SEARCH · Search PubMed
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.
This article defines an unusual previously unreported entity afflicting a maxillary lateral incisor. Labial idiopathic external root resorption just apical to the cemento-enamel presented as a gingival (periodontal) problem and was misinterpreted as cervical dental caries. This report defines a new possibility for a radicular defect in a maxillary lateral incisor that may cause periodontal problems.
Azospirillum brasilense Sp245 has a mixed type of flagellation: a single polar flagellum (Fla) is synthesized constitutively, and abundant lateral flagella (Laf) are produced only in solid and semisolid media. In the present study, Omegon-Km Fla-Laf-, Fla-Laf+, Fla-/Mot-Laf-. Fla-/Mot-Laf+, Mot-Laf-, and Che- mutants of Sp245 were constructed in vivo. In some of the mutants, a number of cells possessed from 1 to 5 subpolar long flagella (Sfl). These Sfl provided the host cells with unusual motility patterns. Mutants producing shortened Fla and Laf were also detected. In the mutants still producing Laf, their expression retained the wild-type inducibility. However, all the mutants described were unable to form swarm rings in semisolid media. The results suggest the existence of common control or structural elements in assembly and rotation apparatus of both Fla and Laf systems. Single Omegon-Km insertions were localized in 85 MD (in two mutants) and in 120 MD (in one mutant) indigenous plasmids, as well as to least in two different regions of chromosomal DNA (in other mutants).
A case reported here is one year-old girl, who was admitted to our neurosurgical service because of gradually increasing swelling in the left lumbar region, and maldevelopment and paresis of the left leg since birth. From the level of L-2 to S-1, there was a 8 X 7 xm subcutaneous swelling of lipomatous consistency with well-defined margins. Of particular characteristics was that the swelling didn't cross the midline and was entirely located in the left paravertebral region (Fig. 1). In the spine no gap could be felt between the spinous processes. There was no evidence of hydrocephalus, but she bad marked right sided scoliotic deformity of the lumbar region, and dislocation of hip joint and club-foot on the left side. Rectum-bladder-vaginal fistula with defect of anus and hypoplasia of kidney on the left side were also detected. Skiagram of the lumbosacral spine revealed marked right-sided scoliosis at the level of L-1 and hypoplasia of left pedicles, accompanied with marked dilation of transverse diameter of spinal canal between the level of L-1 to S-2. Defect of laminae of lumbosacral spine was not definately determined. Conray myelogram showed presence of cyst protruding laterally to the left paravertebral region probably through defect of lamina on the left side at the level of L-5 (Fig 2). At operation, it was confirmed that meningomyelocele protruded out laterally through the defect of half of lamina at the level of L-5. Massive lipoma was noted inside as well as outside the dura mater. Neural elements were replaced inside the spinal canal and the dura repaired. The postoperative period was uneventful. Diagram of defect of lamina at the level of L-5 and its relationships to the meningomyelocele sac is shown in Fig. 3. Meningocele or meningomyelocele which lays in the paravertebral lumbar region is very rare (Table 2), but the possibility of this disease should always be considered when we examine the patients with lipomatous or cystic swelling in the paravertebral lumbar region, especially when the patients present the neurological symptoms or signs.
Since 1984, 42 patients have been treated with gluteus maximus myocutaneous flaps. In 37 patients, a "classical" gluteus maximus myocutaneous flap was used to cover a sacral-gluteal defect. In 5 patients, a "nontypical" gluteus maximus myocutaneous flap was used: two flaps were advanced from caudal to cranial to close defects over the lumbar spinal area, two flaps were advanced from cranial to caudal to close defects in the perineal region, and one flap was advanced from medial to lateral to close a trochanteric defect. All defects could be closed. There was no flap necrosis. In 12 patients (out of 42) there were minor wound infections, and in 6 patients there were minor wound dehiscences. The average blood loss never exceeded 500 cc, the average time of hospitalization (postoperatively) was 17 days, and mobilization (walking) was started 3 to 4 days postoperatively. The average distance of flap advancement was 10 cm. The maximum defect closed by a bilateral V-Y gluteus maximus myocutaneous flap was 24 x 20 cm.
