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 577 records · Page 32Linked to original sources
PubMed2005

Endonasal endoscopic repair of anterior skull-base fistulas: the Kuala Lumpur experience.

The purpose of this retrospective study is to determine the pattern of cerebrospinal fluid (CSF) rhinorrhoea presenting to our tertiary referral centre in Kuala Lumpur and to assess the clinical outcomes of endonasal endoscopic surgery for repair of anterior skull base fistulas. Sixteen patients were treated between 1998 and 2004. The aetiology of the condition was spontaneous in seven and acquired in nine patients. In the acquired category, three patients had accidental trauma and this was iatrogenic in six patients (five post pituitary surgery), with one post endoscopic sinus surgery (ESS). Imaging included computed tomography (CT) scan and magnetic resonance imaging (MRI). Endoscopic repair is less suited for defects in the frontal sinuses with prominent lateral extension and defects greater than 1.5 cm in diameter involving the skull base. Fascia lata, middle turbinate mucosa, nasal perichondrium and ear fat ('bath plug') were the preferred repair materials in the anterior skull base, whereas fascia lata, cartilage and abdominal fat obliteration was preferentially used in the sphenoid leak repair. Intrathecal sodium flourescein helped to confirm the site of CSF fistula in 81.3 per cent of the patients. Ninety per cent of the patients who underwent 'bath plug' repair were successful. The overall success rate for a primary endoscopic procedure was 87.5 per cent, although in two cases a second endoscopic procedure was required for closure. In the majority of cases endoscopic repair was successful, and this avoids many of the complications associated with craniotomy, particularly in a young population. Therefore it is our preferred option, but an alternative procedure should be utilized should this prove necessary.

Adolescent↗
PubMed2006

Use of anterolateral thigh and lateral arm fasciocutaneous free flaps in lateral skull base reconstruction.

Lateral skull base defects following tumor ablation are ideally reconstructed with microvascular free tissue transfer. Although the rectus abdominis free flap is the workhorse in skull base reconstruction, it has a number of drawbacks. Anecdotal reports have indicated that fasciocutaneous free flaps may be useful alternatives in selected cases. Patients undergoing lateral arm (4 cases) or anterolateral thigh (8 cases) fasciocutaneous free flap reconstruction of lateral skull base defects between 1999 and 2005 were therefore reviewed. Twelve consecutive patients (4 males, 8 females) with a mean age of 63 years (range, 39 to 74) underwent such reconstruction following resection of lateral (11 cases) and anterolateral (1 case) skull base lesions. Eight patients had squamous cell carcinoma, 3 had infection or osteoradionecrosis, and 1 had adenoid cystic carcinoma. The duration of surgery (from induction of anesthesia to exit from the operating room) averaged 14.5 hours (range, 10 to 19.5 hours). All donor sites were closed directly. All the flap transfers were successful, with minimal reconstructive and donor site morbidity. During the follow-up period (average, 18 months; range, 2-48 months), 2 patients died of metastatic disease, and another 2 died of other unrelated causes. The remaining 8 patients are alive and disease free. It is concluded that lateral arm and anterolateral thigh fasciocutaneous free flaps should be considered as viable reconstructive options for lateral skull base ablative defects.

Adult↗
PubMed1987

Lateral arm composite tissue transfer to ipsilateral hand defects.

Different applications in the use of the ipsilateral lateral arm free flap in 29 patients treated in our unit from November 1983 to December 1984 are described. The flap was used in both elective and emergency reconstruction with a success rate of 96.5%. This flap is elevated from the same limb as the injured hand, permitting the entire operative procedure to be performed with the patient under a single regional block anesthesia, both flap and recipient sites being prepared synchronously in a bloodless field.

Adolescent↗
PubMed1999

Malar fat pad elevation: An aid to closure.

BACKGROUND: In closure of defects inferior to the eye, it is important to avoid inducing lower lid ectropion. OBJECTIVE: To describe a new technique for closure of defects inferior and lateral to the eye. METHODS: A case of malar fat pad elevation to close a post-Mohs surgical defect is described and the procedure is detailed. RESULTS: This technique enabled good wound closure with minimal tension and avoided the complication of ectropion. A transient asymmetry was manifest postoperatively. CONCLUSION: Malar fat pad elevation is an effective and elegant means of closing defects inferior and lateral to the eye. This technique minimizes extensive tissue undermining and movement with its consequences of postoperative tissue swelling, bruising, and hematoma formation. The side effect of ectropion is prevented.

