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Results for “laterality defects”

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At least 631 records · Page 35Linked to original sources
PubMed1993

Histologic analysis of the osseointegration of endosseous implants in simulated extraction sockets with and without e-PTFE barriers. Part II: Histomorphometric findings.

This investigation constitutes a pilot study of osseous changes around hydroxylapatite-coated implants analyzed histologically nine weeks following their placement into stimulated mongrel dog extraction sites either with or without e-PTFE barriers. An image analysis system was utilized for the assessment of undecalcified sections for the following parameters: (1) crestal alveolar bone height, (2) distance to the most coronal bone in residual defects, (3) distance to the most lateral bone in residual defects, and (4) area of bone regenerated in standardized 1 mm x 3 mm portions of original defects. Two-way ANOVA demonstrated that there were significant differences among the barrier, non-barrier, and control sites for all parameters except crestal bone height (p < 0.05). When one animal which displayed premature clinical exposure of e-PTFE was excluded from the analysis, crestal change showed a significant improvement (P < 0.05) for barrier vs. non-barrier sites. Therefore, the proper application of e-PTFE barriers was usually associated with crestal bone apposition rather than resorption and a greater osseous fill of the original crestal defect when compared with sites where no barrier had been placed.

Alveolar Process↗
PubMed2005

Algorithm for autologous breast reconstruction for partial mastectomy defects.

BACKGROUND: The use of lateral thoracic skin and fat for breast reconstruction is advantageous because it does not require the use of muscle transfer, and the donor-site incision is well hidden under the arm. In patients with redundant skin at the thoracic flank, use of this tissue has the added benefit of removal of an unsightly roll. The lateral thoracic skin and fat flap can be harvested using microsurgical technique based on three different pedicles: the thoracodorsal artery perforators; a direct cutaneous branch of the thoracodorsal, axillary, or lateral thoracic arteries; and the lateral thoracic intercostal perforating vessel. METHODS: The authors describe the techniques for harvest of lateral thoracic tissue based on each of the pedicle options. A case is then presented to illustrate each option, and an algorithm is suggested for deciding which pedicle to use. RESULTS: The authors have used lateral thoracic tissue for partial breast reconstruction for a variety of defects. In this report, the authors review the results of three illustrative cases. CONCLUSIONS: Partial breast reconstruction may be required for patients after breast-conserving therapy or after breast reconstruction by other methods. Lateral thoracic tissue can be safely transferred to correct defects in treated or reconstructed breast, or to obtain symmetry. Knowledge of the vascular anatomy to this region is helpful in understanding the pedicle options when harvesting this tissue. The authors present an algorithm for determining which pedicle is most appropriate for the transfer of lateral thoracic tissue for partial breast reconstruction.

Adult↗
PubMed2006

A novel oculo-oto-facial dysplasia in a Native Alaskan community with autosomal recessive inheritance.

We describe a novel autosomal recessive malformation syndrome in four related individuals from a geographically isolated Native Alaskan community, who have facial defects similar to those of individuals with Treacher Collins (TCS) and Miller syndrome. Distinctive findings include malar and mandibular hypoplasia, lower eyelid coloboma, choanal atresia, orofacial clefting, and external ear malformation with preauricular tags. Intellect is normal and profound mixed hearing loss has been observed in affected adults. Variable extracranial findings include atrioseptal defect, renal dysplasia, and imperforate anus, however, no limb defects have been observed. Cranial imaging studies demonstrate relative prominence of the zygoma, inferior orbital maxillary hypoplasia, and lateral orbital wall defects with an accessory superior bony projection off the zygoma lateral to the orbital rim. We propose that these individuals have inherited a novel autosomal recessive condition we have termed oculo-oto-facial dysplasia (OOFD) with unique radiographic findings.

Adult↗
PubMedDate not supplied

Defect in dorso-ventral patterning, asplenia, and conotruncus in a spontaneously aborted fetus.

We describe a very unusual combination, and previously unreported, of malformations in an 18-week, spontaneously aborted male fetus. The fetus had a reversed dorsoventral positioning of the head and upper limbs relative to the body axis with the head and both upper limbs directed dorsally, and an abrupt rotation of the vertebral bones at the level of CZ The fetus also had asplenia, single ventricle, and conotruncus. The fetus also had flexion deformities at the wrist, reduction deformity of the left second digit, anomalies in ossification of the bones of the left hand, and bilateral talipes calcaneovalgus. The major malformations in this fetus were all blastogenetic in origin and consisted of dorsoventral patterning defect involving structures cranial to C7, a laterality, and a septation defect of the ventricle and outflow tract of the heart. The defects are interpreted as being the result of abnormal coordination of the molecular signaling involved in dorsoventral axis formation and laterality of the limbs and trunk, and possibly also in cardiac septation.

