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At least 595 records · Page 33Linked to original sources
PubMed1990

[Microsurgical repair of heel and sole defects].

Since 1984, microsurgical technique has been applied to reconstruct and repair the defects of heel and sole in 21 cases by replantation and implantation. Among them, 12 cases were heel defects, 3 cases were fore-sole defects and 6 cases were complete sole defects. Emergency repair and reconstruction has been performed in 13 cases and late reconstruction in 8 cases. All flaps survived. Our main experiences were: 1. All sorts of defected tissues should be reconstructed at the same time. 2. The selection of donor area should be according to the principles:lateral or medial leg flap should be used for moderate defects; lateral thoracic flap for large defects; and the flap of center sole for small defects. 3. Debridement of focus should be done thoroughly.

Adolescent↗
PubMed2004

Genetic dissection of the formation of the forebrain in Medaka, Oryzias latipes.

The forebrain, consisting of the telencephalon and diencephalon, is essential for processing sensory information. To genetically dissect formation of the forebrain in vertebrates, we carried out a systematic screen for mutations affecting morphogenesis of the forebrain in Medaka. Thirty-three mutations defining 25 genes affecting the morphological development of the forebrain were grouped into two classes. Class 1 mutants commonly showing a decrease in forebrain size, were further divided into subclasses 1A to 1D. Class 1A mutation (1 gene) caused an early defect evidenced by the lack of bf1 expression, Class 1B mutations (6 genes) patterning defects revealed by the aberrant expression of regional marker genes, Class 1C mutation (1 gene) a defect in a later stage, and Class 1D (3 genes) a midline defect analogous to the zebrafish one-eyed pinhead mutation. Class 2 mutations caused morphological abnormalities in the forebrain without considerably affecting its size, Class 2A mutations (6 genes) caused abnormalities in the development of the ventricle, Class 2B mutations (2 genes) severely affected the anterior commissure, and Class 2C (6 genes) mutations resulted in a unique forebrain morphology. Many of these mutants showed the compromised sonic hedgehog expression in the zona-limitans-intrathalamica (zli), arguing for the importance of this structure as a secondary signaling center. These mutants should provide important clues to the elucidation of the molecular mechanisms underlying forebrain development, and shed new light on phylogenically conserved and divergent functions in the developmental process.

Animals↗
PubMed2006

Contribution of mGluR and Fmr1 functional pathways to neurite morphogenesis, craniofacial development and fragile X syndrome.

Fragile X Syndrome is a leading heritable cause of mental retardation that results from the loss of FMR1 gene function. Studies in mouse and Drosophila model organisms have been critical in understanding many aspects of the loss of function of the FMR1 gene in the human syndrome. Here, we establish that the zebrafish is a useful model organism for the study of the human fragile X syndrome and can be used to examine phenotypes that are difficult or inaccessible to observation in other model organisms. Using morpholino knockdown of the fmr1 gene, we observed abnormal axonal branching of Rohon-Beard and trigeminal ganglion neurons and guidance and defasciculation defects in the lateral longitudinal fasciculus. We demonstrate that this axonal branching defect can be rescued by treatment with MPEP [2-methyl-6-(phenylethynyl) pyridine]. This is consistent with an interaction between mGluR signalling and fmr1 function in neurite morphogenesis. We also describe novel findings of abnormalities in the abundance of trigeminal ganglion neurons and of craniofacial abnormalities apparently due to dysmorphic cartilage formation. These abnormalities may be related to a role for fmr1 in neural crest cell specification and possibly in migration.

Animals↗
PubMed1998

Flagellin-containing membrane vesicles excreted from Vibrio alginolyticus mutants lacking a polar-flagellar filament.