OBJECTIVE: To describe the association between prevalent and incident knee cartilage defects and loss of knee cartilage in male and female adults. METHODS: A convenience sample of 325 subjects (mean age 45 years; age range 26-61 years) was evaluated at baseline and approximately 2 years later. Knee cartilage volume, cartilage defect scores (0-4 scale), and joint surface area were determined using T1-weighted fat-suppression magnetic resonance imaging techniques. Height, weight, and radiographic evidence of osteoarthritis were measured by standard protocols. RESULTS: Multivariable analysis revealed that baseline cartilage defect scores at the medial tibia, lateral tibia, and patella had a dose-response association with the annual rate of change in knee cartilage volume at the corresponding site (beta = -1.3% to -1.2% per grade; P < 0.05 for all comparisons). In addition, an increase in knee cartilage defect score (change of > or =1) was associated with higher rates of knee cartilage volume loss at all sites (beta = -1.9% to -1.7% per year; P < 0.01 for all comparisons). Furthermore, a decrease in the knee cartilage defect score (change of less than or equal to -1) was associated with an increase in knee cartilage volume at all sites (beta = 1.0% to 2.7% per year; P < 0.05 for all comparisons). CONCLUSION: Prevalent knee cartilage defects are predictive of compartment-specific cartilage loss over 2 years. Both increases and decreases in knee cartilage defects are associated with changes in knee cartilage volume, which implies a potential for reversal of knee cartilage loss.
PURPOSE: We sought to determine whether visual field abnormalities occur in infants with deformational posterior plagiocephaly and to assess whether there is a relationship between the severity and laterality of visual field abnormalities with the severity and laterality of skull deformity. METHODS: A retrospective chart review was performed on 40 consecutive infants with deformational posterior plagiocephaly. Each was tested with standardized binocular arc perimetry in the horizontal plane. Sixteen patients also had 3-dimensional computed tomography of the skull. Hemifield asymmetry of >/=20 degrees and/or a decrease in hemifield values by >/=20 degrees from established normal patients was considered abnormal. Visual field data from study patients was plotted against previously published normative data. Graphs comparing visual field defects and laterality to cranial asymmetry also were generated. RESULTS: Thirty-five percent of infants with deformational posterior plagiocephaly had constriction of one or both hemifields by at least 20 degrees from established normal patients. Hemifield asymmetry of 20 degrees or more was found in 17.5% of infants tested. There was a significant difference in the worse hemifield values measured in each patient and the standard visual fields obtained from normative data ( P = 0.036). There was no correlation between the laterality of the visual fields to the laterality of the defects. A correlation between severity of hemifield constriction and % asymmetry on computed tomography was noted ( P = 0.209). CONCLUSIONS: Deformational posterior plagiocephaly may affect visual field development but neither the laterality nor the severity of skull deformity is predictive of the severity of visual field defects.
One hundred forty-four infants with anomalies of the gastrointestinal tract and abdominal wall were treated at Children's Memorial Hospital between July 1970 and July 1973. The overall mortality, including unoperated infants and those dying from other causes up to six months later, was 17%. Associated defects, particularly of the heart and CNS, were the most common causes for death. Many infants were premature; however, this factor alone did not contribute to mortality. Differences in surgical technique did not affect mortality in patients with esophageal atresia, but one baby with total aganglionosis of his colon and two with gastroschisis may have survived with different modes of therapy. Although previous advances in pediatric surgery contributed to the overall good results in these infants, parenteral alimentation emerged as the single most important factor in improved survival during this study period.
Defects of the heel can be difficult to treat because they require a thin, sensate, soft-tissue cover. The lateral calcaneal flap can provide this type of reconstruction in selected patients. A 27-year-old man had a painful defect in a grafted heel that prevented him from working. A satisfactory painless heel was provided by resurfacing the area with a lateral calcaneal flap. The donor defect was minimized by interfascicular dissection of the sural nerve.