Abnormalities, Multiple↗
PubMed2002

The genetic control of arista lateral morphogenesis in Drosophila.

The sensory bristles and epidermal hairs of Drosophila have proven to be valuable model cell types for studying the role of the cytoskeleton in cellular morphogenesis. We have recently begun to use the arista laterals as a third model cell type. The laterals display a combination of bristle and hair characteristics and provide a system where we can compare the relative importance of specific genes and subcellular structures for the morphogenesis of different polarized cellular extensions. We have characterized the lateral phenotype of a collection of mutations selected because of their phenotypes in hairs and bristles. In many but not all ways the lateral phenotypes are similar to the hair and bristle phenotypes. We provide compelling genetic evidence for the importance of the actin cytoskeleton in lateral elongation, shaping and integrity. Our observations provide evidence that defects in actin bundling can destabilize laterals so that they split during growth. Temperature shift experiments suggest that a defect in lateral initiation can lead to subsequent splitting. These observations provide a link between multiple hair and lateral cells forming by both multiple initiation events and by the splitting of individual cellular extensions. We also found that mutations that lead to lateral splitting typically alter the stereotypic arrangement of actin filament bundles and microtubules in laterals.

Actins↗
PubMed1995

The use of a lateral patellar autologous graft for the repair of a large osteochondral defect in the knee.

An autologous graft from the lateral facet of the patella was used to repair a large osteochondral defect of the weight-bearing surface of the femoral condyle in ten patients who were then followed for an average of six and one-half years (range, four to nine years). Function was improved and symptoms were alleviated in all of the patients. Four patients had mild pain in the anterior part of the knee and two patients had a flexion deformity, which was 5 degrees in one and 10 degrees in the other. Small osteophytes developed laterally in five of the patients; three of the five had pain in the anterior part of the knee and two had a mild lateral patellar tilt.

Adult↗
PubMedDate not supplied

Talar dome fracture repaired using bioabsorbable fixation.

We describe a man with an acute osteochondral defect in the lateral talar dome associated with a supination-adduction-type ankle fracture. The osteochondral defect was readily visible on plain film radiographs, and magnetic resonance imaging was ordered to determine the full extent of soft-tissue and articular injury. It was discovered that the patient had a stage IV lesion of the talar dome, with complete inversion of the fragment, and rupture of the anterior talofibular and calcaneofibular lateral ankle ligaments. Furthermore, the patient experienced an oblique fracture of the medial malleolus with comminution. The talar dome lesion was surgically reduced and fixated using bioabsorbable pins. Nine months after surgery, the patient was fully recovered from his injury and had no functional limitations.

Absorbable Implants↗
PubMed1984

Electrocardiographic changes of acute lateral wall myocardial infarction: a reappraisal based on scintigraphic localization of the infarct.

To determine how often acute lateral myocardial infarcts may be electrocardiographically "silent," a new approach was utilized in which subjects were selected by admission thallium scintigraphy. Thirty-one patients with their first infarction were identified with moderate to severe perfusion defects of the lateral and posterolateral walls, persistent over 7 days and associated with severe wall motion abnormalities. Patients with involvement of the anterior, septal or "inferior" regions were not included. In nine patients, the perfusion defect extended to the anterolateral wall: all developed ST elevation and Q waves in at least one of the "lateral" leads (I, aVL or V6) but none showed changes in the "inferior" leads (II, III or aVF). In the other 22 patients, the perfusion defect was limited to the lateral and posterolateral walls: only 12 showed ST elevations (inferior leads only in 7, lateral leads only in 2, both leads in 3) and only 9 developed Q waves (inferior in all). In 8 of these 22 patients, the infarct was silent in the sense that no ST segment elevation or Q waves were seen, although ST depressions or T wave inversions, or both, in all but one patient were compatible with subendocardial infarction. The results indicate that the standard electrocardiogram is insensitive to changes in the lateral and posterolateral regions. Additional diagnostic studies are needed for proper localization and sizing of acute myocardial infarcts.

Adult↗
PubMed1998

Screening for fetal abdominal wall defects.

Failure of the lateral ventral folds to close by the third month of embryonic life results in an omphalocele. Although the abdominal wall defect is easily closed, the survival rate for infants with an omphalocele remains only 79%, largely the result of coexistent anomalies and chromosomal abnormalities. Gastroschisis is a deformation caused by disruption of the right omphalomesenteric artery and a resultant full-thickness defect in the abdominal wall. As a result, small bowel and, on occasion, even large bowel herniate into the amniotic space. Despite evidence of increased bowel irritability manifested by echogenic bowel wall thickening in fetuses with gastroschisis, the survival rate of more than 95% is largely the result of the lack of other severe anomalies associated with this defect. In addition, recent evidence suggests that the improvement in survival rate is also the result of improved perinatal care. The ability of perinatal specialists to categorize the defect along with associated anomalies and improved counseling regarding neonatal outcome have measurably increased the ability of families to assess the reproductive consequences and make informed decisions. This article outlines methods to identify patients at risk for having a fetus with an abdominal wall defect along with sonographic techniques to diagnose the majority of cases. Prompt consultation with individuals skilled in evaluating such defects ensures that appropriate perinatal care is provided.

