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We obtained favorable results in reconstruction of the posterior heel with a lateral calcaneal V-Y advancement flap. This technique simplifies the operative procedure and eliminates the disadvantages of the original lateral calcaneal flap and its island version while retaining the advantages of these methods.
A prospective study was designed to determine the course of ocular hypertension without visual field loss if untreated and to estimate the value of various clinical findings in prediction the course of ocular hypertension. Seventy-five patients with intraocular pressure greater than 21 mm Hg but without demonstrable visual field defects were followed up without glaucoma therapy for a minimum of nine years. While under observation, seven of 75 ocular hypertensives developed typical glaucomatous visual field defects. Both the sensitivity and the specificity of each clinical finding in the individuals who later developed visual field defects were determined, and none of the clinical findings was found to be a good predictive indicator.
Complex congenital heart defects due to the absence of a ventricular chamber can often be treated by the Fontan surgical procedure. The objective of this work was to quantify the haemodynamics in the Fontan operation (cavopulmonary connection) with extracardiac lateral conduit. Four different models based on the finite element method were constructed with different lengths of inferior anastomosis (range 18-25 mm) and inclinations of the conduit (33 and 47.5 degrees). Mass conservation and Navier-Stokes equations were solved by means of the FIDAP code, based on the finite element method. The left-to-right pulmonary flow ratio and percentage inferior caval blood to the left lung were the highest with the smallest anastomosis and highest inclination: 1.35 and 83.26%, respectively. Dissipated power percentage was higher with the largest anastomosis than with the smallest (19.4 vs 15.8%). It was concluded that, when performing a total cavopulmonary connection, an extracardiac lateral conduit: (i) diverts more flow to the left lung, and (ii) shows higher energy losses when compared with a connection with intra-atrial tunnel. This study could be useful to evaluate the incidence of pulmonary arteriovenous malformations.
OBJECTIVE: To analyze the results of reconstruction in terms of complications, functional restoration and cosmetic restoration of lateral cheek rotation flap. METHODS: A cross sectional study was conducted between April 2004 and January 2005. Patient's particulars and history were documented. The cause, whether trauma or tumor resection, and dimensions of the defects were recorded. All the patients underwent a "cheek rotation flap" procedure to reconstruct the defect. Post-operative complications like haematoma formation, infection and flap necrosis were noted. Results were assessed in terms of functional as well as aesthetic restoration. RESULTS: A total of 30 patients were included with a male to female ratio of 3:1 and an average age of 46 +/- 14.7. The majority of the defects (76%) were post tumour excision, while the rest (24%) followed trauma. The average defect diameter was 7.5 cms. There was no peri-operative mortality or total flap loss. There were three cases (10%) of transient facial nerve palsy who recovered spontaneously. The final reconstruction was deemed satisfactory in terms of functional and cosmetic restoration in the majority of cases (93%). CONCLUSION: Our results with the lateral cheek rotation flap to reconstruct the defects involving medial cheek have prompted us to recommend it as a first line reconstructive option for many varieties of defects in this area.
Two patients presented with loss of skin in the Achilles tendon region, which is difficult to repair satisfactorily. They were both treated with microvascular flaps, one of which was taken from the lateral arm, and the other from the radial forearm. Both methods gave good functional results.
Numerous genes and developmental processes have been implicated in the establishment of the vertebrate left-right axis. Although the mechanisms that initiate left-right patterning may be distinct in different classes of vertebrates, it is clear that the asymmetric gene expression patterns of nodal, lefty, and pitx2 in the left lateral plate mesoderm are conserved and that left-right development of the brain, heart, and gut is tightly linked to the development of the embryonic midline. This review categorizes left-right patterning defects based on asymmetric gene expression patterns, midline phenotypes, and situs phenotypes. In so doing, we hope to provide a framework to assess the genetic bases of laterality defects in humans and other vertebrates.
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Neurofilament proteins synthesized in the cell body of neurons are assembled and transported into axons, where they influence axon radial growth, axonal transport, and nerve conduction velocities. In diseased states, neurofilaments accumulate in cell bodies and proximal axons of affected neurons, and these lesions are characteristic of many neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD), spinal muscular atrophy (SMA), Charcot-Marie-Tooth disease type 2 (CMT2), and hereditary sensory motor neuropathy. Although the molecular mechanisms that contribute to these accumulations are not yet identified, transgenic mouse models are beginning to provide insight into the role of neurofilament transport in disease-related dysfunction of neurons. This review addresses axonal transport in mouse models of ALS and the special significance of neurofilament transport in this disease.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
In mutagenesis screens for recessive female sterile mutations on the second chromosome of Drosophila melanogaster 528 lines were isolated which allow the homozygous females to survive but cause sterility. In 62 of these lines early stages of oogenesis are affected, and these females usually do not lay any eggs. In 333 lines oogenesis proceeds apparently normally to stage 8 of oogenesis, but morphological defects become often apparent during later stages of oogenesis, and are visible in the defective eggs produced by these females whereas 133 lay eggs that appear morphologically normal, but do not support normal embryonic development. Of the lines 341 have been genetically characterized and define a total of 140 loci on the second chromosome. Not all the loci are specific for oogenesis. From the numbers obtained we estimate that the second chromosome of Drosophila contains about 13 loci that are relatively specific for early oogenesis, 70 loci that are specifically required in mid to late oogenesis, and around 30 maternal-effect lethals.
