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Sample records for gracilis muscular flap

  1. Surgical repair of rectovaginal fistula using gracilis muscular flap. A case report

    Inoue, Yasuhiro; Ooi, Masataka; Takeuchi, Kenji; Honzumi, Makoto [Nabari City Hospital, Mie (Japan); Fukunishi, Shigeji

    1999-07-01

    A 78 year-old female suffered from vaginal discharge of flatus and stool for 20 years after the radiation therapy for cervical cancer. Digital and endoscopic examination of the rectum and the vagina disclosed a large, short rectovaginal fistula at the level of the cervix. Since laparotomy and low anterior resection of the rectum were impossible, a perineal approach was adopted. After perineal skin incision, the fistula was resected and the defects of the rectum and the vagina were closed. Gracilis muscular flap was anchored between the two closures. Though the closure of the rectal side was torn, her postoperative course was uneventful. Endoscopic examination 24 days after the operation confirmed healing of the dehiscence. The results verified the usefulness of the perineal approach using the gracilis muscular flap as an alternative method to low anterior resection for troublesome radiation induced rectovaginal fistula. (author)

  2. Surgical repair of rectovaginal fistula using gracilis muscular flap. A case report

    Inoue, Yasuhiro; Ooi, Masataka; Takeuchi, Kenji; Honzumi, Makoto; Fukunishi, Shigeji

    1999-01-01

    A 78 year-old female suffered from vaginal discharge of flatus and stool for 20 years after the radiation therapy for cervical cancer. Digital and endoscopic examination of the rectum and the vagina disclosed a large, short rectovaginal fistula at the level of the cervix. Since laparotomy and low anterior resection of the rectum were impossible, a perineal approach was adopted. After perineal skin incision, the fistula was resected and the defects of the rectum and the vagina were closed. Gracilis muscular flap was anchored between the two closures. Though the closure of the rectal side was torn, her postoperative course was uneventful. Endoscopic examination 24 days after the operation confirmed healing of the dehiscence. The results verified the usefulness of the perineal approach using the gracilis muscular flap as an alternative method to low anterior resection for troublesome radiation induced rectovaginal fistula. (author)

  3. Muscle conserving free gracilis transfer (mini-gracilis free flap

    Bibhuti Bhusan Nayak

    2012-01-01

    Full Text Available Gracilis is a commonly used muscle for free tissue transfer. It is also split into two based on its pedicles and used as two units. Use of distal part as a free flap in isolation has never been described in literature. We describe a technique of harvesting a small unit of gracilis based on its minor pedicle and maintaining the continuity and conserving the major bulk of muscle. Thus, the function of the muscle is preserved and the same is also available for transfer on its major pedicle later, if required.

  4. The transverse musculocutaneous gracilis flap for breast reconstruction: guidelines for flap and patient selection.

    Schoeller, Thomas; Huemer, Georg M; Wechselberger, Gottfried

    2008-07-01

    The transverse musculocutaneous gracilis (TMG) flap has received little attention in the literature as a valuable alternative source of donor tissue in the setting of breast reconstruction. The authors give an in-depth review of their experience with breast reconstruction using the TMG flap. A retrospective review of 111 patients treated with a TMG flap for breast reconstruction in an immediate or a delayed setting between August of 2002 and July of 2007 was undertaken. Of these, 26 patients underwent bilateral reconstruction and 68 underwent unilateral reconstruction, and 17 patients underwent reconstruction unilaterally with a double TMG flap. Patient age ranged between 24 and 65 years (mean, 37 years). Twelve patients had to be taken back to the operating room because of flap-related problems and nine patients underwent successful revision microsurgically, resulting in three complete flap losses in a series of 111 patients with 154 transplanted TMG flaps. Partial flap loss was encountered in two patients, whereas fat tissue necrosis was managed conservatively in six patients. Donor-site morbidity was an advantage of this flap, with a concealed scar and minimal contour irregularities of the thigh, even in unilateral harvest. Complications included delayed wound healing (n = 10), hematoma (n = 5), and transient sensory deficit over the posterior thigh (n = 49). The TMG flap is more than an alternative to the deep inferior epigastric perforator (DIEP) flap in microsurgical breast reconstruction in selected patients. In certain indications, such as bilateral reconstructions, it possibly surpasses the DIEP flap because of a better concealed donor scar and easier harvest.

  5. Release of hand burn contracture: comparing the ALT perforator flap with the gracilis free flap with split skin graft.

    Misani, M; Zirak, C; Hau, Lê Thua Trung; De Mey, A; Boeckx, W

    2013-08-01

    The use of microsurgery in the management of burn sequelae is not a new idea. According to the properties of various types of free flaps different goals can be achieved or various additional procedures have to be combined. We report the comparison of two different free flaps on a single patient for reconstruction of both upper extremities for burn sequelae. A 1-year-old child sustained severe burns on both hands, arms and thorax and was initially only treated conservatively. This resulted in severe contractures. At the age of 4-years a free gracilis flap was selected for reconstruction of his left hand and a free anterolateral thigh flap for the right hand. We noticed a better functional and esthetic result for the gracilis flap associated with a shorter operative time and a minor donor site morbidity. The intraoperative technique and time, postoperative complications, functional and esthetic results and donor site morbidities were studied in the two types of flaps chosen. A review of literature was also performed. Our experience reported a better success of the gracilis muscle flap covered with a split skin graft compared to the anterolateral thigh flap in the reconstruction of hand function after severe burn sequelae. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  6. Extending the use of the gracilis muscle flap in perineal reconstruction surgery.

    Goldie, Stephen J; Almasharqah, Riyadh; Fogg, Quentin A; Anderson, William

    2016-08-01

    Reconstruction of the perineum is required following oncological resections. Plastic surgical techniques can be used to restore the aesthetics and function of the perineum. The gracilis myocutaneous flap provides a substantial skin paddle, with minimal donor site morbidity. The flap is pedicled on a perforator from the medial circumflex femoral artery, giving it limited reach across the perineum. Tunnelling the flap under the adductor longus muscle may free up more of the arterial pedicle, increasing its reach. On three female cadavers, bilateral gracilis flaps were raised in the standard surgical manner, giving six flaps in total. With the flaps pedicled across the perineum, the distance from the tip of each flap was measured to the anterior superior iliac spine (ASIS). The flaps were then tunnelled under the adductor longus muscle. The distances to the ASIS were measured again. The average pedicle length was greater than 7 cm. Tunnelling the flap under the adductor longus muscle increased the reach by more than 4 cm on average. Cadaveric dissection has shown that tunnelling of the flap in a novel way increase its reach across the perineum. This additional flexibility improves its use clinically and is of benefit to plastic surgeons operating in perineal reconstruction. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Treatment of ischial pressure sores using a modified gracilis myofasciocutaneous flap.

    Lin, Haodong; Hou, Chunlin; Chen, Aimin; Xu, Zhen

    2010-04-01

    Despite the availability of a variety of flap reconstruction options, ischial pressure sores continue to be the most difficult pressure sores to treat. This article describes a successful surgical procedure for the coverage of ischial ulcers using a modified gracilis myofasciocutaneous flap. From August 2000 to April 2004, 12 patients with ischial sores were enrolled in the study. All patients underwent early aggressive surgical debridement followed by surgical reconstruction with a modified gracilis myofasciocutaneous flap. The follow-up period ranged from 13 to 86 months, with a mean of 44 months. Overall, 91.7% of the flaps (11 of 12) survived primarily. Partial flap necrosis occurred in one patient. Primary wound healing occurred without complications at both the donor and recipient sites in all cases. In one patient, grade II ischial pressure sores recurred 13 months after the operation. There was no recurrence in other 11 patients. A modified gracilis myofasciocutaneous flap provides a good cover for ischial pressure sores. Because it is easy to use and has favorable results, it can be used in the primary treatment for large and deep ischial pressure sores. Copyright Thieme Medical Publishers.

  8. Scrotal Reconstruction with a Pedicled Gracilis Muscle Flap after ...

    Several scrotal reconstructive options are available including split thickness skin grafts, scrotal advancement flaps, local fasciocutaneous, muscle or myocutaneous flaps, and free tissue transfer. We report a case of a 34 year old African male who presented as a referral from a district hospital with a scrotal defect and ...

  9. The transverse musculo-cutaneous gracilis flap for breast reconstruction: How to avoid complications.

    Bodin, Frédéric; Dissaux, Caroline; Dupret-Bories, Agnes; Schohn, Thomas; Fiquet, Caroline; Bruant-Rodier, Catherine

    2016-01-01

    The transverse musculocutaneous gracilis (TMG) flap has become a common solution for breast reconstruction. However, the safe skin paddle limits are not yet understood. In this study, we attempted to address this issue based on our experiences with inferior and posterior skin paddle extension. Forty-four breast reconstructions with TMG flaps performed between November 2010 and January 2014 were analyzed retrospectively. For the first 20 cases, the flap skin paddle was extended 3 cm posteriorly to the middle thigh (group 1). For the next 20 flaps (group 2), the posterior tip was limited to this line, whereas more fat was recruited inferiorly. In the four cases of group 3, the skin flap was extended posteriorly with a second vascular pedicle from the profunda artery perforator (PAP) flap. The weights and the dimensions of the flaps, operating durations, and postoperative complications of the entire series were analyzed. Groups 1 and 2 were statistically compared. Flap complications were statistically more frequent in group 1 compared with group 2 (45 vs. 0%, P = 0.0012); 40% posterior flap tip necrosis was observed in group 1. Conversely, donor site complications were statistically more frequent in group 2 than in group 1 (40 vs. 5%, P = 0.019) with 35% inner thigh dehiscence. In the TMG with extended PAP flap group, the operating duration was 77 min longer compared with the rest of the series with no donor site complications. In one case, limited necrosis occurred at the anterior skin tip. Harvesting the posterior portion of the TMG up to the middle of the posterior thigh may lead to partial flap necrosis. Extending subcutaneous fat removal under the inferior skin incision may increase the risk of donor site complications. Adding a second vascular pedicle from the PAP flap may improve posterior TMG tip perfusion at the expense of a longer operation. © 2015 Wiley Periodicals, Inc.

  10. scrotal reconstruction with a pedicled gracilis muscle flap after

    nonviable tissue is removed and a granulation bed suitable for .... The pedicled or free greater omental flap as well as scrotal tissue ... Bien-keem Tan, Mohammed ZulfikarRasheed,. WofflesT.L.Wu ... Honda Hsu Chih Ming Lin, Tzong-Bon Sun,.

  11. Adynamic Graciloplasty With a Pedicled Gracilis Muscle Flap Wrapped Around Bulbar Urethra for Treatment of Male Acquired Urinary Incontinence.

    Guo, Hailin; Sa, Yinglong; Xu, Yuemin; Wang, Lin; Fei, Xiaofang

    2016-05-01

    To evaluate the efficacy of adynamic gracilis urethral myoplasty with a pedicled gracilis muscle flap wrapped around bulbar urethra for treatment of male acquired urinary incontinence. Twenty-four patients with acquired urinary incontinence (8 after radical prostatectomy, 7 after transurethral resection of the prostate, and 9 after posterior urethroplasty) were included in our study. Eighteen of these patients (75.0%) had mild to moderate urinary incontinence, and 6 (25.0%) had severe urinary incontinence. All patients received adynamic gracilis urethral myoplasty with a pedicled gracilis muscle flap wrapped around bulbar urethra and had a close follow-up. The mean postoperative maximum urethral pressure after the gracilis muscle wrapped around bulbar urethra was significantly higher than that of the preoperative measurements (P urethra can raise the urethral pressure. Adynamic graciloplasty with a pedicled gracilis muscle flap wrapped around bulbar urethra is a safe and effective surgical option in the treatment of male patients with mild to moderate incontinence, but is not suitable for severe incontinence. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Transverse musculocutaneous gracilis flap for treatment of capsular contracture in tertiary breast reconstruction.

    Pülzl, Petra; Huemer, Georg M; Schoeller, Thomas

    2015-02-01

    Capsular contracture is a common complication associated with implant-based breast reconstruction and augmentation leading to pain, displacement, and rupture. After capsulectomy and implant exchange, the problem often reappears. We performed 52 deepithelialized free transverse musculocutaneous gracilis (TMG) flaps in 33 patients for tertiary breast reconstruction or augmentation of small- and medium-sized breasts. The indications for implant removal were unnatural feel and emotion of their breasts with foreign body feel, asymmetry, pain, and sensation of cold. Anyway, most of the patients did not have a severe capsular contracture deformity. The TMG flap is formed into a cone shape by bringing the tips of the ellipse together. Depending on the contralateral breast, the muscle can also be shaped in an S-form to get more projection if needed. The operating time for unilateral TMG flap breast reconstruction or augmentation was on average 3 hours and for bilateral procedure 5 hours. One patient had a secondary revision of the donor site due to disruption of the normal gluteal fold. Eighty percent of the unilateral TMG flap reconstructions had a lipofilling procedure afterward to correct small irregularities or asymmetry. The advantages of the TMG flap such as short harvesting time, inconspicuous donor site, and the possibility of having a natural breast shape make it our first choice to treat capsular contracture after breast reconstruction and augmentation.

  13. Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure.

    Cherubino, Mario; Maggiulli, Francesca; Pellegatta, Igor; Valdatta, Luigi

    2016-01-01

    Poland's syndrome (PS) is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gracilis flap (FGF). In this patient, only the pectoralis major muscle was missing. An FGF was performed to reconstruct the anterior axillary fold and the soft tissue defect. There was no flap loss, the patient had a clearly improved appearance of the chest wall, and the pain syndrome was solved. In this case report, we demonstrate our experience with the use of an FGF for chest wall reconstruction in male patients with PS after prosthesis explantation.

  14. Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure

    Mario Cherubino

    2016-01-01

    Full Text Available Poland's syndrome (PS is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gracilis flap (FGF. In this patient, only the pectoralis major muscle was missing. An FGF was performed to reconstruct the anterior axillary fold and the soft tissue defect. There was no flap loss, the patient had a clearly improved appearance of the chest wall, and the pain syndrome was solved. In this case report, we demonstrate our experience with the use of an FGF for chest wall reconstruction in male patients with PS after prosthesis explantation.

  15. The accordion gracilis muscle flap: a new design for coverage of recurrent and complicated ischeal pressure sores.

    El-Sabbagh, Ahmed H

    2011-10-01

    Management of patients with large or recurrent pressure ulcerations can be complicated by the lack of available local flap, whether already used or because adjacent lesions make such flap insufficient for complete coverage. In this article, the gracilis muscle was modified to cover large defects without help from its cutaneous territory. Twelve ischeal pressure sores were treated between August 2007 and 2009 with the modified gracilis muscle flap in a single-staged procedure. Five ulcers were recurrent and seven patients have associated pressure ulcers. All reconstructions were successful. Mean patient age was 35 years and nearly all patients had multiple significant comorbidities, including associated ulcers, diabetes and urethrocutaneous fistula. All flaps and donor sites healed uneventfully. There was one complication presented as cellulites at the donor site. Follow-up in some cases extend up to 1·5 years. No recurrence was observed. The accordion gracilis muscle flap is a handy, safe and fast flap for reconstruction of recurrent, difficult ischeal pressure sores. © 2011 The Author. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

  16. Reconstruction of the pelvic floor and the vagina after total pelvic exenteration using the transverse musculocutaneous gracilis flap.

    Kaartinen, Ilkka S; Vuento, Maarit H; Hyöty, Marja K; Kallio, Jukka; Kuokkanen, Hannu O

    2015-01-01

    Total pelvic exenteration (TPE) is a rare operation in which the pelvic contents are removed entirely. Several options for pelvic floor and vaginal reconstruction have been described including transverse rectus abdominis musculocutaneous (TRAM) or deep inferior epigastric perforator (DIEP) flaps. The transverse musculocutaneous gracilis (TMG) flap has been introduced for breast reconstruction as a free flap. We adopted the pedicled TMG flap for reconstructions after TPE. To the best of our knowledge, this is the first report of this method in the literature. Between November 2011 and February 2014, 12 patients underwent TPE and reconstruction with unilateral (six patients) or bilateral (six patients) pedicled TMG flaps. Five patients underwent vaginal reconstruction with bilateral TMG flaps. We describe the operative procedure and the outcome of the operation in these patients. The total mean operative times for TPE with or without vaginal reconstruction were 467 ± 12 and 386 ± 59 min, respectively. The TMG flaps had enough vascular tissue and mobility for reconstructing the TPE defects. There was distal edge necrosis in one out of 18 flaps, while the rest survived completely. During the follow-up, complete wound healing with no signs of weakening of the pelvic floor was observed in all cases. Soft-tissue reconstructions are needed to reduce complications associated with TPE, to secure the pelvic floor and to reconstruct the vagina in select patients. The TMG flap is a logical flap choice that does not lead to functional deficits, complicate the abdominal ostomies or weaken the abdominal wall. It reduces the length of operation compared to that of abdominal flaps. IV, therapeutic. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. [Genital elephantiasis: reconstructive treatment of penoscrotal lymphoedema with a myocutaneous M. gracilis flap. Experiences from a District Hospital in Ethiopia].

    Prica, S; Donati, O F; Schaefer, D J; Peltzer, J

    2008-08-01

    Genital elephantiasis is an illness leading to serious functional and aesthetic as well as psychosocial impairment. Since the 19th century there have been articles describing methods for surgical ablative treatment of penoscrotal lymphoedema. However, most of these methods ignore the creation a new drainage for the lymph. We now describe a new technique using a myocutaneous M. gracilis muscle flap for the reconstruction of the soft tissue damage resulting from radical excision, thus ensuring drainage of the lymph into the deep muscle compartment of the thigh. In the District Hospital "Mettu-Karl Hospital" in the Ethiopian rain forest region of Illubabor, during a period of 6 months the described surgical procedure was applied to 9 patients suffering from severe forms of this grotesquely disfiguring disease. Two patients presented with combined penoscrotal oedema, while the other 7 patients were suffering from isolated scrotal lymphoedema alone. All patients benefited from reconstruction with a myocutaneous M. gracilis muscle flap after radical excision of the affected tissue. All patients were evaluated after 3 and 12 months postoperatively in the presence of a translator. All nine patients showed a functionally and aesthetically satisfying result after 3 months without postoperative occurrence of infection. The evaluation 12 months postoperatively showed no recurrence of genitoscrotal lymphoedema. All patients reported on having regained normal ability for sexual intercourse and no occurrence of urinary tract infections since the operation. Concerning fertility, no statements could be made. A significant improvement in the quality of life was observed by the regained ability to walk and work and consequently the reintegration of the patients into their socio-economic environment. Radical excision of the affected tissue followed by transferring a functioning lymphatic drainage into the deep muscle compartment of the ipsilateral thigh using a proximally based

  18. Comparison of Oone-Stage Free Gracilis Muscle Flap With Two-Stage Method in Chronic Facial Palsy

    J Ghaffari

    2007-08-01

    Full Text Available Background:Rehabilitation of facial paralysis is one of the greatest challenges faced by reconstructive surgeons today. The traditional method for treatment of patients with facial palsy is the two-stage free gracilis flap which has a long latency period of between the two stages of surgery.Methods: In this paper, we prospectively compared the results of the one-stage gracilis flap method with the two -stage technique.Results:Out of 41 patients with facial palsy refered to Hazrat-e-Fatemeh Hospital 31 were selected from whom 22 underwent two- stage and 9 one-stage method treatment. The two groups were identical according to age,sex,intensity of illness, duration, and chronicity of illness. Mean duration of follow up was 37 months. There was no significant relation between the two groups regarding the symmetry of face in repose, smiling, whistling and nasolabial folds. Frequency of complications was equal in both groups. The postoperative surgeons and patients' satisfaction were equal in both groups. There was no significant difference between the mean excursion of muscle flap in one-stage (9.8 mm and two-stage groups (8.9 mm. The ratio of contraction of the affected side compared to the normal side was similar in both groups. The mean time of the initial contraction of the muscle flap in the one-stage group (5.5 months had a significant difference (P=0.001 with the two-stage one (6.5 months.The study revealed a highly significant difference (P=0.0001 between the mean waiting period from the first operation to the beginning of muscle contraction in one-stage(5.5 monthsand two-stage groups(17.1 months.Conclusion:It seems that the results and complication of the two methods are the same,but the one-stage method requires less time for facial reanimation,and is costeffective because it saves time and decreases hospitalization costs.

  19. Vascular anatomy of the medial sural artery perforator flap: a new classification system of intra-muscular branching patterns.

    Dusseldorp, Joseph R; Pham, Quy J; Ngo, Quan; Gianoutsos, Mark; Moradi, Pouria

    2014-09-01

    The medial sural artery perforator (MSAP) flap is a versatile fasciocutaneous flap. The main difficulty encountered when raising the MSAP flap is in obtaining adequate pedicle length during intra-muscular dissection. The objective of this study was to determine the pattern of intra-muscular course of the MSAP flap pedicle. 14 cadaveric specimens were dissected and CT angiograms of 84 legs were examined. The intra-muscular branching pattern and depths of the medial sural artery branches were analyzed. The number of perforators, position of the dominant perforator and both intra-muscular and total pedicle length were also recorded and compared to existing anatomical data. Three types of arterial branching pattern were identified within the medial gastrocnemius, demonstrating one (31%), two (59%) or three or more (10%) main branches. A dominant perforator from the medial sural artery was present in 92% of anatomical specimens (13/14). Vertically, the location of the perforator from the popliteal crease was on average 13 cm (±2 cm). Transversely, the perforator originated 2.5 cm (±1 cm) from the posterior midline. Using CT angiography it was possible in 10 consecutive patients to identify a more superficial intra-muscular branch and determine the leg with the optimal branching pattern type for flap harvest. This study is the first to describe the variability of the intra-muscular arterial anatomy of the medial head of gastrocnemius muscle. Surgeons utilizing the MSAP flap option should be aware of the possible branching pattern types and consequently the differing perforator distribution and depths of intra-muscular branches. Routine use of pre-operative CT angiogram may help determine which leg has the most favorable branching pattern type and intra-muscular course for flap harvest. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Dynamic Penile Corpora Cavernosa Reconstruction Using Bilateral Innervated Gracilis Muscles: A Preclinical Investigation.

    Yin, Zhuming; Liu, Liqiang; Xue, Bingjian; Fan, Jincai; Chen, Wenlin; Liu, Zheng

    2018-03-07

    Prosthesis-assisted penile reconstruction has been performed extensively to restore a cosmetically acceptable phallus. However, a large number of patients will undergo revision surgery for various prosthesis-related complications. To develop a 1-stage prosthesis-free dynamic cavernosa reconstruction method using bilateral innervated gracilis muscles and to investigate the feasibility and reliability of the surgical design. 10 fresh cadavers were dissected to assess the availability of bilateral gracilis muscles for functional cavernosa rebuilding. 11 mongrel female dogs were involved in the penile reconstruction surgery. The neophallus consisted of bilateral gracilis muscles as the neo-cavernosa, a right gracilis skin flap as the neourethra, and a lower abdominal flap with an anterior rectus sheath as the skin envelope and neo-tunica albuginea. The function and structure of the neo-phalli were assessed 7 months postoperatively. The neurovascular pedicle length of the gracilis muscles and the volume of the gracilis venter musculi were measured in the cadaveric investigation. The average dimensions of the canine neo-phalli at rest and during electrostimulated erection were obtained and the muscular fatigue-resistant curve was drawn. Histologic evaluations also were performed. The neurovascular pedicle length and volume of the gracilis muscles were sufficient to yield a nearly normal appearance of the neo-cavernosa in the cadaveric and animal studies. The muscular fatigue-resistant curve demonstrated adequate length, stiffness, and duration of erection of the neo-phalli to accomplish normal coitus. Histologic evaluations showed an intact neourethra and nearly normal muscle structure in the inner layer of the canine neo-cavernosa, except for significantly increased amount of collagen fibers and type I/III collagen ratio in the outer layer of the neo-cavernosa. The percentage of type II (fatigue-prone) muscle fibers did not change significantly. Our preclinical

  1. Treatment of ischial pressure sores with both profunda femoris artery perforator flaps and muscle flaps.

    Kim, Chae Min; Yun, In Sik; Lee, Dong Won; Lew, Dae Hyun; Rah, Dong Kyun; Lee, Won Jai

    2014-07-01

    Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. We retrospectively analyzed data from 14 patients (16 ischial sores) whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. All flaps survived the entire follow-up period. Seven patients (50%) had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years). The mean follow-up period was 27.9 months (range, 3-57 months). In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%), wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%), but resolved with conservative treatment. Among 16 cases, there was only one (6%) recurrence at 34 months. The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

  2. Reconstrucción de rodilla con doble colgajo de gemelo Knee reconstruction with double gemelar muscular flap

    C. Márquez Zevallos

    2011-06-01

    Full Text Available Los traumatismos de miembros inferior representan un reto importante para el cirujano plástico en cuanto a su reconstrucción cuando no se dispone de técnicas microquirúrgicas. En el presente trabajo se presentan 2 casos de reconstrucción de rodilla con doble colgajo muscular de gemelo, en los que se demuestra que se pueden utilizar simultáneamente los dos gemelos sin dejar ninguna secuela estética importante ni funcional en la deambulación de los pacientes. Hasta donde podemos conocer, no existe en la literatura nacional ni internacional un reporte de casos con esta aplicación, ya que siempre se ha empelado un solo músculo precisamente por el temor a alterar la función de flexo-extensión del pie.Lower limb traumatism has always been a problem for plastic surgeon when in the moment of the surgical reconstruction we have not microsurgical techniques. In this paper, we present 2 cases of knee reconstruction using a double gemelar muscular flap, showing how is possible the simultaneous use of the two muscles without aesthetic or functional sequels. As we know, there is no national or international report of cases with this muscular reconstruction; it has been usual to use only one muscle, in order to avoid problems in the flexo-extension movements of the foot.

  3. Involuntary movement during mastication in patients with long-term facial paralysis reanimated with a partial gracilis free neuromuscular flap innervated by the masseteric nerve.

    Rozen, Shai; Harrison, Bridget

    2013-07-01

    Midface reanimation in patients with chronic facial paralysis is not always possible with an ipsilateral or contralateral facial nerve innervating a free neuromuscular tissue transfer. Alternate use of nonfacial nerves is occasionally indicated but may potentially result in inadvertent motions. The goal of this study was to objectively review videos of patients who underwent one-stage reanimation with a gracilis muscle transfer innervated by the masseteric nerve for (1) inadvertent motion during eating, (2) characterization of masticatory patterns, and (3) social hindrance perceived by the patients during meals. Between the years 2009 and 2012, 18 patients underwent midfacial reanimation with partial gracilis muscle transfer coapted to the masseter nerve for treatment of midfacial paralysis. Sixteen patients were videotaped in detail while eating. Involuntary midface movement on the reconstructed side and mastication patterns were assessed. In addition, 16 patients were surveyed as to whether involuntary motion constituted a problem in their daily lives. All 16 patients videotaped during mastication demonstrated involuntary motion on the reconstructed side while eating. Several unique masticatory patterns were noted as well. Only one of the 16 patients reported involuntary motion as a minor disturbance in daily life during meals. All patients with chronic facial paralysis who plan to undergo midface reanimation with a free tissue transfer innervated by the ipsilateral masseter nerve should be told that they would universally have involuntary animation during mastication. Most patients do not consider this a major drawback in their daily lives. Therapeutic, IV.

  4. Deltoid muscular flap transfer for the treatment of irreparable rotator cuff tears

    Justus Gille

    2009-09-01

    Full Text Available The purpose of this study was to evaluate the outcome of deltoid muscle flap transfer for the treatment of irreparable rotator cuff tears. In a retrospective study 20 consecutive patients were evaluated. The index procedure took place between 2000 and 2003. Fifteen patients were male, mean age was 62 years. Inclusion criterion was a rotator cuff defect Bateman grade IV. Exclusion criteria were smaller defects, shoulder instability and fractures of the injured shoulder. An open reconstruction with acromioplasty and a pedicled delta flap was performed. Follow up period was mean 42 months. Follow-up included clinical examination, Magnetic Resonance Imaging (MRI and the Constant and Simple (CS shoulder tests. According to the Constant shoulder test the results were good in 13 patients, fair in 5 and unsatisfactory in 2. The pre-operative Constant Score improved from mean 25.7 points (±5.3 to 72.3 (±7.8 at follow-up. The mean values for the subcategories of CS increased significantly from 3.9 to 14.4 points for pain and from 4.2 to 15.9 points for activities daily routine (p0.05. Results of the Simple Shoulder Test showed a significant increase of the mean values from pre-operative 4.3 to 14.7 points post-operatively. MRI showed a subacromial covering of the defect in all cases, all flaps where intact on MRI but always the flap showed marked fatty degeneration. In conclusion, the delta flap is a simple method for the repair of large defects of the rotator cuff leading to satisfying medium results.

  5. Treatment of Ischial Pressure Sores with Both Profunda Femoris Artery Perforator Flaps and Muscle Flaps

    Chae Min Kim

    2014-07-01

    Full Text Available Background Reconstruction of ischial pressure sore defects is challenging due to extensive bursas and high recurrence rates. In this study, we simultaneously applied a muscle flap that covered the exposed ischium and large bursa with sufficient muscular volume and a profunda femoris artery perforator fasciocutaneous flap for the management of ischial pressure sores. Methods We retrospectively analyzed data from 14 patients (16 ischial sores whose ischial defects had been reconstructed using both a profunda femoris artery perforator flap and a muscle flap between January 2006 and February 2014. We compared patient characteristics, operative procedure, and clinical course. Results All flaps survived the entire follow-up period. Seven patients (50% had a history of surgery at the site of the ischial pressure sore. The mean age of the patients included was 52.8 years (range, 18-85 years. The mean follow-up period was 27.9 months (range, 3-57 months. In two patients, a biceps femoris muscle flap was used, while a gracilis muscle flap was used in the remaining patients. In four cases (25%, wound dehiscence occurred, but healed without further complication after resuturing. Additionally, congestion occurred in one case (6%, but resolved with conservative treatment. Among 16 cases, there was only one (6% recurrence at 34 months. Conclusions The combination of a profunda femoris artery perforator fasciocutaneous flap and muscle flap for the treatment of ischial pressure sores provided pliability, adequate bulkiness and few long-term complications. Therefore, this may be used as an alternative treatment method for ischial pressure sores.

  6. A three-dimensional study of the musculotendinous and neurovascular architecture of the gracilis muscle: application to functional muscle transfer.

    Fattah, A Y; Ravichandiran, K; Zuker, R M; Agur, A M R

    2013-09-01

    Muscle transfer is used to restore function typically using a single vector of contraction. Although its use with two independently functional muscular units has been employed, in order to refine this concept we endeavoured to detail the intramuscular anatomy of gracilis, a muscle commonly used for transfer. A novel method to capture intramuscular fibre bundle and neurovascular arrangement was used to create a three-dimensional (3D) digital model that allowed for accurate representation of the relationships between all the intramuscular structures to facilitate flap planning. Twenty gracilis muscles were harvested from 15 cadavers. All components of the muscle were digitised using a Microscribe G2 Digitiser. The data were exported to the 3D animation software Autodesk(®) Maya(®) 2012 whereupon it was rendered into a 3D model that can be exported as static images or videos. Neurovascular anatomy and muscle architecture were analysed from these models, and fibre bundle length, pennation angle and physiological cross-sectional area were calculated from digitised data. The muscle is composed of a variable number of distinct longitudinal segments with muscle fibres spiralling onto the tendon. The main artery to the muscle has three main intramuscular patterns of distribution. The venae comitantes drain discrete zones without intramuscular macroscopic anastomoses. The minor pedicles form an anastomotic chain along the anterior border of the muscle and all vessels were biased to the deep surface. The nerve is related to the vessels in a variable manner and both run between longitudinal muscular compartments. The digitisation technique may be used to advance knowledge of intramuscular architecture and it demonstrated that the gracilis muscle is comprised of four to seven muscular compartments, each representing a functional unit that may theoretically be differentially activated and could be harnessed for more sophisticated muscle transfers. Copyright © 2013 British

  7. A combined technique using a muscular flap and endobronchial stent to repair complex broncho-oesophageal fistulae supported by ECMO.

    Baste, Jean-Marc; Haddad, Laura; Philouze, Guillaume

    2018-02-01

    Certain broncho-oesophageal fistulae require surgical repair. Herein, we describe an innovative surgical technique combining intercostal flap and endobronchial stenting. Two patients, each with a with complex broncho-oesophageal fistula 2 years after radio-chemotherapy, were hospitalised for severe respiratory infection and extension of the fistula despite previous endoscopic treatment. The first patient presented with respiratory distress (ARDS). She had emergency surgery under extra corporeal membrane oxygenation: oesophagectomy and reconstruction of the left bronchus by a vascularised intercostal flap. Stenting was performed on day 10, due to persistence of the fistula. At 3 months the bronchus was healed, but the patient died of cerebral bleeding. For the second patient, repair was proposed before severe ARDS with the same surgical and ventilatory strategy and a stent was preventively inserted after surgery. After 3 months, the stent was removed and the left bronchus was healed. Complex post-radiotherapy broncho-oesophageal fistulae should be treated surgically before respiratory complications arise, by combining reconstruction with a vascularised flap and transient stenting.

