis in cardiac positron tomography.

Interpretation of emission tomographic images of the heart is typically performed using short-axis sections which are oriented perpendicular to the long axis of the left ventricle. A completely automated method is presented to find the orientation and length of the long axis in positron emission tomographic studies of the heart. The correlation coefficient is maximized between the measured transaxial images and an ellipsoid model of the left ventricular myocardium. The major axis of this fitted ellipsoid corresponds to the long axis of the left ventricle. The orientation and position of the long axis (with respect to the measured transaxial images) define two rotation angles and a 3D coordinate origin which are used to re-orient the transaxial images into a series of standard short-axis sections. The accuracy and precision of this technique are validated on phantom data as well as on patients with documented myocardial infarction. The transaxial and vertical long-axis rotation angles are determined with standard deviations of 3.3 degrees and 1.5 degrees, respectively. The 3D coordinate origin (centre) of the ellipsoid is accurate to within 1.5 mm on average. The estimated length of the left ventricle is accurate to within 3 mm. All parameters are insensitive to statistical noise found in typical 18F-fluorodeoxyglucose (FDG) patient studies. The technique produces accurate estimates even in the presence of moderate uptake defects in the lateral wall and septum. Apical defects in the uptake of FDG do not increase the variance of the length estimate. These results demonstrate that an ellipsoid model can be fitted accurately to the myocardium of the left ventricle. Standard short-axis sections are produced with no inter-operator or intra-operator variability because the technique is fully automatic.

Deoxyglucose↗
PubMed2003

Genetics of human laterality disorders: insights from vertebrate model systems.

Many internal organs in the vertebrate body are asymmetrically oriented along the left-right (L-R) body axis. Organ asymmetry and some components of the molecular signaling pathways that direct L-R development are highly conserved among vertebrate species. Although individuals with full reversal of organ L-R asymmetry (situs inversus totalis) are healthy, significant morbidity and mortality is associated with perturbations in laterality that result in discordant orientation of organ systems and complex congenital heart defects. In humans and other vertebrates, genetic alterations of L-R signaling pathways can result in a wide spectrum of laterality defects. In this review we categorize laterality defects in humans, mice, and zebrafish into specific classes based on altered patterns of asymmetric gene expression, organ situs defects, and midline phenotypes. We suggest that this classification system provides a conceptual framework to help consolidate the disparate laterality phenotypes reported in humans and vertebrate model organisms, thereby refining our understanding of the genetics of L-R development. This approach helps suggest candidate genes and genetic pathways that might be perturbed in human laterality disorders and improves diagnostic criteria.

Animals↗
PubMed2006

Is septal glucose metabolism altered in patients with left bundle branch block and ischemic cardiomyopathy?

UNLABELLED: Left bundle branch block (LBBB) is common in patients with heart failure (HF) and contributes to left ventricular (LV) dysfunction. The abnormal septal motion may alter septal metabolic demand but this has not been well characterized in patients with ischemic cardiomyopathy (ICM) and LV dysfunction. The aim of this study was to determine the effect of LBBB on septal metabolism in patients with ICM, LV dysfunction, and LBBB. METHODS: Fifty-three patients with LV dysfunction and ICM were identified: 34 with LBBB, 19 with normal QRS (</=100, control patients). PET using (18)F-FDG and (82)Rb was used to measure myocardial glucose metabolism and perfusion, respectively. Perfusion-metabolism differences were determined. Scar scores (matched decreases in (18)F-FDG and (82)Rb), mismatch scores (hibernating myocardium with decreased (82)Rb relative to (18)F-FDG), and reverse-mismatch (R-MM) scores (reduced (18)F-FDG relative to (82)Rb) were assessed in the septum and lateral wall. RESULTS: (18)F-FDG uptake in the septum was reduced in patients with LBBB (64.0% +/- 15.4%) compared with control patients (74.9% +/- 14.3%; P < 0.05). Mean septal R-MM was greater in patients with LBBB (19.1% +/- 15.3%) versus control patients (4.7% +/- 10.6%; P < 0.05). However, 32% (11/34) of patients with LBBB did not demonstrate septal R-MM, 91% (10/11) of whom demonstrated lateral wall perfusion defects. Of the 68% (23/34) of patients with LBBB and septal R-MM, 52% (12/23) demonstrated lateral wall perfusion defects (P < 0.05). There was a significant difference in the percentage of the lateral wall with scar between those with septal R-MM (9.3% +/- 10.5%) and those without (19.9% +/- 14.3%; P < 0.05). CONCLUSION: Previously, LBBB was believed to be characterized by reduced glucose metabolism relative to perfusion in the septum; however, this is not always the case in ICM. LBBB is not associated with septal R-MM in >30% of this patient population. Absence of this finding was often associated with lateral wall perfusion defects, suggesting an alteration in the metabolic demand on the septum. This may have implications for HF therapies such as resynchronization and requires further study.