Free vascularized bone grafts have revolutionized mandibular reconstruction, yet their use in all mandibulectomy patients is not always necessary. A recently developed alternative to bony reconstruction has been the use of the AO reconstruction plate. We compared the use of the AO reconstruction plate with immediate free bone graft mandibular reconstruction in 31 patients. Reconstruction plates were used in 20 and immediate free bone grafts were used in 11 patients. The overall success rate for use of the plate was 15 of 20 (75 percent). There were 6 anterior reconstructions, of which only 2 (33 percent) were successful. This is opposed to 13 of 14 (93 percent) lateral reconstructions that were successful in lateral plate placements. There were 11 immediate composite free flaps: 4 iliac crest, 4 scapula, 2 fibula, and 1 composite radial forearm flaps. Six repairs were for anterior defects, and there were 5 full-thickness defects, 3 of which were in the anterior position. All 11 flaps were successful. In conclusion, we believe the reconstruction plates are a useful adjunct for mandibular replacement in the head and neck cancer patient but should be reserved for lateral defects. For anterior reconstructions, even in patients with locally advanced disease, free-tissue transfer of composite osteocutaneous flaps is the reconstructive method of choice.
The Antiretroviral Pregnancy Registry (APR) is an international pregnancy exposure registry designed to monitor prenatal antiretroviral medication exposures and detect any potential increase in the risk of major birth defects. The APR process imitates that of the Metropolitan Atlanta Congenital Defects Program (MACDP) modified to account for the differences in surveillance systems. The APR case definition attempts to separate prenatal and postnatal medication exposure, includes cases with multiple conditional defects only and collects cases diagnosed at later ages. Possible temporal association between defect pathogenesis and antiretroviral medication exposure includes a way to identify cases with known etiology--such as familial genetic conditions--and those with currently ambiguous pathogenesis--like hemangiomata and club feet. The APR also accounts for confounding factors like maternal alcohol use. Some defect reports automatically generate questions back to the reporter asking for more information. The APR incorporates procedures for managing and recording some of the more inconsistently reported malformations, such as microcephaly.
A method for reconstruction of skin defects around the knee using the lateral genicular artery flap is presented. This flap is supplied mainly by the cutaneous perforator of the superior lateral genicular artery. On the basis of ten cadaver dissections, we found that the nutrient artery is reliable, penetrates the deep fascia at a small triangular area surrounded by the lateral femoral condyle, the vastus lateralis, and the short head of the biceps femoris, and anastomoses predominantly with the lateral perforators of the profunda femoris artery in the midlayer of the subcutaneous fatty tissue. This flap can be safely extended to the midpoint between the lateral femoral condyle and the greater trochanter.
During the past 2 1/2 years, we have used 21 deltopectoral (DP) and 25 pectoralis major myocutaneous (PM) flaps of which 25 were applied to oral and pharyngeal defects. The concurrent use of both flaps has enabled elucidation of some specific and relative advantages and disadvantages. The following five situations have been identified in which we believe the PM flap is clearly superior: (1) lateral mandibular composite resection defects; (2) large anterior segmental defects; (3) reconstitution of tongue and base of tongue; (4) radionecrosis; and (5) through-and-through defects of skin and oral cavity. The DP flap appears to hold an advantage in the repair of the following defects: (1) limited anterior mandibular loss; (2) posterior and lateral pharyngeal loss; (3) complex resections involving the palate; and (4) cervicofacial skin. The unique advantages of each flap must be weighed against certain disadvantages. Application to each reconstructive problem should be individualized. Proficiency with both flaps enhances the surgeon's ability to deal with major ablative procedures.
OBJECTIVE: The aim of this study was to determine if there was a difference in the sacral base angle in females with spondylolysis compared with females without spondylolysis. This is a follow-up study to an earlier pilot program, in which the female sample size was too small. DESIGN: Retrospective study utilizing upright neutral lateral lumbar radiographs of females with evidence of pars defects (test group) and upright neutral lateral radiographs of females with no evidence of pars defects (control group). The control group was age matched to the test group. SETTING: Chiropractic college clinic. INTERVENTIONS: None. MAIN OUTCOME MEASURES: The sacral base angle was measured on each radiograph. RESULTS: The mean sacral base angle was found to be 52.7 +/- 6.8 degrees (mean +/- SD) (n = 22) and 38.6 +/- 7.6 degrees (mean +/- SD) (n = 47) in the test and control groups respectively. This difference was found to be statistically significant (p < .001). CONCLUSIONS: The study has determined that females with spondylolysis have a steeper sacral base angle than females without spondylolysis. It does not, however, indicate whether a larger sacral base angle is a cause or an effect of the spondylolysis. This study also suggests that there is virtually no difference in the sacral base angles between males and females with and without pars defects.