Abdominal Muscles↗
PubMed1990

Reconstruction of the external genitals and repair of skin defects of the perineal region using three types of lateral groin flap.

Three types of lateral groin flap have been applied to reconstruct the external genitals and to repair skin defects in the perineal region. A single lateral groin flap was used to construct a vagina for 2 patients who had congenital absence of vagina. A composite flap containing iliac crest bone was applied to reconstruct the penis in 11 patients: 8 suffered traumatic amputation and 3 had congenital micropenis. A coaxial pedicle flap of the lateral groin and abdominal area was used to repair skin defects of the penis and scrotum after resection of the elephantiasis caused by recurrent erysipelas in 2 patients, and to relieve postburn scar contracture in the perineal region in another. Using this operative technique, 14 flaps survived completely with satisfactory results; 70% of one composite flap was lost as a result of hematoma. In the single-flap group, the distal portion (3 x 5 cm) of one flap necrosed and was resected and resurfaced with a free skin graft; the final result was good.

Adolescent↗
PubMed1989

Pectoralis major muscle-musculocutaneous flap for chest-wall reconstruction.

Pectoralis major muscle and musculocutaneous flaps are the most frequently selected for the ventral chest wall, sternum, and anterior mediastinum because of their proximity, reliability, and versatility. These advantages are derived from consistent anatomic features that allow knowledgeable surgeons to use a variety of flap designs tailored to defect needs. The flaps can be transferred on either thoracoacromial or internal mammary vascular pedicles and can be segmentally split to achieve defect closure while retaining portions of the muscle in situ to preserve donor motor function and surface form. The musculocutaneous paddles can be placed in a variety of locations and extended beyond the muscle borders to meet specific defect needs. This anatomic versatility gives pectoralis major muscle and musculocutaneous flaps a most useful role in the reconstruction of defects of the sternum and anterior mediastinum, defects of the ventral and lateral chest wall, and intrathoracic defects such as empyema cavities and bronchopleural fistula. A detailed knowledge of surgical anatomy is essential for optimal application of these flaps in the full spectrum of clinical needs.

Humans↗
PubMed1998

A gastroschisis-like abdominal wall defect in the left hypochondrium. Case report and literature review.

Congenital abdominal wall defects are exceedingly rare on the left side. The presented patient had an upper abdominal wall defect located just lateral to the left rectus muscle. Additionally, upper parts of the abdominal flat muscles were defective on that side. Because no report was found in the literature about the defect described here, both its terminological and embryological backgrounds are discussed.

Abdominal Muscles↗
PubMed2005

Bone regeneration in cranial defects previously treated with radiation.

OBJECTIVES/HYPOTHESIS: Bone reconstruction in the head and neck region is frequently performed in the context of previous radiation treatment. Thus, the effectiveness of tissue engineering approaches for regenerating bone in radiated defects needs to be determined before considering application to patients. Incomplete healing is described when using osteoinductive protein therapy alone for bone defects previously treated with radiation. We hypothesized that a different approach using ex vivo gene therapy can heal these severely compromised defects. STUDY DESIGN: Animal study using Fisher rats. METHODS: Two weeks before surgery, rats received either no radiation or a 12 Gray radiation dose to the calvarium. Syngeneic dermal fibroblasts were transduced ex vivo using an adenoviral vector containing the cDNA for bone morphogenetic protein (BMP)-7. Critical-sized calvarial defects were created, and either a transduced cell-seeded scaffold or an autologous bone graft was placed into the defect. Nonradiated defects were harvested 4 weeks later for both groups. Radiated defects treated with bone grafts were harvested at 4 weeks, and those treated with gene therapy were harvested either at 4 or 8 weeks. Gross inspection and histology were used to evaluate wound healing. RESULTS: None of the bone grafts had gross or histologic evidence of healing at the wound margins. The nonradiated gene therapy treated defects revealed gross and histologic near-100% bone regeneration by 4 weeks after surgery. By gross inspection, the radiated defects had soft tissue admixed with islands of bone at both 4 and 8 weeks. The histologic appearance revealed areas of dense bone in a nonconfluent pattern admixed with adjacent cells having the morphologic appearance of hypertrophic chondrocytes, suggesting continued endochondral ossification. CONCLUSIONS: Preoperative radiation significantly impairs the ability of BMP-7 ex vivo gene therapy to heal rat critical-sized cranial defects. This finding has significant implications for translating this tissue engineering approach to patients with cancer-related segmental bone defects.