Polar flagellum-defective mutants (Pof- Laf-) have been isolated from a lateral flagella-defective mutant (Pof+ Laf-). Among these Pof- Laf- mutants, polar-filamentless mutants, which have the hook structure but not the filament, were identified by electron microscopy. Their hooks were covered with a sheath structure which is contiguous to the outer membrane. The filament proteins, flagellins, were shed into the culture medium of these mutants. These flagellins could be sedimented by high-speed centrifugation even after heat or low pH treatment whereas the depolymerized flagellin of the Pof+ strain was degraded by these treatments. After Triton X-100 treatment, most flagellin of the filamentless mutants could no longer be sedimented, and was degraded. We observed vesicle-like structures on the tips of the hooks and in the flagellin fraction sedimented by high speed centrifugation. These results suggest that flagellin of the filamentless mutants is not assembled into the tip of the hook, but is excreted together with a membrane structure which is probably the sheath of polar flagella.

Cytoplasmic Granules↗
PubMed2002

The effect of a fibrin glue on the integration of Bio-Oss with bone tissue. A experimental study in labrador dogs.

BACKGROUND: Bio-Oss is a deproteinized bovine mineral used in bone augmentation procedures. The particles are often mixed with a protein product (Tisseel) to form a mouldable graft material. AIM: The aim of the present experiment was to study the healing of self-contained bone defects after the placement of Bio-Oss particles alone or mixed with Tisseel in cylindrical defects in the edentulous mandibular ridge of dogs. MATERIAL AND METHODS: In 4 labrador dogs, the 2nd, 3rd and 4th mandibular premolars were extracted bilaterally. 3 months later, 3 cylindrical bone defects, 4 mm in diameter and 8 mm in depth, were produced in the right side of the mandible. Following a crestal incision, full thickness flaps were raised and the bone defects were prepared with a trephine drill. The defects were filled with Bio-Oss (Geistlich Biomaterials, Wolhuser, Switzerland) particles alone or mixed with Tisseel (Immuno AG, Vienna, Austria), or left "untreated". A collagen membrane (Bio-Gide, Geistlich Biomaterials, Wolhuser, Switzerland) was placed to cover all defects and the flaps were sutured. 2 months later, the defect preparation and grafting procedures were repeated in the left side of the mandible. After another month, the animals were sacrificed and biopsies obtained from the defect sites. RESULTS: Bio-Oss-treated defects revealed a higher percentage of contact between graft particles and bone tissue than defects treated with Bio-Oss+ Tisseel (15% and 30% at 1 and 3 months versus 0.4% and 8%, respectively). Further, the volume of connective tissue in the Bio-Oss treated defects decreased from the 1 to the 3 month interval (from 44% to 30%). This soft tissue was replaced with newly formed bone. In the Bio-Oss+ Tisseel treated defects, however, the proportion of connective tissue remained unchanged between 1 and 3 months. CONCLUSION: The adjunct of Tisseel may jeopardize the integration of Bio-Oss particles with bone tissue.

Animals↗
PubMed2002

Reconstruction of through-and-through cheek defects involving the oral commissure, using chimeric flaps from the thigh lateral femoral circumflex system.

Repairing full-thickness cheek defects involving the oral commissure in the head and neck regions after tumor resection is a challenge for reconstructive surgeons. First, they are usually relatively large defects. Second, the axes of the cheek and intraoral lining are different from each other. Third, the shape and volume of the defect and the oral sphincter should be considered individually. Lateral femoral circumflex perforator flaps with at least two independent cutaneous perforators are suitable for reconstruction of such a defect in one stage. In this study, between January and December of 1999, a total of nine patients underwent reconstruction with chimeric lateral femoral circumflex perforator flaps immediately after resection of their oral cancers. The average age of the patients was 61 years (range, 42 to 74 years). The oral lining defects were between 5 x 5 cm and 6 x 12 cm in size, whereas the cheek defects were between 5 x 6 and 8 x 12 cm. Fifteen flaps were supplied by one perforator, and three flaps were supplied by two perforators. There were nine single arterial anastomoses, eight single venous anastomoses, and one double venous anastomosis. There were no total flap failures. One case of postoperative venous congestion was successfully treated by a second venous anastomosis. The average duration of hospitalization was 31.8 days (range, 18 to 49 days). The median follow-up time was 8.6 months, and all patients were alive at the time of evaluation. Six of nine patients had satisfactory or good contours of the cheek. Five of nine patients had normal deglutition. Six of nine patients had adequate oral continence. Compared with other free flaps, use of the combined (chimeric) lateral femoral circumflex perforator flaps for the reconstruction of cheek through-and-through defects involving the oral commissure has several advantages: (1) easy three-dimensional insetting, (2) a unique character suitable for the requirements of the oral lining and cheek skin to achieve good aesthetic appearance, (3) functional preservation of the oral sphincter and the resistance of gravity by use of the tensor fasciae latae, (4) minimal donor-site morbidity, (5) economic design, and (6) no need for microsurgical fabrication, because major vascular branches such as the transverse branch, the ascending branch, and the feeding branch to the rectus femoris muscle are not sacrificed in the procedure. The disadvantages of these flaps include (1) the complicated anatomy of the perforators, (2) the learning-curve requirement for their use, and (3) the occasional need for secondary venous drainage and shifts to double flaps. Although there are some difficulties, it was concluded that use of the chimeric lateral femoral circumflex perforator flaps in the selected cases is one of the good options available for the reconstruction of cheek through-and-through defects involving the oral commissure.