  8. Retalho pediculado do músculo grande dorsal para reparo de defeito diafragmático experimental em cães Latissimus dorsi muscular flap for repair of experimental diaphragmatic defect in dogs

    Luciana Oliveira de Oliveira

    2000-12-01

    Full Text Available Neste experimento, foi utilizado um retalho do músculo grande dorsal, com pedículo dorso-caudal, para o reparo de defeitos diafragmáticos iatrogênicos em 18 cães adultos. O acesso ao diafragma foi através de toracotomia no décimo espaço intercostal, sendo criado um defeito diafragmático, onde o retalho foi suturado. O retalho muscular pediculado cobriu um terço do hemidiafragma direito. Os animais tiveram boa recuperação pós-cirúrgica, sem sinais de comprometimento respiratório. Foram feitas necropsias aos 15, 30 e 60 dias do pós -operatório. O local submetido ao implante apresentou algumas aderências com vísceras adjacentes e consolidação da sutura macro e microscopicamente. Conclui-se que o retalho pediculado do grande dorsal pode ser útil para o reparo de grandes defeitos diafragmáticos em cães.In this study, the Latissimus dorsi muscular flap was experimentally used for the repair of iatrogenic diaphragmatic defects in 18 adult dogs. The flap was elevated maintaining its dorso-caudal attachment. The diaphragm was accessed through a right thoracotomy in the tenth intercostal space, a defect in the diaphragm was created and the flap was sutured in the margins of the defect. The flap was capable of covering one third of the right hemidiaphragm. All the animals had good post-surgery recoveries. Respiratory function was not compromised. Necropsies were taken at 15, 30 and 60 days post-surgery. Macro and microscopically, the muscle showed few adhesions with adjacent viscera and excellent healing. The Latissimus dorsi muscular flap can be useful for reconstruction of large diaphragmatic defects in dogs.

  9. AAV vector encoding human VEGF165-transduced pectineus muscular flaps increase the formation of new tissue through induction of angiogenesis in an in vivo chamber for tissue engineering: A technique to enhance tissue and vessels in microsurgically engineered tissue.

    Moimas, Silvia; Manasseri, Benedetto; Cuccia, Giuseppe; Stagno d'Alcontres, Francesco; Geuna, Stefano; Pattarini, Lucia; Zentilin, Lorena; Giacca, Mauro; Colonna, Michele R

    2015-01-01

    In regenerative medicine, new approaches are required for the creation of tissue substitutes, and the interplay between different research areas, such as tissue engineering, microsurgery and gene therapy, is mandatory. In this article, we report a modification of a published model of tissue engineering, based on an arterio-venous loop enveloped in a cross-linked collagen-glycosaminoglycan template, which acts as an isolated chamber for angiogenesis and new tissue formation. In order to foster tissue formation within the chamber, which entails on the development of new vessels, we wondered whether we might combine tissue engineering with a gene therapy approach. Based on the well-described tropism of adeno-associated viral vectors for post-mitotic tissues, a muscular flap was harvested from the pectineus muscle, inserted into the chamber and transduced by either AAV vector encoding human VEGF165 or AAV vector expressing the reporter gene β-galactosidase, as a control. Histological analysis of the specimens showed that muscle transduction by AAV vector encoding human VEGF165 resulted in enhanced tissue formation, with a significant increase in the number of arterioles within the chamber in comparison with the previously published model. Pectineus muscular flap, transduced by adeno-associated viral vectors, acted as a source of the proangiogenic factor vascular endothelial growth factor, thus inducing a consistent enhancement of vessel growth into the newly formed tissue within the chamber. In conclusion, our present findings combine three different research fields such as microsurgery, tissue engineering and gene therapy, suggesting and showing the feasibility of a mixed approach for regenerative medicine.

  10. Resection and reconstruction of giant cervical metastatic cancer using a pectoralis major muscular flap transfer: A prospective study of 16 patients.

    Zhang, Xiangmin; Liu, Folin; Lan, Xiaolin; Huang, Jing; Luo, Keqing; Li, Shaojin

    2015-07-01

    If not promptly or properly treated, certain cervical metastatic cancers that develop from unknown primary tumors may rapidly grow into giant tumors that can invade the blood vessels, muscle and skin. The present study examined the feasibility and efficacy of radical neck dissection combined with reconstruction using the pectoralis major myocutaneous flap for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin. A total of 16 patients who met the inclusion criteria were subjected to radical neck dissection to adequately resect invaded skin, and the pectoralis major myocutaneous flap was used to repair the large skin defect created in the cervical region. Following the surgery, the patients received concurrent chemoradiotherapy. The pectoralis major myocutaneous flap survived in all 16 patients, with no cases of flap necrosis. In addition, no post-operative lymphedema, paresthesia or dysfunction of an upper extremity occurred due to the cutting of a pectoralis major muscle. In 9 cases, patients were satisfied with their post-operative shoulder movement at the donor site; in the remaining 7 cases, patients felt greater weakness in this region following surgery relative to prior to surgery. The 14 male patients were generally satisfied with the post-operative appearance of the donor region, whereas the 2 female patients were dissatisfied with the appearance of this region. Follow-up for 6-53 months after the patients were discharged following surgery and chemotherapy revealed that the recurrence of cervical tumors in 6 cases. Overall, radical neck dissection combined with the use of the pectoralis major myocutaneous flap for reconstruction is a feasible approach for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin. Post-operative concurrent chemoradiotherapy should be administered to improve the local control rate and

  11. Venous coupler use for free-flap breast reconstructions: specific analyses of TMG and DIEP flaps.

    Bodin, Frédéric; Brunetti, Stefania; Dissaux, Caroline; Erik, A Sauleau; Facca, Sybille; Bruant-Rodier, Catherine; Liverneaux, Philippe

    2015-05-01

    The purpose of this report was to present the results of comparisons of anastomotic data and flap complications in the use of venous coupler in breast reconstruction with the transverse musculocutaneous gracilis (TMG) flap and the deep inferior epigastric perforator (DIEP) flap. Over a three-year period, 95 patients suffering from breast cancer were treated with mastectomy and breast reconstruction using free flaps. We performed 121 mechanical venous anastomoses for 105 flap procedures (80 DIEP and 25 TMG). The coupler size, anastomotic duration, number of anastomoses and postoperative complications were assessed for the entire series. The coupling device was perfectly suitable for all end-to-end anastomoses between the vein(s) of the flap and the internal mammary vein(s). No venous thrombosis occurred. The mean anastomotic time did not significantly differ between the DIEP (330 seconds) and TMG flap procedures (352 seconds) (P = 0.069). Additionally, there were no differences in coupling time observed following a comparison of seven coupler sizes (P = 0.066). The mean coupler size used during the TMG flap procedure was smaller than that used with the DIEP (2.4 mm versus 2.8 mm) (P TMG flap (28%) than with the DIEP flap (11%). The coupler size used was smaller for the TMG procedure and when double venous anastomosis was performed. Additionally, anastomotic time was not affected by the flap type or coupler size used or by anastomosis number. © 2014 Wiley Periodicals, Inc.

  12. CT findings of muscular dystrophy

    Saitoh, Hiroshi

    1991-01-01

    CT scans of muscles in patients with limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD) dystrophies were obtained at five different body levels: the neck, L3 vertebral body, pelvic girdle, thigh and lower leg. CT numbers, cross sectional areas (CSA) and %CSA of muscle or fat were evaluated in each muscle. The characteristic CT patterns for each type of muscular dystrophy were obtained. Compared with DMD, the gracilis and soleus were more severely damaged in LG and the biceps femoris remained relatively preserved among the hamstrings. In addition, the multifidus of the neck and sternocleidomastoid also were more severely damaged in MYD. This study suggests that CT scan will be useful in the differential diagnosis of these types of muscular dystrophy as well as in planning appropriate rehabilitation and detecting damaged muscles. (author)

  13. Use of the Anterolateral Thigh and Vertical Rectus Abdominis Musculocutaneous Flaps as Utility Flaps in Reconstructing Large Groin Defects

    Edwin Jonathan Aslim

    2014-09-01

    Full Text Available BackgroundGroin dissections result in large wounds with exposed femoral vessels requiring soft tissue coverage, and the reconstructive options are diverse. In this study we reviewed our experience with the use of the pedicled anterolateral thigh and vertical rectus abdominis musculocutaneous flaps in the reconstruction of large groin wounds.MethodsGroin reconstructions performed over a period of 10 years were evaluated, with a mean follow up of two years. We included all cases with large or complex (involving perineum defects, which were reconstructed with the pedicled anterolateral thigh musculocutaneous or the vertical rectus abdominis musculocutaneous (VRAM flaps. Smaller wounds which were covered with skin grafts, locally based flaps and pedicled muscle flaps were excluded.ResultsTwenty-three reconstructions were performed for large or complex groin defects, utilising the anterolateral thigh (n=10 and the vertical rectus abdominis (n=13 pedicled musculocutaneous flaps. Femoral vein reconstruction with a prosthetic graft was required in one patient, and a combination flap (VRAM and gracilis muscle flap was performed in another. Satisfactory coverage was achieved in all cases without major complications. No free flaps were used in our series.ConclusionsThe anterolateral thigh and vertical rectus abdominis pedicled musculocutaneous flaps yielded consistent results with little morbidity in the reconstruction of large and complex groin defects. A combination of flaps can be used in cases requiring extensive cover.

  14. Anatomía arterial de los colgajos musculares de extensor carpi radialis longus y extensor carpi radialis brevis para su uso en transferencia muscular funcional libre Arterial anatomy of the extensor carpi radialis longus and extensor carpi radialis brevis muscle flaps related to its use in free functioning muscle transfer

    A. Rodríguez Lorenzo

    2008-09-01

    Full Text Available El objetivo de este trabajo es documentar el aporte arterial y el patrón vascular intramuscular de los músculos Extensor Carpi Radialis Longus (ECRL y Extensor Carpi Radialis Brevis (ECRB para analizar su utilización como colgajos libres en transferencia muscular funcional para reanimación facial. Realizamos un estudio anatómico en 29 brazos humanos en fresco. Las técnicas de inyección utilizadas fueron la modificada de oxido de plomo y gelatina en 11 cadáveres y la de inyección pulsátil de látex color en 18. Disecamos los músculos ECRL y ECRB y sus pedículos, los fotodocumentamos y radiografiamos valorando los resultados en función del patrón vascular intramuscular, relaciones anatómicas, calibres y longitud de pedículos. Encontramos dos patrones vasculares diferentes en las 29 disecciones siguiendo la clasificación de Mathes y Nahai de la anatomía vascular de los músculos (en función del número de pedículos vasculares y su dominancia: Tipo I( 37,9% ECRL y 20,7% ECRB y Tipo II(62,1% del ECRL y 79,3% del ECRB. El pedículo principal del ECRL (de diámetro medio 1,73 mm y longitud de pedículo media de 32,32 mm es en el 100% de los casos rama de la arteria recurrente radial y el pedículo principal del ECRB (de diámetro medio 1,11 mm y longitud de pedículo media de 27,77 mm es rama de la arteria radial en el 68,9% de los casos y de la arteria recurrente radial en el 31,1% de los casos. Concluimos que El ECRL y ECRB presentan dos tipos de patrones vasculares: tipo I y tipo II, siendo más frecuente en nuestro trabajo el tipo II, que hacen que ambos puedan ser transferidos como colgajos libres por su pedículo principal. Ambos músculos presentan un tamaño, contorno, contenido fascial importante para el anclaje de suturas y una longitud de pedículo y calibre vascular adecuados para su transferencia microvascular libre en reanimación facial. De los dos, el más realizable como colgajo libre es el ECRB ya que la relaci

  15. Carrying capacity of Chaetoceros gracilis in Homa Lagoon and the ...

    The possibility for nutrient limitation to affect C. gracilis was assessed from two different ecosystems (Izmir Bay and Homa Lagoon). Our goal was to determine the growth rate of all nutrients and the maximum levels of the C. gracilis phytoplankton biomass (the maximum biomass carrying capacity) on the extent of its full ...

  16. Experience with 32 Pelvic Fracture Urethral Defects Associated with Urethrorectal Fistulas: Transperineal Urethroplasty with Gracilis Muscle Interposition.

    Guo, Hailin; Sa, Yinglong; Fu, Qiang; Jin, Chongrui; Wang, Lin

    2017-07-01

    Pelvic fracture urethral defects associated with urethrorectal fistulas are rare and difficult to repair. The aim of this study was to evaluate the efficacy of transperineal urethroplasty with gracilis muscle interposition for the repair of pelvic fracture urethral defects associated with urethrorectal fistulas. We identified 32 patients who underwent transperineal urethroplasty with gracilis muscle interposition to repair pelvic fracture urethral defects associated with urethrorectal fistulas. Patient demographics as well as preoperative, operative and postoperative data were obtained. Mean followup was 33 months (range 6 to 64). The overall success rate was 91% (29 of 32 cases). One-stage repair was successful in 17 of 18 patients (94%) using perineal anastomosis with separation of the corporeal body and in 12 of 14 (86%) using perineal anastomosis with inferior pubectomy and separation of the corporeal body. All 22 patients (100%) without a previous history of repair were successfully treated. However, only 7 of 10 patients (70%) with a previous history of failed urethroplasty and urethrorectal fistula repair were cured. Recurrent urethral strictures developed in 2 cases. One patient was treated successfully with optical internal urethrotomy and the other was treated successfully with tubed perineoscrotal flap urethroplasty. Recurrent urethrorectal fistulas associated with urethral strictures developed in an additional patient. Transperineal urethroplasty with gracilis muscle interposition is a safe and effective surgical procedure for most pelvic fracture urethral defects associated with urethrorectal fistulas. Several other factors may affect its postoperative efficiency. Copyright © 2017 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Muscular Dystrophy

    ... sets of muscles and cause different degrees of muscle weakness. Duchenne muscular dystrophy is the most common and the most severe ... can walk independently. Prednisone If a child has Duchenne muscular ... to help slow the rate of muscle deterioration. By doing so, the child may be ...

  18. AAV vector encoding human VEGF165–transduced pectineus muscular flaps increase the formation of new tissue through induction of angiogenesis in an in vivo chamber for tissue engineering: A technique to enhance tissue and vessels in microsurgically engineered tissue

    Silvia Moimas

    2015-12-01

    Full Text Available In regenerative medicine, new approaches are required for the creation of tissue substitutes, and the interplay between different research areas, such as tissue engineering, microsurgery and gene therapy, is mandatory. In this article, we report a modification of a published model of tissue engineering, based on an arterio-venous loop enveloped in a cross-linked collagen–glycosaminoglycan template, which acts as an isolated chamber for angiogenesis and new tissue formation. In order to foster tissue formation within the chamber, which entails on the development of new vessels, we wondered whether we might combine tissue engineering with a gene therapy approach. Based on the well-described tropism of adeno-associated viral vectors for post-mitotic tissues, a muscular flap was harvested from the pectineus muscle, inserted into the chamber and transduced by either AAV vector encoding human VEGF165 or AAV vector expressing the reporter gene β-galactosidase, as a control. Histological analysis of the specimens showed that muscle transduction by AAV vector encoding human VEGF165 resulted in enhanced tissue formation, with a significant increase in the number of arterioles within the chamber in comparison with the previously published model. Pectineus muscular flap, transduced by adeno-associated viral vectors, acted as a source of the proangiogenic factor vascular endothelial growth factor, thus inducing a consistent enhancement of vessel growth into the newly formed tissue within the chamber. In conclusion, our present findings combine three different research fields such as microsurgery, tissue engineering and gene therapy, suggesting and showing the feasibility of a mixed approach for regenerative medicine.

  19. Muscular Dystrophy

    ... Surveillance Tracking and Research Network , known as MD STAR net . Learn more about CDC’s other muscular dystrophy ... for Disease Control and Prevention Email Recommend Tweet YouTube Instagram Listen Watch RSS ABOUT About CDC Jobs ...

  20. Muscular dystrophy

    ... are no known cures for the various muscular dystrophies. The goal of treatment is to control symptoms. Physical therapy may help maintain muscle strength and function. Leg braces and a wheelchair ...

  1. Anatomical basis of the extended TDAP flap: study of its territories of vascularization and its volume.

    Dast, Sandy; Havet, Eric; Dessena, Lidia; Abdulshakoor, Abeer; Alharbi, Mohammed; Vaucher, Richard; Herlin, Christian; Sinna, Raphael

    2017-08-01

    The concept of extended thoracodorsal artery perforator (TDAP) flap was described in 2015 for breast reconstruction. Our anatomical study aims to identify the territories vascularised by the thoracodorsal artery perforator via the deep muscular fascial network. The second goal was to define the volume of the extended TDAP flap. Ten extended TDAP flaps were dissected on 5 fresh human cadavers. Around the classical skin paddle of a TDAP flap, the dissections were performed in a subfascial level, including the muscular fascia and the adipose tissue compartments to increase the volume of the flap. After injection of methylene blue in the thoracodorsal artery, we measured the length and width, the surface and the volume of the coloured flap. The mean sizes of the extended TDAP flap were 24.9 cm × 20.1 cm. The mean surface of the total vascularization zone was 441 cm 2 . The mean volume of the vascularized flap was 193 ml. The thoracodorsal artery perforator via the deep muscular fascial network allows us to harvest a flap of 25 cm × 20 cm with a mean surface of 441 cm² and a mean volume of 193 ml. The extended TDAP flap is a credible option in breast reconstruction.

  2. Campylobacter gracilis and Campylobacter rectus in primary endodontic infections.

    Siqueira, J F; Rôças, I N

    2003-03-01

    A species-specific nested polymerase chain reaction (PCR) assay was used to investigate the occurrence of Campylobacter gracilis and C. rectus in primary root canal infections. Samples were collected from 57 single-rooted teeth with carious lesions, necrotic pulps and radiographic evidence of periradicular disease. Twenty-eight cases were diagnosed as chronic asymptomatic periradicular lesions, 12 cases as acute apical periodontitis, and 17 cases as acute periradicular abscess. DNA was extracted from the samples and initially amplified using universal 16S rDNA primers. A second round of amplification using the first PCR products was performed to specifically detect C. gracilis or C. rectus in the samples. Campylobacter gracilis and C. rectus were, respectively, detected in 21.4 (6 of 28) and 30% (6 of 20) of the root canals associated with chronic asymptomatic periradicular lesions. Campylobacter gracilis was found in 16.7% (2 of 12) of the cases diagnosed as acute apical periodontitis, whilst C. rectus was found in 33.3% (two of six cases). In the abscessed cases, C. gracilis and C. rectus were detected in 23.5 (4 of 17) and 11.8% (2 of 17) of the cases, respectively. No association of these species with clinical symptoms was observed (P > 0.01) In general, species-specific nPCR allowed the detection of C. gracilis in 21.1% (12 of 57) and C. rectus in 23.3% (10 of 43)of the samples taken from primary endodontic infections. Findings confirmed the assertion that both C. gracilis and C. rectus participate in infections of endodontic origin and suggest a pathogenetic role with regard to periradicular diseases.

  3. Pedicularis gracilis Wall. Ex Benth. (Scrophulariaceae Complex in the Himalayas – A Taxonomic Reinvestigation

    Tariq Husain

    2003-03-01

    Full Text Available The paper highlights the complex nature of Pedicularis gracilis Wall. ex Benth. in the Himalayas and enumerates two subspecies and four varieties of this species. Morphological and distributional data have been appended to show that the subspecies – gracilis and brunoniana (Wall. ex Pennell Husain & Garg and varieties – gracilis and stricta (Wall. Husain & Garg (under subsp. gracilis and brunoniana and macrocarpa (Prain Husain & Garg (under subsp. brunoniana are distinct.

  4. Outcomes of electrically stimulated gracilis neosphincter surgery.

    Tillin, T; Chambers, M; Feldman, R

    2005-07-01

    To examine patient quality of life (QoL) and long-term costs of electrically stimulated gracilis neosphincter surgery (ESGNS). Independently conducted prospective case-comparison study of patients at the Royal London Hospital (RLH), plus a cross-sectional study of outcomes of ESGNS performed at three other UK centres. Cases were patients who underwent ESGNS at the participating hospitals during a 5-year period from 1977. Comparisons were made with two groups of people with similar bowel disorders who did not undergo ESGNS. ESGNS is a procedure designed to improve bowel function for people living with severe faecal incontinence or stomas. It involves transposition of the gracilis muscle to form a neo-anal sphincter. The transposed muscle is electrically stimulated via an electronic pulse generator implanted beneath the skin of the abdomen. Clinical success and symptomatic outcomes of surgery. Generic, domain and condition specific measures of QoL. Comparative costs to the NHS of ESGNS and conventional alternatives. At 3 years after surgery approximately three-quarters of patients still had functioning neosphincters. At this stage, bowel-related QoL and continence improved by more than 20% for nearly two-thirds of RLH patients. However, ongoing bowel evacuation difficulties occurred in half of those with good continence outcomes. QoL improvements were maintained in the smaller group of RLH patients who had reached 4 and 5 years of follow-up, although at this stage the proportion with failed neosphincters had increased. The RLH findings were supported by those from the three other UK centres. No significant changes in QoL were observed in the comparison groups during the follow-up period. The mean cost of patient care at RLH, was 23,253 pounds. In the other three centres, the estimated mean cost of the intervention per patient was 11,731 pounds, reflecting fewer planned operations and repeat admissions. Costs of patient care for those with stomas who did not undergo

  5. Myotonic Muscular Dystrophy

    ... Marie-Tooth Disease (CMT) Congenital Muscular Dystrophy (CMD) Duchenne Muscular Dystrophy (DMD) Emery-Dreifuss Muscular Dystrophy Endocrine Myopathies Metabolic Diseases of Muscle Mitochondrial Myopathies (MM) Myotonic Dystrophy (DM) Spinal-Bulbar ...

  6. Unexpectedly Streamlined Mitochondrial Genome of the Euglenozoan Euglena gracilis

    Dobáková, Eva; Flegontov, Pavel; Skalický, Tomáš; Lukeš, Julius

    2015-01-01

    Roč. 7, č. 12 (2015), s. 3358-3367 ISSN 1759-6653 R&D Projects: GA ČR GA15-21974S Institutional support: RVO:60077344 Keywords : Euglena gracilis * mitochondrial genome * transcription * RNA editing Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.098, year: 2015

  7. Exploring the glycans of Euglena gracilis

    O’Neill, Ellis C.; Kuhaudomlarp, Sakonwan; Rejzek, Martin

    2017-01-01

    Euglena gracilis is an alga of great biotechnological interest and extensive metabolic capacity, able to make high levels of bioactive compounds, such as polyunsaturated fatty acids, vitamins and β-glucan. Previous work has shown that Euglena expresses a wide range of carbohydrate-active enzymes,...

  8. Use of gastrointestinal anastomosis stapler for harvest of gracilis muscle and securing it in the face for facial reanimation: a novel technique.

    Shridharani, Sachin M; Stapleton, Sahael M; Redett, Richard J; Magarakis, Michael; Rosson, Gedge D

    2010-04-08

    The primary objective of this study is to report a novel technique that uses the gastrointestinal anastomosis (GIA) stapler for harvesting and securing the gracilis muscle in facial reanimation surgery. We conducted a retrospective chart review with 18 consecutive patients who underwent gracilis muscle flap transfer with or without the use of a GIA stapler. Of 11 operations with the GIA stapler, one patient developed a hematoma (donor site) and another required drainage of an abscess (recipient site). Of 8 operations without the use of the stapler, one patient had total flap failure and three required drainage of an abscess (2 recipient sites and 1 donor site). These differences trended toward improvement but were not statistically different. The use of the GIA stapler is a fast, safe technique. Larger studies are, however, warranted to further examine this novel approach in order to test precisely what factors of increased efficiency occur, the amount of suture pull-through, and overall tension capable of being applied to the secured staple line.

  9. Pedicled perforator flaps

    Demirtas, Yener; Ozturk, Nuray; Kelahmetoglu, Osman

    2009-01-01

    Described in this study is a surgical concept that supports the "consider and use a pedicled perforator flap whenever possible and indicated" approach to reconstruct a particular skin defect. The operation is entirely free-style; the only principle is to obtain a pedicled perforator flap...... to reconstruct the defect. The perforators are marked with a hand-held Doppler probe and multiple flaps are designed. The appropriate flap is elevated after identifying the perforator(s). Dissection of the perforator(s) or complete incision of the flap margins are not mandatory if the flap is mobilized...... adequately to cover the defect. Defects measuring 3 x 3 cm up to 20 x 20 cm at diverse locations were successfully reconstructed in 20 of 21 patients with 26 flaps. Pedicled perforator flaps offer us reliable and satisfactory results of reconstruction at different anatomic territories of the body. It sounds...

  10. Transferências microcirúrgicas do músculo grácil para flexão do cotovelo na lesão do plexo braquial do adulto: estudo retrospectivo de oito casos Microsurgical transfer of the gracilis muscle for elbow flexion in brachial plexus injury in adults: retrospective study of eight cases

    Luiz Koiti Kimura

    2011-10-01

    Full Text Available OBJETIVO: O tratamento das lesões do plexo braquial representa um grande desafio, principalmente as lesões tardias, com mais de 12 meses de evolução. Analisamos retrospectivamente pacientes que foram submetidos a uma das possibilidades para tentar restaurar a função do membro superior afetado nestas condições, a transferência microcirúrgica do músculo grácil para flexão do cotovelo. MÉTODOS: Foram incluídos oito pacientes, divididos em dois grupos: um cujo procedimento realizado consistia em neurorrafia do retalho muscular com enxerto de nervo sural e anastomoses mais distais; o outro em que a neurorrafia era realizada diretamente no nervo espinal acessório, e anastomose nos vasos toracoacromiais. RESULTADOS: Encontramos significante diferença entre os grupos, sendo que aqueles submetidos à neurorrafia direta obtiveram resultados satisfatórios em maior número (75% M4 quando comparados com o outro grupo, que fez uso de enxerto para neurorrafia, em que foi menor o sucesso do procedimento (25% M4. CONCLUSÃO: Pacientes submetidos à transferência funcional microcirúrgica do músculo grácil cujas anastomoses vasculares foram realizadas nos vasos toracoacromiais apresentaram melhor resultado funcional do que aqueles que tiveram suas anastomoses realizadas na artéria braquial e consequente utilização de enxerto de nervo.OBJECTIVE: Treating brachial plexus injuries is a major challenge, especially lesions that are presented late, with more than 12 months of evolution. We retrospectively analyzed patients who underwent one of the possibilities for attempting to restore the function of upper limbs affected under such conditions: microsurgical transfer of the gracilis muscle for elbow flexion. METHODS: Eight patients were included, divided into two groups: one in which the procedure consisted of neurorrhaphy of the muscle flap with sural nerve grafting and anastomosis more distally; and the other, in which the neurorrhaphy was

  11. CABLES MUSCULARES

    Alejandro Gómez

    Full Text Available Los cables musculares o fibras de nitinol presentan una excelente alternativa a los actuadores convencionales, con una fuerza de actuación muy alta, equivalente a la de los actuadores hidráulicos, proporcionalmente a su peso, además de su acción silenciosa. Este material, inventado en 1963, aún no es muy conocido y de ahí que se haya realizado una recopilación de sus propiedades. Entre ellas, la temperatura de transición es la más importante, por ser la que activa la aleación. Muchos sistemas se han creado para alcanzar adecuadamente la temperatura de transición, y también se continúa en la investigación de métodos que ayuden a lograr un control preciso del movimiento de la aleación con memoria de forma (SMA.

  12. Free flap reconstructions of tibial fractures complicated after internal fixation.

    Nieminen, H; Kuokkanen, H; Tukiainen, E; Asko-Seljavaara, S

    1995-04-01

    The cases of 15 patients are presented where microvascular soft-tissue reconstructions became necessary after internal fixation of tibial fractures. Primarily, seven of the fractures were closed. Eleven fractures had originally been treated by open reduction and internal fixation using plates and screws, and four by intramedullary nailing. All of the patients suffered from postoperative complications leading to exposure of the bone or fixation material. The internal fixation material was removed and radical revision of dead and infected tissue was carried out in all cases. Soft tissue reconstruction was performed using a free microvascular muscle flap (11 latissimus dorsi, three rectus abdominis, and one gracilis). In eight cases the nonunion of the fracture indicated external fixation. The microvascular reconstruction was successful in all 15 patients. In one case the recurrence of deep infection finally indicated a below-knee amputation. In another case, chronic infection with fistulation recurred postoperatively. After a mean follow-up of 26 months the soft tissue coverage was good in all the remaining 13 cases. All the fractures united. Microvascular free muscle flap reconstruction of the leg is regarded as a reliable method for salvaging legs with large soft-tissue defects or defects in the distal leg. If after internal fixation of the tibial fracture the osteosynthesis material or fracture is exposed, reconstruction of the soft-tissue can successfully be performed by free flap transfer. By radical revision, external fixation, bone grafting, and a free flap the healing of the fracture can be achieved.

  13. Free gracilis flap for chest wall reconstruction in male patient with Poland syndrome after implant failure

    Cherubino, Mario; Maggiulli, Francesca; Pellegatta, Igor; Valdatta, Luigi

    2016-01-01

    Poland's syndrome (PS) is a congenital monolateral deformity that may involve breast, chest wall, and upper limb with different degrees of clinical expressions. In some cases, the problem is mainly cosmetic, and the reconstruction should be performed to achieve minimal scarring and donor site morbidity. The authors describe a case report of a male patient with PS who developed a severe capsular contraction after 25 years implant reconstruction, who was treated after explantation using free gr...

  14. Ankistrodesmus gracilis (Chlorophyta fertilized in swine manure in the laboratory

    Lúcia Helena Sipaúba-Tavares

    2008-03-01

    Full Text Available The objective of the present work was to investigate the influence of swine manure media on the growth, total length, dry weight, and nutritional value of Ankistrodesmus gracilis microalgae. Two media were measured: “in natura” and biodigested. The growth rate peak for A. gracilis was highest with biodigester treatment (6.2 x 107 cells.mL-1 on the 5th day, at a volume of 2L. The highest percentage of lipids was verifi ed for “in natura” media. Protein was highest (p > 0.05 for the biodigested media at 2L. Biovolume, ash rate, and total length were different (p 0.05. Light demand was also different between media, with lesser intensity being required for biodigested media (13.5μE.cm-2.s-1. In fact, the biodigested media proved to be cheaper in terms of cost and benefit. Generally, the medium containing swine manure, both “in natura” and biodigested, showed better results in A. gracilis development, with water quality adequate for culture systems. Swine manure in both forms may also be used in high-density cultures in the laboratory.

  15. Optimization of breast reconstruction results using TMG flap in 30 cases: Evaluation of several refinements addressing flap design, shaping techniques, and reduction of donor site morbidity.

    Nickl, Stefanie; Nedomansky, Jakob; Radtke, Christine; Haslik, Werner; Schroegendorfer, Klaus F

    2018-01-31

    The transverse myocutaneous gracilis (TMG) flap is a widely used alternative to abdominal flaps in autologous breast reconstruction. However, secondary procedures for aesthetic refinement are frequently necessary. Herein, we present our experience with an optimized approach in TMG breast reconstruction to enhance aesthetic outcome and to reduce the need for secondary refinements. We retrospectively analyzed 37 immediate or delayed reconstructions with TMG flaps in 34 women, performed between 2009 and 2015. Four patients (5 flaps) constituted the conventional group (non-optimized approach). Thirty patients (32 flaps; modified group) underwent an optimized procedure consisting of modified flap harvesting and shaping techniques and methods utilized to reduce denting after rib resection and to diminish donor site morbidity. Statistically significant fewer secondary procedures (0.6 ± 0.9 versus 4.8 ± 2.2; P < .001) and fewer trips to the OR (0.4 ± 0.7 versus 2.3 ± 1.0 times; P = .001) for aesthetic refinement were needed in the modified group as compared to the conventional group. In the modified group, 4 patients (13.3%) required refinement of the reconstructed breast, 7 patients (23.3%) underwent mastopexy/mammoplasty or lipofilling of the contralateral breast, and 4 patients (13.3%) required refinement of the contralateral thigh. Total flap loss did not occur in any patient. Revision surgery was needed once. Compared to the conventional group, enhanced aesthetic results with consecutive reduction of secondary refinements could be achieved when using our modified flap harvesting and shaping techniques, as well as our methods for reducing contour deformities after rib resection and for overcoming donor site morbidities. © 2017 Wiley Periodicals, Inc.

  16. NMR-CT in muscular disorders

    Matsumura, Kiichiro; Nakano, Imaharu; Ikehira, Hiroo; Fukuda, Nobuo; Tateno, Yukio.

    1986-01-01

    Proton NMR-CT (magnetic field strength 0.1 Tesla, resonant frequency 4.5 MHz) was performed in 15 normal (NC) and 20 Duchenne muscular dystrophy (DMD) males. The age ranged from 3 to 47 years for the NC males, and 1 to 14 years for the DMD males. In the DMD group there were one subclinical stage, 4 stage 1, 6 stage 2, 4 stage 3, and 5 stage 5 or higher patients. T 1 (longitudinal relaxation) images were obtained for three slices at the buttock, midthigh, and calf levels. The T 1 values were measured for the medial portion of the gluteus maximus, the vastus lateralis of the quadriceps femoris, the adductors, the sartorius, the gracilis, and the gastrocnemius muscles. Bound water fraction (BWF) was calculated from Fullerton's equation based on the fast diffusion model. The following results were obtained: (1) In the NC group, muscle T 1 values declined gradually with maturation under the age of 10, and became constant beyond that. The average T 1 value was 280 ms for the age group between 3 and 6 years, 270 ms for 7 and 10 years, and 260 ms for those older than 10 years. (2) Muscle BWF increased with maturation in the NC group. (3) In the DMD group, T 1 values were initially higher than normal (300 ms), declined rapidly with the progress of the disease, and reached the same low level as the subcutaneous fat (190 ms). (4) This decrease of T 1 value in DMD was not uniform for all muscles, being most prominent in the gluteus maximus and least so in the sartorius and gracilis. (5) In the early stages of DMD, the BWF was lower than normal. (J.P.N.)