Animals↗
PubMed1977

[Subaortic stenosis due to antero-lateral muscular band, associated with ventricular septal defect and underdevelopment of the aortic arch. Anatomical features in three cases (author's transl)].

The pathological findings in three cases with ventricular septal defect and severe coarctation or tubular hypoplasia of the aortic arch are reported. The left ventricular outflow tract was partially obstructed by muscle situated on its antero-lateral wall. The haemodynamic relationship between this type of subaortic stenosis and aortic arch underdevelopment, due to unequal partitioning of the blood flow between the ascending aorta and the pulmonary artery during foetal life, is emphasized. The normal anatomy of the left ventricular infundibulum is described and some embryological hypotheses to explain this antero-lateral muscular band are forwarded.

Aortic Coarctation↗
PubMed2006

Isolated bilateral lateral geniculate infarction producing bow-tie visual field defects.

CASE REPORT: We examined a unique case of stroke in a 29-year-old woman. Magnetic resonance imaging revealed isolated bilateral acute infarctions of the lateral geniculate bodies (LGB). Visual field testing demonstrated incongruous but homonymous bilateral visual field loss in a bow-tie configuration. COMMENTS: Isolated bilateral damage to the LGB is a rare event. Literature review has revealed only 4 previous incidents of bilateral damage to both LGB. We present a literature review and a case of bilateral LGB infarction producing visual field defects suggestive of bilateral lateral choroidal artery involvement in an individual with classic migraine.

Adult↗
PubMed2000

[Autologous lateral patellar transplant as a reserve method for managing large osteochondral defects of the knee joint in young adults].

Between 1995 and 1997, five patients were operated on with a large osteochondral defect of the femoral condyle using the lateral third of the patella. The age of the four male and one female ranged from 18 to 23 years. Initially all of them suffered from an osteochondrosis dissecans which was located at the typical site on the medial condyle of the femur, in the maximal weight bearing region. The follow-up study was 14 to 35 months and showed an improvement from 35 points preoperatively to 89 points postoperatively based on the Cincinnati knee score. All patients returned to there previous profession as well as mild sports activity. The postoperative examination did not show any retropatellar problems and there were no radiological signs of the femoropatellar joint osteoarthritis. For the operative treatment of large chondral defects at the femoral condyle autologous osteochondral transplantation using the lateral third of the patella seems to be a successful alternative.

Adolescent↗
PubMed2005

[Advanced carcinoma of the eyelids. Principles of plastic reconstruction after excision].

BACKGROUND: We present the surgical methods and results of operations in cases with advanced carcinoma of the eyelids over a 5-year period. METHODS: The study included 71 patients with advanced mono- and multifocal carcinoma (n=76) of the eyelids, selected from 324 consecutive cases with tumors of the eyelids. Various reconstruction techniques were performed after frozen section control. RESULTS: Thirty-two defects at the medial canthus were handled by glabellar transposed flap. A "dog-ear" fold occurred in three cases of this group. Twelve defects of the lower eyelid were closed by transposed nasojugal flap and 21 defects at the lateral canthus by advancement flap without any complications. For the reconstruction of three large upper eyelid defects, the Cutler-Beard procedure was applied. The Mustarde cheek rotation flap with and without skin graft was used in eight patients with large defects of the lower lid. A small part of the skin graft became necrotic in two patients of this group. CONCLUSIONS: We recommend the described surgical techniques for the reconstruction of large eyelid defects. These are successful procedures with good therapeutic, functional and esthetic results. The choice of the method depends on the individual assessment of the patients.

Adult↗
PubMed2002

Atelectasis--an unusual and late complication of lung transplant.

We report a previously unrecognized late complication of allograft lung transplantation - persistent recurrent atelectasis of the transplanted lung. The patient developed sudden, severe respiratory distress about 2 yr after a right lung transplant, because of acute atelectasis of her transplanted lung. Multiple transbronchial biopsies at the time revealed minimal inflammation and no evidence of rejection. She was treated with surfactant replacement therapy, and her collapsed lung fully expanded following surfactant installation. To eliminate the possibility of acquired deficiency of surfactant lipids or proteins, ultrastructural examination and immunostains for surfactant proteins were performed in a transbronchial lung biopsy. No deficiency of surfactant lipids or proteins was found. On ultrastructural examination of the lung biopsy, the number of Type II cells per alveolus and the number of lamellar bodies per square micron of Type II cell cross-sectional area was increased compared with an age-matched control. We conclude that synthesis of surfactant lipids and proteins was unimpaired and because of the patient's response to surfactant replacement therapy, that the increase in number of lamellar bodies could reflect a compensatory mechanism for a surfactant functional defect. The patient later developed breast carcinoma to which she succumbed. We raise the possibility that the functional surfactant defect is a hitherto unrecognized non-metastatic manifestation of malignancy.

Female↗