BACKGROUND: The frizzled pathway in Drosophila has been studied intensively for its role in the development of planar polarity in wing hairs, thoracic bristles and ommatidia. Selected cells in the arista (the terminal segment of the antenna) elaborate a lateral projection that shares characteristics with both hairs and bristles. RESULTS: We found that mutations in putative downstream members of the frizzled pathway, such as inturned resulted in multipled and split laterals, but no obvious polarity defects. Mutations in upstream genes such as frizzled did not show an adult arista phenotype. When we examined lateral development in the mutants we found that, as is the case on the wing for hair development the frizzled pathway regulated the subcellular location for lateral initiation. However, on the arista an altered location for lateral initiation did not result in altered polarity, as did an altered site for hair initiation. The regulation of lateral development involved the preferential accumulation of Frizzled protein at the distal edges of lateral cells much as is seen on the wing. In contrast to the situation in wing cells, in arista cells the location for lateral initiation was close to but did not overlap the region of preferential Frizzled accumulation. CONCLUSION: Our data indicates that a modified version of the frizzled pathway regulates arista development. We conclude that the lack of a polarity defect in mutant aristae is likely to be a consequence of inherent differences in the cell biology of wing hair and lateral forming cells.
Large skull defects lead to progressive depression deformities, with resulting neurological deficits. Thus, cranioplasty with various materials is considered the first choice in therapy to restore cerebral function. A 31-year-old female presented with a massive left-sided hemispheric substance defect involving bone and brain tissue. Computed tomography showed a substantial convex defect involving the absence of calvarial bone as well as more than half of the left hemisphere of the brain, with a profound midline shift and a compression of the ventricular system. There was a severe problem due to multiple deep-skin ulcerations at the depression margin, prone to skin perforation with a probability of intracranial infection. In a first step, a free myocutaneous latissimus dorsi flap was transplanted for volume replacement of the hemispheric brain defect, and 4 months later, artificial bone substitute was implanted in order to prevent progressive vault depression deformity. Healing was uneventful, and the patient showed definite neurological improvement postoperatively. Free tissue transfer can be a valuable option in addition to cranioplasty in the treatment of large bony defects of the skull. Besides providing stable coverage for the reconstructed bone or its substitute, it can also serve as a volume replacement.
It was well known that auxin is critical for anther/pollen grain development, however, the clear distribution and detailed effects of auxin during floral development are still unclear. We have shown here that, through analyzing GUS activities of Arabidopsis lines harboring auxin response elements DR5-GUS, auxin was mainly accumulated in the anther during flower stages 10-12. Further studies employing the indoleacetic acid-lysine synthetase (iaaL) coding gene from Pseudomonas syringae subsp. savastanoi under control of the promoter region of Arabidopsis phosphatidylinositol monophosphate 5-kinase 1 gene, which conducts the anther filament-specific expression, showed that block of auxin flow of filaments resulted in shortened filaments and significantly defective pollen grains. Similar phenotype was observed in tobacco plants transformed with the same construct, confirming the effects of auxin flow in filaments on anther development. Detailed studies further revealed that the meiosis process of pollen grain was normal while the mitosis at later stage was significantly defected, indicating the effects of auxin flow in filaments on pollen grain mitosis process. Analysis employing [(14)C]IAA, as well as the observation on the expression of AtPIN1, coding for auxin efflux carrier, demonstrated the presence of polar auxin transport in anther filaments and pollen grains.
Molecular and statistical studies support the close phylogenetic relation between Cetacea and Artiodactyla. The presence of the tracheal bronchus has been pointed out as one of the common traits between only these groups. Nakakuki (1980) has investigated the mammalian tracheobronchial trees in 50 species based on his new nomenclature, and his study has consequently demonstrated the above-mentioned indication. Therefore, comparative anatomy of the tracheobronchial tree based on the nomenclature seems to be useful for investigations of the cetacean phylogeny. Three pairs of fetal lungs of the minke whale (Balaenoptera acutorostrata) were supplied from the Institute of Cetacean Research, Tokyo (1991) to observe their tracheobronchial trees and the ramification of the pulmonary artery. The fetal tracheobronchial tree consisted of one tracheal, four lateral, four dorsal and one medial secondary bronchi in the right lung, and five or six lateral and four or five dorsal secondary bronchi in the left, using the new nomenclature. The right pulmonary artery crossed the right axial bronchus from the ventral side to the dorsal over the third lateral bronchus. The tracheal bronchus in the fetal minke whale seems to belong to the type II of Nakakuki's nomenclature, and this type is seen in one species of the river dolphins. The other conspicuous traits of the fetal lungs are the defect of the second lateral broncus and the route of the pulmonary artery in the right side. This route is very different from that of many other mammals.
