[Correction of defects and deformities in the lateral zone of the face by means of muscle and bone plastic surgery].
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Adult↗
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Results for “laterality defects”
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Increased scatter of responses as a precursor of visual field changes in glaucoma.
A patient with ocular hypertension developed a glaucomatous field defect in the right eye 10 years after the initial examination. For several years preceding the appearance of the defect there had been scatter of threshold responses localized to the area where the defect was later found. We suggest that localized scatter may be an early sign of glaucomatous damage to visual function.
Aged↗
Discrepancies in ultrasonography of the infant hip.
A total of 4,984 ultrasonographic (US) examinations of infant hips were done for the diagnosis or management of congenital/developmental dislocation/ dysplasia of the hip; 48 instances of lack of correlation (0.96%) between the US and radiographic images were noted. Analysis of these cases permitted classification into two groups: (a) apparent discrepancy (44 cases, 0.88%) for which faulty technique or interpretation of the sonogram/radiograph, hyperlaxity, inadvertent stress views, and lateral ossification defects led to disparity in the imaging modalities; and (b) true discrepancy (4 cases, 0.08%) where no explanation was possible for the dissimilarity. The relevance of this study is that the majority of discrepancies can be eliminated by (a) avoiding the common causes of apparent discrepancies mentioned in this article and by (b) the use of the Graf and Harcke techniques as complementary methods of US examination.
Female↗
A further case of vertical transmission of proximal femoral focal deficiency?
We report on a newborn boy with congenital asymmetrically hypoplastic fibulae, lateral oligodactyly, and mild left ectrodactyly. The patient's grandfather had a short femoral shaft with a slightly smaller collodiaphyseal angle on the left as compared to the right side, probably a proximal focal femoral deficiency (PFFD). The upper limbs were not affected in either patient. PFFD in the grandfather and hypoplastic fibulae with lateral ray defects in the grandson raise the possibility of genetic transmission, specifically autosomal-dominant inheritance with variable penetrance and expressivity. This case gives further support to the fibular developmental field concept postulated by Lewin und Opitz [1986: Am J Med Genet (Suppl) 2:215-238].
Bone Diseases, Developmental↗
Treatment of tibial defects due to osteomyelitis by postero-lateral cortico-cancellous bone grafting.
Four cases of children with tibial defects due to osteomyelitis are presented. Tibialization of the fibula using postero-lateral cortico-cancellous bone grafting achieved a stable weight bearing limb in all four patients. The surgical technique employed should be within the skills of any tropical surgeon able to take a bone graft and expose the tibiofibular joints.
Age Factors↗
Simultaneous ipsilateral temporal fossa and orbital dermoid cysts.
PURPOSE: To describe a case of simultaneous dermoid cysts in the lateral orbit and temporal fossa. DESIGN: Interventional case report. METHODS: A 7-year-old boy with a lateral orbital mass and infratemporal fossa mass underwent computed tomography and surgical excision. RESULTS: Intraoperatively, two distinct cystic lesions were identified. The orbital lesion extended just beneath the lateral rim. The temporal fossa lesion extended posteriorly along the temporal fossa. No bony defect in the lateral orbital wall was identified, and each distinct lesion was completely excised. CONCLUSIONS: To our knowledge, this is the first reported case of multiple dermoid cysts in the orbital region. When imaging studies demonstrate separate cystic lesions and do not reveal a bony defect in the lateral orbital wall, multiple lesions should be suspected.
Child↗
Simulated torsade de pointes--the role of conduction defects and mechanism of QRS rotation.
A possible mechanism of torsade de pointes consisting of moving sites of reentry in the presence of disparate recovery of excitability has been previously proposed. This study evaluates the role of conduction defects in that mechanism. A computer model that simulated propagation, cycle length dependent recovery of excitability, and slow propagation during incomplete recovery and in conduction defects was used. Localized conduction defects consisting of slow propagation were shown to allow reentry at changing locations in the presence of uniform recovery properties. Later activation within defects resulted in later recovery, which permitted independent antegrade propagation adjacent to the defects. Retrograde propagation in the defects then resulted in reentry. The location of serial reentry changed because retrograde propagation and antegrade recovery had opposing directions and met distal to the origin of antegrade excitation. This mechanism was similar to that produced by disparate recovery and the combination of conduction defects and disparate recovery permitted the mechanism to occur with less marked disparity than otherwise required. The study also showed bidirectional serial reentry around a localized conduction defect or region of disparate recovery, which resulted in rotation of QRS peaks around the isoelectric line. The study provided evidence that either conduction defects or disparate recovery of excitability may be a substrate for torsade de pointes. It also indicated that combination of these factors might permit torsade de pointes when neither alone does so. This provides a possible explanation for the special propensity of quinidine and other drugs that slow conduction as well as prolong recovery to result in torsade de pointes. Findings also suggested a more explicit mechanism for rotation of QRS peaks about the electrocardiogram baseline than was previously available.