Aged↗
PubMed1990

Lip reconstruction with motor and sensory innervated composite flaps.

Among the most elegant of recent flap refinements are innervated composite skin-muscle-mucosal flaps that restore the oral sphincter and carry both motor and sensory nerves. These flaps are based on the orbicularis oris, depressor anguli oris, and levator anguli oris perioral muscles of facial expression. Each flap can be dissected in a manner that allows transfer of the muscle into the oral sphincteric ring while restoring lip form and preserves the motor and sensory innervation. Each flap can be designed to carry skin and mucosa as needed for cover, lining, and vermilion reconstruction. Choice is determined by the specific anatomic lip defects. The orbicularis oris flap is most useful for large central defects of either the upper or lower lip. The depressor anguli oris flap is most useful for lateral lower lip defects or total lower lip reconstruction with bilateral flaps. The levator anguli oris is most useful for upper lip lateral element defects or for total upper lip restoration with bilateral flaps and an Abbe flap philtral reconstruction. Innervated composite flaps demonstrate substantial advantages when compared with preceding methods because of the superior function conveyed by the sphincter reconstruction and preserved motor and sensory nerve innervation.

History, 15th Century↗
PubMedDate not supplied

The frequency, appearance, and significance of splenic perfusion defects in CT arterial portography.

BACKGROUND: The purpose of this study was to determine the frequency, appearance, and significance of splenic perfusion defects on computed tomographic arterial portography (CTAP). METHODS: CTAP was performed with dynamic scanning at 1-cm increments on 46 consecutive patients prior to laparotomy. Two readers retrospectively reviewed these studies in consensus and recorded the number, size, and shape of focal splenic perfusion defects. These defects were later correlated with surgical findings and at least one of the following imaging modalities: delayed CT 4-6 h after CTAP, intravenously enhanced CT, sonography, or magnetic resonance imaging (MRI). RESULTS: Splenic perfusion defects were present in 14 of 46 CTAP studies (30%), and in seven patients these defects were multiple. Most defects were wedge-shaped and peripherally located, although several round defects simulating metastases were also present. The spleen was normal at surgery in all patients, and comparison imaging revealed only a small splenic infarct in one patient on MRI. CONCLUSIONS: Splenic perfusion defects occur in about one-third of patients referred for CTAP, are usually wedge-shaped but may be round, and should not be interpreted as metastases without other evidence of a space-occupying mass.

Contrast Media↗
PubMed2006

[Filling of a lateral pre-malleolar soft tissue defect with the extensor digitorum brevis flap and the abductor digiti minimi flap].

The authors report the filling of a lateral pre-malleolar soft tissue defect after sub-talar arthrodesis. Four months after surgery the loss of substance measured 2,5 cm in depth, 3 cm diameter at the skin level and 5 cm diameter at the bone level. An autologous tricortical bone graft impacted in the sinus tarsi was also exposed. In this area of the body, soft tissue coverage is difficult because of the lake of local sub-cutaneus tissue and muscle. The authors used two locoregional pedicled flaps: the extensor digitorum brevis flap and the abductor digiti minimi flap. These transfers left a minimum of functional and aesthetic after-effects. The optimal coverage of the exposed structures allowed the patient to walk thirty days after surgery. The way to harvest these flaps, their advantages and disadvantages are detailed.

Adolescent↗
PubMed1996

Full characterization of the maculopathy associated with an Arg-172-Trp mutation in the RDS/peripherin gene.