Adipose Tissue↗
PubMed1986

Defective interhemispheric integration and anomalous language lateralization in children at risk for schizophrenia.

The present study was carried out to determine whether children at risk for schizophrenia might exhibit abnormalities in test performance indicative of defective interhemispheric integration and abnormal specialization of language function. Twenty-two high-risk and 22 matched normal children were administered two independent tests of speech comprehension, delivered under monaural and binaural listening conditions, and a standard verbal dichotic listening test. On both comprehension tests the high-risk children exhibited significantly poorer binaural, relative to monaural, recall. On the verbal dichotic test the normal group exhibited a significant right ear advantage whereas for the high-risk group there was no significant difference between right and left ear recall. These results were taken to indicate abnormalities of both interhemispheric integration and language specialization in the high-risk group. Analyses indicate that these two abnormalities may be related in a specific fashion. The implications of these results are discussed within a developmental framework.

Adolescent↗
PubMed1993

Closure of bronchial defects using a pedicled pericardial flap.

A technique for closure of lateral or terminal defects in the bronchial wall after tissue-saving procedures, which obviates the need for sleeve resection in few selected situations, is described. Its main advantages are a low risk of surgical complications at the suture line and easy performance.

Adult↗
PubMed1982

The lateral periodontal cyst and isolated periodontal defects.

Over a period of 4 years, 41 isolated, advanced periodontal defects were selected for histologic examination. The objective of this study was to establish the presence of cystic epithelium. Twenty of the biopsies fulfilled the criteria for lateral periodontal cyst (LPC). These results indicate that there is a distinct possibility that proliferation of epithelial elements other than crevicular could be implicated in isolated periodontal defects.

Epithelium↗
PubMed1991

Effect of differential tracer washout during SPECT acquisition.

A central assumption in SPECT is that the projection data are "consistent," that is, the camera views an unchanging distribution during acquisition. Several new radiotracers of interest, including 99mTc-teboroxime (Cardiotec), have rapid clearance from the myocardium. Furthermore, the washout is different in normal and ischemic tissues. We used computer simulations to estimate the effect of this differential washout on quantification of the severity of ischemia. We simulated defect-to-normal myocardial activity ratios of 1 (no defect), 0.8, 0.6, 0.4, 0.2, and 0 (complete defect), with single defects placed either in the lateral wall or apex, and SPECT acquisitions of 1, 3, 6, 12, and 24 total minutes. We modeled washout with a monoexponential curve whose clearance half-time was 5.9 min for "normal myocardium" and 9.3 min for "ischemic myocardium." We found that differential washout from normal and ischemic zones produced image artifacts and errors in defect quantification for acquisitions longer than 3 min. With longer acquisitions, the degree of ischemia was significantly underestimated, with increasing error at longer acquisition times. In addition, in the "no defect" situation an apparent small lateral wall defect (relative to the apex) was present. Finally, lateral wall defects produced artifacts (streaks and reduced apparent activity) in the opposite (medial) wall. Differential normal/ischemic zone washout during SPECT acquisition produces artifacts and errors in quantification, whose severity is dependent on acquisition length, actual defect severity, and defect location.

Computer Simulation↗
PubMed1992

Treatment of an osseous lesion associated with a severe palato-radicular groove: a case report.

This is a case report that describes the management of a severe periodontal defect associated with a palato-radicular (palato-gingival) groove affecting the maxillary right lateral incisor of a 50 year-old male. The patient presented with pain, gingival swelling, and a 10 mm periodontal pocket on the distopalatal aspect of the right maxillary lateral incisor. The defect was initially treated by scaling and root planing. Several days later a flap was elevated, the osseous defect was debrided, and odontoplasty was performed to eliminate the groove. The root surface was treated with citric acid for 3 minutes, the osseous defect was filled with non-porous hydroxyapatite, a periodontal membrane was placed, and the flap was readapted to the tooth. Postoperative care included systemic (minocycline) and local (chlorhexidine) antimicrobial therapy. The membrane was removed 6 weeks postoperatively and 14 months postoperatively the gingiva appeared healthy; radiographs suggested substantial resolution of the osseous defect and about 7 mm of probing attachment gain was recorded. Further studies are necessary to determine which of the several modes of therapy used to treat this lesion are necessary for success.

Alveolar Bone Loss↗
PubMed2004

[Head and neck reconstruction using laparoscopically harvested omentum].