Computer Simulation↗
Branched coordination multilayers on gold.
A C3-symmetric tridentate hexahydroxamate ligand molecule was specially synthesized and used for coordination self-assembly of branched multilayers on Au surfaces precoated with a self-assembled monolayer (SAM) of ligand anchors. Layer-by-layer (LbL) growth of multilayers via metal-organic coordination using Zr4+ ions proceeds with high regularity, adding one molecular layer in each step, as shown by ellipsometry, wettability, UV-vis spectroscopy, and atomic force microscopy (AFM). The branched multilayer films display improved stiffness, as well as a unique defect self-repair capability, attributed to cross-linking in the layers and lateral expansion over defects during multilayer growth. Transmetalation, i.e., exposure of Zr4+-based assemblies to Hf4+ ions, was used to evaluate the cross-linking. Conductive atomic force microscopy (AFM) was used to probe the electrical properties of the multilayers, revealing excellent dielectric behavior. The special properties of the branched layers were emphasized by comparison with analogous multilayers prepared similarly using linear (tetrahydroxamate) ligand molecules. The process of defect annihilation by bridging over defective areas, attributed to lateral expansion via the excess bishydroxamate groups, was demonstrated by introduction of artificial defects in the anchor monolayer, followed by assembly of two layers of either the linear or the branched molecule. Analysis of selective binding of Au nanoparticles (NPs) to unblocked defects emphasized the superior repair mechanism in the branched layers with respect to the linear ones.
Journal Article↗
[Repair of soft tissue defect on heel with island-shaped fascial flap of lateral foot].
OBJECTIVE: To research the result of defect repairing on heel with island-shaped fascial flap of lateral foot. METHODS: Twelve cases of soft tissue defected on heel, who were resulted from trauma, chronic ulcer, chronic osteomyelitis, squamous carcinoma, and necrosis following frozen injury, were treated by transfer of island-shaped fasical flap of lateral foot. RESULTS: Only 2 patients suffered marginal necrosis of flap in early stage and healed after changing dressing. The others succeeded completely. All the cases were followed up for 8 to 78 months. There was no recurrence of squamous carcinoma, no fistula or necrosis bone formed. The sensation of the flap recovered. The repaired area was similar to the heel in skin texture. CONCLUSION: For the characteristics of heel skin, the transfer of island-shaped fascial flap of lateral foot has the following advantages: Similar structure of skin, reliable nerve and blood supply, simple operative techniques, and large area of donor flap.
Adult↗
Rotation flap reconstruction for nasal tip defect after mohs surgery.
BACKGROUND: Skin cancer of the nasal tip is frequent, and reconstruction after Mohs surgery might be challenging. The rotation flap is a very commonly used flap for reconstructions on the vertex and the extremities but rarely on the nose. In textbooks rotation flaps in nose reconstruction are rarely mentioned. OBJECTIVE: We present a rotation flap from the caudal tip and the columella of the nose for defects of the lateral tip of the nose. METHODS: With graphics and photographs of case studies we explain the mechanism of placement and movement of the flap. RESULTS: The rotation flap is useful for reconstructions of medium-size defects of the distal lateral nose tip. CONCLUSION: The rotation flap can be used in the reconstruction of laterally placed nasal tip defects. As this flap is not mentioned in textbooks for nasal tip reconstruction, its value for this localization is probably underestimated.
Humans↗
[Decorative repair and reconstruction of subtotal thumb and finger defect with trimmed toe flap transfer].
OBJECTIVE: In partial loss of distal finger segment, a corresponding part of the toe tissue compound is harvested and transplanted for repair or reconstruction. This new procedure gives forth a new concept and is called decorative repair or reconstruction. METHODS: In a series of 77 patients with 88 thumb and/or finger subtotal defects in forms of lateral half, dorsal half or volar half composite tissue defects were reconstructed with lateral nail-skin flap, dorsal skin-nail flap or pulp flap taken from corresponding part of the toes. The blood circulations were re-established by anastomosing digital arteries of the toe transplants and fingers. RESULTS: In this series 75 patients with 78 fingers reconstructed are successful. The overall survival rate is 97.5%. Follow-up examinations made half to 12 years postoperatively showed the fingers are having a normal length, outward appearance and function. There are nails preserved. The pulps are full. Sweating function are present. Two-point-discrimination tests are between 4-6 mm. CONCLUSION: By decorative reconstruction of subtotal dorsal, lateral, or volar halves defect of thumb and/or fingers by transplanting corresponding part of soft tissue taken from the toe has the merit of repair of any parts of tissue loss precisely what is needed. This procedure is better than any traditional toe-to-hand transfer and realizing the exact meaning of decorative reconstruction.