The objective of this study was to fully characterize the macular dystrophy phenotype and genotype in a large family of the Zermatt area of Switzerland. Clinical and molecular studies of the family included a comprehensive eye examination and a mutational analysis of the RDS, rhodopsin, and TIMP-3 genes. In selected cases, fluorescein angiography, perimetry, and electroretinography were performed. Forty-two family members at risk of expressing the maculopathy were studied. Of these, 24 were found to be clinically affected. The severity of macular disease in these patients was clearly age-related and different stages of progression were identified. Central pigmentary alterations were seen in adolescent patients, while patients in their late teens and twenties exhibited drusen-like deposits. Later, these defects formed focal areas of atrophy which eventually led to central geographic atrophy with severe visual loss by the fifth decade and cone-rod dysfunction. The transmission of this condition is autosomal dominant with complete penetrance. The underlying genetic defect is a mutation in codon 172 of the RDS/peripherin gene, a gene expressed in both rods and cones, which results in the substitution of tryptophan for an arginine residue at that position. 'Zermatt macular dystrophy' is a dominant, age-related, progressive macular dystrophy which in later stages resembles atrophic age-related macular degeneration. The size of the family studied allowed definition of the clinical spectrum of this condition and identification of the related genetic defect which allows more precise diagnosis and counseling.

Adult↗
PubMedDate not supplied

Ultrastructural changes of mitochondria in the skeletal muscle of patients with amyotrophic lateral sclerosis.

Functional defects and morphological changes of mitochondria have been reported to be in the skeletal muscle of patients with amyotrophic lateral sclerosis (ALS). Recent studies suggested that mitochondrial abnormalities are related to the pathogenesis of ALS. The purpose of this study is to evaluate the ultrastructural changes of muscle mitochondria in ALS patients. The authors examined 49 cases of diagnostic muscle biopsy samples with definite or probable ALS by electron microscopy. Of the 49 cases, 5 (10%) had ultrastructural abnormalities of muscle mitochondria, including giant mitochondria, paracrystalline inclusions, and abnormal cristae. These abnormal mitochondria were mainly observed among subsarcolemmal mitochondrial aggregates.

Adult↗
PubMed2006

The role of the lateral thoracodorsal fasciocutaneous flap in immediate conservative breast surgery reconstruction.

BACKGROUND: Although the lateral thoracodorsal fasciocutaneous flap is a well-studied procedure for late breast reconstruction following radical surgery, there are few previous reports regarding its indication, flap design, and clinical outcome following conservative breast surgery. METHODS: Thirty-four patients underwent immediate unilateral lateral thoracodorsal fasciocutaneous flap breast reconstructions. Mean time of follow-up was 23 months. The lateral thoracodorsal fasciocutaneous flap was indicated to reconstruct moderate lateral breast defects where there was not enough breast tissue to perform the reconstruction. Flap and donor-site complications were evaluated. Information on aesthetic results and patient satisfaction was collected. RESULTS: All tumors were located in lateral breast regions, and 64.7 percent measured 2 cm or less (T1). Flap complications occurred in four patients (11.8 percent), with partial flap necrosis in three (8.8 percent). Donor-site complications occurred in eight (23.5 percent), with seroma in five (14.7 percent) and wound dehiscence in three (8.8 percent). The cosmetic result was considered to be good or very good in 88.2 percent, and the majority of patients were either very satisfied or satisfied. Surgical intervention was necessary in two cases of wound dehiscence. Serial dorsal puncture in cases of seroma were performed with satisfactory results. CONCLUSIONS: The lateral thoracodorsal fasciocutaneous flap is a simple and reliable technique for conservative breast surgery reconstruction. Success depends on patient selection, coordinated planning with the oncologic surgeon, and careful intraoperative management.

Adult↗
PubMed1999

Treatment of osteochondral defects with tendon autografts in a dog knee model.