  17. Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats

    Durdane Keskin

    2017-09-01

    Full Text Available Background The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. Methods Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes was applied with a latex tourniquet (remote ischemic conditioning. In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning. In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning. In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning. Results The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning. Conclusions The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemia-reperfusion injury in muscle flaps.

  18. Effects of Remote Ischemic Conditioning Methods on Ischemia-Reperfusion Injury in Muscle Flaps: An Experimental Study in Rats.

    Keskin, Durdane; Unlu, Ramazan Erkin; Orhan, Erkan; Erkilinç, Gamze; Bogdaycioglu, Nihal; Yilmaz, Fatma Meric

    2017-09-01

    The aim of this study was to investigate the effects of remote ischemic conditioning on ischemia-reperfusion injury in rat muscle flaps histopathologically and biochemically. Thirty albino rats were divided into 5 groups. No procedure was performed in the rats in group 1, and only blood samples were taken. A gracilis muscle flap was elevated in all the other groups. Microclamps were applied to the vascular pedicle for 4 hours in order to achieve tissue ischemia. In group 2, no additional procedure was performed. In groups 3, 4, and 5, the right hind limb was used and 3 cycles of ischemia-reperfusion for 5 minutes each (total, 30 minutes) was applied with a latex tourniquet (remote ischemic conditioning). In group 3, this procedure was performed before flap elevation (remote ischemic preconditoning). In group 4, the procedure was performed 4 hours after flap ischemia (remote ischemic postconditioning). In group 5, the procedure was performed after the flap was elevated, during the muscle flap ischemia episode (remote ischemic perconditioning). The histopathological damage score in all remote conditioning ischemia groups was lower than in the ischemic-reperfusion group. The lowest histopathological damage score was observed in group 5 (remote ischemic perconditioning). The nitric oxide levels were higher in the blood samples obtained from the remote ischemic perconditioning group. This study showed the effectiveness of remote ischemic conditioning procedures and compared their usefulness for preventing ischemia-reperfusion injury in muscle flaps.

  19. Propeller TAP flap

    Thomsen, Jørn Bo; Bille, Camilla; Wamberg, Peter

    2013-01-01

    major complications needing additional surgery. One flap was lost due to a vascular problem. Breast reconstruction can be performed by a propeller TAP flap without cutting the descending branch of the thoracodorsal vessels. However, the authors would recommend that a small cuff of muscle is left around...

  20. SURGICAL RECONSTRUCTION IN PRESSURE ULCERS- A RETROSPECTIVE STUDY OF THE WORKHORSE FLAP OPTIONS

    Sheeja Rajan T. M

    2016-11-01

    Full Text Available BACKGROUND Pressure ulcers can significantly contribute to morbidity and mortality by chronic infections. Radical debridement of all devitalised and infected tissues followed by a reconstructive algorithm for soft tissue padding over bony prominences to prevent recurrent breakdown are the mainstay of surgical management of pressure ulcers. Choice of the soft tissue flap for reconstruction is influenced by the dimensions of ulcers, local tissue availability and surgeon’s preferences. MATERIALS AND METHODS This retrospective study includes 140 patients with spinal injuries having pressure ulcers of NPUAP grade III and IV treated surgically over a period of four years. The demographics of pressure ulcers, the workhorse flap options as well as the outcome were analysed. RESULTS The pressure ulcers were seen predominantly in males (93.6% of 40-49 years’ age group (42.8%. Ischial pressure ulcers (n=104 constituted 74.2% followed by sacral pressure ulcers (n=24 that is 17.1% and trochanteric pressure ulcers (n=12 in 8.6%. Debridement and direct closure of wound were possible only in 10 cases. Majority (92.8% of patients needed additional tissues for wound coverage. Our workhorse fasciocutaneous flaps were rotation flaps from the gluteal region or posterior thigh with medial or lateral based designs (34.2%. Local muscle tissue was used in 64 cases (46% either as gluteal, tensor fascia lata and biceps femoris myocutaneous flaps or gluteus maximus, hamstring or gracilis muscle fillers in myoplasty. CONCLUSIONS Rotation flap along with myoplasty were our workhorse flap options in majority of the pressure ulcers. But, our future perspective is to spare muscle and use more fasciocutaneous perforator flaps for reconstruction according to evidence-based clinical practice.

  1. [Analysis of sequelae of the latissimus dorsi flap removal. Report of 44 cases reviewed and tested].

    Legré, R; Boghossian, V; Servant, J M; Magalon, G; Bureau, H

    1990-01-01

    Since Tanzini, the latissimus dorsi muscle flap has been widely used in plastic surgery. Based on the experience of two plastic surgery units, we decided to try to define the sequelae of this operation. In order to simplify our analysis we only considered free flaps. Out study is based on 42 patients (26 pure muscular flaps and 16 musculo-cutaneous flaps). The sequelae were analysed in terms of aesthetic and functional criteria. The aesthetic sequelae appeared to be minima in the case of pure muscular flaps, but more severe in the case of musculo-cutaneous flaps. Functional sequelae in the shoulder were observed on muscle testing in 30% of cases, although there were no repercussions on sport or work activities. Analysis of spinal posture demonstrated a modification in the frontal plane in 40% of cases although this could not be clearly attributed to the donor site. On the basis of this study, we can conclude that the latissimus dorsi flap retains an important place in the therapeutic arsenal of plastic surgery due to its reliability and its minor cicatricial and functional sequelae at the donor site.

  2. [Saphenous perforator flap].

    Winkel, R; Tajsic, N; Husum, H; Schlageter, M; Hanebuth, G; Hoffmann, R

    2013-04-01

    Replacement of full thickness soft tissue defects in the lower leg and ankle, appropriate to the defect and following the course of blood vessels feeding the skin of a distally hinged fasciocutaneous flap most reliably based on the individual anatomy of distal perforators of the posterior tibial artery. Full thickness soft tissue defects, up to 12 cm in length and up to 8 cm in width. Sufficient vascularization of the foot required, in osteomyelitis, and when joints, fractures, implants and tendons are exposed and when a split skin graft, a local flap, a suralis perforator flap or a free flap is not indicated. For patients, in whom a 1-2 h operation is not possible; necessity of angioplasty; decollement or scars around the distal perforators of the posterior tibial artery; local infection or necrosis of soft tissues and/or bone, which cannot be totally excised. Radical debridement; flap dissection without tourniquet; microdissection; design of the flap on the skin: pivot point ~ 10 cm (6-14 cm) proximal of the tip of the medial malleolus; base ~ 5 cm in width, between the course of the saphenous nerve and of the great saphenous vein and the Achilles tendon; adipofascial pedicle up to 15 cm in length sited over the septum between soleus and flexor digitorum muscles, following the course of the saphenous nerve, with a central skin stripe, which expands into a proximal skin island; skin island is outlined similar to the defect, but larger by 1 to 2 cm, surrounded by an adipofascial border: adjustment of the planning as well as of the elevation of these flaps according to the individual position and the caliber of perforators requires in each case the search for a perforator at the estimated pivot point. Delay of transposition, if the division of more than one perforator proximal to the pivot point obviously diminishes circulation. No "tunnelling "of the pedicle; defects of skin due to the elevation of the flap are replaced by split and meshed skin grafts or temporary

  3. Quantitative analysis of muscular wastings of lower limbs in Duchenne muscular dystrophy by computed tomography

    Horikawa, Hirosei; Konagaya, Masaaki; Takayanagi, Tetsuya; Otsuji, Hideaki

    1985-01-01

    We quantitatively evaluated the muscular wastings of lower extremities in Duchenne muscular dystrophy (DMD) by computed tomography (CT). The subjects were 21 cases of DMD (an ambulant case and 20 wheelchair-ridden cases, ages ranging from 10 to 21 years old) and 4 control males. The CT scan was carried out at the mid-level between lesser trochanter and medial condyle of femur and the largest diameter level of lower leg. The density and the cross-sectional area of each muscle were measured on the CT image. The average CT number of normal muscle was varying from 40 to 60, as well as that of fat was -115. Then we calculated CT index of each muscle denoted as follows: CT index = [average CT number of muscle-(-115)] X(cross-sectional area of each muscle). The measurements of muscle strength and serum CK level were performed and their relationships to CT index were examined. The results were achieved as follows: 1) Wheelchair-ridden cases with DMD showed severe decrease in the average CT number and the CT index of each muscle with normal controls. With progression, the average CT number and the CT index were reduced. But gracilis muscle and sartorius muscle were relatively spared in comparison with other muscles. 2) There was positive correlation between the CT index and the muscle strength in triceps surae muscle, hamstrings muslce and quardriceps femoris muscle. 3) The CT index of whole thigh muscles and that of whole lower leg muscles were highly correlated to serum CK level. These results suggest that the quantitative analysis of muscle CT is an useful measurement for assessement of muscular wastings in DMD. (author)

  4. Gravitaxis of Euglena gracilis depends only partially on passive buoyancy

    Richter, Peter R.; Schuster, Martin; Lebert, Michael; Streb, Christine; Häder, Donat-Peter

    In darkness, the unicellular freshwater flagellate Euglena gracilis shows a pronounced negative gravitactic behavior, and the cells swim actively upward in the water column. Up to now it was unclear whether this behavior is based on a passive (physical) alignment mechanism (e.g., buoyancy due to a fore-aft asymmetry of the cell body) or on an active physiological mechanism. A sounding rocket experiment was performed in which the effect of sub-1g-accelerations (0.05, 0.08, 0.12, and 0.2g) on untreated living cells and immobilized (fixation with liquid nitrogen) cells was observed. By means of computerized image analysis the angles of the cells long axis with respect to the acceleration vector were analyzed in order to calculate and compare the reorientation kinetics of the immobilized cells versus that of the controls. In both groups, the reorientation kinetics depended on the dose, but the reorientation of the living cells was about five times faster than that of the immobilized cells. This indicates that in young cells gravitaxis can be explained by a physical mechanism only to a small extend. In older cultures, in which the cells often have a drop shaped cell body, the physical reorientation is considerably faster, and a more pronounced influence of passive alignment caused by fore/aft asymmetry (drag-gravity model) can not be excluded. In addition to these results, Euglena gracilis cells seem to respond very sensitively to small accelerations when they are applied after a longer microgravity period. The data indicate that gravitactic orientation occurred at an acceleration as low as 0.05g.

  5. Spinal Muscular Atrophy FAQ

    ... as ALS (Lou Gehrig’s Disease), cystic fibrosis and Duchenne muscular dystrophy. Approximately 1 in 50 Americans, or about 6 ... Pediatric Neuromuscular Clinical Research Network ( PNCR ) and the Muscular ... is the SMN2 gene? Muscle weakness and atrophy in SMA results from the ...

  6. Blowing Flap Experiment: PIV Measurements

    Hutcheson, Florence V.; Stead, Daniel J.; Bremmer, David M.

    2004-01-01

    PIV measurements of the flow in the region of a flap side edge are presented for several flap configurations. The test model is a NACA 63(sub 2)-215 Hicks Mod-B main element airfoil with a half-span Fowler flap. Air is blown from small slots located along the flap side edge on either the top, bottom or side surfaces. The test set up is described and flow measurements for a baseline and three blowing flap configurations are presented. The effects that the flap tip jets have on the structure of the flap side edge flow are discussed for each of the flap configurations tested. The results indicate that blowing air from a slot located along the top surface of the flap greatly weakened the top vortex system and pushed it further off the top surface. Blowing from the bottom flap surface kept the strong side vortex further outboard while blowing from the side surface only strengthened the flap vortex system. It is concluded that blowing from the top or bottom surfaces of the flap may lead to a reduction of flap side edge noise.

  7. Euglena gracilis Z and its carbohydrate storage substance relieve arthritis symptoms by modulating Th17 immunity.

    Kengo Suzuki

    Full Text Available Euglena gracilis Z is a microorganism classified as a microalga and is used as a food or nutritional supplement. Paramylon, the carbohydrate storage substance of E. gracilis Z, is reported to affect the immunological system. This study evaluated the symptom-relieving effects of E. gracilis Z and paramylon in rheumatoid arthritis in a collagen-induced arthritis mouse model. The efficacy of both substances was assessed based on clinical arthritis signs, as well as cytokine (interleukin [IL]-17, IL-6, and interferon [IFN]-γ levels in lymphoid tissues. Additionally, the knee joints were harvested and histopathologically examined. The results showed that both substances reduced the transitional changes in the visual assessment score of arthritis symptoms compared with those in the control group, indicating their symptom-relieving effects on rheumatoid arthritis. Furthermore, E. gracilis Z and paramylon significantly reduced the secretion of the cytokines, IL-17, IL-6, and IFN-γ. The histopathological examination of the control group revealed edema, inflammation, cell hyperplasia, granulation tissue formation, fibrosis, and exudate in the synovial membrane, as well as pannus formation and articular cartilage destruction in the femoral trochlear groove. These changes were suppressed in both treatment groups. Particularly, the E. gracilis Z group showed no edema, inflammation, and fibrosis of the synovial membrane, or pannus formation and destruction of articular cartilage in the femoral trochlear groove. Furthermore, E. gracilis Z and paramylon exhibited symptom-relieving effects on rheumatoid arthritis and suppressed the secretion of cytokines IL-17, IL-6, and IFN-γ. These effects were likely mediated by the regulatory activities of E. gracilis Z and paramylon on Th17 immunity. In addition, the symptom-relieving effects of both substances were comparable, which suggests that paramylon is the active component of Euglena gracilis Z.

  8. Antiviral Ability of Kalanchoe gracilis Leaf Extract against Enterovirus 71 and Coxsackievirus A16

    Ching-Ying Wang

    2012-01-01

    Full Text Available Pandemic infection or reemergence of Enterovirus 71 (EV71 and coxsackievirus A16 (CVA16 occurs in tropical and subtropical regions, being associated with hand-foot-and-mouth disease, herpangina, aseptic meningitis, brain stem encephalitis, pulmonary edema, and paralysis. However, effective therapeutic drugs against EV71 and CVA16 are rare. Kalanchoe gracilis (L. DC is used for the treatment of injuries, pain, and inflammation. This study investigated antiviral effects of K. gracilis leaf extract on EV71 and CVA16 replications. HPLC analysis with a C-18 reverse phase column showed fingerprint profiles of K. gracilis leaf extract had 15 chromatographic peaks. UV/vis absorption spectra revealed peaks 5, 12, and 15 as ferulic acid, quercetin, and kaempferol, respectively. K. gracilis leaf extract showed little cytotoxicity, but exhibited concentration-dependent antiviral activities including cytopathic effect, plaque, and virus yield reductions. K. gracilis leaf extract was shown to be more potent in antiviral activity than ferulic acid, quercetin, and kaempferol, significantly inhibiting in vitro replication of EV71 (IC50=35.88 μg/mL and CVA16 (IC50=42.91 μg/mL. Moreover, K. gracilis leaf extract is a safe antienteroviral agent with the inactivation of viral 2A protease and reduction of IL-6 and RANTES expressions.

  9. Antibacterial and Antioxidant Activity of Green Algae Halimeda gracilis from Seribu Island District

    Abdul Basir

    2017-08-01

    Full Text Available Seaweeds have ecological functions as primary producers in marine waters. It also has an important economic value as a producer of hydrocolloids (alginate, agar and carrageenan that is used in various industries of food and pharmaceuticals. This study aimed to determine the antibacterial and antioxidant activity of green algae Halimeda gracilis. The study was conducted in several stages, sample collection and preparation, extraction of bioactive compound, fractionation, antibacterial and antioxidant test, and phytochemical. Extraction was done by maceration method using methanol and concentrated by rotary evaporator. The methanol extracts of H. gracilis were tested against Staphylococcus aureus and Escherichia coli. Methanol extract of H. gracilis formed inhibition zone against the test bacteria with diameter of inhibition zone was 10 mm and 6 mm, respectively. After liquid-liquid partition (water: ethyl acetate, inhibition zone was only seen in the ethyl acetate fraction of H. gracilis with diameter of inhibition zone was 6 mm and 7.50±1.71 mm, respectively. Antioxidant test methanol extracts and ethyl acetate fractions of H. gracilis each show IC50 value of 290.49 ppm and 375.50 ppm. Phytochemical test showed methanol extract of H. gracilis contains phenols and steroids.

  10. Antiviral Ability of Kalanchoe gracilis Leaf Extract against Enterovirus 71 and Coxsackievirus A16

    Wang, Ching-Ying; Huang, Shun-Chueh; Zhang, Yongjun; Lai, Zhen-Rung; Kung, Szu-Hao; Chang, Yuan-Shiun; Lin, Cheng-Wen

    2012-01-01

    Pandemic infection or reemergence of Enterovirus 71 (EV71) and coxsackievirus A16 (CVA16) occurs in tropical and subtropical regions, being associated with hand-foot-and-mouth disease, herpangina, aseptic meningitis, brain stem encephalitis, pulmonary edema, and paralysis. However, effective therapeutic drugs against EV71 and CVA16 are rare. Kalanchoe gracilis (L.) DC is used for the treatment of injuries, pain, and inflammation. This study investigated antiviral effects of K. gracilis leaf extract on EV71 and CVA16 replications. HPLC analysis with a C-18 reverse phase column showed fingerprint profiles of K. gracilis leaf extract had 15 chromatographic peaks. UV/vis absorption spectra revealed peaks 5, 12, and 15 as ferulic acid, quercetin, and kaempferol, respectively. K. gracilis leaf extract showed little cytotoxicity, but exhibited concentration-dependent antiviral activities including cytopathic effect, plaque, and virus yield reductions. K. gracilis leaf extract was shown to be more potent in antiviral activity than ferulic acid, quercetin, and kaempferol, significantly inhibiting in vitro replication of EV71 (IC50 = 35.88 μg/mL) and CVA16 (IC50 = 42.91 μg/mL). Moreover, K. gracilis leaf extract is a safe antienteroviral agent with the inactivation of viral 2A protease and reduction of IL-6 and RANTES expressions. PMID:22666293

  11. Antimicrobial action of the essential oil of Lippia gracilis Schauer

    Cynthia Cavalcanti de Albuquerque

    2006-07-01

    Full Text Available Antimicrobial activity of the essential oil (EO of Lippia gracilis Schauer over fungi and heliconia endophytic bacteria was evaluated. For the fungi Geotrichum candidum; Trichoderma viride; Torula herbarum; Paecillomyces sp.; Fusicoccum sp.; P. aeruginens; Curvularia lunata; Aspergillus nidulans; A. flavus; and A. niger mycelial discs were inoculated in PDA medium with oil (0; 420; 440; 460; 480 e 500 µL L-1. The inhibition percentage in 420 µL L-1 was 100% for all fungi, except for C. lunata and A. niger, which was 95.58% and 89.40% , respectively. In other experiment, a suspension of the Salmonella choleraceuis-diarizonae, Enterobacter asburiae, Bacillus thuringiensis, B. pumilus, B. cereus, Klebsiella pneumoniae, and E. hormaechei was individually added to the solid NYDA medium dishes. In each dish, wells were drilled in medium and filled with water or EO (420 µL L-1. The diameter of the inhibition halo was assessed. K. pneumoniae was the bacterial species less sensitive and E. hormaechei was the most sensitive.Avaliou-se a atividade antimicrobiana do óleo essencial (OE de Lippia gracilis Schauer sobre fungos contaminantes de laboratórios de cultura de tecidos vegetais e bactérias endofíticas de helicônias. Discos de micélio dos fungos Geotrichum candidum; Trichoderma viride; Torula herbarum; Paecillomyces sp.; Aspergillus nidulans; Fusicoccum sp.; A. flavus; P. aeruginens; Curvularia lunata e A. niger, foram inoculados em meio BDA com óleo (0; 420; 440; 460; 480 e 500 µL L-1. O percentual de inibição em 420 µL L-1 foi de 100% para todos os fungos exceto paraC. lunata and A. niger, o qual foi de 95.58% and 89.40% respectivamente. Em outro experimento, suspensão das espécies Salmonela choleraceuis-diarizonae, Enterobacter asburiae, Bacillus thuringiensis, B. pumilus, Klebsiella pneumoniae, E. hormaechei, Bacillus pumilus, B. cereus, B. pumilus foi individualmente adicionada ao meio NYDA, que foi vertido em placas de Petri e, ap

  12. CT findings of muscular dystrophy; Limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD)

    Saitoh, Hiroshi (Tokushima Univ. (Japan). School of Medicine)

    1991-07-01

    CT scans of muscles in patients with limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD) dystrophies were obtained at five different body levels: the neck, L3 vertebral body, pelvic girdle, thigh and lower leg. CT numbers, cross sectional areas (CSA) and %CSA of muscle or fat were evaluated in each muscle. The characteristic CT patterns for each type of muscular dystrophy were obtained. Compared with DMD, the gracilis and soleus were more severely damaged in LG and the biceps femoris remained relatively preserved among the hamstrings. In addition, the multifidus of the neck and sternocleidomastoid also were more severely damaged in MYD. This study suggests that CT scan will be useful in the differential diagnosis of these types of muscular dystrophy as well as in planning appropriate rehabilitation and detecting damaged muscles. (author).

  13. Muscular Dystrophy (MD)

    ... patients may need assisted ventilation to treat respiratory muscle weakness and a pacemaker for cardiac abnormalities. View Full Treatment Information Definition The muscular dystrophies (MD) are a group of more than 30 ...

  14. Facioscapulohumeral muscular dystrophy

    ... There is no known cure for facioscapulohumeral muscular dystrophy. Treatments are given to control symptoms and improve quality of life. Activity is encouraged. Inactivity such as bedrest can make the muscle disease worse. Physical therapy may help maintain muscle ...

  15. Copper and Cadmium Toxicity to Marine Phytoplankton, Chaetoceros gracilis and Isochrysis sp.

    Suratno Suratno

    2015-07-01

    Full Text Available In Copper (Cu based antifouling (AF paints Cu was largely used as booster biocide after organotin was banned. Cu is micronutrient which is important in photosynthesis process because Cu is an essential metal as component of enzyme and electron transport chain. But in certain dosage, Cu could be toxic to marine organism. Chaetoceros gracilis and Isochrysis sp. are dominant microalgae in aquatic ecosystem. In this study the effect of Cu and Cadmium (Cd on two marine microalgae, C. gracilis and Isochrysis sp. were compared. Toxicity test was based on American Standard for Testing Material (ASTM. IC50-96 h of Cd as reference toxicant was 2,370 mg.L-1 for C. gracilis and 490 mg.L-1 for Isochrysis sp. IC50-96 h of Cu to growth of C. gracilis was 63.75 mg.L-1 and Isochrysis sp. was 31.80 mg.L-1. Both Cd and Cu were inhibited growth of microalgae. Based on IC50-96 h value, it could be concluded that Cu was more toxic than Cd. Toxicity of Cu was 37 times stronger than Cd for C. gracilis and 15 times for Isochrysis sp. It was estimated that at concentration 10 mg.L-1 Cu does not show observable effect (NOEC to C. gracilis and 5 mg.L-1 to Isochrysis sp. The lowest observable effect of Cu (LOEC to C. gracilis was at concentration 17 mg.L-1 and 10 mg.L-1 for Isochrysis sp.

  16. Trophic transfer of gold nanoparticles from Euglena gracilis or Chlamydomonas reinhardtii to Daphnia magna

    Lee, Woo-Mi; Yoon, Sung-Ji; Shin, Yu-Jin; An, Youn-Joo

    2015-01-01

    Understanding the trophic transfer of nanoparticles (NPs) is important because NPs are small enough to easily penetrate into organisms. In this study, we evaluated the trophic transfer of gold NPs (AuNPs) within the aquatic food chain. We observed AuNPs transfer from 2 species of primary producers (Chlamydomonas reinhardtii or Euglena gracilis) to the primary consumer (Daphnia magna). Also, bioaccumulation of AuNPs in E. gracilis was higher than that in C. reinhardtii. The reasons for the difference in Au accumulation may be the physical structure of these organisms, and the surface area that is available for interaction with NPs. C. reinhardtii has a cell wall that may act as a barrier to the penetration of NPs. The size of E. gracilis is larger than that of C. reinhardtii. This study demonstrates the trophic transfer of AuNPs from a general producer to a consumer in an aquatic environment. - Highlights: • This study evaluated the trophic transfer of AuNPs in an aquatic food chain. • Chlamydomonas reinhardtii and Euglena gracilis were selected as the primary producers. • Daphnia magna was used as the primary consumer. • The bioaccumulation of AuNPs in E. gracilis was higher than that in C. reinhardtii. • AuNPs were transferred from C. reinhardtii and E. gracilis to D. magna. - Gold nanoparticles can transfer from primary producers (Chlamydomonas reinhardtii or Euglena gracilis) to the primary consumer (Daphnia magna) in an aquatic environment

  17. The Versatile Modiolus Perforator Flap

    Gunnarsson, Gudjon Leifur; Thomsen, Jorn Bo

    2016-01-01

    BACKGROUND: Perforator flaps are well established, and their usefulness as freestyle island flaps is recognized. The whereabouts of vascular perforators and classification of perforator flaps in the face are a debated subject, despite several anatomical studies showing similar consistency. In our...... experience using freestyle facial perforator flaps, we have located areas where perforators are consistently found. This study is focused on a particular perforator lateral to the angle of the mouth; the modiolus and the versatile modiolus perforator flap. METHODS: A cohort case series of 14 modiolus...... perforator flap reconstructions in 14 patients and a color Doppler ultrasonography localization of the modiolus perforator in 10 volunteers. RESULTS: All 14 flaps were successfully used to reconstruct the defects involved, and the location of the perforator was at the level of the modiolus as predicted...

  18. Rhabdomyolysis featuring muscular dystrophies.

    Lahoria, Rajat; Milone, Margherita

    2016-02-15

    Rhabdomyolysis is a potentially life threatening condition of various etiology. The association between rhabdomyolysis and muscular dystrophies is under-recognized in clinical practice. To identify muscular dystrophies presenting with rhabdomyolysis at onset or as predominant feature. We retrospectively reviewed clinical and laboratory data of patients with a genetically confirmed muscular dystrophy in whom rhabdomyolysis was the presenting or main clinical manifestation. Thirteen unrelated patients (males=6; females=7) were identified. Median age at time of rhabdomyolysis was 18 years (range, 2-47) and median duration between the first episode of rhabdomyolysis and molecular diagnosis was 2 years. Fukutin-related protein (FKRP) muscular dystrophy (n=6) was the most common diagnosis, followed by anoctaminopathy-5 (n=3), calpainopathy-3 (n=2) and dystrophinopathy (n=2). Four patients experienced recurrent rhabdomyolysis. Eight patients were asymptomatic and 3 reported myalgia and exercise intolerance prior to the rhabdomyolysis. Exercise (n=6) and fever (n=4) were common triggers; rhabdomyolysis was unprovoked in 3 patients. Twelve patients required hospitalization. Baseline CK levels were elevated in all patients (median 1200 IU/L; range, 600-3600). Muscular dystrophies can present with rhabdomyolysis; FKRP mutations are particularly frequent in causing such complication. A persistently elevated CK level in patients with rhabdomyolysis warrants consideration for underlying muscular dystrophy. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Effect of γ-irradiation on Euglena gracilis Algae

    Hlinkova, E.; Zhuchkina, N.I.; Koltovaya, N.A.; Koltovoj, N.A.

    2011-01-01

    Given the prospects for using Euglena algae as part of the biological systems of human life support in long-term space flights, we studied the effects of low doses of radiation and genotype influence on the radiosensitivity of Euglena cells. Irradiation of several Euglena gracilis strains with 60 Co γ-rays shows that strain Z is the most radioresistant. Its chloroplastless derivate OFL strain shows increased radiosensitivity. The E. bacillaris strain and its derivates W3 and W10 without chlorophyll have intermediate radiosensitivity. Irradiation up to 10 Gy had the hormesis effect on the initial strains, and it is only above 100 Gy that cell death was observed. The hormesis effect was observed concerning both radioresistance and growth rate. The use of methylen blue and fluorochrome dyes allows a rapid estimation of the share of the living and dead cells. A comparison of two survival rate tests shows that the classical method of plating on a growth medium yields an increased death rate because this method does not take into account the living non-dividing cells

  20. Genetics Home Reference: Fukuyama congenital muscular dystrophy

    ... with mental retardation Muscular dystrophy, congenital, Fukuyama type Muscular dystrophy, congenital, with central nervous system involvement Polymicrogyria with muscular dystrophy Related Information How ...

  1. High-speed stimulated Raman scattering microscopy for studying the metabolic diversity of motile Euglena gracilis

    Suzuki, Y.; Wakisaka, Y.; Iwata, O.; Nakashima, A.; Ito, T.; Hirose, M.; Domon, R.; Sugawara, M.; Tsumura, N.; Watarai, H.; Shimobaba, T.; Suzuki, K.; Goda, K.; Ozeki, Y.

    2017-02-01

    Microalgae have been receiving great attention for their ability to produce biomaterials that are applicable for food supplements, drugs, biodegradable plastics, and biofuels. Among such microalgae, Euglena gracilis has become a popular species by virtue of its capability of accumulating useful metabolites including paramylon and lipids. In order to maximize the production of desired metabolites, it is essential to find ideal culturing conditions and to develop efficient methods for genetic transformation. To achieve this, understanding and controlling cell-to-cell variations in response to external stress is essential, with chemically specific analysis of microalgal cells including E. gracilis. However, conventional analytical tools such as fluorescence microscopy and spontaneous Raman scattering are not suitable for evaluation of diverse populations of motile microalgae, being restricted either by the requirement for fluorescent labels or a limited imaging speed, respectively. Here we demonstrate video-rate label-free metabolite imaging of live E. gracilis using stimulated Raman scattering (SRS) - an optical spectroscopic method for probing the vibrational signatures of molecules with orders of magnitude higher sensitivity than spontaneous Raman scattering. Our SRS's highspeed image acquisition (27 metabolite images per second) allows for population analysis of live E. gracilis cells cultured under nitrogen-deficiency - a technique for promoting the accumulation of paramylon and lipids within the cell body. Thus, our SRS system's fast imaging capability enables quantification and analysis of previously unresolvable cell-to-cell variations in the metabolite accumulation of large motile E. gracilis cell populations.

  2. Muscular subunits transplantation for facial reanimation

    Hazan André Salo Buslik

    2006-01-01

    Full Text Available PURPOSE: To present an alternative technique for reconstruction of musculocutaneous damages in the face transferring innervated subsegments(subunits of the latissimus dorsi flap for replacement of various facial mimetic muscles. METHODS: One clinical case of trauma with skin and mimetic muscles damage is described as an example of the technique. The treatment was performed with microsurgical transfer of latissimus dorsi muscle subunits. Each subunit present shape and dimensions of the respective mimetic muscles replaced. The origin, insertions and force vectors for the mimicmuscle lost were considered. Each subsegment has its own arterial and venous supply with a motor nerve component for the muscular unit. RESULTS: Pre and one year postoperative photos registration of static and dynamic mimic aspects, as well as digital electromyography digital data of the patients were compared. The transplanted muscular units presented myoeletric activity, fulfilling both the functional and cosmetic aspect. CONCLUSION: This technique seems to be a promising way to deal with the complex musculocutaneous losses of the face as well as facial palsy.

  3. Dismorfia muscular Muscle dysmorphia

    Sheila Seleri Marques Assunção

    2002-12-01

    Full Text Available Preocupações mórbidas com a imagem corporal eram tidas até recentemente como problemas eminentemente femininos. Atualmente estas preocupações também têm sido encontradas no sexo masculino. A dismorfia muscular é um subtipo do transtorno dismórfico corporal que ocorre principalmente em homens que, apesar da grande hipertrofia muscular, consideram-se pequenos e fracos. Além de estar associada a prejuízos sociais, ocupacionais, recreativos e em outras áreas do funcionamento do indivíduo, a dismorfia muscular é também um fator de risco para o abuso de esteróides anabolizantes. Este artigo aborda aspectos epidemiológicos, etiológicos e padrões clínicos da dismorfia muscular, além de tecer comentários sobre estratégias de tratamento para este transtorno.Morbid concern over body image was considered, until recently, a female issue. Nowadays, it has been viewed as a common male disorder. Muscle dysmorphia, a subtype of a body dysmorphic disorder, affects men who, despite having clear muscular hypertroph,y see themselves as frail and small. Besides being associated to major social, leisure and occupational dysfunction, muscle dysmorphia is also a risk factor for the abuse of steroids. This article describes epidemiological, etiological and clinical characteristics of muscle dysmorphia and comments on its treatment strategy.