Adult↗
PubMed1994

Oromandibular reconstruction using a keel-shaped modification of the radial forearm osteocutaneous flap.

The keel-shaped modification for harvest of the radial forearm osteocutaneous flap has been used to reconstruct 19 oromandibular defects in 18 patients. Fourteen men and 4 women ranging in age from 22 to 72 years have undergone composite mandibular reconstruction, with follow-up ranging from 3 to 36 months. Sixteen patients (17 reconstructions) had resection of advanced malignancies, and 2 patients sustained shotgun wounds. Twelve symphyseal and 7 lateral or posterior defects were reconstructed with donor radius bone ranging in length from 5 to 13.5 cm. Double osteotomies were performed in 7 patients. Two skin paddles were used in 4 patients to provide simultaneous intraoral lining and external skin coverage. The radial forearm osteocutaneous flap is still an excellent choice for oromandibular reconstruction. Anterior and lateral composite mandibular defects were satisfactorily reconstructed both aesthetically and functionally using the keel-shaped modification of the radial forearm flap. Donor-site problems were uncommon and minor, and long-term forearm function was minimally affected. Radius fracture occurred in only 1 patient.

Adult↗
PubMed1991

Applications of the crescentic advancement flap.

Repair of defects of the lateral nose, perialar, and nasolabial region are often challenging. Maintaining the normal anatomic boundary lines and if possible placing the sutures within these lines are important considerations when designing a closure. The crescentic advancement flap has proved to be a versatile closure for skin cancer defects in these regions. A brief historic perspective on this flap along with important concepts in its utilization for defects of the lateral nose, perialar region, and nasolabial fold are discussed.

Cheek↗
PubMed2002

The nasal base in cleft lip rhinoplasty.

The discussion on how to correct the nasal base in cleft lip (CL) rhinoplasty focuses on timing of the surgery, the type of approach, and the technique of repositioning the ala. Little attention is paid to the nasal vestibule. We compared the results of two different techniques. Forty-two patients were operated on via an endonasal approach with total mobilization of the lateral crus and fixation after repositioning. An external approach was used in 12 patients and the lateral crus freed as a medially based chondrocutaneous flap. The defect in the lateral vestibule wall was covered with an ear composite graft. The latter group showed more stable results concerning symmetry and breathing. We conclude that in most cases of unilateral CL noses there is not only a malposition and deformity of soft tissues and skin of the ala, but also a deficiency in the surface of inner lining of the nasal vestibule that needs appropriate repair. In general, the numerous procedures for repair of the nasal base in unilateral CL patients can be attributed to three principles based on different philosophies concerning the underlying pathology.

Adolescent↗
PubMed1976

A long-term prognosis for the fixed saddle-bridge. A study of 100 constructions.