Tendon autograft was used for the treatment of osteochondral defects induced experimentally in dogs' knees. Osteochondral defects were created on the femoral condyles in both knees of five dogs. The tendon was harvested from the anterior cruris, and a knot was tied in the middle. Then two tunnels were bored in the medial condyle. The free ends of the tendon were individually inserted into the tunnels and pulled from the openings on the medial recessus side so that the knot itself sat within the osteochondral defect. The lateral condyle was left untreated for comparison. At 24 weeks postoperatively, the dogs were killed and macroscopical and histological examinations were performed. A congruous articular surface had formed, and the grafted tendon was bonded into the defect. The tendon was not degraded, and was covered with reparative tissue as seen microscopically. Despite weight-bearing being allowed in the early stages after the operation, no sign of degradation was noted in the tendon.

Animals↗
PubMed2004

A case of pulmonary embolism after abdominal angiography.

The patient was a 72-year-old woman who had been diagnosed with cholecystolithiasis and had undergone laparoscopic cholecystectomy. Since the postoperative pathologic diagnosis was a gallbladder cancer with a depth of wall penetration of subserosa, she was admitted to Kurume University Hospital for a second-look operation. After admission, abdominal angiography was performed with a right femoral arterial puncture. After the release of inguinal compression with a belt, chest pain and difficulty in breathing appeared. Despite her normal blood pressure, arterial blood gas analysis showed a PO2 of 74.7 mmHg and a PCO2 of 41.5 mmHg, representing a slight decrease in PO2. Chest X-rays showed an increased cardiothoracic ratio and decreased lucency in the left upper lung field. The electrocardiogram revealed atrial premature contraction. Cardiac ultrasound did not show expansion of the right heart and blood vessels or abnormal structures in the main pulmonary artery. Since lung perfusion scintigraphy revealed perfusion defects in the left upper to middle and right upper lung fields, acute pulmonary embolism was diagnosed, and oxygen inhalation, thrombolytic, and anticoagulant therapy were instituted immediately. The symptoms improved the following day, but 240,000 u/day of urokinase was administered for 5 days, and 1,500 u/day of heparin for 10 days. On lung perfusion scintigrams 6 days later, the defects had disappeared. Moreover, no definite abnormal shadows were noted on chest X-rays. Radical surgery for gallbladder cancer was performed 3 weeks later. Considering the possible development of pulmonary embolism, we felt the need for careful management if the patient is released from bed rest after abdominal angiography.

Aged↗
PubMed2004

MicroRNAs act sequentially and asymmetrically to control chemosensory laterality in the nematode.

Animal microRNAs (miRNAs) are gene regulatory factors that prevent the expression of specific messenger RNA targets by binding to their 3' untranslated region. The Caenorhabditis elegans lsy-6 miRNA (for lateral symmetry defective) is required for the left/right asymmetric expression of guanyl cyclase (gcy) genes in two chemosensory neurons termed ASE left (ASEL) and ASE right (ASER). The asymmetric expression of these putative chemoreceptors in turn correlates with the functional lateralization of the ASE neurons. Here we find that a mutation in the die-1 zinc-finger transcription factor disrupts both the chemosensory laterality and left/right asymmetric expression of chemoreceptor genes in the ASE neurons. die-1 controls chemosensory laterality by activating the expression of lsy-6 specifically in ASEL, but not in ASER, where die-1 expression is downregulated through two sites in its 3' untranslated region. These two sites are complementary to mir-273, a previously uncharacterized miRNA, whose expression is strongly biased towards ASER. Forced bilateral expression of mir-273 in ASEL and ASER causes a loss of asymmetric die-1 expression and ASE laterality. Thus, an inverse distribution of two sequentially acting miRNAs in two bilaterally symmetric neurons controls laterality of the nematode chemosensory system.

Animals↗
PubMed2004

One-stage reconstruction of an alar defect using a bilobed nasolabial-nasal tip flap based on the aesthetic subunits in Orientals: case report.

The ala of the nose is difficult to repair for a variety of reasons, including the special texture of the skin, its shape, and the free margin. A method is reported for the one-stage reconstruction of a lateral nasal defect, including a full-thickness defect of the ala, using a bilobed flap composed of nasolabial and nasal tip skin. The flap was designed according to the aesthetic subunits principle, as modified for Orientals by Yotsuyanagi and colleagues in 2000. Satisfactory alar reconstruction was achieved, and good aesthetic and functional results were obtained. This flap is useful for restoring an alar defect.