  4. Hydrothermal liquefaction of Gracilaria gracilis and Cladophora glomerata macro-algae for biocrude production.

    Parsa, Mehran; Jalilzadeh, Hamoon; Pazoki, Maryam; Ghasemzadeh, Reza; Abduli, MohammadAli

    2018-02-01

    The potential of Gracilaria gracilis (G. gracilis) and Cladophora glomerata (C. glomerata) macro-algae species harvested from Caspian Sea for biocrude oil production under Hydrothermal Liquefaction (HTL) reaction at 350 °C and 15 min has been investigated. Furthermore, the effect of using recycled aqueous phase as the HTL reaction solvent was studied. The biocrude yield for G. gracilis and C. glomerata was 15.7 and 16.9 wt%, respectively with higher heating value (HHV) of 36.01 and 33.06 MJ/kg. The sources of each existing component in bio-oil were identified by GC-MS based on their suggested reaction pathways. Moreover, after two series of aqueous solution recycling, experiments showed that the bio-oil yield significantly increased compared with the initial condition. This increasing directly relates with recovery of carbon content from the aqueous solution residue. Copyright © 2017. Published by Elsevier Ltd.

  5. The freestyle pedicle perforator flap

    Gunnarsson, Gudjon Leifur; Jackson, Ian T; Westvik, Tormod S

    2015-01-01

    BACKGROUND: Perforating vessels are a consistent anatomical finding and well described in the current literature. Any skin flap can be raised on a subcutaneous pedicle as long as it contains at least one supplying perforator. Perforator flaps have been interlinked with microsurgery and generally...... not widely performed by the general plastic surgeons. The aim of this paper is to present the simplicity of pedicled perforator flap reconstruction of moderate-sized defects of the extremities and torso. METHODS: We retrospectively reviewed the charts of 34 patients reconstructed using 34 freestyle pedicled...... perforator flaps for moderate-sized defects of the truncus and extremities. We registered indications, flap size and localization, success rate, and complications. Most importantly, we describe a simple approach to the design of freestyle pedicled perforator flaps and elaborate on technical aspects...

  6. Computed tomography in Duchenne type muscular dystrophy

    Kawai, Mitsuru; Kunimoto, Masanari; Motoyoshi, Yasufumi; Kuwata, Takashi; Nakano, Imaharu

    1985-01-01

    The computed tomography (CT) scan was performed on 91 Duchenne type muscular dystrophy (DMD) patients on the following four levels; (1) at the level of L3 vertebra, (2) 2-3cm above the symphysis pubica, (3) midposition of the thigh, (4) largest-diameter section of the lower leg. The CT of muscles common to most of the DMD patients were as follows: 1. Muscle atrophy: Muscle atrophy was shown as a reduction in the cross-sectional area of the muscles. Very mild muscle atrophy could be detected either by the clearly identified muscle border or by scattered low-density areas of so-called ''moth-eaten'' appearance within muscles. 2. Fat infiltration: The decrease in radio-density of muscles was interpreted as infiltration of fatty tissue. This type of density change was further classified into diffuse, streaked, cobblestone and salt-and-pepper patterns according to the spacial distribution of low-density areas. 3. Selectivity pattern: As the chronological sequence of DMD muscle degeneration is usually different among individual muscles, it may be seen, in some stages, that some of the synergistic muscles are still only slightly involved, while the others are quite severely atrophied with evident fat infiltration. In certain stages of the disease, most of the patients show relative preservation of particular muscles although they assumed a rounded shape. The most resistent muscle was musculus gracilis, followed by the musculus sartorius, musculus semitendinosus (and/or musculus semimembranosus) in that order. According to the severity of the CT changes, 86 of the 91 patients were classed into five stages from A1 to A5. Morphological stages (A1-A5) were well correlated to the functional disability stages by Ueda with a correlation factor of r=0.88. (J.P.N.)

  7. Evaluation of Limb-Girdle Muscular Dystrophy

    2014-03-06

    Becker Muscular Dystrophy; Limb-Girdle Muscular Dystrophy, Type 2A (Calpain-3 Deficiency); Limb-Girdle Muscular Dystrophy, Type 2B (Miyoshi Myopathy, Dysferlin Deficiency); Limb-Girdle Muscular Dystrophy, Type 2I (FKRP-deficiency)

  8. Learning about Duchenne Muscular Dystrophy

    ... protein. Often these boys are classified as having Becker muscular dystrophy. Genetic testing (looking at the body's genetic instructions) ... National Library of Medicine Web site Duchenne and Becker muscular dystrophy [ghr.nlm.nih.gov] From Genetics Home Reference ...

  9. Keystone flaps in coloured skin: Flap technology for the masses?

    Satish P Bhat

    2013-01-01

    Full Text Available Introduction: Viscoelastic properties of skin in coloured ethnic groups are less favourable compared to Caucasians for executing Keystone flaps. Keystone flaps have so far been evaluated and reported only in Caucasians. The potential of Keystone flaps in a coloured ethnic group is yet unknown. Aim: This article reviews the experience to reconstruct skin defects presenting in a coloured ethnic group, by using Keystone flaps, with a review of existing literature. Design: Uncontrolled case series. Materials and Methods: This retrospective review involves 55 consecutive Keystone flaps used from 2009 to 2012, for skin defects in various locations. Patient demographic data, medical history, co-morbidity, surgical indication, defect features, complications, and clinical outcomes are evaluated and presented. Results: In this population group with Fitzpatrick type 4 and 5 skin, the average patient age was 35.73. Though 60% of flaps (33/55 in the series involved specific risk factors, only two flaps failed. Though seven flaps had complications, sound healing was achieved by suitable intervention giving a success rate of 96.36%. Skin grafts were needed in only four cases. Conclusions: Keystone flaps achieve primary wound healing for a wide spectrum of defects with an acceptable success rate in a coloured skin population with unfavorable biophysical properties. By avoiding conventional local flaps and at times even microsurgical flaps, good aesthetic outcome is achieved without additional skin grafts or extensive operative time. All advantages seen in previous studies were verified. These benefits can be most appreciated in coloured populations, with limited resources and higher proportion of younger patients and unfavorable defects.

  10. Meaning of Muscular Dystrophy

    ... is very similar to Duchenne, except kids with Becker MD may not have problems until much later, when they're teenagers or adults. It takes a long time for their muscles to become weak. How Does a Kid Get Muscular Dystrophy? MD is not contagious (say: con-TAY-juss), ...

  11. Proximal hamstring reconstruction using semitendinosus and gracilis autograft: a novel technique.

    Muellner, Thomas; Kumar, Sandeep; Singla, Amit

    2017-01-01

    The complete proximal hamstring avulsion is relatively uncommon injury and predominantly occurs in young athletes but causes significant functional impairment. In chronic cases, the muscle mass is so much retracted that primary repair is not possible. A surgical technique for reconstruction of chronic proximal hamstring avulsion using contralateral semitendinosus and gracilis autograft is described in this case report. V.

  12. Chemical Composition Variability of Essential Oils of Daucus gracilis Steinh. from Algeria.

    Benyelles, Batoul; Allali, Hocine; Dib, Mohamed El Amine; Djabou, Nassim; Paolini, Julien; Costa, Jean

    2017-06-01

    The chemical compositions of 20 Algerian Daucus gracilis essential oils were investigated using GC-FID, GC/MS, and NMR analyses. Altogether, 47 compounds were identified, accounting for 90 - 99% of the total oil compositions. The main components were linalool (18; 12.5 - 22.6%), 2-methylbutyl 2-methylbutyrate (20; 9.2 - 20.2%), 2-methylbutyl isobutyrate (10; 4.2 - 12.2%), ammimajane (47; 2.6 - 37.1%), (E)-β-ocimene (15; 0.2 - 12.8%) and 3-methylbutyl isovalerate (19; 3.3 - 9.6%). The chemical composition of the essential oils obtained from separate organs was also studied. GC and GC/MS analysis of D. gracilis leaves and flowers allowed identifying 47 compounds, amounting to 92.3% and 94.1% of total oil composition, respectively. GC and GC/MS analysis of D. gracilis leaf and flower oils allowed identifying linalool (22.7%), 2-methylbutyl 2-methylbutyrate (18.9%), 2-methylbutyl isovalerate (13.6%), ammimajane (10.4%), 3-methylbutyl isovalerate (10.3%), (E)-β-ocimene (8.4%) and isopentyl 2-methylbutyrate (8.1%) as main components. The chemical variability of the Algerian oil samples was studied using statistical analysis, which allowed the discrimination of three main Groups. A direct correlation between the altitudes, nature of soils and the chemical compositions of the D. gracilis essential oils was evidenced. © 2017 Wiley-VHCA AG, Zurich, Switzerland.

  13. Genotoxicity and subchronic toxicity evaluation of dried Euglena gracilis ATCC PTA-123017.

    Simon, Ryan R; Vo, Trung D; Levine, Robert

    2016-10-01

    Euglena gracilis is a microalga capable of synthesizing various nutrients of interest in human and animal nutrition. When cultivated aerobically in the dark, Euglena synthesize paramylon, a storage polysaccharide comprised of high molecular weight beta-1,3-D-glucose polymers organized in cytoplasmic granules. Beta-glucans have been shown to have immune modulation effects, including anti-microbial, anti-tumor, and anti-oxidant properties, and metabolic effects, such as regulation of cholesterol and blood sugar levels. Preparations of E. gracilis and paramylon may therefore have potential utility as functional food ingredients for human and animal nutrition. A battery of toxicological studies was conducted on a dried preparation of E. gracilis and paramylon to support their safe food use. The dried alga was not genotoxic in a bacterial reverse mutation test and mammalian micronucleus test. In the subchronic toxicity study, rats were provided E. gracilis in the diet at levels of 0, 12,500, 25,000 or 50,000 ppm. Paramylon was provided at a concentration of 50,000 ppm. No effects that could be attributable to treatment were observed in clinical observations, body weight, food consumption, ophthalmology, hematology and clinical chemistry, urinalysis, and macroscopic and microscopic findings. A NOAEL of 50,000 ppm in the diet was determined for both ingredients. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Consequences of acclimation to Microcystis on the selective feeding behavior of the calanoid copepod Eudiaptomus gracilis

    Ger, K.A.; Panosso, R.; Lürling, M.

    2011-01-01

    We tested the hypothesis that calanoid copepods would adapt to extended periods of Microcystis exposure by increasing selective feeding on alternative food. Copepod (Eudiaptomus gracilis) clearance rates were compared before and after a 5-d acclimation to Microcystis aeruginosa using paired food

  15. Gracilioethers A-C, Antimalarial Metabolites from the Marine Sponge Agelas gracilis

    Ueoka, R.; Nakao, Y.; Kawatsu, S.; Yaegashi, J.; Matsumoto, Y.; Matsunaga, S.; Furihata, K; van Soest, R.W.M.; Fusetani, N.

    2009-01-01

    Three new antiprotozoan compounds, gracilioethers A−C (1−3), have been isolated from the marine sponge Agelas gracilis. Their structures were elucidated on the basis of spectroscopic and chemical methods. Gracilioethers A−C showed antimalarial activity against Plasmodium falciparum with IC50 values

  16. Antioxidant, anti-inflammatory and antiproliferative activities of Kalanchoe gracilis (L.) DC stem.

    Lai, Zhen-Rung; Ho, Yu-Ling; Huang, Shun-Chieh; Huang, Tai-Hung; Lai, Shang-Chih; Tsai, Jen-Chieh; Wang, Ching-Ying; Huang, Guan-Jhong; Chang, Yuan-Shiun

    2011-01-01

    Oxidative stress and inflammation are related to several chronic diseases including cancer and atherosclerosis. Kalanchoe gracilis (L.) DC is a special folk medicinal plant in Taiwan. The aim of this study was to evaluate the antioxidant, anti-inflammatory and antiproliferative activities of the methanolic extract and fractions of the stem of K. gracilis. TEAC, total phenolic compound content, total flavonoid content, DPPH radical scavenging activity, reducing power, inhibition of NO production in LPS-induced RAW264.7 cells, and inhibition of cancer cell proliferation were analyzed. Among all fractions, the chloroform fraction showed the highest TEAC and DPPH radical scavenging activities. The chloroform fraction also had the highest content of polyphenols and flavonoids. Chloroform fractions also decreased LPS-induced NO production and expressions of iNOS and COX-2 in RAW264.7 cells. The antiproliferative activities of the methanolic extract and fractions were studied in vitro using HepG2 cells, and the results were consistent with their antioxidant capacities. Chloroform fractions had the highest antiproliferative activity with an IC(50) of 136.85 ± 2.32 μg/ml. Eupafolin also had good pharmacological activity in the antioxidant, anti-inflammation and antiproliferative. Eupafolin might be an important bioactive compound in the stem of K. gracilis. The above experimental data indicated that the stem of K. gracilis is a potent antioxidant medicinal plant, and such efficacy may be mainly attributed to its polyphenolic compounds.

  17. Propeller Flaps: A Literature Review.

    Sisti, Andrea; D'Aniello, Carlo; Fortezza, Leonardo; Tassinari, Juri; Cuomo, Roberto; Grimaldi, Luca; Nisi, Giuseppe

    2016-01-01

    Since their introduction in 1991, propeller flaps are increasingly used as a surgical approach to loss of substance. The aim of this study was to evaluate the indications and to verify the outcomes and the complication rates using this reconstructing technique through a literature review. A search on PubMed was performed using "propeller flap", "fasciocutaneous flap", "local flap" or "pedicled flap" as key words. We selected clinical studies using propeller flaps as a reconstructing technique. We found 119 studies from 1991 to 2015. Overall, 1,315 propeller flaps were reported in 1,242 patients. Most frequent indications included loss of substance following tumor excision, repair of trauma-induced injuries, burn scar contractures, pressure sores and chronic infections. Complications were observed in 281/1242 patients (22.6%) occurring more frequently in the lower limbs (31.8%). Partial flap necrosis and venous congestion were the most frequent complications. The complications' rate was significantly higher in infants (70 years old) but there was not a significant difference between the sexes. Trend of complication rate has not improved during the last years. Propeller flaps showed a great success rate with low morbidity, quick recovery, good aesthetic outcomes and reduced cost. The quality and volume of the transferred soft tissue, the scar orientation and the possibility of direct donor site closure should be considered in order to avoid complications. Indications for propeller flaps are small- or medium-sized defects located in a well-vascularized area with healthy surrounding tissues. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  18. Duchenne muscular dystrophy carriers

    Matsumura, K.; Nakano, I.

    1989-01-01

    By means of magnetic resonance imaging (MRI), the proton spin-lattice relaxation times (T1 values) of the skeletal muscles were measured in Duchenne muscular dystrophy (DMD) carriers and normal controls. The bound water fraction (BWF) was calculated from the T1 values obtained, according to the fast proton diffusion model. In the DMD carriers, T1 values of the gluteus maximus and quadriceps femoris muscles were significantly higher, and BWFs of these muscles were significantly lower than in normal control. Degenerative muscular changes accompanied by interstitial edema were presumed responsible for this abnormality. No correlation was observed between the muscle T1 and serum creatine kinase values. The present study showed that MRI could be a useful method for studying the dynamic state of water in both normal and pathological skeletal muscles. Its possible utility for DMD carrier detection was discussed briefly. (orig.)

  19. [Fasciocutaneous flap reliable by deep femoral artery perforator for the treatment of ischial pressure ulcers].

    Gebert, L; Boucher, F; Lari, A; Braye, F; Mojallal, A; Ismaïl, M

    2018-04-01

    The surgical management of pressure ulcers in the paraplegic or quadriplegic population is marked by the high risk of recurrence in the long-term. In the current era of perforator flaps, newer reconstructive options are available for the management of pressure ulcers, decreasing the need to use the classically described muscular or musculocutaneous locoregional flaps. The coverage of ischial sores described in this article by a pedicled flap based on a deep femoral artery perforator, appears to be an effective first-line reconstructive option for the management of limited size pressure ulcers. A number of fifteen paraplegic or quadriplegic patients having at least one ischial bed sore with underlying osteomyelitis were included in this series. The approximate location of the deep femoral artery perforator was initially identified using the "The Atlas of the perforator arteries of the skin, the trunk and limbs", which was confirmed, with the use of a Doppler device. A fasciocutaneous transposition flap was elevated, with the pivot point based on the cutaneous bridge centered on the perforator, and then transposed to cover the area of tissue loss. The donor site was closed primarily. A total of fifteen patients were operated from November 2015 to November 2016. The series comprised of 16 first presentations of a stage 4 pressure ulcers associated with underlying osteomyelitis that were subsequently reconstructed by the pedicled deep femoral artery perforator flap. The healing rate and functional results were both satisfactory. Fasciocutaneous flap reliable by deep femoral artery perforator appears to have a promising role in the treatment of ischial pressure sores. It is an attractive option to spare the use of musculocutaneous flaps in the area. Thus this flap could be used as a first-line option to cover ischial pressure ulcers of limited size. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  20. The Temporalis Muscle Flap in Maxillofacial Reconstruction

    ElSheikh, M; Zeitoun, I; ElMassry, M A K

    1991-01-01

    The temporalis muscle flap is a very versatile and valuable axial flap, which could be used in various reconstructive procedures in and around the oro-maxillofacial region. The surgical anatomy, vascular pattern and technique of elevation of the flap are described, together with our experience in different reconstructive situations. The advantages and disadvantages of the use of this flap are thoroughly discussed taking into consideration the potentiality of cancer recurrence under cover of the flap. (author)

  1. The Pedicled LICAP Flap Combined with a Free Abdominal Flap In Autologous Breast Reconstructions

    Thomas Sjøberg, MD

    2018-01-01

    Conclusion:. In selected patients with insufficient abdominal flap tissue, a combination of a free abdominal flap and a pedicled LICAP flap is a valuable option to increase breast size and cosmetic outcome. Additional symmetrizing surgery might still be necessary.

  2. Flap Edge Noise Reduction Fins

    Khorrami, Mehdi R. (Inventor); Choudhan, Meelan M. (Inventor)

    2015-01-01

    A flap of the type that is movably connected to an aircraft wing to provide control of an aircraft in flight includes opposite ends, wherein at least a first opposite end includes a plurality of substantially rigid, laterally extending protrusions that are spaced apart to form a plurality of fluidly interconnected passageways. The passageways have openings adjacent to upper and lower sides of the flap, and the passageways include a plurality of bends such that high pressure fluid flows from a high pressure region to a low pressure region to provide a boundary condition that inhibits noise resulting from airflow around the end of the flap.

  3. Chemical analysis, antimicrobial and anti-oxidative properties of Daucus gracilis essential oil and its mechanism of action

    Meriem El Kolli

    2016-01-01

    Conclusions: D. gracilis EO showed potent antimicrobial and anti-oxidative activities and had acted on the cytoplasm membrane. These activities could be exploited in the food industry for food preservation.

  4. Free Vastus Intermedius Muscle Flap: A Successful Alternative for Complex Reconstruction of the Neurocranium in Preoperated Patients.

    Horn, Dominik; Freudlsperger, Christian; Berger, Moritz; Freier, Kolja; Ristow, Oliver; Hoffmann, Jürgen; Sakowitz, Oliver; Engel, Michael

    2017-07-01

    The reconstruction of large cranial and scalp defects is a surgical and esthetic challenge. Single autologous tissue transfer can be insufficient due to the defect size and the anatomic complexity of the recipient site. Alloplastic patient-specific preformed implants can be used to recover hard tissue defects of the neurocranium. Nevertheless, for long-term success adequate soft tissue support is required. In this brief clinical study, the authors describe calvarian reconstruction in a 33-year-old patient with wound healing disorder after an initial resection of ependymoma. The patient suffered from osteonecrosis and wound breakdown in the fronto-parietal region. An alloplastic polymethylmethacrylate implant for hard tissue support was manufactured based on 3-dimensional visualization of a computed tomography scan. After the resection of remaining pathologic bone from earlier surgical procedures, the alloplastic implant was inserted to achieve functional coverage of the brain. Due to anatomic variation of donor site vessels during anterolateral thigh flap preparation, the authors performed a vastus intermedius free flap as a new muscular flap for craniofacial reconstruction. The authors achieved excellent functional and esthetic results. The muscular vastus intermedius free flap in combination with a split skin graft proves to be a new alternative to the anterolateral thigh flap for soft tissue reconstruction of the neurocranium.

  5. Dynamic Flaps Electronic Scan Antenna

    Gonzalez, Daniel

    2000-01-01

    A dynamic FLAPS(TM) electronic scan antenna was the focus of this research. The novelty S of this SBIR resides in the use of plasma as the main component of this dynamic X-Band phased S array antenna...

  6. Can the gracilis be used to replace the anterior cruciate ligament in the knee? A cadaver study.

    Cavaignac, Etienne; Pailhé, Regis; Murgier, Jérôme; Reina, Nicolas; Lauwers, Frederic; Chiron, Philippe

    2014-12-01

    The purpose of this study was to evaluate whether a four-strand gracilis-only graft can be used in anterior cruciate ligament (ACL) reconstruction. Cadaver study. This study involved 16 cadaver knees. The length and diameter of the native ACL were measured in each one. The same measurements were performed on a four-strand graft of the gracilis only, the semitendinosus only and both tendons. Student's t-test was used to compare the various conditions. The average diameter of the G4 construct was 0.07 mm greater (1%) than the native ACL (p=0.044). The average cross-sectional area of the G4 construct was 1.2 mm(2) greater (3.9%) than the native ACL (p=0.049). The G4 was on average 38.9 mm longer than the intra-articular portion of the ACL (p<0.001). A four-strand gracilis construct meets the anatomical specifications for use as an ACL reconstruction graft. By using the gracilis only, the morbidity associated with harvesting the gracilis and semitendinosus tendons should be reduced. Further studies must be performed to compare the biomechanical properties of this graft with other graft types and also to evaluate how this four-strand gracilis graft behaves in a clinical setting. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Desenvolvimento marsupial e pós-marsupial de Janaira Gracilis (Crustacea, Isopoda, Asellota Marsupial and postmarsupial development of Janaira gracilis

    Ana Maria Setubal Pires

    1977-01-01

    Full Text Available No presente estudo são descritos os estádios de desenvolvimento de Janaira gracilis e discutidos vários aspectos de seu crescimento. Coletou-se o material mensalmente, de janeiro de 1972 a janeiro de 1973, junto ao trapiche da Base Norte do Instituto Oceanográfico da Universidade de São Paulo, Ubatuba, Estado de Sao Paulo. Janaira gracilis apresenta 4 estádios de desenvolvimento marsupial, 9 de desenvolvimento pós-marsupial para as fêmeas, e 10 para os machos. Os estádios pós-marsupiais podem ser bem determinados através do número de artículos do flagelo da antena 1, pereópodo I e VII, pleópodos 1 e 2 masculino e desenvolvimento de oostégitos na fêmea. As transformações decorrentes do desenvolvimento pós-marsupial são mais marcantes nos machos, pois as fêmeas conservam uma morfologia juvenil e uniforme durante toda a sua vida. O crescimento médio dos machos suplanta o das fêmeas a partir do estádio 7. Nestas, a diminuição de crescimento observada deve-se, provavelmente, à utilização crescente de energia disponível, para fins reprodutivos. Os machos alcançam a maturidade sexual precocemente às fêmeas.The development and growth of Janaira gracilis are described and discussed. The sampling was carried out once a month from January 1972 to January 1973 at the pier of Base Norte, Instituto Oceanográfico USP, Ubatuba, State of São Paulo. Four distinct marsupial stages were disclosed in the development of Janaira gracilis as well as 9 distinct postmarsupial stages for the females and 10 for the males. Every postmarsupial instar can be distinguished by morphological features, such as first antennae articles, first and seventh pereopod, first and second pair of pleopods and the oostegites. During the course of development females undergo less morphological changes than males. Considering the final stages, in average males are larger than females. It is suggested that the decrease in growth of females may be related to

  8. Active Control of Long Bridges Using Flaps

    Hansen, H. I.; Thoft-Christensen, Palle

    The main problem in designing ultra-long span suspension bridges is flutter. A solution to this problem might be to introduce an active flap control system to increase the flutter wind velocity. The investigated flap control system consists of flaps integrated in the bridge girder so each flap...... is the streamlined part of the edge of the girder. Additional aerodynamic derivatives are shown for the flaps and it is shown how methods already developed can be used to estimate the flutter wind velocity for a bridge section with flaps. As an example, the flutter wind velocity is calculated for different flap...... configurations for a bridge section model by using aerodynamic derivatives for a flat plate. The example shows that different flap configurations can either increase or decrease the flutter wind velocity. for optimal flap configurations flutter will not occur....

  9. Muscle MRI findings in patients with limb girdle muscular dystrophy with calpain 3 deficiency (LGMD2A) and early contractures.

    Mercuri, Eugenio; Bushby, Kate; Ricci, Enzo; Birchall, Daniel; Pane, Marika; Kinali, Maria; Allsop, Joanna; Nigro, Vincenzo; Sáenz, Amets; Nascimbeni, Annachiara; Fulizio, Luigi; Angelini, Corrado; Muntoni, Francesco

    2005-02-01

    Limb girdle muscular dystrophy 2A is a common variant secondary to mutations in the calpain 3 gene. A proportion of patients has early and severe contractures, which can cause diagnostic difficulties with other conditions. We report clinical and muscle magnetic resonance imaging findings in seven limb girdle muscular dystrophy 2A patients (four sporadic and three familial) who had prominent and early contractures. All patients showed a striking involvement of the posterior thigh muscles. The involvement of the other thigh muscles was variable and was related to clinical severity. Young patients with minimal functional motor impairment showed a predominant involvement of the adductors and semimembranosus muscles while patients with restricted ambulation had a more diffuse involvement of the posterolateral muscles of the thigh and of the vastus intermedius with relative sparing of the vastus lateralis, sartorius and gracilis. At calf level all patients showed involvement of the soleus muscle and of the medial head of the gastrocnemius with relative sparing of the lateral head. MRI findings were correlated to those found in two patients with the phenotype of limb girdle muscular dystrophy 2A without early contractures and the pattern observed was quite similar. However, the pattern observed in limb girdle muscular dystrophy 2A is different from that reported in other muscle diseases such as Emery-Dreifuss muscular dystrophy and Bethlem myopathy which have a significant clinical overlap with limb girdle muscular dystrophy 2A once early contractures are present. Our results suggest that muscle MRI may help in recognising patients with limb girdle muscular dystrophy 2A even when the clinical presentation overlaps with other conditions, and may therefore, be used as an additional investigation to target the appropriate biochemical and genetic tests.

  10. [Aesthetic effect of wound repair with flaps].

    Tan, Qian; Zhou, Hong-Reng; Wang, Shu-Qin; Zheng, Dong-Feng; Xu, Peng; Wu, Jie; Ge, Hua-Qiang; Lin, Yue; Yan, Xin

    2012-08-01

    To investigate the aesthetic effect of wound repair with flaps. One thousand nine hundred and ninety-six patients with 2082 wounds hospitalized from January 2004 to December 2011. These wounds included 503 deep burn wounds, 268 pressure sores, 392 soft tissue defects caused by trauma, 479 soft tissue defects due to resection of skin cancer and mole removal, 314 soft tissue defects caused by scar excision, and 126 other wounds. Wound area ranged from 1.5 cm x 1.0 cm to 30.0 cm x 22.0 cm. Sliding flaps, expanded flaps, pedicle flaps, and free flaps were used to repair the wounds in accordance with the principle and timing of wound repair with flaps. Five flaps showed venous congestion within 48 hours post-operation, 2 flaps of them improved after local massage. One flap survived after local heparin wet packing and venous bloodletting. One flap survived after emergency surgical embolectomy and bridging with saphenous vein graft. One flap showed partial necrosis and healed after skin grafting. The other flaps survived well. One thousand three hundred and twenty-one patients were followed up for 3 months to 2 years, and flaps of them were satisfactory in shape, color, and elasticity, similar to that of normal skin. Some patients underwent scar revision later with good results. Application of suitable flaps in wound repair will result in quick wound healing, good function recovery, and satisfactory aesthetic effect.

  11. Cardio-Muscular Conditioner

    1993-01-01

    In the mid-sixties, Gary Graham, a Boeing designer, developed a cardiovascular conditioner for a planned Air Force orbiting laboratory. After the project was cancelled, Graham participated in space station conditioning studies for the Skylab program. Twenty years later, he used this expertise to develop the Shuttle 2000-1, a physical therapy and athletic development conditioner, available through Contemporary Designs. The machine is used by football teams, sports clinics and medical rehabilitation centers. Cardiovascular fitness and muscular strength development are promoted through both kinetic and plyometric exercises.

  12. Limb-Girdle Muscular Dystrophy (LGMD)

    ... Marie-Tooth Disease (CMT) Congenital Muscular Dystrophy (CMD) Duchenne Muscular Dystrophy (DMD) Emery-Dreifuss Muscular Dystrophy Endocrine Myopathies Metabolic Diseases of Muscle Mitochondrial Myopathies (MM) Myotonic Dystrophy (DM) Spinal-Bulbar ...

  13. Reduced satellite cell number in situ in muscular contractures from children with cerebral palsy.

    Dayanidhi, Sudarshan; Dykstra, Peter B; Lyubasyuk, Vera; McKay, Bryon R; Chambers, Henry G; Lieber, Richard L

    2015-07-01

    Satellite cells (SC) are quiescent adult muscle stem cells critical for postnatal development. Children with cerebral palsy have impaired muscular growth and develop contractures. While flow cytometry previously demonstrated a reduced SC population, extracellular matrix abnormalities may influence the cell isolation methods used, systematically isolating fewer cells from CP muscle and creating a biased result. Consequently, the purpose of this study was to use immunohistochemistry on serial muscle sections to quantify SC in situ. Serial cross-sections from human gracilis muscle biopsies (n = 11) were labeled with fluorescent antibodies for Pax7 (SC transcriptional marker), laminin (basal lamina), and 4',6-diamidino-2-phenylindole (nuclei). Fluorescence microscopy under high magnification was used to identify SC based on labeling and location. Mean SC/100 myofibers was reduced by ∼70% (p muscle growth and apparent decreased responsiveness of CP muscle to exercise. © 2015 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  14. Effect of Cadmium on the population growth of the marine diatom Chaetoceros gracilis Schutt

    Giovana Vera

    2014-06-01

    Full Text Available Phytoplankton constitutes the base of the trophic webs in the marine environment, so it is important to know the possible effects of pollutants on the algal populations. In the present paper the effect of cadmium on the population growth of the diatom Chaetoceros gracilis was assessed. The microalgae were cultured in the a modified “f/2” Guillard medium, and were exposed to different concentrations of cadmium between 50 and 100000 µg.–1, which produced an inhibitory effect from 20% to 99% on the population growth of Chaetoceros gracilis. Based on the dose (cadmium-response (inhibition relationship, a mean effective concentration (EC50% equal to 591 µg.L–1 of cadmium was obtained.

  15. With a flick of the lid: a novel trapping mechanism in Nepenthes gracilis pitcher plants.

    Ulrike Bauer

    Full Text Available Carnivorous pitcher plants capture prey with modified leaves (pitchers, using diverse mechanisms such as 'insect aquaplaning' on the wet pitcher rim, slippery wax crystals on the inner pitcher wall, and viscoelastic retentive fluids. Here we describe a new trapping mechanism for Nepenthes gracilis which has evolved a unique, semi-slippery wax crystal surface on the underside of the pitcher lid and utilises the impact of rain drops to 'flick' insects into the trap. Depending on the experimental conditions (simulated 'rain', wet after 'rain', or dry, insects were captured mainly by the lid, the peristome, or the inner pitcher wall, respectively. The application of an anti-slip coating to the lower lid surface reduced prey capture in the field. Compared to sympatric N. rafflesiana, N. gracilis pitchers secreted more nectar under the lid and less on the peristome, thereby directing prey mainly towards the lid. The direct contribution to prey capture represents a novel function of the pitcher lid.

  16. Free-style puzzle flap: the concept of recycling a perforator flap.

    Feng, Kuan-Ming; Hsieh, Ching-Hua; Jeng, Seng-Feng

    2013-02-01

    Theoretically, a flap can be supplied by any perforator based on the angiosome theory. In this study, the technique of free-style perforator flap dissection was used to harvest a pedicled or free skin flap from a previous free flap for a second difficult reconstruction. The authors call this a free-style puzzle flap. For the past 3 years, the authors treated 13 patients in whom 12 pedicled free-style puzzle flaps were harvested from previous redundant free flaps and recycled to reconstruct soft-tissue defects at various anatomical locations. One free-style free puzzle flap was harvested from a previous anterolateral thigh flap for buccal cancer to reconstruct a foot defect. Total flap survival was attained in 12 of 13 flaps. One transferred flap failed completely. This patient had received postoperative radiotherapy after the initial cancer ablation and free anterolateral thigh flap reconstruction. Another free flap was used to close and reconstruct the wound. All the donor sites could be closed primarily. The free-style puzzle flap, harvested from a previous redundant free flap and used as a perforator flap to reconstruct a new defect, has proven to be versatile and reliable. When indicated, it is an alternative donor site for further reconstruction of soft-tissue defects.