This report constitutes a long-term study of 100 saddle-bridges applied by the author during the years 1958-1973. The aim of the investigation has been to assess the prognosis for this form of therapy. The probability that a saddle-bridge will still be functioning completely, without repair, after 5 years is 93%, and after 10 years (as also after 12 years) 83%. Only 12% of the appliances had been removed 12 years after the application. The risk of defects is about the same during the first 5-year period after the application as it is during the second and the third 5-year periods. A comparison between saddle-bridges applied before and after 1965 shows no demonstrable difference as regards the 5-year prognosis in spite of modifications with respect to range of indication and therapy. The causes of the defects have been divided into biological and technical. During the first 5-year period technical defects appear to be in the majority, whereas during the later stages, biological defects predominate. Background factors such as sex, the age of the patient, length of saddle, localization in the jaw do not prove to have any appreciable importance for the prognosis. There is, on the other hand, a significantly better prognosis when the opposing jaw is furnished with the patient's own teeth and/or fixed bridges than with a removable denture. The author points out that from the result of the study, the saddle-bridge has such a good long-term prognosis that its range of application for fixed constructions should be considerably extended.

Adult↗
PubMed1996

Bone density changes after 1 year in periodontal lesions treated surgically with or without ePTFE membrane placement.

The present study was designed to quantitatively assess radiographic changes in alveolar bone density in intrabony defects treated with expanded polytetrafluorethylene membranes (ePTFE) or by conventional flap surgery alone. 15 patients with 2 periodontal defects of comparable morphology which could be depicted on a single radiograph made up the test panel. Standardized radiographs of the periodontal defects were taken immediately prior to surgery and 12 months later. The 2 defects were treated simultaneously using the modified Widman flap procedure and prepared for membrane placement. Then one of the lesions was randomly assigned for treatment with the membrane. All radiographs and surgical procedures were managed by one person. The radiographs were assessed by another person according to a blind design. Periodontal defects treated with ePTFE membranes (test), and sites treated by conventional flap procedures (control) were then analyzed using a computerized image analysis program. In 8 patients, the test site outcome was better than the outcome in the control site. 6 of the control sites indicated increased bone density, while 7 sites showed decreased values, and 2 sites were unchanged. The corresponding values from the test sites were 5, 6 and 4, respectively. In the present controlled clinical study, the use of an ePTFE membrane to cover the opening of a vertical bone defects during periodontal surgery did not predictably increase the bone density of the defects.

Alveolar Bone Loss↗
PubMed1995

Sequence of the superoxide dismutase 1 (SOD 1) gene in familial Parkinson's disease.

Mutations in the superoxide dismutase 1 (SOD1) gene have been detected in affected members of some families with familial amyotrophic lateral sclerosis. To evaluate the possibility of a shared genetic defect in amyotrophic lateral sclerosis and Parkinson's disease, the SOD1 gene was sequenced in index patients with familial Parkinson's disease from 23 families. No changes were detected.

Amyotrophic Lateral Sclerosis↗
PubMed2003

Sixteen novel mutations in the Cu/Zn superoxide dismutase gene in amyotrophic lateral sclerosis: a decade of discoveries, defects and disputes.

OBJECTIVE: Since the discovery of mutations in the gene encoding Cu/Zn superoxide dismutase (SOD1) ten years ago, testing for SOD1 gene mutations has become a part of the investigation of patients with suspected motor neuron disease. We searched for novel SOD1 mutations and for clinical characteristics of patients with these mutations. METHODS: Analysis was made of patient files at the Neurogenetic DNA Diagnostic Laboratory at Massachusetts General Hospital. We also scrutinized available medical records and examined patients with the different SOD1 mutations. RESULTS: One hundred and forty eight (148) of 2045 amyotrophic lateral sclerosis (ALS) patients carried a disease-associated mutation in the SOD1 gene. The most prevalent was the A4V missense mutation, found in 41% of those patients. Sixteen novel exonic mutations (L8V, F20C, Q22L, H48R, T54R, S591, V87A, T88deltaTAD, A89T, V97M, S105deltaSL, V118L, D124G, G141X, G147R, 11515) were found, bringing the total number of SOD1 gene mutations in ALS to 105. CONCLUSIONS: Mutations in the SOD1 gene are found both in sporadic and familial ALS cases without any definite predilection for any part of the gene. A common structural denominator for the 16 novel mutations or previously reported mutations is not obvious. Similarly, the nature of the putative acquired toxic function of mutant SOD1 remains unresolved. We conclude that patients with SOD1 mutations may infrequently show symptoms and signs unrelated to the motor systems, sometimes obscuring the diagnosis of ALS.