Since the need for laparotomy in harvesting the omentum is the most significant drawback, the omentum has not been the tissue of choice for reconstructive surgery. To compensate for this drawback, we started laparoscopic harvesting of the omentum and clarified the advantages and disadvantages of this procedure. Ten patients underwent laparoscopic harvesting of the omentum by abdominal surgeons, followed by reconstruction of head and neck defects. Surgery was conducted in 5 cases of defect reconstructions for parotid gland tumor surgery and 5 of oropharyngeal defect after cancer surgery. The average harvesting time was 107 minutes (55-140 minutes) and used the omentum and different amounts and length of the vascular pedicle. Although the omentum was successfully transplanted in 9 of 10 cases, 2 cases showed partial peripheral necrosis and 1 total necrosis. With the advantage of laparoscopic harvesting of the omentum, we could obtain appropriate omental size for the defect size. Especially after total parotidecomy, the omentum was useful to fill in the defect, reducing the patients' worries about postoperative deformity. In one case, the omentum was used to treat Frey syndrome, successfully relieving the symptoms. In oropharyngeal reconstruction, the omentum is used to fill dead space and prevented postoperative infection. Although mild abdominal pain was observed a few days after surgery, no major abdominal complications such as intestinal perforation or ileus occurred in the 8 to 39 months following laparoscopic harvest of the omentum. Since the omentum is pliable and easily fills a complicated defect, the omentum is considered satisfactory for reconstructing defects of the lateral face after parotid tumor surgery and small defects after oropharyngeal tumor surgery.

Aged↗
PubMed1982

[Ventricular septal defect after operation in hypertrophic obstructive cardiomyopathy (author's transl)].

After surgical resection in idiopathic hypertrophic subaortic stenosis, a ventricular septal defect was observed in one patient at a later date. The defects was closed in a second operation. - The hemodynamically relevant changes in the vascular bed of the lung with preoperative congestion and postoperative shunt found their expression in discrete changes only of the chest x-ray.

Cardiomyopathy, Hypertrophic↗
PubMed2000

Osteochondral defects in the knee. A treatment using lateral patella autografts.

Sixteen patients (13 males and three females; average age, 27 years) with large symptomatic osteochondral defects of the femoral condyle were treated with an osteochondral autograft taken from the ipsilateral lateral patellar facet. Two patients had bilateral procedures for a total of 18 knees. These patients were followed up prospectively with an average followup of 7.6 years (range, 2-14.6 years). Cincinnati knee scores showed significant changes, from an average preoperative score of 37 to an average final followup score of 85. In all of the patients, knee function was improved, and they were able to return to their normal lifestyle with minimal or no restriction. Eighty-one percent of patients have returned to a high level of functioning.

Adolescent↗
PubMed2005

Sodium phenylbutyrate prolongs survival and regulates expression of anti-apoptotic genes in transgenic amyotrophic lateral sclerosis mice.

Multiple molecular defects trigger cell death in amyotrophic lateral sclerosis (ALS). Among these, altered transcriptional activity may perturb many cellular functions, leading to a cascade of secondary pathological effects. We showed that pharmacological treatment, using the histone deacetylase inhibitor sodium phenylbutyrate, significantly extended survival and improved both the clinical and neuropathological phenotypes in G93A transgenic ALS mice. Phenylbutyrate administration ameliorated histone hypoacetylation observed in G93A mice and induced expression of nuclear factor-kappaB (NF-kappaB) p50, the phosphorylated inhibitory subunit of NF-kappaB (pIkappaB) and beta cell lymphoma 2 (bcl-2), but reduced cytochrome c and caspase expression. Curcumin, an NF-kappaB inhibitor, and mutation of the NF-kappaB responsive element in the bcl-2 promoter, blocked butyrate-induced bcl-2 promoter activity. We provide evidence that the pharmacological induction of NF-kappaB-dependent transcription and bcl-2 gene expression is neuroprotective in ALS mice by inhibiting programmed cell death. Phenylbutyrate acts to phosphorylate IkappaB, translocating NF-kappaB p50 to the nucleus, or to directly acetylate NF-kappaB p50. NF-kappaB p50 transactivates bcl-2 gene expression. Up-regulated bcl-2 blocks cytochrome c release and subsequent caspase activation, slowing motor neuron death. These transcriptional and post-translational pathways ultimately promote motor neuron survival and ameliorate disease progression in ALS mice. Phenylbutyrate may therefore provide a novel therapeutic approach for the treatment of patients with ALS.

Acetylation↗
PubMed1982

The developmental field concept in clinical genetics.