  17. Spermiogenesis and spermatozoon of the tapeworm Parabothriocephalus gracilis (Bothriocephalidea): Ultrastructural and cytochemical studies

    Šípková, Lenka; Levron, Céline; Freeman, M.; Scholz, Tomáš

    2010-01-01

    Roč. 55, č. 1 (2010), s. 58-65 ISSN 1230-2821 R&D Projects: GA ČR GP524/07/P039; GA ČR GA524/08/0885; GA MŠk LC522 Institutional research plan: CEZ:AV0Z60220518 Keywords : Eucestoda * Bothriocephalidea * Parabothriocephalus gracilis * spermiogenesis * spermatozoon * ultrastructure Subject RIV: GJ - Animal Vermins ; Diseases, Veterinary Medicine Impact factor: 1.144, year: 2010

  18. Cadmium removal by Euglena gracilis is enhanced under anaerobic growth conditions

    Santiago-Martínez, M. Geovanni; Lira-Silva, Elizabeth; Encalada, Rusely; Pineda, Erika; Gallardo-Pérez, Juan Carlos [Departamento de Bioquímica, Instituto Nacional de Cardiología (Mexico); Zepeda-Rodriguez, Armando [Facultad de Medicina, UNAM, Mexico City (Mexico); Moreno-Sánchez, Rafael; Saavedra, Emma [Departamento de Bioquímica, Instituto Nacional de Cardiología (Mexico); Jasso-Chávez, Ricardo, E-mail: rjass_cardiol@yahoo.com.mx [Departamento de Bioquímica, Instituto Nacional de Cardiología (Mexico)

    2015-05-15

    Highlights: • The protist Euglena gracilis had the ability to grow and remove large amounts of Cd{sup 2+} under anaerobic conditions. • High biomass was attained by combination of glycolytic and mitochondrial carbon sources. • Routes of degradation of glucose, glutamate and malate under anaerobic conditions in E. gracilis are described. • Biosorption was the main mechanism of Cd{sup 2+} removal in anaerobiosis, whereas the Cd{sup 2+} intracellularly accumulated was inactivated by thiol-molecules and polyphosphate. - Abstract: The facultative protist Euglena gracilis, a heavy metal hyper-accumulator, was grown under photo-heterotrophic and extreme conditions (acidic pH, anaerobiosis and with Cd{sup 2+}) and biochemically characterized. High biomass (8.5 × 10{sup 6} cells mL{sup −1}) was reached after 10 days of culture. Under anaerobiosis, photosynthetic activity built up a microaerophilic environment of 0.7% O{sub 2}, which was sufficient to allow mitochondrial respiratory activity: glutamate and malate were fully consumed, whereas 25–33% of the added glucose was consumed. In anaerobic cells, photosynthesis but not respiration was activated by Cd{sup 2+} which induced higher oxidative stress. Malondialdehyde (MDA) levels were 20 times lower in control cells under anaerobiosis than in aerobiosis, although Cd{sup 2+} induced a higher MDA production. Cd{sup 2+} stress induced increased contents of chelating thiols (cysteine, glutathione and phytochelatins) and polyphosphate. Biosorption (90%) and intracellular accumulation (30%) were the mechanisms by which anaerobic cells removed Cd{sup 2+} from medium, which was 36% higher versus aerobic cells. The present study indicated that E. gracilis has the ability to remove Cd{sup 2+} under anaerobic conditions, which might be advantageous for metal removal in sediments from polluted water bodies or bioreactors, where the O{sub 2} concentration is particularly low.

  19. Sequence Evidence for the Presence of Two Tetrapyrrole Pathways in Euglena gracilis

    Kořený, Luděk; Oborník, Miroslav

    2011-01-01

    Roč. 3, - (2011), 359-364 ISSN 1759-6653 R&D Projects: GA ČR GA206/08/1423; GA ČR GD206/09/H026 Institutional research plan: CEZ:AV0Z60220518 Keywords : tetrapyrrole synthesis * heme pathway * Euglena gracilis * secondary endosymbiosis * evolution * plastid Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 4.618, year: 2011

  20. Cadmium removal by Euglena gracilis is enhanced under anaerobic growth conditions

    Santiago-Martínez, M. Geovanni; Lira-Silva, Elizabeth; Encalada, Rusely; Pineda, Erika; Gallardo-Pérez, Juan Carlos; Zepeda-Rodriguez, Armando; Moreno-Sánchez, Rafael; Saavedra, Emma; Jasso-Chávez, Ricardo

    2015-01-01

    Highlights: • The protist Euglena gracilis had the ability to grow and remove large amounts of Cd 2+ under anaerobic conditions. • High biomass was attained by combination of glycolytic and mitochondrial carbon sources. • Routes of degradation of glucose, glutamate and malate under anaerobic conditions in E. gracilis are described. • Biosorption was the main mechanism of Cd 2+ removal in anaerobiosis, whereas the Cd 2+ intracellularly accumulated was inactivated by thiol-molecules and polyphosphate. - Abstract: The facultative protist Euglena gracilis, a heavy metal hyper-accumulator, was grown under photo-heterotrophic and extreme conditions (acidic pH, anaerobiosis and with Cd 2+ ) and biochemically characterized. High biomass (8.5 × 10 6 cells mL −1 ) was reached after 10 days of culture. Under anaerobiosis, photosynthetic activity built up a microaerophilic environment of 0.7% O 2 , which was sufficient to allow mitochondrial respiratory activity: glutamate and malate were fully consumed, whereas 25–33% of the added glucose was consumed. In anaerobic cells, photosynthesis but not respiration was activated by Cd 2+ which induced higher oxidative stress. Malondialdehyde (MDA) levels were 20 times lower in control cells under anaerobiosis than in aerobiosis, although Cd 2+ induced a higher MDA production. Cd 2+ stress induced increased contents of chelating thiols (cysteine, glutathione and phytochelatins) and polyphosphate. Biosorption (90%) and intracellular accumulation (30%) were the mechanisms by which anaerobic cells removed Cd 2+ from medium, which was 36% higher versus aerobic cells. The present study indicated that E. gracilis has the ability to remove Cd 2+ under anaerobic conditions, which might be advantageous for metal removal in sediments from polluted water bodies or bioreactors, where the O 2 concentration is particularly low

  1. Kalanchosides A-C, new cytotoxic bufadienolides from the aerial parts of Kalanchoe gracilis.

    Wu, Pei-Lin; Hsu, Yu-Lin; Wu, Tian-Shung; Bastow, K F; Lee, Kuo-Hsiung

    2006-11-09

    [Structure: see text] Three new compounds, kalanchosides A-C (1-3), as well as five known compounds, were isolated from the aerial parts of Kalanchoe gracilis. The compound structures were determined by spectroscopic methods. All eight isolated compounds showed significant cytotoxic activity against a panel of human tumor cell lines, with potency reaching the nanomolar range. However, only bryophyllin B (8) inhibited HIV replication in H9 lymphocyte cells.

  2. Free gracilis muscle transfer for smile reanimation after treatment for advanced parotid malignancy.

    Faris, Callum; Heiser, Alyssa; Hadlock, Tessa; Jowett, Nate

    2018-03-01

    The purpose of this study was to characterize the outcomes of free gracilis muscle transfer for delayed smile reanimation after radical parotidectomy. A retrospective chart review of patients who underwent free gracilis muscle transfer for smile reanimation after radical parotidectomy between 2003 and 2016 was performed. Patient-reported quality of life (Facial Clinimetric Evaluation Scale [FaCE]), physician-reported facial function ("eFACE" facial grading scale), and oral commissure excursion were compared preoperatively and postoperatively. Twelve patients were identified with prior surgery and adjuvant therapy (radiotherapy in 6 cases and chemoradiotherapy in 6 cases). Significant postoperative improvements were demonstrated for ipsilateral commissure excursion with smile (preoperatively: -2.2 mm [SD 2.3 mm] vs postoperatively: 7.9 mm [SD 2.5 mm]; P = .002), with meaningful smile achieved in 11 of 12 cases (91.7%). The average duration of facial paralysis before intervention was 72 months (range 12-204 months). Free gracilis muscle transfer is an option for dynamic smile reanimation in select patients who have undergone treatment for advanced parotid malignancy. © 2017 Wiley Periodicals, Inc.

  3. PIV Measurements on a Blowing Flap

    Hutcheson, Florence V.; Stead, Daniel J.

    2004-01-01

    PIV measurements of the flow in the region of a flap side edge are presented for several blowing flap configurations. The test model is a NACA 63(sub 2)-215 Hicks Mod-B main-element airfoil with a half-span Fowler flap. Air is blown from small slots located along the flap side edge on either the top, bottom or side surfaces. The test set up is described and flow measurements for a baseline and three blowing flap configurations are presented. The effects that the flap tip jets have on the structure of the flap side edge flow are discussed for each of the flap configurations tested. The results indicate that blowing air from a slot located along the top surface of the flap greatly weakened the top vortex system and pushed it further off the top surface. Blowing from the bottom flap surface kept the strong side vortex further outboard while blowing from the side surface only strengthened the vortex system or accelerated the merging of the side vortex to the flap top surface. It is concluded that blowing from the top or bottom surfaces of the flap may lead to a reduction of flap side edge noise.

  4. Factors affecting growth of the spiny lobsters Panulirus gracilis and Panulirus inflatus (Decapoda: Palinuridae in Guerrero, México

    Patricia Briones-Fourzán

    2003-03-01

    Full Text Available The effects of sex, injuries, season and site on the growth of the spiny lobsters Panulirus gracilis, and P. inflatus, were studied through mark-recapture techniques in two sites with different ecological characteristics on the coast of Guerrero, México. Panulirus gracilis occurred in both sites, whereas P. inflatus occurred only in one site. All recaptured individuals were adults. Both species had similar intermolt periods, but P. gracilis had significantly higher growth rates (mm carapace length week -1 than P. inflatus as a result of a larger molt increment. Growth rates of males were higher than those of females in both species owing to larger molt increments and shorter intermolt periods in males. Injuries had no effect on growth rates in either species. Individuals of P. gracilis grew faster in site 1 than in site 2. Therefore, the effect of season on growth of P. gracilis was analyzed separately in each site. In site 2, growth rates of P. gracilis were similar in summer and in winter, whereas insite 1 both species had higher growth rates in winter than in summer. This could be due to spatial differences in processes related to changes in population density and food resources, which were documented in previous works. The overall results show that P. gracilis grows faster than P. inflatus, and that growth rates of both species are highly variable and are affected by environmental factors such as site and season, which should be taken into account when attempting to produce population growth curves for each species.Se analizaron, por medio de marcado-recaptura, los efectos del sexo, heridas, estación del año y localidad sobre el crecimiento de las langostas espinosas Panulirus gracilis Streets, 1871, y Panulirus inflatus (Bouvier, 1895 en dos localidades con diferentes características ecológicas en la costa de Guerrero, México. Panulirus gracilis se presentó en ambas localidades, mientras que P. inflatus sólo se encontró en una de

  5. Experimental Study of Wake / Flap Interaction Noise and the Reduction of Flap Side Edge Noise

    Hutcheson, Florence V.; Stead, Daniel J.; Plassman, Gerald E.

    2016-01-01

    The effects of the interaction of a wake with a half-span flap on radiated noise are examined. The incident wake is generated by bars of various widths and lengths or by a simplified landing gear model. Single microphone and phased array measurements are used to isolate the effects of the wake interaction on the noise radiating from the flap side edge and flap cove regions. The effects on noise of the wake generator's geometry and relative placement with respect to the flap are assessed. Placement of the wake generators upstream of the flap side edge is shown to lead to the reduction of flap side edge noise by introducing a velocity deficit and likely altering the instabilities in the flap side edge vortex system. Significant reduction in flap side edge noise is achieved with a bar positioned directly upstream of the flap side edge. The noise reduction benefit is seen to improve with increased bar width, length and proximity to the flap edge. Positioning of the landing gear model upstream of the flap side edge also leads to decreased flap side edge noise. In addition, flap cove noise levels are significantly lower than when the landing gear is positioned upstream of the flap mid-span. The impact of the local flow velocity on the noise radiating directly from the landing gear is discussed. The effects of the landing gear side-braces on flap side edge, flap cove and landing gear noise are shown.

  6. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis.

    Simeone, F Joseph; Huang, Ambrose J; Chang, Connie Y; Smith, Maximilian; Gill, Thomas J; Bredella, Miriam A; Torriani, Martin

    2015-04-01

    To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings. We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects. Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26). Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome.

  7. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis

    Simeone, F.J.; Huang, Ambrose J.; Chang, Connie Y.; Smith, Maximilian; Bredella, Miriam A.; Torriani, Martin [Massachusetts General Hospital and Harvard Medical School, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Gill, Thomas J. [Boston Sports Medicine and Research Institute, Boston, MA (United States)

    2014-12-20

    To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings. We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects. Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26). Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome. (orig.)

  8. Posteromedial knee friction syndrome: an entity with medial knee pain and edema between the femoral condyle, sartorius and gracilis

    Simeone, F.J.; Huang, Ambrose J.; Chang, Connie Y.; Smith, Maximilian; Bredella, Miriam A.; Torriani, Martin; Gill, Thomas J.

    2015-01-01

    To describe MRI features of an entity consisting of medial knee pain and edema between the posteromedial femoral condyle (PMFC), sartorius and/or gracilis tendons and determine whether reduced tendon-bone distances may account for these findings. We retrospectively identified MRI cases of edema between the PMFC, sartorius and/or gracilis tendons (25 subjects, 26 knees). Two musculoskeletal radiologists independently graded edema and measured the sartorius- and gracilis-PMFC distances and knee flexion angle. Age- and gender-matched subjects with normal knee MRIs (27 subjects, 27 knees) served as controls for measurements. Statistical analyses compared abnormal to control subjects. Sartorius-PMFC and gracilis-PMFC spaces were narrower in abnormal compared to control subjects (1.6 ± 1.0 vs. 2.1 ± 1.2 mm, P = 0.04; 2.3 ± 2.0 vs. 4.6 ± 3.0 mm, P = 0.002, respectively). The knee flexion angle was similar between groups (P > 0.05). In subjects with clinical information, medial knee pain was the main complaint in 58 % (15/26) of abnormal subjects, with 42 % (11/26) having clinical suspicion of medial meniscal tear. Edema between the PMFC, sartorius and/or gracilis was mild in 54 % (14/26), moderate in 35 % (9/26) and severe in 12 % (3/26), and it was most frequent deep to both the sartorius and gracilis (50 %, 13/26). Edema between the PMFC, sartorius and/or gracilis tendons identified on knee MRI may be associated with medial knee pain and may represent a friction syndrome. (orig.)

  9. Limb girdle muscular dystrophies

    Vissing, John

    2016-01-01

    PURPOSE OF REVIEW: The aim of the study was to describe the clinical spectrum of limb girdle muscular dystrophies (LGMDs), the pitfalls of the current classification system for LGMDs, and emerging therapies for these conditions. RECENT FINDINGS: Close to half of all LGMD subtypes have been...... or are registered in other classification systems for muscle disease. On the contrary, diseases that fulfill classical criteria for LGMD have found no place in the LGMD classification system. These shortcomings call for revision/creation of a new classification system for LGMD. The rapidly expanding gene sequencing...... capabilities have helped to speed up new LGMD discoveries, and unveiled pheno-/genotype relations. Parallel to this progress in identifying new LGMD subtypes, emerging therapies for LGMDs are under way, but no disease-specific treatment is yet available for nonexperimental use. SUMMARY: The field of LGMD...

  10. Effects of irradiation of skin flaps

    Sumi, Y.; Ueda, M.; Oka, T.; Torii, S.

    1984-01-01

    The reaction of skin flaps to irradiation and the optimum postoperative time for irradiation was studied in the rat. Flaps showed different reactions depending on the time of irradiation. There was a correlation between the radiosensitivity and the vascularity of the flap. Those flaps in the marginal hypovascular stage of revascularization showed reactions similar to normal skin. However, severe adverse reactions were observed in the marginal hypervascular stage

  11. Free-flap cover of complex defects around the knee using the descending genicular artery as the recipient pedicle.

    Venkatramani, H; Sabapathy, S R; Nayak, S

    2014-01-01

    Selection of ideal recipient vessels is one of the most important factors determining success in free-flap reconstruction of the lower limb. At the knee, the choice of vessels has traditionally been either the common femoral or the popliteal vessels and their branches but these are often difficult to use or cannot be used. A series of 32 free flaps for cover of complex injuries of the knee involving the distal femur, the knee joint and the upper tibia were reconstructed using the descending genicular branch of the femoral artery in the adductor canal and its muscular branches to the vastus medialis as the recipient vessels. All but one flap survived with no major complications. The use of the descending genicular artery as the recipient vessel for reconstruction with free flaps around the knee has various advantages including: (i) it is mostly remote from the zone of trauma, (ii) it is constant in location, (iii) the recipient vessels are an excellent size match for end-to-end anastomosis, (iv) there is no need for changes of position of the patient when using most free flaps commonly used for knee reconstruction, (v) it is easy to harvest these simultaneously, (vi) secondary exposure of the underlying skeleton from all quadrants is unlikely to divide the flap pedicle as it is superior and (vii), perhaps most important of all, it obviates the need for exploration of the popliteal fossa. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  12. Vascularized Fibula Flaps for Mandibular Reconstruction: An ...

    For decades, osseous vascularised flaps have been used for reconstruction of the mandible with the vascularised fibula flap (VFF) remaining the commonly used osseous free flap, reasons ranging from its adequate bone and pedicle length to its receptive dental implant placement quality. This report considers a modest use ...

  13. Efficient flapping flight of pterosaurs

    Strang, Karl Axel

    In the late eighteenth century, humans discovered the first pterosaur fossil remains and have been fascinated by their existence ever since. Pterosaurs exploited their membrane wings in a sophisticated manner for flight control and propulsion, and were likely the most efficient and effective flyers ever to inhabit our planet. The flapping gait is a complex combination of motions that sustains and propels an animal in the air. Because pterosaurs were so large with wingspans up to eleven meters, if they could have sustained flapping flight, they would have had to achieve high propulsive efficiencies. Identifying the wing motions that contribute the most to propulsive efficiency is key to understanding pterosaur flight, and therefore to shedding light on flapping flight in general and the design of efficient ornithopters. This study is based on published results for a very well-preserved specimen of Coloborhynchus robustus, for which the joints are well-known and thoroughly described in the literature. Simplifying assumptions are made to estimate the characteristics that can not be inferred directly from the fossil remains. For a given animal, maximizing efficiency is equivalent to minimizing power at a given thrust and speed. We therefore aim at finding the flapping gait, that is the joint motions, that minimize the required flapping power. The power is computed from the aerodynamic forces created during a given wing motion. We develop an unsteady three-dimensional code based on the vortex-lattice method, which correlates well with published results for unsteady motions of rectangular wings. In the aerodynamic model, the rigid pterosaur wing is defined by the position of the bones. In the aeroelastic model, we add the flexibility of the bones and of the wing membrane. The nonlinear structural behavior of the membrane is reduced to a linear modal decomposition, assuming small deflections about the reference wing geometry. The reference wing geometry is computed for

  14. Flexible wings in flapping flight

    Moret, Lionel; Thiria, Benjamin; Zhang, Jun

    2007-11-01

    We study the effect of passive pitching and flexible deflection of wings on the forward flapping flight. The wings are flapped vertically in water and are allowed to move freely horizontally. The forward speed is chosen by the flapping wing itself by balance of drag and thrust. We show, that by allowing the wing to passively pitch or by adding a flexible extension at its trailing edge, the forward speed is significantly increased. Detailed measurements of wing deflection and passive pitching, together with flow visualization, are used to explain our observations. The advantage of having a wing with finite rigidity/flexibility is discussed as we compare the current results with our biological inspirations such as birds and fish.

  15. Orocaecal transit time in Duchenne muscular dystrophy.

    Korman, S H; Bar-Oz, B; Granot, E; Meyer, S

    1991-01-01

    Smooth muscle degeneration may occur in Duchenne muscular dystrophy. We measured fasting orocaecal transit time in patients with advanced Duchenne muscular dystrophy and other muscular dystrophies and in healthy controls. No significant differences were found. In contrast to reports of gastric hypomotility in Duchenne muscular dystrophy, we found no evidence of impaired small intestinal motility.

  16. Evaluation of the analgesic and anti-inflammatory effects of the essential oil of Lippia gracilis leaves.

    Mendes, S S; Bomfim, R R; Jesus, H C R; Alves, P B; Blank, A F; Estevam, C S; Antoniolli, A R; Thomazzi, S M

    2010-06-16

    The aim of the present study is to investigate the antinociceptive, anti-inflammatory, and antioxidant activities of essential oil (EO) of Lippia gracilis Schauer (Verbenaceae) leaves to support the medicinal uses claimed by folklore practitioners in the caatinga region (semi-arid) of Northeastern Brazil. The chemical composition and antinociceptive and anti-inflammatory activities of the EO of Lippia gracilis leaves (50-200 mg/kg) were investigated. Antinociceptive activity of the EO was evaluated by writhing test. Anti-inflammatory activity of the EO was evaluated using paw oedema and peritonitis methods. Oral treatment with the EO of Lippia gracilis leaves elicited inhibitory activity on acetic acid effect at 50, 100, and 200 mg/kg (30.33+/-2.36, 25.20+/-1.48, and 21.00+/-1.54 abdominal writhes, respectively, Pleaves at 200 mg/kg (0.72+/-0.06 mL h, Pleaves at 50, 100, and 200 mg/kg (13.81+/-0.61, 11.77+/-0.91, and 10.30+/-0.60 leukocytes x 10(6)/mL, respectively, Pessential oil allowed the identification of Lippia gracilis as a thymol-p-cymene chemotype (32.68% and 17.82%, respectively). The EO of Lippia gracilis leaves shows antinociceptive and anti-inflammatory activities. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  17. Bilateral simultaneous breast reconstruction with SGAP flaps.

    Flores, Jaime I; Magarakis, Michael; Venkat, Raghunandan; Shridharani, Sachin M; Rosson, Gedge D

    2012-07-01

    Two work-horse approaches to postmastectomy breast reconstruction are the deep inferior epigastric perforator flap and the superior gluteal artery perforator (SGAP) flap [and its variation, the lateral septocutaneous superior gluteal artery perforator flap]. Our purpose was fourfold: 1) to analyze our experience with the SGAP flaps for simultaneous bilateral breast reconstruction; 2) to analyze our experience with lateral septocutaneous superior gluteal artery perforator flaps for that procedure; 3) to compare our results with those in the literature; and 4) to highlight the importance of preoperative three-dimensional computed tomographic angiography. A retrospective chart review was completed for 23 patients who underwent breast reconstruction between December 2005 and January 2010 via an SGAP flap (46 flaps). We reviewed flap weight, ischemia time, length of stay, overall flap survival, fat necrosis development, and emergency re-exploration. Mean weights were 571.2 ± 222.0 g (range 186-1,117 g) and 568.0 ± 237.5 g (range 209-1,115 g) for the left and right buttock flap, respectively. Mean ischemia time was 129.1 ± 15.7 and 177.7 ± 24.7 minutes for the first and second flap, respectively. Mean hospital stay was 5.3 ± 2.5 days. All flaps survived. Fat necrosis developed in five flaps (10.8%), and emergency re-exploration was required in three patients (three flaps). When harvesting abdominal tissue is a poor option, the SGAP flap is an efficacious procedure for patients desiring autologous breast reconstruction, and bilateral procedures can be performed simultaneously. Copyright © 2012 Wiley Periodicals, Inc.

  18. Muscular Dystrophy: Hope Through Research

    ... of muscular dystrophy appeared in 1830, when Sir Charles Bell wrote an essay about an illness that ... linked disorder to their sons but their daughters will be carriers of that disorder. Carrier females occasionally ...

  19. Estabelecimento de protocolo para micropropagação de Lippia gracilis Schauer Establishment of protocol for Lippia gracilis Schauer micropropagation

    M.J.M Marinho

    2011-01-01

    Full Text Available A espécie Lippia gracilis SCHAUER (Verbenaceae é nativa do Nordeste brasileiro e se destaca pela capacidade de acumular nos tricomas glandulares óleos essenciais com atividade antimicrobiana. Tendo em vista que não constam trabalhos na literatura sobre o estabelecimento in vitro dessa espécie, este trabalho teve como objetivo estabelecer protocolo para micropropagação de L. gracilis. Para tanto, ramos contendo folhas foram coletados de plantas matrizes no habitat natural para a confecção de estacas. Em laboratório, os explantes provenientes do processo de estaquia foram assepticamente tratados e inoculados em meio MS, acrescido de fitorreguladores, com o intuito de se estabelecer a melhor dose para o desenvolvimento dos explantes. Em decorrência de altos níveis de contaminação, avaliou-se o efeito da cefalexina. No entanto, apesar do antibiótico ter apresentado diminuição na contaminação bacteriana, a porcentagem de oxidação foi elevada. Portanto, testou-se o carvão ativado, ácido ascórbico, ácido cítrico e metade dos sais de MS quanto a eficiência no controle da oxidação. Concluiu-se que, o antibiótico na concentração utilizada provocou a oxidação dos explantes e os fitorreguladores, bem como os métodos antioxidantes testados, não apresentaram resultados consistentes para o melhor desenvolvimento dos explantes e controle da oxidação, respectivamente.The species Lippia gracilis Schauer (Verbenaceae is native to Northeastern Brazil and has been important for its ability to accumulate essential oils with antimicrobial activity in the glandular trichomes. Since there are no reports in the literature on the micropropagation of this species, the present work aimed to establish a protocol for L. gracilis micropropagation. Thus, branches containing leaves were collected from plant matrices in their natural habitat to prepare cuttings. In the laboratory, explants from cutting were aseptically treated and inoculated

  20. Observations on the symbiosis between Colus gracilis (Da Costa, 1778) (Mollusca: Gastropoda) and Hormathia digitata (O.F. Müller, 1776) (Cnidaria: Actiniaria)

    Ates, R.M.L.

    1998-01-01

    Aquarium observations of the behaviour of the actinian Hormathia digitata when mounting live specimens of the gastropod Colus gracilis are fully described for the first time. C. gracilis actively initiates an association with H. digitata by approaching and remaining stationary near the actinian.

  1. Reconstruction of Facial Defect Using Deltopectoral Flap.

    Aldelaimi, Tahrir N; Khalil, Afrah A

    2015-11-01

    Reconstruction of the head and neck is a challenge for otolarygology surgeons, maxillofacial surgeons as well as plastic surgeons. Defects caused by the resection and/or trauma should be closed with flaps which match in color, texture and hair bearing characteristics with the face. Deltopectoral flap is a one such flap from chest and neck skin mainly used to cover the facial defects. This study report a patient presenting with tragic Road Traffic Accident (RTA) admitted to maxillofacial surgery department at Ramadi Teaching Hospital, Anbar province, Iraq. An incision, medially based, was done and deltopectoral fascio-cutaneous flap was used for surgical exposure and closure of defects after RTA. There was no major complication. Good aesthetic and functional results were achieved. Deltopectoral flap is an excellent alternative for the reconstruction of head and neck. Harvesting and application of the flap is rapid and safe. Only a single incision is sufficient for dissection and flap elevation.

  2. Innervated boomerang flap for finger pulp reconstruction.

    Chen, Shao-Liang; Chiou, Tai-Fung

    2007-11-01

    The boomerang flap originates from the dorsolateral aspect of the proximal phalanx of an adjacent digit and is supplied by the retrograde blood flow through the vascular arcades between the dorsal and palmar digital arteries. To provide sensation of the boomerang flap for finger pulp reconstruction, the dorsal sensory branch of the proper digital nerve and the superficial sensory branch of the corresponding radial or ulnar nerve are included within the skin flap. After transfer of the flap to the injured site, epineural neurorrhaphies are done between the digital nerves of the pulp and the sensory branches of the flap. We used this sensory flap in five patients, with more than 1 year follow-up, and all patients achieved measurable two-points discrimination. The boomerang flap not only preserves the proper palmar digital artery but also provides an extended and innervated skin paddle. It seems to be an alternative choice for one-stage reconstruction of major pulp defect.

  3. Cost-effectiveness of monitoring free flaps.

    Subramaniam, Shiva; Sharp, David; Jardim, Christopher; Batstone, Martin D

    2016-06-01

    Methods of free flap monitoring have become more sophisticated and expensive. This study aims to determine the cost of free flap monitoring and examine its cost effectiveness. We examined a group of patients who had had free flaps to the head and neck over a two-year period, and combined these results with costs obtained from business managers and staff. There were 132 free flaps with a success rate of 99%. The cost of monitoring was Aus $193/flap. Clinical monitoring during this time period cost Aus$25 476 and did not lead to the salvage of any free flaps. Cost equivalence is reached between monitoring and not monitoring only at a failure rate of 15.8%. This is to our knowledge the first study to calculate the cost of clinical monitoring of free flaps, and to examine its cost-effectiveness. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

  4. Micrositios del pasto navajita (Bouteloua gracilis en comunidades de pastizal y de matorral del Altiplano Mexicano

    Rosalva García-Sánchez

    2005-01-01

    Full Text Available El objetivo de este trabajo fue determinar si hay un tipo de micrositio específico para el establecimiento de Bouteloua gracilis, con patrones recurrentes, en dos diferentes tipos de comunidades vegetales. El pasto navajita azul es una especie perenne de alto valor forrajero y resistente a la sequía. Para ello se realizó un recorrido por tres matorrales y tres pastizales del Altiplano Mexicano; los sitios estudiados fueron elegidos con base en los reportes de ejemplares colectados y herborizados. Los resultados muestran, por un lado, que en los pastizales se presentan micrositios más de tipo funcional que físico, que determinan el establecimiento de B. gracilis, debido principalmente a los altos requerimientos de humedad edáfica de las semillas para germinar y desarrollarse. El micrositio más frecuente que determina el reclutamiento de los individuos provenientes de semilla es el suelo cercano a individuos adultos de su propia especie. Por otro lado, en los matorrales se detectaron, de manera recurrente, varias condiciones de micrositio para la especie y se observó que el tipo de micrositio es determinante, tanto para el establecimiento como para el crecimiento de este y otros pastos; también, el estudio mostró que en comunidades de matorral existe una mayor diversidad de micrositios que en los pastizales, por lo que se concluye que los individuos de B. gracilis, en los matorrales, crecen asociados a micrositios específicos que le brindan protección contra la desecación.

  5. Cutaneous flaps in the treatment of 338 pressure sores: a better choice.

    Greco, Manfredi; Marchetti, Francesco; Tempesta, Massimo; Ruggiero, Marco; Marcasciano, Marco; Carlesimo, Bruno

    2013-01-01

    Muscular flaps are considered by many surgeons as a treatment of choice for pressure sores. Nevertheless fasciocutaneous and adipofascial flaps are less sensitive to ischemia, more resistant to pressure and have higher mechanical resistance. The aim of this study is to evaluate the results of our integrated rehabilitative and surgical protocol in pressure sore management based on the use of cutaneous flaps. Since 1998, we treated 338 pressure sores (PS) in 195 patients (120 males; 75 females), 189 patients were affected by paraplegia and tetraplegia and 6 of them by neurological disorders. Ninety sacral, 156 ischiatic, 75 trochanteric, 9 calcanean and 8 sores of the iliac-crest were succesfully treated. All showed an involvement of the bone element, with osteitis and/or periosteitis. 14 cases of trocanteric sores showed a deeper bone involvement, with evidences of osteomyelitis. Follow up ranges from 7 years to 2 months. Median time for wound healing was 18 days. The use of fasciocutaneous flaps, as an alternative to the traditional muscolocutaneous flaps in the treatment of pressure sores leads to good and statistically comparable, healing rate, time and incidence of complications. Reconstructive plastic surgery as is a decisive factor to reach a good rehabilitative outcome, minimizing the time of rehabilitation with a following decrease of hospitalization costs. In spinal cord injured patients, surgical treatment of pressure sores is not proposed as the main procedure, but it is an important stage during the natural history of pressure sores. Cutaneous, adipofascial and fasciocutaneous flaps are less invasive, of a relatively easy execution, provided by a reliable vascular pedicle and they could be "re-used" in case of recurrences.

  6. Lift production through asymmetric flapping

    Jalikop, Shreyas; Sreenivas, K. R.

    2009-11-01

    At present, there is a strong interest in developing Micro Air Vehicles (MAV) for applications like disaster management and aerial surveys. At these small length scales, the flight of insects and small birds suggests that unsteady aerodynamics of flapping wings can offer many advantages over fixed wing flight, such as hovering-flight, high maneuverability and high lift at large angles of attack. Various lift generating mechanims such as delayed stall, wake capture and wing rotation contribute towards our understanding of insect flight. We address the effect of asymmetric flapping of wings on lift production. By visualising the flow around a pair of rectangular wings flapping in a water tank and numerically computing the flow using a discrete vortex method, we demonstrate that net lift can be produced by introducing an asymmetry in the upstroke-to-downstroke velocity profile of the flapping wings. The competition between generation of upstroke and downstroke tip vortices appears to hold the key to understanding this lift generation mechanism.

  7. Taxonomy of the phyllosoma of Panulirus inflatus (Bouvier, 1895 and P. gracilis Streets, 1871, based on morphometry and molecular analysis

    Isabel Muñoz-García

    Full Text Available Analysis of wild phyllosoma of Panulirus inflatus (Bouvier, 1895 and P. gracilis Streets, 1871 determined the morphological structures having taxonomic value for differentiation of the two species, in addition to the structures described previously. Of 54 phyllosoma, species identity was confirmed by PCR-restriction fragment length polymorphism (RFLP on 42 P. inflatus and 4 P. gracilis, for which morphology and morphometric measurements were taken. Morphological analysis found subexopodal spines, spines at the base of pereopods 1 and 2, and the mandibles are structures of taxonomic value for differentiating the two species. Morphometric data did not allow differentiation.