Adult↗
PubMed1990

Buccal mucosal flaps in nasal reconstruction.

Buccal mucosal flaps provide a simple and effective method of replacing nasal mucosal lining. This technique has been used in 15 patients requiring reconstruction of full thickness defects of the lateral nasal wall and tip of nose, in combination with a variety of local flaps for skin cover. The buccal mucosal flap is of particular value in reconstructing the common defect of the lower lateral nasal wall and alar rim where more bulky reconstructions often distort the airway.

Adolescent↗
PubMed1993

Trimethyltin encephalopathy.

A chemistry student was acutely exposed to vapors of an organotin compound. Seventy-two hours later, he exhibited delirium, spatial disorientation, perseveration, inappropriate affect, and memory defects. Five months later, he experienced episodes of complex partial seizures, which continue to require anticonvulsant medication after 7 years. Trimethyltin was identified in blood and urine samples taken 17 days after the accident; the blood level of trimethyltin was elevated 35 days after exposure. Serial electroencephalograms showed persistent left temporal paroxysmal epileptogenic potentials. Serial neuropsychological tests revealed persistent memory defects, cognitive dysfunction, and dysphoria 4 years after exposure. We review acute, resolving, and long-term residual neurotoxic effects of trimethyltin in man. We describe detailed clinical observations, serial neuropsychological test results, electroencephalographic findings, and exposure data in this patient, confirming the limbic system effects of trimethyltin and relating them to the known histopathologic pattern of this condition.

Accidents, Occupational↗
PubMed1988

Lateral face reconstruction with the medial-based cervicopectoral flap.

The problem of reconstructing large defects involving the lateral facial skin following extirpative surgery for cancer was ideally addressed by the use of the cervicopectoral flap. It has proved reliable, easy to fashion, and cosmetically acceptable; yet it does not interfere with sound oncologic principles for carcinoma resection in the head and neck. It has received little exposure in the literature and we feel it is an underutilized flap. No major complications are reported with this flap in our series of six patients.

Aged↗
PubMed2005

Dynamic evaluation of contact pressure and the effects of graft harvest with subsequent lateral release at osteochondral donor sites in the knee.

PURPOSE: To dynamically evaluate contact pressure about the periphery of the lateral femoral condyle in intact knees, to qualify the effects of osteochondral donor graft harvest on this contact pressure, and to quantify the effects of lateral release on contact pressure after graft harvest. TYPE OF STUDY: Cadaveric analysis. METHODS: Digital electronic pressure-sensing cells were used to measure contact pressure over the periphery of the lateral femoral condyle in 10 fresh-frozen knee specimens. Nonweightbearing resistive extension was simulated as the knees were placed through a functional range of motion. Dynamic pressure readings were evaluated over intact cartilage, around the rims of four 5-mm osteochondral defects, and after lateral release. RESULTS: The pressure cells were all subjected to contact pressures as the knees were placed through a functional range of motion. Average maximal contact pressure progressed distally as the knees were flexed. The creation of 5-mm osteochondral defects did not lead to a significant increase in rim stress concentration over the surrounding cartilage. Lateral release resulted in small decreases in contact pressure over the osteochondral defects. CONCLUSIONS: The creation of 5-mm donor defects about the lateral aspect of the lateral femoral condyle does not lead to significant alterations in local contact pressure. CLINICAL RELEVANCE: Our biomechanical findings may have important implications relating to cartilage restoration using osteochondral autografting procedures. Donor-site morbidity may be minimized if donor-site defects are limited to 5 mm and smaller.

Amputation, Surgical↗