Fields are those parts of the embryo in which the processes of development of complex structure appropriate to those parts are controlled and coordinated in a spatially ordered, temporally synchronized, and epimorphically hierarchical manner. Disturbances of field development may be corrected or may lead to anomalies of abnormal or incomplete differentiation. Powerful evidence for the existence of developmental fields comes from the observation of identical malformations resulting from two or more different causes; this identifies groups of embryonic structures that respond as a single developmental unit. Early action of a dysmorphogenetic cause in a field may lead to an extensive defect (e.g., cyclopic holoprosencephaly), later action to a lesser defect (e.g., single upper central incisor as mildest expression of autosomal-dominant holoprosencephaly). Disturbances of "long-distance" inductive relationships between primordia may simulate the presence of a malformation syndrome (e.g., renal and limb anomalies as disturbance of the acrorenal developmental field). The biology of developmental fields is complex but accessible through knowledge of comparative anatomy and embryology, phylogeny, experimental embryology, developmental genetics, and teratology. It challenges the clinician to a deeper understanding of development in order to give better care to the malformed and their families.

Arm↗
PubMed1982

Programmed visual field testing.

The use of programmed static spot-checking is remarkably accurate in detecting the presence of visual field defects, even the earliest abnormality, provided the correct stimulus (or stimuli) is chosen to check an appropriate number of spots, and the location of each missed response is retested. Automatic quantitation of visual field defects (so it can later be determined if the defects are worsening) can be accomplished automatically with some of the more expensive new instruments. The less elaborate instruments require repetitive testing or manual interaction, achieving accurate results, but typically with a cumbersome record of the results that is difficult to interpret. An efficient plan for the usual office at present is to use an automated spot-checking instrument for screening and diagnosis, but to depend upon the tangent screen or Goldmann perimeter for quantitation unless the most expensive automated instruments can be afforded.

Automation↗
PubMed1993

Thermal aspects of the use of polymethylmethacrylate in large metaphyseal defects in bone. A clinical review and laboratory study.

The potential necrotizing effects of the heat produced by the exothermic polymerization process has raised questions regarding the use of polymethylmethacrylate (PMMA) in orthopedic surgery. An experimental model was used to: (1) analyze the amplitude and distribution of heat in bone taken from autopsy specimens when large metaphyseal defects (simulating tumor excision) were filled with curing PMMA and (2) to observe any significant necrotizing temperatures. The experimental design included two experimental groups of five distal femora into which either a small- or large-bore defect was made in the lateral epicondylar region. These defects were filled with either one or two packs of PMMA cement, and temperature probes were used to record temperature elevations at the cement core, the bone-cement interface, and the surrounding 1-, 2-, 3-, and 5-mm bone intervals. To simulate physiologic temperature and fluid environment, the experiment was conducted in a 37 degrees normal saline bath. There is clinical evidence suggesting that the large amounts of PMMA used in tumor reconstructive surgery (often two packs or more) may lead to thermal necrosis of remaining tumor cells in the curetted cavity. This may explain, at least in part, the decrease in recurrence of giant-cell bone tumor after curettage and PMMA cementation.

Bone Neoplasms↗
PubMed1985

Free chondral fragment involving the lateral trochlear ridge of the talus in a dog.

A saucer-shaped defect involving the lateral trochlear ridge of the talus and a radiopaque joint fragment were evident on radiographs of the left tarsus in a 6-month-old Rottweiler. Surgical treatment involved removal of the joint fragment and debridement of the defect. Histologic interpretation of the specimen was a chondral fragment. It is important to realize the possibility of a lesion in the location described, as this may be an additional site for osteochondrosis dissecans of the canine tarsus.

Animals↗
PubMed2002

The growth defect of lrt1, a maize mutant lacking lateral roots, can be complemented by symbiotic fungi or high phosphate nutrition.

The growth of three maize (Zea mays L.) mutants, each impaired in the formation of one individual element of its root system, was compared under "natural" limiting phosphate conditions (0.1 mM). Mutant plants exhibiting a reduction in root hairs (rth3-1) or a depletion of crown and brace roots (rtcs) grew as well as the corresponding wild-type plants. However, mutant plants lacking lateral roots (lrt1) showed a strong reduction in plant growth. The growth defect of lrt1 was overcome when it was grown in association with an arbuscular mycorrhizal fungus, Glomus mosseae. Establishment of symbiosis was associated with the occurrence of a new type of lateral root. These new lateral roots were stunted and highly branched, giving rise to a bush-like structure. Supply of high phosphate (1 microM) ameliorated the growth of lrt1 plants too, but less efficiently than the symbiosis did. Hence, arbuscular mycorrhizal fungi as well as phosphate functionally complemented the lrt1 mutation.

Fungi↗