  8. Induction of anthocyanin formation and of enzymes related to its biosynthesis by UV light in cell cultures of Haplopappus gracilis

    Wellmann, E.; Hrazdina, G.; Grisebach, H.

    1976-01-01

    Only UV light below 345 nm stimulates anthocyanin formation in dark grown cell suspension cultures of Haplopappus gracilis. A linear relationship between UV dose and flavonoid accumulation, as found previously with parsley cell cultures was not observed with the H.gracilis cells. Only continuous irradiation with high doses of UV was effective. Drastic increases in the activities of the enzymes phenylalanine ammonia-lyase, chalcone isomerase and flavanone synthase were observed under continuous UV light. The increase in enzyme activities paralleled anthocyanin formation. (author)

  9. Anatomic variability of the vascularized composite osteomyocutaneous flap from the medial femoral condyle: an anatomical study

    Trung-Hau Le Thua

    2014-12-01

    Full Text Available Aim: The anatomical study and clinical application for the vascularized corticoperiosteal flap from the medial femoral condyle have been performed and described previously. Although prior studies have described the composite osteomyocutaneous flap from the medial femoral condyle, a detailed analysis of the vascularity of this region has not yet been fully evaluated. Methods: This anatomical study described the variability of the arteries from the medial femoral condyle in 40 cadaveric specimens. Results: The descending genicular artery (DGA was found in 33 of 40 cases (82.5%. The  superomedial genicular artery (SGA was present in 10 cases (25%. All 33 cases (100% of the DGA had articular branches to the periosteum of the medial femoral condyle. Muscular branches and saphenous branches of the DGA were present in 25 cases (62.5% and 26 cases (70.3%, respectively. Conclusion: The current study demonstrates that the size and length of the vessels to the medial femoral condyle are sufficient for a vascularized bone flap. A careful preoperative vascular assessment is essential prior to use of the vascularized composite osteomyocutaneous flap from the medial femoral condyle, because of the considerable anatomical variations in different branches of the DGA.

  10. Revisit of Nasolabial flap in the reconstruction of defects involving ...

    Conclusion: Data from this study suggest that NL flap is a reliable option for reconstruction of the oral floor, in form as well as function, without esthetic compromise and has a major role even in this era of free flaps. Keywords: Floor of mouth defects, local flaps, nasolabail flap, oral cavity defects, reconstruction, regional flaps ...

  11. Distribution of skeletal muscle involvement in autosomal recessive distal muscular dystrophy

    Mizusawa, Hidehiro; Nakanishi, Takao; Kobayashi, Fumie.

    1987-01-01

    Distribution of skeletal muscle involvement in 5 cases with autosomal recessive distal muscular dystrophy was studied clinically and by computed tomography (CT). Manual muscle test showed muscle involvement with a predilection for flexors in the lower leg and adductors in the thigh. Flexion and extension of the thigh and the lower leg was impaired to similar degree. In progressed cases, neck flexors and trunk muscles were also affected mildly. CT disclosed more clearly the preferential involvement of flexors in the lower leg, and involvement of both hamstrings · adductors group and extensors group of the thigh to similar degree. However, m. popliteus was curiously well preserved. In addition, there was a stage showing high density and hypertrophy of m. sartorius, m. gracilis, m. adductor, m. biceps femoris, m. semimenbranosus, m. semitendinosus or m. rectus femoris, which in thought to be compensatory hypertrophy. M. gluteus minimus in the pelvic girdle and m. dorsi proprii in the trunk were also liable to be affected. The CT findings are regarded as characteristic features noted clearly before muscle weakness and atrophy become apparent clinically. CT is very useful for distinguishing distal muscular dystrophy from rimmed vacuolar distal myopathy in which m. quadriceps femoris and flexors of the lower leg are usually well preserved without compensatory hypertrophy on CT. (author)

  12. Preliminary diffusion tensor imaging studies in limb-girdle muscular dystrophies

    Hidalgo-Tobon, S.; Hernandez-Salazar, G.; Vargas-Cañas, S.; Marrufo-Melendez, O.; Solis-Najera, S.; Taboada-Barajas, J.; Rodriguez, A. O.; Delgado-Hernandez, R.

    2012-10-01

    Limb-girdle muscular dystrophies (LGMD) are a group of autosomal dominantly or recessively inherited muscular dystrophies that also present with primary proximal (limb-girdle) muscle weakness. This type of dystrophy involves the shoulder and pelvic girdles, distinct phenotypic or clinical characteristics are recognized. Imaging experiments were conducted on a 1.5T GE scanner (General Electric Medical Systems. Milwaukee. USA), using a combination of two eight-channel coil array. Diffusion Tensor Imaging (DTI) data were acquired using a SE-EPI sequence, diffusion weighted gradients were applied along 30 non-collinear directions with a b-value=550 s/mm2. The connective tissue content does not appear to have a significant effect on the directionality of the diffusion, as assessed by fractional anisotropy. The fibers of the Sartorius muscle and gracilis showed decreased number of tracts, secondary to fatty infiltration and replacement of connective tissue and muscle mass loss characteristic of the underlying pathology. Our results demonstrated the utility of non-invasive MRI techniques to characterize the muscle pathology, through quantitative and qualitative methods such as the FA values and tractrography.

  13. Rescate de colgajo muscular de trapecio con isla cutánea en paciente lesionado medular que precisa rehabilitación inmediata Rescue of a pedicled trapezious muscle flap with skin paddle in a patient with spinal cord injury who needded inmediate rehabilitation

    J.M. Arévalo Velasco

    2011-12-01

    terapias VAC® y VIA® de absoluta indicación en heridas complejas tanto agudas como crónicas porque ahorran tiempo, no sólo en las curas, sino también en términos de estancia hospitalaria total a la vez que evitan tiempos quirúrgicos innecesarios y con alta morbilidad para los pacientes.Negative pressure therapy (subatmospheric is a noninvasive treatment modality included in the armamentarium of any Service of Plastic Surgery and also in General Surgery, Vascular Surgery and Traumatology Services. It can be applied in the treatment of both chronic and acute wounds to decrease the time and number of priests and also to reduce surgeries with high morbidity for the patient. We present a patient with depressive syndrome secondary to an unfortunate postoperative course of a vertebroplasty that produced an spinal cord injury, classified as ASIA C, level D4. The patient suffered a high dorsal ulcer with 6 months of complicated evolution which finally was covered with a pedicled trapezious flap with skin paddle and, again iatrogenicaly, suffered a partial loss of the paddle and a significant seroma at the donor site. In our opinion, this case is interesting because the use of negative pressure therapy with VAC® system allows: 1 Minimize the loss of flap tissue. 2 To decrease the number of cures. 3 To decrease the time in each healing. 4 Allows the patient to move in his wheelchair with two portable VAC® systems to assist to the gym and follow his rehabilitation program. 5 With this unexpected and fast evolution, the patient had a significant clinical improvement of his depressive-anxious state and 6 The final placement of a latest generation VAC-VIA® systems on autografts allowed the patient to go on with his occupational therapy and physiotherapy for the upper extremities. We think that VAC-VIA® therapy is completely indicated to complex acute and chronic wounds because it can save time in terms of total hospital stance and avoid unnecessary surgeries with high risk

  14. Head and neck reconstruction with pedicled flaps in the free flap era.

    Mahieu, R; Colletti, G; Bonomo, P; Parrinello, G; Iavarone, A; Dolivet, G; Livi, L; Deganello, A

    2016-12-01

    Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results. The aim of this study was to assess whether pedicled flap reconstruction of head and neck defects is inferior to microvascular free flap reconstruction in terms of complications, functionality and prognosis. The records of consecutive patients who underwent free flap or pedicled flap reconstruction after head and neck cancer ablation from 2006 to 2015, from a single surgeon, in the AOUC Hospital, Florence Italy were analysed. A total of 93 patients, the majority with oral cancer (n = 59), were included, of which 64 were pedicled flap reconstructions (69%). The results showed no significant differences in terms of functional outcome, flap necrosis and complications in each type of reconstruction. Multivariate regression analysis of flap necrosis and functional impairments showed no associated factors. Multivariate regression analysis of complicated flap healing showed that only comorbidities remained an explaining factor (p = 0.019). Survival analysis and proportional hazard regression analysis regarding cancer relapse or distant metastasis, showed no significant differences in prognosis of patients concerning both types of reconstruction. In this retrospective, non-randomised study cohort, pedicled flaps were not significantly inferior to free flaps for reconstruction of head and neck defects, considering functionality, complications and prognosis. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

  15. Muscular dystrophy in a dog resembling human becker muscular dystrophy.

    Baroncelli, A B; Abellonio, F; Pagano, T B; Esposito, I; Peirone, B; Papparella, S; Paciello, O

    2014-05-01

    A 3-year-old, male Labrador retriever dog was presented with clinical signs of progressive exercise intolerance, bilateral elbow extension, rigidity of the forelimbs, hindlimb flexion and kyphosis. Microscopical examination of muscle tissue showed marked variability in myofibre size, replacement of muscle with mature adipose tissue and degeneration/regeneration of muscle fibres, consistent with muscular dystrophy. Immunohistochemical examination for dystrophin showed markedly reduced labelling with monoclonal antibodies specific for the rod domain and the carboxy-terminal of dystrophin, while expression of β-sarcoglycan, γ-sarcoglycan and β-dystroglycan was normal. Immunoblotting revealed a truncated dystrophin protein of approximately 135 kDa. These findings supported a diagnosis of congenital canine muscular dystrophy resembling Becker muscular dystrophy in man. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Progression and variation of fatty infiltration of the thigh muscles in Duchenne muscular dystrophy, a muscle magnetic resonance imaging study.

    Li, Wenzhu; Zheng, Yiming; Zhang, Wei; Wang, Zhaoxia; Xiao, Jiangxi; Yuan, Yun

    2015-05-01

    The purpose of this study was to assess the progression and variation of fatty infiltration of the thigh muscles of Duchenne muscular dystrophy patients. Muscle magnetic resonance imaging was used to measure the degree of fatty infiltration of the thigh muscles of 171 boys with Duchenne muscular dystrophy (mean age, 6.09 ± 2.30 years). Fatty infiltration was assigned using a modified Mercuri's scale 0-5 (normal-severe). The gluteus maximus and adductor magnus were affected in patients less than two years old, followed by the biceps femoris. Quadriceps and semimembranosus were first affected at the age of five to six years; the sartorius, gracilis and adductor longus remained apparently unaffected until seven years of age. Fatty infiltration of all the thigh muscles developed rapidly after seven years of age. The standard deviation of the fatty infiltration scores ranged from 2.41 to 4.87 before five years old, and from 6.84 to 11.66 between six and ten years old. This study provides evidence of highly variable degrees of fatty infiltration in children of different ages with Duchenne muscular dystrophy, and indicates that fatty infiltration progresses more quickly after seven years of age. These findings may be beneficial for the selection of therapeutic regimens and the analysis of future clinical trials. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Effect of chromium on the fatty acid composition of two strains of Euglena gracilis

    Rocchetta, Iara [Departamento de Biodiversidad y Biologia Experimental, Universidad de Buenos Aires, Pab. II, Ciudad Universitaria, 1428 Buenos Aires (Argentina)]. E-mail: rocchetta@bg.fcen.uba.ar; Mazzuca, Marcia [Departamento de Quimica, Facultad de Ciencias Naturales, Universidad de Patagonia, Comodoro Rivadavia, Chubut (Argentina); Conforti, Visitacion [Departamento de Biodiversidad y Biologia Experimental, Universidad de Buenos Aires, Pab. II, Ciudad Universitaria, 1428 Buenos Aires (Argentina); Ruiz, Laura [Departamento de Biodiversidad y Biologia Experimental, Universidad de Buenos Aires, Pab. II, Ciudad Universitaria, 1428 Buenos Aires (Argentina); Balzaretti, Vilma [Departamento de Quimica, Facultad de Ciencias Naturales, Universidad de Patagonia, Comodoro Rivadavia, Chubut (Argentina); Rios de Molina, Maria del Carmen [Departamento de Quimica Biologica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires, Pab. II, Ciudad Universitaria, 1428 Buenos Aires (Argentina)

    2006-05-15

    The effect of hexavalent chromium on fatty acid composition was studied in two strains of Euglena gracilis; UTEX 753 (from the Culture Collection of Algae of Texas University, USA) and MAT (isolated from a highly polluted River). Both were grown in photoauxotrophic and photoheterotrophic conditions and exposed to two metal concentrations, one below and one above IC{sub 5}. The high malondialdehyde (MDA) levels (3 to 7-fold) obtained with chromium concentration above IC{sub 5}, suggested the existence of metal-induced lipid peroxidation. Total lipid content increased only with concentration below IC{sub 5}, whereas it was inhibited by higher metal concentration. Photoheterotrophic control strains exhibited a significantly higher proportion of saturated and polyunsaturated fatty acids. Polyunsaturated acids were most affected by chromium, especially those related to chloroplast structures. Ultra-structure studies showed clear thylakoid disorganization in all treated cells. The results indicate that hexavalent chromium affects levels of fatty acids, especially those related to photosynthetic activity. - Fatty acid evaluation in the presence of chromium in Euglena gracilis grown in different culture conditions.

  18. Effect of chromium on the fatty acid composition of two strains of Euglena gracilis

    Rocchetta, Iara; Mazzuca, Marcia; Conforti, Visitacion; Ruiz, Laura; Balzaretti, Vilma; Rios de Molina, Maria del Carmen

    2006-01-01

    The effect of hexavalent chromium on fatty acid composition was studied in two strains of Euglena gracilis; UTEX 753 (from the Culture Collection of Algae of Texas University, USA) and MAT (isolated from a highly polluted River). Both were grown in photoauxotrophic and photoheterotrophic conditions and exposed to two metal concentrations, one below and one above IC 5 . The high malondialdehyde (MDA) levels (3 to 7-fold) obtained with chromium concentration above IC 5 , suggested the existence of metal-induced lipid peroxidation. Total lipid content increased only with concentration below IC 5 , whereas it was inhibited by higher metal concentration. Photoheterotrophic control strains exhibited a significantly higher proportion of saturated and polyunsaturated fatty acids. Polyunsaturated acids were most affected by chromium, especially those related to chloroplast structures. Ultra-structure studies showed clear thylakoid disorganization in all treated cells. The results indicate that hexavalent chromium affects levels of fatty acids, especially those related to photosynthetic activity. - Fatty acid evaluation in the presence of chromium in Euglena gracilis grown in different culture conditions

  19. An innovative method of planning and displaying flap volume in DIEP flap breast reconstructions

    Hummelink, S.L.; Verhulst, A.C.; Maal, T.J.J.; Hoogeveen, Y.L.; Schultze Kool, L.J.; Ulrich, D.J.O.

    2017-01-01

    BACKGROUND: Determining the ideal volume of the harvested flap to achieve symmetry in deep inferior epigastric artery perforator (DIEP) flap breast reconstructions is complex. With preoperative imaging techniques such as 3D stereophotogrammetry and computed tomography angiography (CTA) available

  20. Dermatosurgery Rounds - The Island SKIN Infraorbital Flap

    Georgi Tchernev

    2017-07-01

    Full Text Available The main objective in dermatologic surgery is complete excision of the tumour while achieving the best possible functional and cosmetic outcome. Also we must take into account age, sex, and tumour size and site. We should also consider the patient's expectations, the preservation of the different cosmetic units, and the final cosmetic outcome. Various reconstructive methods ranging from secondary healing to free flap applications are usedfor the reconstruction of perinasal or facial defects caused by trauma or tumour surgery. Herein, we describe the nasal infraorbital island skin flap for the reconstruction in a patient with basal cell carcinoma. No complications were observed in operation field. The infraorbital island skin flap which we describe for the perinasal area reconstruction is a safe, easily performed and versatile flap. The multidimensional use of this flap together with a relatively easy reconstruction plan and surgical procedure would be effective in flap choice.

  1. An innovative method of planning and displaying flap volume in DIEP flap breast reconstructions.

    Hummelink, S; Verhulst, Arico C; Maal, Thomas J J; Hoogeveen, Yvonne L; Schultze Kool, Leo J; Ulrich, Dietmar J O

    2017-07-01

    Determining the ideal volume of the harvested flap to achieve symmetry in deep inferior epigastric artery perforator (DIEP) flap breast reconstructions is complex. With preoperative imaging techniques such as 3D stereophotogrammetry and computed tomography angiography (CTA) available nowadays, we can combine information to preoperatively plan the optimal flap volume to be harvested. In this proof-of-concept, we investigated whether projection of a virtual flap planning onto the patient's abdomen using a projection method could result in harvesting the correct flap volume. In six patients (n = 9 breasts), 3D stereophotogrammetry and CTA data were combined from which a virtual flap planning was created comprising perforator locations, blood vessel trajectory and flap size. All projected perforators were verified with Doppler ultrasound. Intraoperative flap measurements were collected to validate the determined flap delineation volume. The measured breast volume using 3D stereophotogrammetry was 578 ± 127 cc; on CTA images, 527 ± 106 cc flap volumes were planned. The nine harvested flaps weighed 533 ± 109 g resulting in a planned versus harvested flap mean difference of 5 ± 27 g (flap density 1.0 g/ml). In 41 out of 42 projected perforator locations, a Doppler signal was audible. This proof-of-concept shows in small numbers that flap volumes can be included into a virtual DIEP flap planning, and transferring the virtual planning to the patient through a projection method results in harvesting approximately the same volume during surgery. In our opinion, this innovative approach is the first step in consequently achieving symmetric breast volumes in DIEP flap breast reconstructions. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. Root coverage with bridge flap

    Pushpendra Kumar Verma

    2013-01-01

    Full Text Available Gingival recession in anterior teeth is a common concern due to esthetic reasons or root sensitivity. Gingival recession, especially in multiple anterior teeth, is of huge concern due to esthetic reasons. Various mucogingival surgeries are available for root coverage. This case report presents a new bridge flap technique, which allows the dentist not only to cover the previously denuded root surfaces but also to increase the zone of attached gingiva at a single step. In this case, a coronally advanced flap along with vestibular deepening technique was used as root coverage procedure for the treatment of multiple recession-type defect. Here, vestibular deepening technique is used to increase the width of the attached gingiva. The predictability of this procedure results in an esthetically healthy periodontium, along with gain in keratinized tissue and good patient′s acceptance.

  3. Exotic wakes of flapping fins

    Schnipper, Teis

    We present, in 8 chapters, experiments on and numerical simulations of bodies flapping in a fluid. Focus is predominantly on a rigid foil, a model fish, that performs prescribed pitching oscillations where the foil rotates around its leading edge. In a flowing soap film is measured, with unpreced......We present, in 8 chapters, experiments on and numerical simulations of bodies flapping in a fluid. Focus is predominantly on a rigid foil, a model fish, that performs prescribed pitching oscillations where the foil rotates around its leading edge. In a flowing soap film is measured......-speed and the strength ratio of the vortices formed at the foil’s leading and trailing edge. The simulated vortex particles and measured thickness variations in the soap film show similar behaviour which indicates that the soap film provides a good approximation the flow of a two-dimensional incompressible and Newtonian...

  4. Free gracilis transfer for smile in children: the Massachusetts Eye and Ear Infirmary Experience in excursion and quality-of-life changes.

    Hadlock, Tessa A; Malo, Juan S; Cheney, Mack L; Henstrom, Douglas K

    2011-01-01

    Free muscle transfer for facial reanimation has become the standard of care in recent decades and is now the cornerstone intervention for dynamic smile reanimation. We sought to quantify smile excursion and quality-of-life (QOL) changes in our pediatric free gracilis recipients following reanimation. We quantified gracilis muscle excursion in 17 pediatric patients undergoing 19 consecutive pediatric free gracilis transplantation operations, using our validated SMILE program, as an objective measure of functional outcome. These were compared against excursion measured the same way in a cohort of 17 adults with 19 free gracilis operations. In addition, we prospectively evaluated QOL outcomes in these children using the Facial Clinimetric Evaluation (FaCE) instrument. The mean gracilis excursion in our pediatric free gracilis recipients was 8.8 mm ± 5.0 mm, which matched adult results, but with fewer complete failures of less than 2-mm excursion, with 2 (11%) and 4 (21%), respectively. Quality-of-life measures indicated statistically significant improvements following dynamic smile reanimation (P = .01). Dynamic facial reanimation using free gracilis transfer in children has an acceptable success rate, yields improved commissure excursion, and improves QOL in the pediatric population. It should be considered first-line therapy for children with lack of a meaningful smile secondary to facial paralysis.

  5. Use of secondary sewage water as a culture medium for Chaetoceros gracilis and Thalassiosira Sp (Chrysophyceae in laboratory conditions

    Rauquírio André Albuquerque Marinho da Costa

    1999-01-01

    Full Text Available Experiments were carried out in order to test the efficiency of additions of secondary sewage as a culture medium for Chaetoceros gracilis and Thalassiosira sp (Chrysophyceae under laboratory conditions. These algae were cultivated in sea water with concentrations of 10%, 20%, 30% and 40% of wastewater. The results were compared with those obtained by the nutritive medium f2 of Guillard (1975. The best results in terms of cellular densities were observed at 40% additions. There were significant differences (significance levels of 5% between the nutritive medium f2 and the 40% additions for both the species. Maximum cellular densities observed for all additions tested were, 4,125.00 x 10³ cells/ml for Chaetoceros gracilis on the ninth day and 834.00 x 10³ cells/ml for Thalassiosira sp on the fifth day. Biomass was higher in the nutritive medium f2 than in the other treatments, reaching average values of 2,363μg/ml for Chaetoceros gracilis. At all experimental units, the best results were registered at 40% addition for Chaetoceros gracilis, where average values of 0.768μg/ml were observed on the fifth day, and at 30% additions for Thalassiosira sp where 0.883μg/ml were observed on the thirteenth day. It was concluded that secondary sewage could be used as a culture medium for the species tested here, after large scale tests.

  6. Review of the South American characiform fish genus Chilodus, with description of a new species, C. gracilis (Pisces, Characiformes, Chilodontidae)

    Isbrücker, I.J.H.; Nijssen, H.

    1988-01-01

    Examination of 291 specimens of Chilodus, a genus of South American fresh water fishes, yielded the presence of three species, viz.: C. punctatus, C. zunevei, and C. gracilis. Of the first species the lectotype is designated. The type material of C. zunevei is lost; new material enabled a

  7. Medial canthal reconstruction with multiple local flaps

    Akihiro Ogino

    2018-03-01

    Conclusion: This method is somewhat complicated compared to reconstruction with a single flap, but it is a combination of standard local flaps and is a simple reconstructive procedure. By adding additional resection, the suture line is consistent with the border of the facial unit, so postoperative scarring is inconspicuous. This technique is aesthetically useful because of the continuity of colour and texture resulting from the use of adjacent flaps.

  8. Muscular atrophy in diabetic neuropathy

    Andersen, H; Gadeberg, P C; Brock, B

    1997-01-01

    Diabetic patients with polyneuropathy develop motor dysfunction. To establish whether motor dysfunction is associated with muscular atrophy the ankle dorsal and plantar flexors of the non-dominant leg were evaluated with magnetic resonance imaging in 8 patients with symptomatic neuropathy, in 8 non...... confirmed that the atrophy predominated distally. We conclude that muscular atrophy underlies motor weakness at the ankle in diabetic patients with polyneuropathy and that the atrophy is most pronounced in distal muscles of the lower leg indicating that a length dependent neuropathic process explains...

  9. Metabolismo muscular en el ejercicio

    Martín Martín, Laura

    2017-01-01

    Fundamentos: Cada vez son más las personas que realizan algún tipo de actividad física, pero pocas son las que poseen un verdadero conocimiento de los procesos que se desencadenan a nivel muscular y la influencia de la alimentación en la misma. El objetivo de este trabajo es ofrecer información de manera general sobre el metabolismo muscular. Métodos: Revisión bibliográfica de artículos y documentos consultando bases de datos y libros. La mayor parte del análisis ha sido ext...

  10. Pedicled Temporalis Muscle Flap for Craniofacial Reconstruction: A 35-Year Clinical Experience with 366 Flaps.

    Spanio di Spilimbergo, Stefano; Nordera, Paolo; Mardini, Samir; Castiglione, Giusy; Chim, Harvey; Pinna, Vittore; Brunello, Massimo; Cusino, Claudio; Roberto, Squaquara; Baciliero, Ugo

    2017-02-01

    In the past 130 years, the temporalis muscle flap has been used for a variety of different indications. In this age of microsurgery and perforator flaps, the temporalis muscle flap still has many useful applications for craniofacial reconstruction. Three hundred sixty-six temporalis muscle flaps were performed in a single center between 1978 and 2012. The authors divided the cases into two series-before and after 1994-because, after 1994, they started to perform free flap reconstructions, and indications for reconstruction with a temporalis muscle flap were changed RESULTS:: In the series after 1994, flaps were most commonly used for reconstruction of defects in the maxilla, mandible, and oropharynx, in addition to facial reanimation and filling of orbital defects. Complications included total flap necrosis (1.6 percent) and partial flap necrosis (10.7 percent). The rate of material extrusion at the donor site decreased after porous polyethylene was uniformly used for reconstruction from 17.1 to 7.9 percent. The pedicled temporalis muscle flap continues to have many applications in craniofacial reconstruction. With increasing use of free flaps, the authors' indications for the pedicled temporalis muscle flap are now restricted to (1) orbital filling for congenital or acquired anophthalmia; (2) filling of unilateral maxillectomy defects; and (3) facial reanimation in selected cases of facial nerve palsy. Therapeutic, IV.

  11. Head and neck reconstruction with pedicled flaps in the free flap era

    Mahieu, R.; Colletti, G.; Bonomo, P.; Parrinello, G.; Iavarone, A.; Dolivet, G.; Livi, L.; Deganello, A.

    2016-01-01

    Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results.

  12. Genetics Home Reference: spinal muscular atrophy

    ... difficulty breathing. Children with this type often have joint deformities (contractures) that impair movement. In severe cases, ... Proximal spinal muscular atrophy Washington University, St. Louis: Neuromuscular Disease Center: Spinal Muscular Atrophy Patient Support and ...

  13. Respiratory function in facioscapulohumeral muscular dystrophy 1

    Wohlgemuth, M.; Horlings, G.C.; Kooi, E.L. van der; Gilhuis, H.J.; Hendriks, J.C.M.; Maarel, S.M. van der; Engelen, B.G.M. van; Heijdra, Y.F.; Padberg, G.W.A.M.

    2017-01-01

    To test the hypothesis that wheelchair dependency and (kypho-)scoliosis are risk factors for developing respiratory insufficiency in facioscapulohumeral muscular dystrophy, we examined 81 patients with facioscapulohumeral muscular dystrophy 1 of varying degrees of severity ranging from ambulatory

  14. What Are the Types of Muscular Dystrophy?

    ... muscular dystrophy? There are more than 30 forms of muscular dystrophy (MD), with information on the primary types included in the table below. 1 Duchenne (DMD) What It Is Common Symptoms How It ...

  15. Refining the intrinsic chimera flap: a review.

    Agarwal, Jayant P; Agarwal, Shailesh; Adler, Neta; Gottlieb, Lawrence J

    2009-10-01

    Reconstruction of complex tissue deficiencies in which each missing component is in a different spatial relationship to each other can be particularly challenging, especially in patients with limited recipient vessels. The chimera flap design is uniquely suited to reconstruct these deformities. Chimera flaps have been previously defined in many ways with 2 main categories: prefabricated or intrinsic. Herein we attempt to clarify the definition of a true intrinsic chimeric flap and provide examples of how these constructs provide a method for reconstruction of complex defects. The versatility of the intrinsic chimera flap and its procurement from 7 different vascular systems is described. A clarification of the definition of a true intrinsic chimera flap is described. In addition, construction of flaps from the lateral femoral circumflex, deep circumflex iliac, inferior gluteal, peroneal, subscapular, thoracodorsal, and radial arterial systems is described to showcase the versatility of these chimera flaps. A true intrinsic chimera flap must consist of more than a single tissue type. Each of the tissue components receives its blood flow from separate vascular branches or perforators that are connected to a single vascular source. These vascular branches must be of appropriate length to allow for insetting with 3-dimensional spatial freedom. There are a multitude of sites from which true intrinsic chimera flaps may be harvested.

  16. Optimal propulsive flapping in Stokes flows.

    Was, Loïc; Lauga, Eric

    2014-03-01

    Swimming fish and flying insects use the flapping of fins and wings to generate thrust. In contrast, microscopic organisms typically deform their appendages in a wavelike fashion. Since a flapping motion with two degrees of freedom is able, in theory, to produce net forces from a time-periodic actuation at all Reynolds numbers, we compute in this paper the optimal flapping kinematics of a rigid spheroid in a Stokes flow. The hydrodynamics for the force generation and energetics of the flapping motion is solved exactly. We then compute analytically the gradient of a flapping efficiency in the space of all flapping gaits and employ it to derive numerically the optimal flapping kinematics as a function of the shape of the flapper and the amplitude of the motion. The kinematics of optimal flapping are observed to depend weakly on the flapper shape and are very similar to the figure-eight motion observed in the motion of insect wings. Our results suggest that flapping could be a exploited experimentally as a propulsion mechanism valid across the whole range of Reynolds numbers.

  17. Optimal propulsive flapping in Stokes flows

    Was, Loïc; Lauga, Eric

    2014-01-01

    Swimming fish and flying insects use the flapping of fins and wings to generate thrust. In contrast, microscopic organisms typically deform their appendages in a wavelike fashion. Since a flapping motion with two degrees of freedom is able, in theory, to produce net forces from a time-periodic actuation at all Reynolds numbers, we compute in this paper the optimal flapping kinematics of a rigid spheroid in a Stokes flow. The hydrodynamics for the force generation and energetics of the flapping motion is solved exactly. We then compute analytically the gradient of a flapping efficiency in the space of all flapping gaits and employ it to derive numerically the optimal flapping kinematics as a function of the shape of the flapper and the amplitude of the motion. The kinematics of optimal flapping are observed to depend weakly on the flapper shape and are very similar to the figure-eight motion observed in the motion of insect wings. Our results suggest that flapping could be a exploited experimentally as a propulsion mechanism valid across the whole range of Reynolds numbers. (paper)

  18. High-Throughput Accurate Single-Cell Screening of Euglena gracilis with Fluorescence-Assisted Optofluidic Time-Stretch Microscopy.

    Baoshan Guo

    Full Text Available The development of reliable, sustainable, and economical sources of alternative fuels is an important, but challenging goal for the world. As an alternative to liquid fossil fuels, algal biofuel is expected to play a key role in alleviating global warming since algae absorb atmospheric CO2 via photosynthesis. Among various algae for fuel production, Euglena gracilis is an attractive microalgal species as it is known to produce wax ester (good for biodiesel and aviation fuel within lipid droplets. To date, while there exist many techniques for inducing microalgal cells to produce and accumulate lipid with high efficiency, few analytical methods are available for characterizing a population of such lipid-accumulated microalgae including E. gracilis with high throughout, high accuracy, and single-cell resolution simultaneously. Here we demonstrate high-throughput, high-accuracy, single-cell screening of E. gracilis with fluorescence-assisted optofluidic time-stretch microscopy-a method that combines the strengths of microfluidic cell focusing, optical time-stretch microscopy, and fluorescence detection used in conventional flow cytometry. Specifically, our fluorescence-assisted optofluidic time-stretch microscope consists of an optical time-stretch microscope and a fluorescence analyzer on top of a hydrodynamically focusing microfluidic device and can detect fluorescence from every E. gracilis cell in a population and simultaneously obtain its image with a high throughput of 10,000 cells/s. With the multi-dimensional information acquired by the system, we classify nitrogen-sufficient (ordinary and nitrogen-deficient (lipid-accumulated E. gracilis cells with a low false positive rate of 1.0%. This method holds promise for evaluating cultivation techniques and selective breeding for microalgae-based biofuel production.

  19. Dysphagia in facioscapulohumeral muscular dystrophy.

    Wohlgemuth, M.; Swart, B.J.M. de; Kalf, J.G.; Joosten, F.B.M.; Vliet, A.M. van der; Padberg, G.W.A.M.

    2006-01-01

    Dysphagia is not considered a symptom of facioscapulohumeral muscular dystrophy (FSHD). In this study, the authors found that dysphagia does occur in patients with advanced FSHD showing mild involvement of the jaw and lingual muscles. Dysphagia is seldom life threatening in these patients. The

  20. Glucocorticoids for Duchenne Muscular Dystrophy

    J Gordon Millichap

    2013-07-01

    Full Text Available Investigators at the Dubowitz Neuromuscular Centre, Great Ormond Street Hospital, and other centers in the UK, conducted a prospective longitudinal study across 17 neuromuscular centers in the UK of 360 boys aged 3-15 years with Duchenne muscular dystrophy who were treated with daily or intermittent (10 days on/10 days off prednisolone for a mean duration of 4 years.