Considering the abundant vascular anastomotic networks in the deep fascia of the posterior calf, three kinds of distally based facial flap containing deep fascial vascular network were applied clinically. They were: 1. posterolateral distally based island fascial flap which could be used to repair the skin defect of heel, dorsum of foot and lateral-distal part of leg; 2. posteromedial distally based island fascial flap which could be used to repair the skin defect of heel, medial malleolus and medial-distal part of leg and 3. posterolateral malleolar distally based fascial flap which could be used to repair the skin defect of heel and lateral malleolus. Eighteen cases with soft tissue defects around the distal calf were treated, the area of skin defect ranged from 4 cm x 3 cm to 13 cm x 6 cm. All the flaps were survived completely after operation with an average of follow-up for 15 months (ranged from 6 months to 2 years). So the advantages of these flaps were as follows: the blood supply was reliable, preparation of the flap was easy and the major arteries of the calf needed not be sacrificed; the flap had a long and rotatable pedicle so that they would basically satisfy the need to repair skin defect of lower leg, dorsum of foot, heel and malleolus and the resistance of the flap to pressure and wear was better. However, the injury to the superficial sural nerve was the shortcoming.
In this article a modified bilobed flap from mastoid and lateral neck skin for reconstruction of complex defects of the posteromedial surface of the auricle and mastoid skin, with the preservation of the retroauricular sulcus, is described. Reconstruction of the postero-medial auricular surface has almost never been a concern for reconstructive surgeons. It is in fact a shaded area with little aesthetic relevance and direct closure, skin grafting and even secondary healing are used for skin cancer defects repair. Also mastoid skin defects can be repaired with simple techniques such as skin grafts or transposition flaps from the remaining mastoid skin or from the neck. On the other hand, cancers involving the postero-medial auricular surface, the retroauricular sulcus and the mastoid skin require wide and deep resections that involve the posterior auricular muscles and reach the perichondral and periosteal surfaces. Direct closure with undermining, if feasible, will obliterate the retroauricular sulcus causing asymmetry with the contralateral ear and, if defects are cephalad will impair the possibility of wearing spectacles, thus leaving functional and aesthetic impairment. Transposition flaps from the remaining mastoid skin, due to the lack of skin laxity, are not feasible because the donor site cannot be closed. Two patients, both affected by basal cell carcinoma involving the posteromedial auricular surface and the mastoid skin have been treated with this flap. In both cases the use of the modified bilobed flap described in this article allowed preservation of the retroauricular sulcus and closure of the donor site. Scars were hidden along minimal tension lines and the possibility of wearing spectacles along with sensitivity all over the reconstructed area were maintained.
Colloid cyst is a relatively rare benign tumor which is usually found in the third ventricle. A patient who had a "colloid cyst" in his right lateral ventricle was experienced. A 33-year-old man had suffered from intermittent attacks of headache and vomiting for five months. On July 22, 1974, he was hospitalized to our clinic because of headache, memory and gait disturbance. At the time of admission his consciousness was clear but he had slight memory disturbance and urinary incontinence. Incipient papilledma was noted and the deep tendon reflexes of the lower extrimities were slightly accentuated. Lumbar puncture revealed a clear CSF and its pressure was within normal limit and the protein was 59 mg/dl. The plain skull films showed no abnormal findings. EEG showed an asymmetry of alpha-wave, and paroxysmal high voltage of slow wave was found in the right frontal area. Right cerebral angiography demonstrated an unrolling of the pericallosal arteries suggesting dilatation of the lateral ventricles. On the 9th hospital day, he suddenly began to complain of severe headache and became drowsy. Mannitol and hydrocortisone were injected intravenously without producing any remarkable effects. A ventricular drainage was done, and the patient recovered rapidly. A conray ventriculography revealed a round filling defect in the right lateral ventricle. A transventricular approach through a short linear incision in the right frontal cortex was preformed on the 25th hospital day. A cyst containing colloid substance, about 5x4 cm in size, was found to be attached to the medial wall of the right lateral ventricle anterior to the foramen of Monro. This cyst was almost completely removed. Histological findings revealed inner lining of epithelial cells, He died on the 25th postoperative day from bacterial meningitis. Autopsy confirmed the cyst to have originated from the right lateral ventricle. A review of the literature was made and the pathogenesis and diagnosis of this disease and the mechanism of development of the symptoms were discussed.