Adolescent↗
[Free-end prosthesis for defects of the lower right 1st molar, central and lateral incisors and lower left 2d premolar and 1st and 2d molar defects].
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Adolescent↗
Avulsion of muscles from the femoral trochanter in the fowl.
Post-mortem examination revealed lateral femoral trochanteric defects in 14 out of 104 broiler type chickens. All birds were severely lame, and in the absence of concomitant musculoskeletal disease trochanteric lesions were implicated in their clinical signs. Trochanteric muscle insertions had avulsed and the lateral metaphyseal defect was usually lined with granulation tissue. Examination of normal trochanteric development identified endochondral ossification at sites of muscle attachment. In some skeletally immature, proximal femurs evidence of osteochondrosis was detected at sites of trochanteric muscle attachment. It is deduced that broiler femoral trochanters are susceptible to muscle avulsion by virtue of their known predisposition to osteochondrosis and the pattern of muscle insertion.
Animals↗
X-linked laterality sequence: situs inversus, complex cardiac defects, splenic defects.
The association of abdominal situs inversus, complex cardiac defects, and alterations in development of the spleen represents a developmental field complex with variable expression of altered laterality. Familial and inherited cases documenting respectively autosomal recessive and dominant inheritance have been reported. We report on the first family in which X-linked recessive inheritance of this defect has been documented.
Child, Preschool↗
Reconstruction of a complex defect on the foot with an osteotendofasciocutaneous lateral arm free flap. Case report.
A one-stage reconstruction of a complex defect of the dorsum of the foot was undertaken with an osteotendofasciocutaneous lateral arm free flap in a 21 year old man. A vascularised strip of the triceps tendon with the adjacent part of the olecranon was used to reconstruct a missing tibialis anterior tendon with the insertion into the medial cuneiform bone. Recovery was uneventful and he was discharged from hospital after two weeks.
Adult↗
Absent relative afferent pupillary defect in an asymptomatic case of lateral chiasmal syndrome from cerebral aneurysm.
INTRODUCTION: This report documents a case of an asymptomatic 34-year-old female who had right eye subtle temporal optic nerve pallor with absent clinically detectable relative afferent pupillary defect. CASE REPORT: This presentation was secondary to a fusiform paraclinoid aneurysm resulting in lateral chiasmal syndrome. Visual fields demonstrated a nasal depression OD. Neuroimaging studies revealed the presence of a fusiform paraclinoid aneurysm compressing the right optic nerve and optic chiasm. The lesion was treated surgically without additional visual loss nor systemic and neurological complications. CONCLUSIONS: A clinically detectable relative afferent pupillary defect may be absent in unilateral optic nerve pallor and/or visual field loss and does not preclude the need to attempt to identify an underlying etiology. Neuroradiological examination of orbital and cranial structures is an imperative protocol in the appropriate management of this potential life- and vision-threatening condition.
Adult↗
Severe alcoholic hepatitis accompanied by Fournier's gangrene.
Fulminant necrotizing soft-tissue infection of the external genitalia and perineum (Fournier's gangrene) occurred in a patient with severe alcoholic hepatitis. By means of radical débridement and disinfection of the necrotizing tissue, use of broad-spectrum antibiotics and prednisolone, and other supportive measures, Fournier's gangrene and severe alcoholic hepatitis eventually subsided with broad skin defects in the waist and external genitalia. Later, the skin defects were successfully reconstructed with skin grafts. Although the route of bacterial intrusion could not be defined, Fournier's gangrene presumably developed in a background of impaired immunological defences, principally associated with habitual massive alcohol consumption and profound liver dysfunction. This present case highlights not only the underlying immunocompromised condition but also the need for concern regarding the urogenital and anorectal areas as potential foci of life-threatening infection in patients with liver dysfunction, especially when related to alcohol intake.
Fournier Gangrene↗
Typical technetium dimercaptosuccinic acid distribution patterns in acute pyelonephritis.
Technetium dimercaptosuccinic acid renal scintiscans in 37 children with clinical diagnosis of acute pyelonephritis were reviewed. In 18 children, follow-up scintigraphy was obtained after an interval ranging from 5 to 8 months. Uptake abnormalities were found in 89% of the children (74% of the kidneys). We were able to identify four typical pathological uptake patterns: (i) pole defect(s), usually wedge shaped (60%); (ii) lateral wedge shaped defect (4%); (ii) scattered multiple defects (21%); and (iv) swollen kidney without areas of diminished uptake (15%). Remaining pathology at follow-up was found in 52% of the kidneys. Vesicoureteric reflux was present in 33% of the children with scintigraphic signs of pyelonephritis. Frequencies of parenchymal changes in the acute phase and at follow-up were not significantly correlated to the presence of reflux.
Acute Disease↗