  1. BEEF CATTLE MUSCULARITY CANDIDATE GENES

    Irida Novianti

    2010-04-01

    Full Text Available Muscularity is a potential indicator for the selection of more productive cattle. Mapping quantitative trait loci (QTL for traits related to muscularity is useful to identify the genomic regions where the genes affecting muscularity reside. QTL analysis from a Limousin-Jersey double backcross herd was conducted using QTL Express software with cohort and breed as the fixed effects. Nine QTL suggested to have an association with muscularity were identified on cattle chromosomes BTA 1, 2, 3, 4, 5, 8, 12, 14 and 17. The myostatin gene is located at the centromeric end of chromosome 2 and not surprisingly, the Limousin myostatin F94L variant accounted for the QTL on BTA2. However, when the myostatin F94L genotype was included as an additional fixed effect, the QTL on BTA17 was also no longer significant. This result suggests that there may be gene(s that have epistatic effects with myostatin located on cattle chromosome 17. Based on the position of the QTL in base pairs, all the genes that reside in the region were determined using the Ensembl data base (www.ensembl.org. There were two potential candidate genes residing within these QTL regions were selected. They were Smad nuclear interacting protein 1 (SNIP1 and similar to follistatin-like 5 (FSTL5. (JIIPB 2010 Vol 20 No 1: 1-10

  2. Inherited myopathies and muscular dystrophies

    Cardamone, Michael; Darras, Basil T.; Ryan, Monique M.

    The inherited myopathies and muscular dystrophies are a diverse group of muscle diseases presenting with common complaints and physical signs: weakness, motor delay, and respiratory and bulbar dysfunction. The myopathies are caused by genetic defects in the contractile apparatus of muscle, and

  3. Innovation in the planning of V-Y rotation advancement flaps: A template for flap design

    Utku Can Dölen

    2018-01-01

    Full Text Available Local flaps exhibit excellent color matching that no other type of flap can compete with. Moreover, surgery using a local flap is easier and faster than surgery using a distant or free flap. However, local flaps can be much more difficult to design. We designed 2 templates to plan a V-Y rotation advancement flap. The template for a unilateral V-Y rotation advancement flap was used on the face (n=5, anterior tibia (n=1, posterior axilla (n=1, ischium (n=1, and trochanter (n=2. The template for a bilateral flap was used on the sacrum (n=8, arm (n=1, and anterior tibia (n=1. The causes of the defects were meningocele (n=3, a decubitus ulcer (n=5, pilonidal sinus (n=3, and skin tumor excision (n=10. The meningocele patients were younger than 8 days. The mean age of the adult patients was 50.4 years (range, 19–80 years. All the donor areas of the flaps were closed primarily. None of the patients experienced wound dehiscence or partial/total flap necrosis. The templates guided surgeons regarding the length and the placement of the incision for a V-Y rotation advancement flap according to the size of the wound. In addition, they could be used for the training of residents.

  4. Kinematics of flagellar swimming in Euglena gracilis: Helical trajectories and flagellar shapes.

    Rossi, Massimiliano; Cicconofri, Giancarlo; Beran, Alfred; Noselli, Giovanni; DeSimone, Antonio

    2017-12-12

    The flagellar swimming of euglenids, which are propelled by a single anterior flagellum, is characterized by a generalized helical motion. The 3D nature of this swimming motion, which lacks some of the symmetries enjoyed by more common model systems, and the complex flagellar beating shapes that power it make its quantitative description challenging. In this work, we provide a quantitative, 3D, highly resolved reconstruction of the swimming trajectories and flagellar shapes of specimens of Euglena gracilis We achieved this task by using high-speed 2D image recordings taken with a conventional inverted microscope combined with a precise characterization of the helical motion of the cell body to lift the 2D data to 3D trajectories. The propulsion mechanism is discussed. Our results constitute a basis for future biophysical research on a relatively unexplored type of eukaryotic flagellar movement. Copyright © 2017 the Author(s). Published by PNAS.

  5. Physiological characterization of gravitaxis in Euglena gracilis and Astasia longa studied on sounding rocket flights.

    Richter, P R; Lebert, M; Tahedl, H; Hader, D P

    2001-01-01

    Euglena gracilis is a photosynthetic, unicellular flagellate found in eutrophic freshwater habitats. The organisms control their vertical position in the water column using gravi- and phototaxis. Recent experiments demonstrated that negative gravitaxis cannot be explained by passive buoyancy but by an active physiological mechanism. During space experiments, the threshold of gravitaxis was determined to be between 0.08 and 0.12 x g. A strong correlation between the applied acceleration and the intracellular cAMP and Ca2+ was observed. The results support the hypothesis, that the cell body of Euglena, which is denser than the surrounding medium exerts a pressure onto the lower membrane and activates mechanosensitive Ca2+ channels. Changes in the membrane potential and the cAMP concentration are most likely subsequent elements in a signal transduction chain, which results in reorientation strokes of the flagellum. c 2001 COSPAR. Published by Elsevier Science Ltd. All rights reserved.

  6. A new homolog of FocA transporters identified in cadmium-resistant Euglena gracilis

    Delomenie, Claudine; Foti, Emilie; Floch, Enora; Diderot, Vimala; Porquet, Dominique; Dupuy, Corinne; Bonaly, Jacqueline

    2007-01-01

    To better understand the cellular mechanism of stress resistance to various pollutants (cadmium, pentachlorophenol), we undertook a survey of the Euglena gracilis transcriptome by mRNA differential display and cDNA cloning. We performed a real-time RT-PCR analysis upon four selected genes. One of them significantly changed its expression level in response to stress treatments: B25 gene was overexpressed in Cd-resistant cells whereas it was down-regulated in PCP-adapted cells. By Race assays we obtained for B25 a 1093 bp cDNA. The deduced protein was identified as a bacterial formate/nitrite transporter (FocA) homolog and the gene was named EgFth. From all the data, we concluded that EgFth overexpression was related to chronic exposure to cadmium

  7. Median forehead flap - beyond classic indication

    Cristian R. Jecan

    2016-11-01

    Full Text Available Introduction. The paramedian forehead flap is one of the best options for reconstruction of the median upper two-thirds of the face due to its vascularity, color, texture match and ability to resurface all or part of the reconstructed area. The forehead flap is the gold standard for nasal soft tissue reconstruction and the flap of choice for larger cutaneous nasal defects having a robust pedicle and large amount of tissue. Materials and Methods. We are reporting a clinical series of cutaneous tumors involving the nose, medial canthus, upper and lower eyelid through a retrospective review of 6 patients who underwent surgical excision of the lesion and primary reconstruction using a paramedian forehead flap. Results. The forehead flap was used for total nose reconstruction, eyelids and medial canthal reconstruction. All flaps survived completely and no tumor recurrence was seen in any of the patients. Cosmetic and functional results were favorable. Conclusions. The forehead flap continues to be one of the best options for nose reconstruction and for closure of surgical defects of the nose larger than 2 cm. Even though is not a gold standard, median forehead flap can be an advantageous technique in periorbital defects reconstruction.

  8. USAGE OF ALGAE SPECIES CHAETOMORPHA GRACILIS AND CH. AEREA FOR DEPURATION PROCESS OF THE RESIDUAL WATERS

    SALARU VICTOR

    2008-11-01

    Full Text Available Rapid increase of the population on the globe scale imposes maximum exploration of the natural resources and first of all of the aquatic resources. As a result are obtained an enormous quantity of residual waters which pollute the waters from rivers, lakes, freatic and underground waters. Elaboration of the depuration methods for residual waters the quantity of which grows continuously, is one of the most up to dated issue of the world. The physical-chemical depuration methods of the residual waters are very expensive and lack the efficiency we would like to have. The most efficient method proved to be the biological method using some species of algae and superior aquatic plants. In our experiences we have involved filamentous green algae Chaetomorpha gracilis and Ch. aerea for depuration of the sewerage water from town Cimishlia. The concentration of the mineral nitrogen compounds in the residual water is around 92,5 mg/l, and of the phosphates 10,1 mg/l. There were used the following concentration of the sewerage water: 10%, 25% and 50%. The most intense development of algae Chaetomorpha aerea was observed in the variant with 10% of residual water, in which the total concentration of the nitrogen was 10,24 mg/l, and of the phosphates 1,05 mg/l. For this variant the depuration water level was about 56,9%. For the case with Chaetomorpha gracilis, the depuration level for the same concentration of the residual water constituted 55,9 %. Increase of the concentration of the polluted water inhibits development of the algae reducing to the minimum their capacity to assimilate the nitrogen and the phosphor. In the solutions with 50 % of residual waters, the algae didn't die, but at the same time they didn't develop. From this results that both algae may be used in the phytoamelioration of the residual waters being diluted at 10% with purified water.

  9. Versatality of Nasolabial Flap in Orofacial Reconstruction

    Nandesh Shetty

    2015-01-01

    Materials and Methods: A total of 10 patients were selected based on the size of surgical defect. Nasolabial flap was used to reconstruct defects of small to moderate size in the oro-facial region and post-operative follow up was done. Results: All of the patients underwent inferiorly based Transposition Island flap for reconstruction of different oro-facial defects. Few complications like bulky size of the flap, slight donor site distortion (scar formation and intra-oral hair growth were seen in six patients. Two incidences of infection in the transferred flap were seen. Conclusion: It is a safe minor procedure done under general anesthesia with good reconstructive results over small or moderately sized maxillofacial defects. Proper attention to flap design, operative technique and post - operative management are useful in reducing the incidence of complications.

  10. Energy management - The delayed flap approach

    Bull, J. S.

    1976-01-01

    Flight test evaluation of a Delayed Flap approach procedure intended to provide reductions in noise and fuel consumption is underway using the NASA CV-990 test aircraft. Approach is initiated at a high airspeed (240 kt) and in a drag configuration that allows for low thrust. The aircraft is flown along the conventional ILS glide slope. A Fast/Slow message display signals the pilot when to extend approach flaps, landing gear, and land flaps. Implementation of the procedure in commercial service may require the addition of a DME navigation aid co-located with the ILS glide slope transmitter. The Delayed Flap approach saves 250 lb of fuel over the Reduced Flap approach, with a 95 EPNdB noise contour only 43% as large.

  11. Amino acids as possible alternative nitrogen source for growth of Euglena gracilis Z in life support systems.

    Richter, P R; Liu, Y; An, Y; Li, X; Nasir, A; Strauch, S M; Becker, I; Krüger, J; Schuster, M; Ntefidou, M; Daiker, V; Haag, F W M; Aiach, A; Lebert, M

    2015-01-01

    In recent times Euglena gracilis Z was employed as primary producer in closed environmental life-support system (CELSS), e.g. in space research. The photosynthetic unicellular flagellate is not capable of utilizing nitrate, nitrite, and urea as nitrogen source. Therefore, ammonium is supplied as an N-source in the lab (provided as diammonium-dihydrogenphosphate, (NH4)2HPO4) to E. gracilis cultures. While nitrate exerts low toxicity to organisms, ammonium is harmful for many aquatic organisms especially, at high pH-values, which causes the ionic NH4+ (low toxicity) to be partially transformed into the highly toxic ammonia, NH3. In earlier reports, Euglena gracilis was described to grow with various amino acids as sole N-source. Our aim was to investigate alternatives for (NH4)2HPO4 as N-source with lower toxicity for organisms co-cultivated with Euglena in a CELSS. The growth kinetics of Euglena gracilis cultures was determined in the presence of different amino acids (glycine, glutamine, glutamic acid, leucine, and threonine). In addition, uptake of those amino acids by the cells was measured. Cell growth in the presence of glycine and glutamine was quite comparable to the growth in (NH4)2HPO4 containing cultures while a delay in growth was observed in the presence of leucine and threonine. Unlike, aforementioned amino acids glutamate consumption was very poor. Cell density and glutamate concentration were almost unaltered throughout the experiment and the culture reached the stationary phase within 8 days. The data are compared with earlier studies in which utilization of amino acids in Euglena gracilis was investigated. All tested amino acids (glutamate with limitations) were found to have the potential of being an alternative N-source for Euglena gracilis. Hence, these amino acids can be used as a non-toxic surrogate for (NH4)2HPO4. Copyright © 2014 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.

  12. Recurrent vulvar carcinoma: complex surgical treatment via perineal excision and reconstruction with musculocutaneous flap

    Dragoș Popa

    2018-04-01

    Full Text Available Vulvar cancer is a malignant disease having a low frequency and with well-established surgical and oncological treatments based on the stage of the disease. The most important therapeutic problem encountered is represented by cases of perineal local regional recurrence, which are common in patients with large primary tumors and can occur even if the margins of the resection had no tumoral invasion. We present a case study of a 64-year-old patient diagnosed one year ago with squamous vulvar carcinoma (G3 for which a vulvectomy was performed after neoadjuvant radiotherapy. The patient later developed local recurrence with invasion of the anal sphincter, creating a delicate problem regarding a surgical approach. The size and the extent of the recurrent tumor required a complex surgical intervention using a mixed surgical team of general surgeons and plastic surgeons. Surgical intervention with a large excision of the recurrent cancer along with amputation of the inferior rectum via perineal route, and creation of a left iliac anus was performed. The perineal defect was covered via a musculocutaneous flap using the gracilis muscle. The immediate post-operative evolution was favorable.

  13. Laser resurfacing of skin flaps: an experimental comparison

    Srdan Babovic

    2011-05-01

    Full Text Available Objective. The influence of Coherent Ultrapulse, TruPulse and Erbium: YAG laser skin resurfacing on survival of the skin flaps when performed simultaneously was evaluated. Material and methods. We used twelve female Yucatan minipigs in the study. Skin flaps including paniculus carnosus were raised on the animals’ back. The flaps were sutured into the defect under tension. We designed 4 experimental groups: Control-Flaps only, Group 2-Flaps + 4 immediate TruPulse laser passes, Group 3-Flaps + 2 immediate Coherent UltraPulse laser passes, Group 4-Flaps – immediate 50J/cm2 total fluence with Erbium: YAG laser. Results. Flap survival in Control group was 98.8%. There was no flap in Group 2 with complete survival. Survival of the flaps in Group 2 (Tru-Pulse ranged from 75-90%, with average flap survival area of 85.2%. In Group 3 (UltraPulse all 24 flaps had some area of necrosis. Flap survival in Group 3 ranged from 75-95%, with an average of 85.6%. In Group 4 (Erbium: YAG flap survival area ranged from 70-95%, with all 24 flaps with some area of necrosis, with average flap survival area of 87.3%. There is a significant statistical difference in flap survival area between groups 2, 3 and 4 versus Control (p<0.001. Conclusion. The results of our study suggest that laser resurfacing of skin flaps sutured under tension in the same operative session is detrimental for skin flap survival. We also found no significant difference in flap survival area between TruPulse, Coherent UltraPulse and Erbium: YAG laser treated flaps.

  14. Wavefront aberrometry and refractive outcomes of flap amputation after LASIK

    Al Saady, Rana L.; van der Meulen, Ivanka J.; Nieuwendaal, Carla P.; Engelbrecht, Leonore A.; Mourits, Maarten P.; Lapid-Gortzak, Ruth

    2014-01-01

    Laser in situ keratomileusis flap amputation was performed in 3 eyes of 2 patients because of flap melt and surface irregularity. In the first patient, a 34-year-old man, flaps were excised after a photorefractive keratectomy retreatment procedure on a previous LASIK flap had been done, secondary to

  15. The Versatile Extended Thoracodorsal Artery Perforator Flap for Breast Reconstruction

    Jacobs, Jordan; Børsen-Koch, Mikkel; Gunnarsson, Gudjon L.

    2016-01-01

    complications occurred in 10 of 106 (10%) cases and included hematoma (1/108), venous congestion (2/108), and partial flap necrosis (7/108). The reconstructive goal was achieved in 103 of 106 (97%) flaps. CONCLUSIONS: The TAP flap is a pedicled, fasciocutaneous flap that can be used for total breast...

  16. Dorsal hand coverage with free serratus fascia flap

    Fotopoulos, Peter; Holmer, Per; Leicht, Pernille

    2003-01-01

    in the flap, leaving the long thoracic nerve intact on the serratus muscle. Coverage of the flap with split-thickness skin graft is done immediately. The free serratus fascia flap is an ideal flap for dorsal hand coverage when the extensor tendons are exposed, especially because of low donor-site morbidity....

  17. A Review Of Pectoralis Major Musculocutaneous Island Flap In ...

    Like microvascular free flaps, pectoralis major flaps can be transferred in a single stage and have largely replaced deltepectoral (Bakanjiam) flap in head and neck reconstruction. This retrospective study was carried out to highlight the usefulness of this flap in different situations. Ten patients, aged six to 55 years operated ...

  18. Total endoscopic free flap harvest of a serratus anterior fascia flap for microsurgical lower leg reconstruction

    Erdmann, Alfons

    2014-04-01

    Full Text Available [english] Background: A tremendous number of free flaps have been developed in the past. As the surgical result depends not only on a successful flap transfer but also on the harvest, this paper details the procedures for undertaking the first total endoscopic harvest of a serratus fascia flap for free flap transplantation to the lower leg. Patient and methods: In September 2012 we performed the first total endoscopic serratus anterior fascia free flap harvest. The incision of 2.5 cm length was made 10 cm in front of anterior muscle border of the latissimus dorsi at level with the midthorax. After insertion of a flexible laparoscopic single port system we started CO gas insufflation. We used this setting to meticulously prepare a neo cavity between atissimus dorsi and M. serratus anterior. The vessels were dissected and the thoraco-dorsal nerve was separated. With a second auxiliary incision we used a clamp to support the raising of the fascia flap from the underlying muscle. Finally we clipped the vessels to the latissimus dorsi muscle and the flap vessels at the Arteria and Vena axillaris. The flap was extracted via the 2.5 cm incision.Results: We were able to perform a total endoscopic harvest of a serratus fascia flap for free flap reconstruction of soft tissues. With this new operative technique we were able to avoid a long skin incision, which in our view lowers the morbidity at the harvest area.Conclusion: We describe a new method for the total endoscopic harvest of the serratus fascia flap for free flap transfer. The flap was harvested within reasonable time and following surgery leaves the patient with minimal donor site morbidity compared to the open technique.

  19. Comparison of gluteal perforator flaps and gluteal fasciocutaneous rotation flaps for reconstruction of sacral pressure sores.

    Chen, Yen-Chou; Huang, Eng-Yen; Lin, Pao-Yuan

    2014-03-01

    The gluteus maximus myocutaneous flap was considered the workhorse that reconstructed sacral pressure sores, but was gradually replaced by fasciocutaneous flap because of several disadvantages. With the advent of the perforator flap technique, gluteal perforator (GP) flap has gained popularity nowadays. The aim of this study was to compare the complications and outcomes between GP flaps and gluteal fasciocutaneous rotation (FR) flaps in the treatment of sacral pressure sores. Between April 2007 and June 2012, 63 patients underwent sacral pressure sore reconstructions, with a GP flap used in 31 cases and an FR flap used in 32 cases. Data collected on the patients included patient age, gender, co-morbidity for being bedridden and follow-up time. Surgical details collected included the defect size, operative time and estimated blood loss. Complications recorded included re-operation, dehiscence, flap necrosis, wound infection, sinus formation, donor-site morbidity and recurrence. The complications and clinical outcomes were compared between these two groups. We found that there was no significant difference in patient demographics, surgical complications and recurrence between these two groups. In gluteal FR flap group, all recurrent cases (five) were treated by reuse of previous flaps. Both methods are comparable, good and safe in treating sacral pressure sores. Gluteal FR flap can be performed without microsurgical dissection, and re-rotation is feasible in recurrent cases. The authors suggest using gluteal FR flaps in patients with a high risk of sore recurrence. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. A Study of CAP-1002 in Ambulatory and Non-Ambulatory Patients With Duchenne Muscular Dystrophy

    2018-04-17

    Muscular Dystrophies; Muscular Dystrophy, Duchenne; Muscular Disorders, Atrophic; Muscular Diseases; Neuromuscular Diseases; Nervous System Diseases; Genetic Diseases, X-Linked; Genetic Diseases, Inborn

  1. Hydrodynamic schooling of flapping swimmers

    Becker, Alexander D.; Masoud, Hassan; Newbolt, Joel W.; Shelley, Michael; Ristroph, Leif

    2015-01-01

    Fish schools and bird flocks are fascinating examples of collective behaviours in which many individuals generate and interact with complex flows. Motivated by animal groups on the move, here we explore how the locomotion of many bodies emerges from their flow-mediated interactions. Through experiments and simulations of arrays of flapping wings that propel within a collective wake, we discover distinct modes characterized by the group swimming speed and the spatial phase shift between trajectories of neighbouring wings. For identical flapping motions, slow and fast modes coexist and correspond to constructive and destructive wing-wake interactions. Simulations show that swimming in a group can enhance speed and save power, and we capture the key phenomena in a mathematical model based on memory or the storage and recollection of information in the flow field. Lastly, these results also show that fluid dynamic interactions alone are sufficient to generate coherent collective locomotion, and thus might suggest new ways to characterize the role of flows in animal groups

  2. Hydrodynamic schooling of flapping swimmers

    Becker, Alexander D.; Masoud, Hassan; Newbolt, Joel W.; Shelley, Michael; Ristroph, Leif

    2015-10-01

    Fish schools and bird flocks are fascinating examples of collective behaviours in which many individuals generate and interact with complex flows. Motivated by animal groups on the move, here we explore how the locomotion of many bodies emerges from their flow-mediated interactions. Through experiments and simulations of arrays of flapping wings that propel within a collective wake, we discover distinct modes characterized by the group swimming speed and the spatial phase shift between trajectories of neighbouring wings. For identical flapping motions, slow and fast modes coexist and correspond to constructive and destructive wing-wake interactions. Simulations show that swimming in a group can enhance speed and save power, and we capture the key phenomena in a mathematical model based on memory or the storage and recollection of information in the flow field. These results also show that fluid dynamic interactions alone are sufficient to generate coherent collective locomotion, and thus might suggest new ways to characterize the role of flows in animal groups.

  3. Redescription of the Indo-West Pacific cardinalfishes (Perciformes: Apogonidae) Rhabdamia spilota Allen Kuiter 1994 and R. gracilis (Bleeker 1856).

    Yoshida, Tomohiro; Motomura, Hiroyuki

    2018-01-31

    Rhabdamia spilota Allen Kuiter 1994 (Apogonidae), a poorly known cardinalfish previously known only from the Philippines, Indonesia and the Red Sea, is redescribed on the basis of 70 specimens (20.9-61.2 mm standard length) (including types), from the Indo-West Pacific (Red Sea, Andaman Sea, Japan, South China Sea, the Philippines, Indonesia, New Caledonia, and Australia). Because most reports of the similar species R. gracilis (Bleeker 1856), following its original description, were based on misidentifications, R. gracilis is also redescribed (based on 98 Indo-West Pacific specimens from Seychelles, Maldives, Andaman Sea, Japan, Malaysia, Indonesia, New Caledonia, and Australia, 27.9-59.3 mm standard length); a lectotype is designated for it. Rhabdamia spilota differs from R. gracilis in having 27-33 (mode 30-31) developed gill rakers [vs. 22-27 (mode 24) in the latter], 27-33 (30) gill rakers including rudiments [vs. 23-27 (24-25)], a black stripe from the jaw tips to the anterior margin of the orbit (vs. black pigments only at snout and tip of lower jaw), 3-6 reddish brown to blackish blotches on the opercle and anterior of body (vs. blotches absent), and indistinct black pigment restricted to caudal fin outer margins (vs. pigment scattered over entire fin). Rhabdamia gracilis exhibits sexual dichromatism, female specimens larger than 41.3 mm SL having one or two black stripes on the lateral surface of the body; the stripes are absent in males and smaller females. No evidence of sexual dichromatism was found in R. spilota.

  4. Arthroscopic intra- and extra-articular anterior cruciate ligament reconstruction with gracilis and semitendinosus tendons: a review

    Marcacci, Maurilio; Zaffagnini, Stefano; Marcheggiani Muccioli, Giulio Maria; Neri, Maria Pia; Bondi, Alice; Nitri, Marco; Bonanzinga, Tommaso; Grassi, Alberto

    2011-01-01

    The purposes of this paper are to summarize the concepts relating to the use of a combined intra-articular and extra-articular reconstructive procedure in the arthroscopic treatment of a torn ACL and to review several operative techniques utilizing gracilis and semitendinosus tendons that are currently in use to treat this instability. The highly satisfactory results obtained over the time show that a combination of intra- and extra-articular procedures for ACL reconstruction is a valid surgi...

  5. Influence of gamma radiation and fast neutrons on the growth of Haplopappus gracilis (Nutt) A. Gray callus

    Cebulska-Wasilewska, A.; Wajda, L.; Korzonek, M.; Polska Akademia Nauk, Krakow. Inst. Fizjologii Roslin)

    1979-01-01

    The sensitivity of the callus of Haplopappus gracilis to gamma radiation and fast neutrons was studied. High doses of radiation cause inhibition of callus growth. At small doses the effect is less pronounced. Stimulation of callus growth was seen. Apart from morphological changes, ionizing radiations lowered the fresh weight ratio of the callus. The RBE value for 5.5 MeV neutrons depended on the dose rate of radiation and the combination of growth medium. (author)

  6. Boomerang flap reconstruction for the breast.

    Baumholtz, Michael A; Al-Shunnar, Buthainah M; Dabb, Richard W

    2002-07-01

    The boomerang-shaped latissimus dorsi musculocutaneous flap for breast reconstruction offers a stable platform for breast reconstruction. It allows for maximal aesthetic results with minimal complications. The authors describe a skin paddle to obtain a larger volume than either the traditional elliptical skin paddle or the extended latissimus flap. There are three specific advantages to the boomerang design: large volume, conical shape (often lacking in the traditional skin paddle), and an acceptable donor scar. Thirty-eight flaps were performed. No reconstruction interfered with patient's ongoing oncological regimen. The most common complication was seroma, which is consistent with other latissimus reconstructions.

  7. Breast reconstruction - natural tissue

    ... flap; TRAM; Latissimus muscle flap with a breast implant; DIEP flap; DIEAP flap; Gluteal free flap; Transverse upper gracilis flap; TUG; Mastectomy - breast reconstruction with natural tissue; Breast cancer - breast reconstruction with natural tissue

  8. Cultivo de Ankistrodesmus gracilis (Chlorophyta em laboratório à base de esterco suíno

    Tatiana Betioli Fioresi

    2008-01-01

    Full Text Available http://dx.doi.org/10.5007/2175-7925.2008v21n1p7 O objetivo do presente trabalho foi testar a influência do meio à base de esterco suíno “in natura” e biodigerido, sobre o desenvolvimento, crescimento, comprimento total, peso seco e valor nutricional da microalga Ankistro desmus gracilis. O pico de crescimento para A. gracilis foi maior no meio biodigerido (6,2 x 107 células. mL-1 no volume de 2L. Alta porcentagem de lipídio foi observada no meio “in natura”, e, elevados teores de proteína no meio biodigerido em 2L. O biovolume, teor de cinzas e comprimento total foram diferentes (p 0,05. O requerimento de luz foi diferente entre os meios, com menor intensidade para o esterco biodigerido (13,5μE.cm-2.s-1, indicando menor custo benefício. O meio a base de esterco suíno, mostrou bons resultados para o crescimento de A. gracilis, com qualidade de água adequada para cultivo, podendo ser utilizado para cultura em larga escala.

  9. Management of fourth degree obstetric perineal tear without colostomy using non - stimulated gracilis - our experience over eleven years

    Jiten Kulkarni

    2016-01-01

    Full Text Available Background: Although gracilis muscle transposition for faecal incontinence has been well-described method, its literature for use in obstetric perineal tear without colostomy is sparse. In this study, we have tried to analyse its use in fourth-degree obstetric perineal tears. Patients and Methods: A total of 30 patients with recto-vaginal fistula with faecal incontinence secondary to obstetric perineal tear were retrospectively studied between February 2003 and May 2014. The recto-vaginal fistula was explored, dissected and identification of sphincters was done using muscle stimulator. Fistula closure was done followed by sphincter repair, vaginal tightening procedure and single gracilis transposition. None of the patients had covering colostomy. Faecal incontinence was assessed pre- and post-operatively by digital rectal examination (single examiner, Park's score and Corman's score in all cases and using barium hold and transperineal ultrasonography, manometric studies in a few cases. The outcome was measured at an average follow-up of 8.8 months (7–24 months. Results: As per Park's score 26 patients had Grade I continence, two had Grade II and two patients had Grade III continence. Corman's score improved from fair to excellent in 26 patients. The patients in whom manometry was performed showed a remarkable rise in both resting and squeeze pressures. Two patients developed post-operative infections in upper 1/3 thigh incision site and three patients at gluteal region scar site. Conclusion: Satisfactory continence following gracilis muscle could be achieved.

  10. Effects of the essential oil of Lippia gracilis Schauer on caulinary shoots of heliconia cultivated in vitro Efeito do óleo essencial de Lippia gracilis Schauer sobre ápices caulinares de heliconia cultivadas in vitro

    C.C. Albuquerque

    2012-01-01

    Full Text Available The effects of thymol and carvacrol and the essential oil of Lippia gracilis on caulinary shoots of heliconia were evaluated. After disinfection, the shoots were inoculated into MS medium and subjected to the treatments with 420 µL L-1 of essential oil (EO of L. gracilis; 420 µL L-1 of thymol; 420 µL L-1 of carvacrol; 210 µL L-1 of thymol and 210 µL L-1 of carvacrol. The control treatment consisted of the MS medium without any phytoregulators. The main components of EO from L. gracilis are carvacrol, ρ-cimene, and thymol. Seven days after the initiation of the experiments, 36.3% of the control treatment shoots were necrotized, but 90% of the caulinary shoots exposed to EO, thymol, or carvacrol appeared necrotized. Transmission electron microscopy of the shoots revealed that the treatment with EO, thymol, or carvacrol caused the destruction of the plasma cell membranes, and the cell organelles and the nucleus were hardly evident. The EO and its main constituent were toxic to caulinary shoots of heliconia.O efeito do timol, carvacrol e óleo essencial de Lippia gracilis foi observado sobre ápices caulinares de heliconia. Após a desinfestação os ápices foram inoculados em meio MS com os tratamentos de 420 µL L-1 do óleo essencial (OE de L. gracilis; 420 µL L-1 de timol; 420 µL L-1 de carvacrol; 210 µg L-1 de timol e 210 µL L-1 de carvacrol. O tratamento controle consistiu de meio MS sem fitorreguladores. Os principais componentes do OE foram carvacrol, ρ-cimeno e timol. Sete dias após o início do experimento 36,3% dos ápices submetidos ao tratamento controle e 90% dos ápices caulinares expostos ao EO, timol ou carvacrol necrosaram. A microscopia eletrônica de transmissão dos ápices caulinares revelou que os tratamentos com OE, timol e carvacrol provocaram desestruturação da membrana plasmática das células. As organelas e o núcleo não estavam evidentes. O OE e seus principais constituintes foram tóxico para os

  11. Lesiones musculares en el deporte. Muscular injuries in sport.

    Jiménez Díaz, José Fernando

    2006-04-01

    Full Text Available ResumenDurante la práctica de la actividad física hay una gran incidencia de lesiones musculares, si bien se han llevado a cabo pocos estudios clínicos sobre el tratamiento y la resolución de las mismas. Desde el punto de vista etiopatogénico, hay que señalar que la incidencia de lesión es mayor en aquellos músculos poliarticulares en condiciones de acumulación de fatiga y con condiciones ambientales desfavorables. La clasificación de las lesiones musculares permite distinguir entre aquellas que no afectan a la fascia produciéndose un sangrado dentro del mismo (intramuscular o bien si la fascia también se rompe, el sangrado se sitúa entre los diferentes músculos (intermuscular. El tratamiento de estas lesiones se realizará combinando reposo, compresión, aplicación de frío y elevación del área lesionada así como el desarrollo de un adecuado programa de readaptación funcional que permita al jugador incorporarse lo antes posible a la dinámica del equipo. En la actualidad se está llevando a cabo opciones terapéuticas con factores de crecimiento, terapia génica y células madre, si bien todavía no están lo suficientemente desarrolladas.AbstractDuring the practice of the physical activity there is a great effect of muscular injuries, though few clinical studies have been carried out on the treatment and the resolution of the same ones. Inside the reasons it is necessary to indicate that the effect of injury is major in those muscles you will polyarticulate in situation of fatigue and with environmental unfavorable conditions.The classification of the muscular injuries allows to distinguish between those that do not affect the fascia producing the bled intramuscular or if the fascia also breaks, the bled one places between the different muscles (intermuscular.The treatment will be realized combining rest, compression, application of cold and elevation of these injuries as well as the development of a program of functional

  12. Face resurfacing using a cervicothoracic skin flap prefabricated by lateral thigh fascial flap and tissue expander.

    Li, Qingfeng; Zan, Tao; Gu, Bin; Liu, Kai; Shen, Guoxiong; Xie, Yun; Weng, Rui

    2009-01-01

    Resurfacing of facial massive soft tissue defect is a formidable challenge because of the unique character of the region and the limitation of well-matched donor site. In this report, we introduce a technique for using the prefabricated cervicothoracic skin flap for facial resurfacing, in an attempt to meet the principle of flap selection in face reconstructive surgery for matching the color and texture, large dimension, and thinner thickness (MLT) of the recipient. Eleven patients with massive facial scars underwent resurfacing procedures with prefabricated cervicothoracic flaps. The vasculature of the lateral thigh fascial flap, including the descending branch of the lateral femoral circumflex vessels and the surrounding muscle fascia, was used as the vascular carrier, and the pedicles of the fascial flap were anastomosed to either the superior thyroid or facial vessels in flap prefabrication. A tissue expander was placed beneath the fascial flap to enlarge the size and reduce the thickness of the flap. The average size of the harvested fascia flap was 6.5 x 11.7 cm. After a mean interval of 21.5 weeks, the expanders were filled to a mean volume of 1,685 ml. The sizes of the prefabricated skin flaps ranged from 12 x 15 cm to 15 x 32 cm. The prefabricated skin flaps were then transferred to the recipient site as pedicled flaps for facial resurfacing. All facial soft tissue defects were successfully covered by the flaps. The donor sites were primarily closed and healed without complications. Although varied degrees of venous congestion were developed after flap transfers, the marginal necrosis only occurred in two cases. The results in follow-up showed most resurfaced faces restored natural contour and regained emotional expression. MLT is the principle for flap selection in resurfacing of the massive facial soft tissue defect. Our experience in this series of patients demonstrated that the prefabricated cervicothoracic skin flap could be a reliable alternative

  13. Power performance optimization and loads alleviation with active flaps using individual flap control

    Pettas, Vasilis; Barlas, Athanasios; Gertz, Drew Patrick

    2016-01-01

    the sensor inputs. The AEP is increased due to the upscaling but also further due to the flap system while the fatigue loads in components of interest (blade, tower, nacelle and main bearing) are reduced close to the level of the original turbine. The aim of this study is to demonstrate a simple....... In an industrial-oriented manner the baseline rotor is upscaled by 5% and the ATEFs are implemented in the outer 30% of the blades. The flap system is kept simple and robust with a single flap section and control with wind speed, rotor azimuth, root bending moments and angle of attack in flap's mid-section being...