Basal Cell Carcinoma↗
PubMed2000

Autologous morsellised bone grafting restores uncontained femoral bone defects in knee arthroplasty. An in vivo study in horses.

The properties of impacted morsellised bone graft (MBG) in revision total knee arthroplasty (TKA) were studied in 12 horses. The left hind metatarsophalangeal joint was replaced by a human TKA. The horses were then randomly divided into graft and control groups. In the graft group, a unicondylar, lateral uncontained defect was created in the third metatarsal bone and reconstructed using autologous MBG before cementing the TKA. In the control group, a cemented TKA was implanted without the bone resection and grafting procedure. After four to eight months, the animals were killed and a biomechanical loading test was performed with a cyclic load equivalent to the horse's body-weight to study mechanical stability. After removal of the prosthesis, the distal third metatarsal bone was studied radiologically, histologically and by quantitative and micro CT. Biomechanical testing showed that the differences in deformation between the graft and the control condyles were not significant for either elastic or time-dependent deformations. The differences in bone mineral density (BMD) between the graft and the control condyles were not significant. The BMD of the MBG was significantly lower than that in the other regions in the same limb. Micro CT showed a significant difference in the degree of anisotropy between the graft and host bone, even although the structure of the area of the MBG had trabecular orientation in the direction of the axial load. Histological analysis revealed that all the grafts were revascularised and completely incorporated into a new trabecular structure with few or no remnants of graft. Our study provides a basis for the clinical application of this technique with MBG in revision TKA.

Animals↗
PubMed1989

Echocardiographic confirmation of mitral valve prolapse: a new finding on radionuclide ventriculography--a case report.

A prominent filling defect was depicted on a radionuclide ventriculogram in a patient with mitral regurgitation. This defect was later shown, by cardiac ultrasound, to be due to mitral valve prolapse into the left ventricle during diastole. This case illustrates that mitral valve prolapse should be added to the list of clinical entities that can result in an intraventricular defect on a radionuclide ventriculogram.

Adult↗
PubMed1997

Clinical application of retrograde island flap pedicled with lateral plantar artery.

The purpose of the study is to identify a repair procedure for the ulcers or defect of the anterior lateral plantar region. The defects of anterior lateral plantar region after resection of the obstinate ulcer, painful corns and callosity were repaired by the retrograde island flap pedicled with lateral plantar artery. One to 10 years following up revealed that all the 10 flaps in 9 patients survived after operation. Patients walked freely without pain and claudication. The flap did not show any sign of damages of the flap even if the patients walked for a long time. It is concluded that the retrograde island flap pedicled with lateral plantar artery is the best choice in repairing the defects of anterior lateral plantar region.

Adolescent↗
PubMed2004

An essential role for Fgfs in endodermal pouch formation influences later craniofacial skeletal patterning.

Fibroblast growth factor (Fgf) proteins are important regulators of pharyngeal arch development. Analyses of Fgf8 function in chick and mouse and Fgf3 function in zebrafish have demonstrated a role for Fgfs in the differentiation and survival of postmigratory neural crest cells (NCC) that give rise to the pharyngeal skeleton. Here we describe, in zebrafish, an earlier, essential function for Fgf8 and Fgf3 in regulating the segmentation of the pharyngeal endoderm into pouches. Using time-lapse microscopy, we show that pharyngeal pouches form by the directed lateral migration of discrete clusters of endodermal cells. In animals doubly reduced for Fgf8 and Fgf3, the migration of pharyngeal endodermal cells is disorganized and pouches fail to form. Transplantation and pharmacological experiments show that Fgf8 and Fgf3 are required in the neural keel and cranial mesoderm during early somite stages to promote first pouch formation. In addition, we show that animals doubly reduced for Fgf8 and Fgf3 have severe reductions in hyoid cartilages and the more posterior branchial cartilages. By examining early pouch and later cartilage phenotypes in individual animals hypomorphic for Fgf function, we find that alterations in pouch structure correlate with later cartilage defects. We present a model in which Fgf signaling in the mesoderm and segmented hindbrain organizes the segmentation of the pharyngeal endoderm into pouches. Moreover, we argue that the Fgf-dependent morphogenesis of the pharyngeal endoderm into pouches is critical for the later patterning of pharyngeal cartilages.

Animals↗