The resistance of two biomaterials, one synthetic and one biologic in origin, to deliberate bacterial infection was compared in a dog model of orthopedic soft tissue reconstruction. Twenty-four adult female dogs were randomly divided into two equal groups and a 2.0-cm-round full-thickness defect was created on the lateral surface of the stifle joint, leaving only the synovium and skin intact. The defect was surgically repaired with either Dacron trade mark mesh or a porcine derived extracellular matrix (ECM) scaffold material. The repair site was inoculated with 1 x 10(8) Staphylococcus aureus at the time of surgery and the dogs were survived for 28 days. Results showed a chronic pyogranulomatous inflammatory response at the Dacron trade mark implant sites versus a constructive tissue-remodeling response without residual inflammation at the ECM implant site. Three dogs in the group receiving the Dacron trade mark mesh were treated with Keflex trade mark (500 mg bid x 7 days) for signs of septicemia. A quantitative bacterial count of the implant sites at the time of sacrifice showed 6.52 x 10(5) +/- 1.2 x 10(6) and 6.5 x 10(2) +/- 1.8 x 10(3) bacteria per gram of tissue for the Dacron trade mark and ECM scaffold sites, respectively (P <.03). The ECM implant material was more resistant than the synthetic implant material to persistent infection following deliberate bacterial contamination and the ECM scaffold supported constructive tissue remodeling.
The purpose of this study was to measure the effect of bone-patellar tendon-bone autograft harvest for anterior cruciate ligament (ACL) reconstruction on the surface strain of the human patella. Through progressive removal of bone from the patella, three different defect shapes as well as the intact patella were tested in each of seven knees. Maximum principal strain and corresponding principal direction were determined from each of three gages around the defect for the four conditions (intact plus three defect shapes). There were no statistically significant differences in overall average surface strain between any of the defect shapes. Following graft harvest, overall average strain (all three defects combined) increased in the patella both medial (15 percent increase) and lateral (34 percent increase) to the defect, while decreasing in the region directly proximal (22 percent decrease) to the harvest site compared to the intact patella. A statistically significant 7.5 deg shift of principal direction from longitudinal toward a more transverse (lateral-superior to medial-inferior) direction was observed in the medial region when a shallow-dome defect was made. We conclude that removal of a bone block from the anterior, inferior part of the patella induces a significant redistribution of the surface strain. This results in greater local strain adjacent to the upper border of the bone block increasing the risk for patella fracture. This effect may be of importance in various complications known to occur after ACL reconstruction.
An appreciation of the appearances of segmental and lobar defects on a lung scan is important for the diagnosis of pulmonary embolism. The appearances of segmental and lobar ventilation defects of known anatomical location have been examined on 81mKr ventilation scans in normal human subjects, utilizing fibreoptic bronchoscopy to place temporary occlusions under direct vision at the orifices of lobar and segmental bronchi. Scans were obtained in the posterior, posterior-oblique and lateral projections. Anterior views were included if the defects could not be adequately visualized on the other views. The completeness of the occlusion and the site and size of each defect could be confirmed by ventilating the segment itself with 81mKr via the balloon catheter while the occlusion was maintained. Segmental defects located anterior to the hilum of the lung tended to be optimally visualized on the lateral view and defects located posterior to the hilum tended to be optimally visualized on the posterior-oblique view. The size of segmental defects could be underestimated on the lung scan, especially those involving the anterior and lateral basal segments of both lower lobes. Defects involving the medial basal segment of the right lower lobe were undetectable on any view. By implication, the same conclusions apply to 99mTc perfusion scans.