  14. Distribution of skeletal muscle involvement in autosomal recessive distal muscular dystrophy. A clinical and computed tomographic study

    Mizusawa, Hidehiro; Nakanishi, Takao; Kobayashi, Fumie

    1987-02-01

    Distribution of skeletal muscle involvement in 5 cases with autosomal recessive distal muscular dystrophy was studied clinically and by computed tomography (CT). Manual muscle test showed muscle involvement with a predilection for flexors in the lower leg and adductors in the thigh. Flexion and extension of the thigh and the lower leg was impaired to similar degree. In progressed cases, neck flexors and trunk muscles were also affected mildly. CT disclosed more clearly the preferential involvement of flexors in the lower leg, and involvement of both hamstrings center dot adductors group and extensors group of the thigh to similar degree. However, m. popliteus was curiously well preserved. In addition, there was a stage showing high density and hypertrophy of m. sartorius, m. gracilis, m. adductor, m. biceps femoris, m. semimenbranosus, m. semitendinosus or m. rectus femoris, which in thought to be compensatory hypertrophy. M. gluteus minimus in the pelvic girdle and m. dorsi proprii in the trunk were also liable to be affected. The CT findings are regarded as characteristic features noted clearly before muscle weakness and atrophy become apparent clinically. CT is very useful for distinguishing distal muscular dystrophy from rimmed vacuolar distal myopathy in which m. quadriceps femoris and flexors of the lower leg are usually well preserved without compensatory hypertrophy on CT.

  15. Route Flap Damping Made Usable

    Pelsser, Cristel; Maennel, Olaf; Mohapatra, Pradosh; Bush, Randy; Patel, Keyur

    The Border Gateway Protocol (BGP), the de facto inter-domain routing protocol of the Internet, is known to be noisy. The protocol has two main mechanisms to ameliorate this, MinRouteAdvertisementInterval (MRAI), and Route Flap Damping (RFD). MRAI deals with very short bursts on the order of a few to 30 seconds. RFD deals with longer bursts, minutes to hours. Unfortunately, RFD was found to severely penalize sites for being well-connected because topological richness amplifies the number of update messages exchanged. So most operators have disabled it. Through measurement, this paper explores the avenue of absolutely minimal change to code, and shows that a few RFD algorithmic constants and limits can be trivially modified, with the result being damping a non-trivial amount of long term churn without penalizing well-behaved prefixes' normal convergence process.

  16. Postirradiation flap infection about the oral cavity

    Cabbabe, E.B.; Herbold, D.R.; Sunwoo, Y.C.; Baroudi, I.F.

    1983-01-01

    Postirradiation alteration of oral flora is well documented in the literature. Infection as a complication leading to partial or complete loss of a flap used to reconstruct a defect in the oral cavity is a worrisome outcome. We describe how a flap that was judged clinically to be viable became overwhelmingly infected with the Klebsiella oxytoca, an oral cavity pathogen encountered in this patient following irradiation. Local and systemic changes led to detachment of the flap. This complication may be explained, in view of the absence of venous congestion or arterial ischemia both clinically and pathologically, by the proven contamination of the flap by the Klebsiella pathogen. Local factors resulted in lower resistance and subsequent overwhelming infection. Discussion of the case, review of pertinent literature, and proposed solutions are presented

  17. Muscular Calf Injuries in Runners.

    Fields, Karl B; Rigby, Michael D

    2016-01-01

    Calf pain is a common complaint among runners of all ages but is most frequent in masters athletes. This article focuses on injuries to the triceps surae or true 'calf muscles.' The most common calf injury is a tear of the medial gastrocnemius muscle (Tennis Leg) but other structures including the lateral gastrocnemius, plantaris and soleus also may be the cause of muscular pain. This article looks at the presentation, evaluation, and treatment of these injuries. We also highlight some examples of musculoskeletal ultrasound which is a valuable tool for rapid diagnosis of the cause and extent of injury.

  18. Genetics Home Reference: Duchenne and Becker muscular dystrophy

    ... Conditions Duchenne and Becker muscular dystrophy Duchenne and Becker muscular dystrophy Printable PDF Open All Close All Enable Javascript ... dystrophy occur almost exclusively in males. Duchenne and Becker muscular dystrophies have similar signs and symptoms and are caused ...

  19. The role of postoperative hematoma on free flap compromise.

    Ahmad, Faisal I; Gerecci, Deniz; Gonzalez, Javier D; Peck, Jessica J; Wax, Mark K

    2015-08-01

    Hematomas may develop in the postoperative setting after free tissue transfer. When hematomas occur, they can exert pressure on surrounding tissues. Their effect on the vascular pedicle of a free flap is unknown. We describe our incidence of hematoma in free flaps and outcomes when the flap is compromised. Retrospective chart review of 1,883 free flaps performed between July 1998 and June 2014 at a tertiary referral center. Patients with free flap compromise due to hematoma were identified. Etiology, demographic data, and outcomes were evaluated. Eighty-eight (4.7%) patients developed hematomas. Twenty (22.7%) of those had flap compromise. Twelve compromises (60%) showed evidence of pedicle thrombosis. The salvage rate was 75% versus 54% in 79 flaps with compromise from other causes (P = .12). Mean time to detection of the hematoma was 35.3 hours in salvaged flaps compared to 91.6 hours in unsalvageable flaps (P = .057). Time to operating room (OR) from detection was 2.8 hours in salvageable flaps compared to 12.4 hours in nonsalvageable flaps (P = .053). The salvage rate for flaps that returned to the OR in hematomas developed rarely. When they did, 23% went on to develop flap compromise. Prompt recognition and re-exploration allowed for a high salvage rate. Vessel thrombosis predicted inability to salvage the flap. 4 © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Compositional analysis of muscle in boys with Duchenne muscular dystrophy using MR imaging

    Marden, Franklin A.; Siegel, Marilyn J.; Rubin, David A. [Mallinckrodt Institute of Radiology at Washington University Medical Center, St. Louis (United States); Barnes-Jewish Hospital, Department of Radiology, St. Louis (United States); Connolly, Anne M. [St. Louis Children' s Hospital, Department of Pediatrics, St. Louis (United States); Barnes-Jewish Hospital, Washington University School of Medicine, Department of Neurology, 660 S. Euclid, Box 8111, St. Louis (United States)

    2005-03-01

    Boys with Duchenne muscular dystrophy (DMD) present by age 5 years with weakness and, untreated, stop walking unaided by age 10 or 11 years. We used magnetic resonance (MR) imaging to study age-related changes in the composition and distribution of diseased muscles. Eleven boys (mean 7.1{+-}1.6 years) with DMD underwent clinical and MR examinations. Quantitative muscle strength and timed functional testing was performed. Thigh muscles were scanned at three levels (hip, mid-thigh, and knee) using T1-weighted spin echo and short-tau inversion recovery (STIR) sequences. Outcome measures included intramuscular fatty infiltration, intermuscle fat deposition, edema, and muscle size. Ten boys completed the study. Older boys demonstrated more prominent fatty infiltration of muscles. Fatty infiltration occurred in a characteristic pattern with the gluteus and adductor magnus muscles most commonly involved and the gracilis most commonly spared. Similarly, patchy increases in free water content suggested a pattern of intramuscular edema or inflammation. Atrophy occurred in muscles heavily infiltrated with fat, and true hypertrophy selectively occurred in those that were spared. While fibrofatty changes have been described in DMD, this study further defines differential involvement and additionally suggests widespread edema or inflammation. Improved imaging techniques to quantify the degree and distribution of these changes may provide a basis for exploring mechanisms of action of medications and perhaps another means for selecting treatment regimens and monitoring their effects. (orig.)

  1. Compositional analysis of muscle in boys with Duchenne muscular dystrophy using MR imaging

    Marden, Franklin A.; Siegel, Marilyn J.; Rubin, David A.; Connolly, Anne M.

    2005-01-01

    Boys with Duchenne muscular dystrophy (DMD) present by age 5 years with weakness and, untreated, stop walking unaided by age 10 or 11 years. We used magnetic resonance (MR) imaging to study age-related changes in the composition and distribution of diseased muscles. Eleven boys (mean 7.1±1.6 years) with DMD underwent clinical and MR examinations. Quantitative muscle strength and timed functional testing was performed. Thigh muscles were scanned at three levels (hip, mid-thigh, and knee) using T1-weighted spin echo and short-tau inversion recovery (STIR) sequences. Outcome measures included intramuscular fatty infiltration, intermuscle fat deposition, edema, and muscle size. Ten boys completed the study. Older boys demonstrated more prominent fatty infiltration of muscles. Fatty infiltration occurred in a characteristic pattern with the gluteus and adductor magnus muscles most commonly involved and the gracilis most commonly spared. Similarly, patchy increases in free water content suggested a pattern of intramuscular edema or inflammation. Atrophy occurred in muscles heavily infiltrated with fat, and true hypertrophy selectively occurred in those that were spared. While fibrofatty changes have been described in DMD, this study further defines differential involvement and additionally suggests widespread edema or inflammation. Improved imaging techniques to quantify the degree and distribution of these changes may provide a basis for exploring mechanisms of action of medications and perhaps another means for selecting treatment regimens and monitoring their effects. (orig.)

  2. Triple flap technique for vulvar reconstruction.

    Mercut, R; Sinna, R; Vaucher, R; Giroux, P A; Assaf, N; Lari, A; Dast, S

    2018-04-09

    Perineal defects are encountered ever more frequently, in the treatment of vulvar cancers or abdominoperineal resection. The surgical treatment of vulvar cancer leads to significant skin defect. The aim of the reconstruction is not to provide volume but rather to resurface perineum. We propose a new solution to cover the extensive skin defect remaining after excision. We report 3 patients who underwent large excision for vulvar cancer, with lymph node dissection. For reconstruction, we performed 3 advancement flaps. Two V-Y flaps cantered on the infra-gluteal folds and based on pudendal perforator arteries were used to cover the postero-lateral parts of the defect. The third advancement flap from the superior aspect of the defect was a Y-V Mons pubis flap. The defects were successfully covered by the 3 flap technique. The first patient suffered a non-union that slowly healed by secondary intention. For the other cases, we used the same technique, but applied negative pressure wound therapy on the sutures, with excellent results. The 3 flap technique is a simple and reliable method and the donor site morbidity is minimal. It can be realised without changing the position of the patient after tumour excision, and does not require delicate perforator dissection. This surgical option can be easily applied, allowing better management of these cases. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  3. Dipteran larvae and microbes facilitate nutrient sequestration in the Nepenthes gracilis pitcher plant host.

    Lam, Weng Ngai; Chong, Kwek Yan; Anand, Ganesh S; Tan, Hugh Tiang Wah

    2017-03-01

    The fluid-containing traps of Nepenthes carnivorous pitcher plants (Nepenthaceae) are often inhabited by organisms known as inquilines. Dipteran larvae are key components of such communities and are thought to facilitate pitcher nitrogen sequestration by converting prey protein into inorganic nitrogen, although this has never been demonstrated in Nepenthes Pitcher fluids are also inhabited by microbes, although the relationship(s) between these and the plant is still unclear. In this study, we examined the hypothesis of digestive mutualism between N. gracilis pitchers and both dipteran larvae and fluid microbes. Using dipteran larvae, prey and fluid volumes mimicking in situ pitcher conditions, we conducted in vitro experiments and measured changes in available fluid nitrogen in response to dipteran larvae and microbe presence. We showed that the presence of dipteran larvae resulted in significantly higher and faster releases of ammonium and soluble protein into fluids in artificial pitchers, and that the presence of fluid microbes did likewise for ammonium. We showed also that niche segregation occurs between phorid and culicid larvae, with the former fragmenting prey carcasses and the latter suppressing fluid microbe levels. These results clarify the relationships between several key pitcher-dwelling organisms, and show that pitcher communities facilitate nutrient sequestration in their host. © 2017 The Author(s).

  4. Expression and characterization of plant aspartic protease nepenthesin-1 from Nepenthes gracilis.

    Kadek, Alan; Tretyachenko, Vyacheslav; Mrazek, Hynek; Ivanova, Ljubina; Halada, Petr; Rey, Martial; Schriemer, David C; Man, Petr

    2014-03-01

    Carnivorous plants of the genus Nepenthes produce their own aspartic proteases, nepenthesins, to digest prey trapped in their pitchers. Nepenthesins differ significantly in sequence from other aspartic proteases in the animal or even plant kingdoms. This difference, which also brings more cysteine residues into the structure of these proteases, can be a cause of uniquely high temperature and pH stabilities of nepenthesins. Their detailed structure characterization, however, has not previously been possible due to low amounts of protease present in the pitcher fluid and also due to limited accessibility of Nepenthes plants. In the present study we describe a convenient way for obtaining high amounts of nepenthesin-1 from Nepenthes gracilis using heterologous production in Escherichia coli. The protein can be easily refolded in vitro and its characteristics are very close to those described for a natural enzyme isolated from the pitcher fluid. Similarly to the natural enzyme, recombinant nepenthesin-1 is sensitive to denaturing and reducing agents. It also has maximal activity around pH 2.5, shows unusual stability at high pH and its activity is not irreversibly inhibited even after prolonged incubation in the basic pH range. On the other hand, temperature stability of the recombinant enzyme is lower in comparison with the natural enzyme, which can be attributed to missing N-glycosylation in the recombinant protein. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Protein synthesis during the initial phase of the temperature-induced bleaching response in Euglena gracilis

    Ortiz, W.

    1990-01-01

    Growing cultures of photoheterotrophic Euglena gracilis experience an increase in chlorophyll accumulation during the initial phase of the temperature-induced bleaching response suggesting an increase in the synthesis of plastid components at the bleaching temperature of 33 degree C. A primary goal of this work was to establish whether an increase in the synthesis of plastid proteins accompanies the observed increase in chlorophyll accumulation. In vivo pulse-labeling experiments with [ 35 S]sodium sulfate were carried out with cells grown at room temperature or at 33 degree C. The synthesis of a number of plastid polypeptides of nucleocytoplasmic origin, including some presumably novel polypeptides, increased in cultures treated for 15 hours at 33 degree C. In contrast, while synthesis of thylakoid proteins by the plastid protein synthesis machinery decreased modestly, synthesis of the large subunit of the enzyme ribulosebisphosphate carboxylase was strongly affected at the elevated temperature. Synthesis of novel plastid-encoded polypeptides was not induced at the bleaching temperature. It is concluded that protein synthesis in plastids declines during the initial phase of the temperature response in Euglena despite an overall increase in cellular protein synthesis and an increase in chlorophyll accumulation per cell

  6. Gravitactic orientation of Euglena gracilis – a sensitive endpoint for ecotoxicological assessment of water pollutants

    Aziz eUllah

    2013-12-01

    Full Text Available Pollution of aquatic environments with natural and anthropogenically produced substances is one of the major environmental problems of the world. In many countries the decreasing quantity of water coupled with its increasing usage in multiple sectors has adversely affected water quality and caused problems of water pollution. Polluted water has been a main cause of adverse effects on plants, animals and humans throughout the world. Physicochemical analysis of water, which is a common method used for quality assessment of water, alone may not be enough as it cannot evaluate the impact on living organisms. Therefore, bioassessment of water and wastewater quality is considered to be essential to reflect the ultimate effects on living organisms. Many organisms like bacteria, algae, fish, invertebrates and protozoan are used as bioassay organisms for assessment of water quality. This review article elucidates the use of Euglena gracilis, a freshwater motile flagellate of the phylum Euglenophyta, as a suitable organism in ecotoxicological studies with special emphasis on its gravitactic orientation as a sensitive end point in ecotoxicological assessment of water pollutants.

  7. Isolation and Characterization of Silaffin that Catalyze Biosilica Formation from Marine Diatom Chaetoceros gracilis

    AGNES IMELDA MANURUNG

    2007-09-01

    Full Text Available The method of making silica in industries requires extreme conditions. The finding of proteins involved in the formation of biosilica from diatoms, has opened up an alternative way of production. Chaetoceros gracilis is one of the diatoms, which is potential in producing silaffin protein. This study aimed to isolate and to characterize the protein. We also analyzed the protein activity toward tetraethoxyorthosilicate (TEOS substrate in in vitro reaction. Diatom biomass was harvested and further kept in 2% SDS/100 mM EDTA solution. Protein isolation was conducted by dissolving the silica and separating the protein by soaking in 2 M HF/8 M NH4F. Protein concentration was analyzed using Bradford method and the molecular weight was estimated through SDS-PAGE. Protein activity was observed by reacting it with TEOS substrate to form silica polymer and measured by colorimetric molibdate assay. Protein concentration was 1.20 mg/ml and appeared filamentous. The apparent molecular weights consisted of 12, 23, 42, 44 kDa. These protein was able to polymerize the silica at room temperature within 10 min. As much as 85.65 μmol TEOS was polymerized per 1.4 × 106 silaffin protein per min. SEM analysis showed the formation of spherical, aggregate biosilica.

  8. Isolation and Characterization of Silaffin that Catalyze Biosilica Formation from Marine Diatom Chaetoceros gracilis

    AGNES IMELDA MANURUNG

    2007-09-01

    Full Text Available The method of making silica in industries requires extreme conditions. The finding of proteins involved in the formation of biosilica from diatoms, has opened up an alternative way of production. Chaetoceros gracilis is one of the diatoms, which is potential in producing silaffin protein. This study aimed to isolate and to characterize the protein. We also analyzed the protein activity toward tetraethoxyorthosilicate (TEOS substrate in in vitro reaction. Diatom biomass was harvested and further kept in 2% SDS/100 mM EDTA solution. Protein isolation was conducted by dissolving the silica and separating the protein by soaking in 2 M HF/8 M NH4F. Protein concentration was analyzed using Bradford method and the molecular weight was estimated through SDS-PAGE. Protein activity was observed by reacting it with TEOS substrate to form silica polymer and measured by colorimetric molibdate assay. Protein concentration was 1.20 mg/ml and appeared filamentous. The apparent molecular weights consisted of 12, 23, 42, 44 kDa. These protein was able to polymerize the silica at room temperature within 10 min. As much as 85.65 mol TEOS was polymerized per 1.4 x 106 silaffin protein per min. SEM analysis showed the formation of spherical, aggregate biosilica.

  9. Low-resolution characterization of the 3D structure of the Euglena gracilis photoreceptor

    Barsanti, Laura; Coltelli, Primo; Evangelista, Valtere; Passarelli, Vincenzo; Frassanito, Anna Maria; Vesentini, Nicoletta; Gualtieri, Paolo

    2008-01-01

    This paper deals with the first characterization of the structure of the photoreceptive organelle of the unicellular alga Euglena gracilis (Euglenophyta). This organelle has a three-dimensional organization consisting of up to 50 closely stacked membrane lamellae. Ionically induced unstacking of the photoreceptor lamellae revealed ordered arrays well suited to structural analysis by electron microscopy and image analysis, which ultimately yielded a low-resolution picture of the structure. Each lamella is formed by the photoreceptive membrane protein of the cell assembled within the membrane layer in a hexagonal lattice. The first order diffraction spots in the calculated Fourier transform reveals the presence of 6-fold symmetrized topography (better resolution about 90 A). The 2D and 3D structural data are very similar with those recently published on proteorodopsin, a membrane protein used by marine bacterio-plankton as light-driven proton pump. In our opinion these similarity indicate that a photoreceptive protein belonging to the same superfamily of proteorodopsin could form the Euglena photoreceptor

  10. Pedal proportions of Poposaurus gracilis: convergence and divergence in the feet of archosaurs.

    Farlow, James O; Schachner, Emma R; Sarrazin, John Cody; Klein, Hendrik; Currie, Philip J

    2014-06-01

    The crocodile-line basal suchian Poposaurus gracilis had body proportions suggesting that it was an erect, bipedal form like many dinosaurs, prompting questions of whether its pedal proportions, and the shape of its footprint, would likewise "mimic" those of bipedal dinosaurs. We addressed these questions through a comparison of phalangeal, digital, and metatarsal proportions of Poposaurus with those of extinct and extant crocodile-line archosaurs, obligate or facultatively bipedal non-avian dinosaurs, and ground birds of several clades, as well as a comparison of the footprint reconstructed from the foot skeleton of Poposaurus with known early Mesozoic archosaurian ichnotaxa. Bivariate and multivariate analyses of phalangeal and digital dimensions showed numerous instances of convergence in pedal morphology among disparate archosaurian clades. Overall, the foot of Poposaurus is indeed more like that of bipedal dinosaurs than other archosaur groups, but is not exactly like the foot of any particular bipedal dinosaur clade. Poposaurus likely had a digitigrade stance, and its footprint shape could have resembled grallatorid ichnotaxa, unless digit I of the foot of Poposaurus commonly left an impression. Copyright © 2014 Wiley Periodicals, Inc.

  11. How to cheat when you cannot lie? Deceit pollination in Begonia gracilis.

    Castillo, Reyna A; Caballero, Helga; Boege, Karina; Fornoni, Juan; Domínguez, César A

    2012-07-01

    Mimicry between rewarding and non-rewarding flowers within individuals has been accepted as a strategy favored by selection to deceive pollinators. It has been proposed that this mechanism relies on the exploitation of pollinator's sensory biases, but field evidence is still scarce. In this study, we describe the mechanism of deceit pollination in the monoecious herb Begonia gracilis, a species with exposed rewarding structures (pollen) and intersexual mimicry. Specifically, we test the role of mimicry and exploitation of sensory biases on the reproductive success of male (pollination visitation) and female flowers (probability of setting fruits). We show that pollinators' perception of the amount of reward provided by male flowers is influenced by the independent variation in the sizes of the androecium and the perianth. Large rewarding structures and small perianths were preferred by pollinators, suggesting a central role of the relative size of the rewarding structure on pollinators' foraging decisions. Hence, rewarding male flowers cheat pollinators by exploiting their sensory biases, a strategy followed by non-rewarding female flowers. We suggest that intersexual mimicry operates through the functional resemblance of male flowers' deceit strategy. Artificial manipulation of the flowers supports our findings in natural conditions. Overall, we propose that the continuous and independent variation in the size of the perianth and the reproductive organs among male and female flowers could itself be adaptive.

  12. Higher levels of multiple paternities increase seedling survival in the long-lived tree Eucalyptus gracilis.

    Martin F Breed

    Full Text Available Studying associations between mating system parameters and fitness in natural populations of trees advances our understanding of how local environments affect seed quality, and thereby helps to predict when inbreeding or multiple paternities should impact on fitness. Indeed, for species that demonstrate inbreeding avoidance, multiple paternities (i.e. the number of male parents per half-sib family should still vary and regulate fitness more than inbreeding--named here as the 'constrained inbreeding hypothesis'. We test this hypothesis in Eucalyptus gracilis, a predominantly insect-pollinated tree. Fifty-eight open-pollinated progeny arrays were collected from trees in three populations. Progeny were planted in a reciprocal transplant trial. Fitness was measured by family establishment rates. We genotyped all trees and their progeny at eight microsatellite loci. Planting site had a strong effect on fitness, but seed provenance and seed provenance × planting site did not. Populations had comparable mating system parameters and were generally outcrossed, experienced low biparental inbreeding and high levels of multiple paternity. As predicted, seed families that had more multiple paternities also had higher fitness, and no fitness-inbreeding correlations were detected. Demonstrating that fitness was most affected by multiple paternities rather than inbreeding, we provide evidence supporting the constrained inbreeding hypothesis; i.e. that multiple paternity may impact on fitness over and above that of inbreeding, particularly for preferentially outcrossing trees at life stages beyond seed development.

  13. Compression and release dynamics of an active matter system of Euglena gracilis

    Lam, Amy; Tsang, Alan C. H.; Ouellette, Nicholas; Riedel-Kruse, Ingmar

    Active matter, defined as ensembles of self-propelled particles, encompasses a large variety of systems at all scales, from nanoparticles to bird flocks. Though various models and simulations have been created to describe the dynamics of these systems, experimental verification has been difficult to obtain. This is frequently due to the complex interaction rules which govern the particle behavior, in turn making systematic varying of parameters impossible. Here, we propose a model for predicting the system evolution of compression and release of an active system based on experiments and simulations. In particular, we consider ensembles of the unicellular, photo-responsive algae, Euglena gracilis, under light stimulation. By varying the spatiotemporal light patterns, we are able to finely adjust cell densities and achieve arbitrary non-homogeneous distributions, including compression into high-density aggregates of varying geometries. We observe the formation of depletion zones after the release of the confining stimulus and investigate the effects of the density distribution and particle rotational noise on the depletion. These results provide implications for defining state parameters which determine system evolution.

  14. Dental microwear reveals mammal-like chewing in the neoceratopsian dinosaur Leptoceratops gracilis

    Frank J. Varriale

    2016-07-01

    Full Text Available Extensive oral processing of food through dental occlusion and orbital mandibular movement is often cited as a uniquely mammalian trait that contributed to their evolutionary success. Save for mandibular translation, these adaptations are not seen in extant archosaurs or lepidosaurs. In contrast, some ornithischian dinosaurs show evidence of precise dental occlusion, habitual intraoral trituration and complex jaw motion. To date, however, a robust understanding of the diversity of jaw mechanics within non-avian dinosaurs, and its comparison with other vertebrates, remains unrealized. Large dental batteries, well-developed dental wear facets, and robust jaws suggests that neoceratopsian (horned dinosaurs were capable chewers. But, biomechanical analyses have assumed a relatively simple, scissor-like (orthal jaw mechanism for these animals. New analyses of dental microwear, presented here, show curvilinear striations on the teeth of Leptoceratops. These features indicate a rostral to caudal orbital motion of the mandible during chewing. A rostrocaudal mandibular orbit is seen in multituberculates, haramiyid allotherians, and some rodents, and its identification in Leptoceratops gracilis is the first evidence of complex, mammal-like chewing in a ceratopsian dinosaur. The term circumpalinal is here proposed to distinguish this new style of chewing from other models of ceratopsian mastication that also involve a palinal component. This previously unrecognized complexity in dinosaurian jaw mechanics indicates that some neoceratopsian dinosaurs achieved a mammalian level of masticatory efficiency through novel adaptive solutions.

  15. Effects of solar and artificial UV irradiation on motility and phototaxis in the flagellate, Euglena gracilis

    Haeder, D.-P.

    1986-01-01

    The effect of solar irradiation on the percentage of motile cells, their average speed and their phototactic orientation to white actinic light was studied in the flagellate, Euglena gracilis. Unfiltered solar radiation in midsummer during mid-day at a location near Lisboa, Portugal, was found to impair motility within 2 h. This effect is exclusively due to the UV-B component of the radiation and not due to UV-A, visible light or a temperature increase. Likewise, phototactic orientation was drastically impaired. Reduction of the solar UV-B irradiation by insertion of an ozone-flooded plexiglass cuvette partially reduced the inhibition and covering the cuvettes with glass prevented any decrease in motility and photoorientation. Similar results were found with artificial irradiation (Xe lamps). After inoculation, the motility of the population follows an optimum curve (optimum at 8 days). Also, the UV-B effect on motility was smallest after about one week and increased for younger and older cultures. (author)

  16. [A variant of island flaps for the covering of pressure sores: the hatchet flap. Apropos of 31 cases].

    Quillot, M; Lodde, J P; Pegorier, O; Reynaud, J P; Cormerais, A

    1994-08-01

    The authors propose a modification of the classical design of island flaps for cover of pressure sores, applied to gluteus maximus and tensor fascia lata muscles: the hatchet flap. 31 flaps have been used including 13 gluteus maximus superior flaps for sacral pressure sores, 9 gluteal inferior flaps for ischial pressure sores and 9 tensor fascia lata flaps for trochanteric pressure sores. A small partial necrosis and two cases of sepsis were observed in this series, but did not require surgical revision. The authors emphasize the value of this modification of the classical flap design, which preserves an even better musculocutaneous capital in these patients, who are often already multi-operated. The very rapid recovery of patients supports the authors' application of hatchet flaps to the surgery of pressure sores, and suggests the extension to other musculocutaneous flaps in the future.

  17. Becker muscular dystrophy: an unusual presentation.

    Thakker, P B; Sharma, A

    1993-01-01

    A 15 year old boy who presented with passing painless dark urine was found to have myoglobinuria. His creatine phosphokinase was raised, and a muscle biopsy specimen showed non-specific dystrophic changes. Subsequent DNA analysis led to the diagnosis of Becker muscular dystrophy. Myoglobinuria may be a presenting symptom of Becker muscular dystrophy.

  18. Preimplantation genetic diagnosis of spinal muscular atrophy

    Dreesen, JCFM; Bras, M; de Die-Smulders, C; Dumoulin, JCM; Cobben, JM; Evers, JLH; Smeets, HJM; Geraedts, JPM

    After Duchenne muscular dystrophy, spinal muscular atrophy (SMA) is the most common severe neuromuscular disease in childhood. Since 1995, homozygous deletions in exon 7 of the survival motor neuron (SMN) gene have been described in >90-95% of SMA patients. However, the presence of a highly

  19. Roentgenological findings in muscular alterations of extremities

    Palvoelgyi, R.

    1978-01-01

    A survey of roentgenological findings in muscular alterations of extremities based on the author's experiences and on the literature is presented. Following a description of the normal roentgen anatomy, the alterations in different diseases of interstitial lipomatosis are demonstrated. By roentgenological examinations differt muscular lesions of the extremities can be differentiated and the clinical follow-up verified. (orig.) [de

  20. Aerodynamics power consumption for mechanical flapping wings undergoing flapping and pitching motion

    Razak, N. A.; Dimitriadis, G.; Razaami, A. F.

    2017-07-01

    Lately, due to the growing interest in Micro Aerial Vehicles (MAV), interest in flapping flight has been rekindled. The reason lies in the improved performance of flapping wing flight at low Reynolds number regime. Many studies involving flapping wing flight focused on the generation of unsteady aerodynamic forces such as lift and thrust. There is one aspect of flapping wing flight that received less attention. The aspect is aerodynamic power consumption. Since most mechanical flapping wing aircraft ever designed are battery powered, power consumption is fundamental in improving flight endurance. This paper reports the results of experiments carried out on mechanical wings under going active root flapping and pitching in the wind tunnel. The objective of the work is to investigate the effect of the pitch angle oscillations and wing profile on the power consumption of flapping wings via generation of unsteady aerodynamic forces. The experiments were repeated for different airspeeds, flapping and pitching kinematics, geometric angle of attack and wing sections with symmetric and cambered airfoils. A specially designed mechanical flapper modelled on large migrating birds was used. It will be shown that, under pitch leading conditions, less power is required to overcome the unsteady aerodnamics forces. The study finds less power requirement for downstroke compared to upstroke motion. Overall results demonstrate power consumption depends directly on the unsteady lift force.

  1. Rescue of Primary Incomplete Microkeratome Flap with Secondary Femtosecond Laser Flap in LASIK

    E. A. Razgulyaeva

    2014-01-01

    Full Text Available For laser-assisted in situ keratomileusis (LASIK retreatments with a previous unsuccessful mechanical microkeratome-assisted surgery, some surgical protocols have been described as feasible, such as relifting of the flap or the creation of a new flap and even the change to a surface ablation procedure (photorefractive keratectomy (PRK. This case shows the use of femtosecond technology for the creation of a secondary flap to perform LASIK in a cornea with a primary incomplete flap obtained with a mechanical microkeratome. As we were unable to characterize the interface of the first partial lamellar cut, a thick flap was planned and created using a femtosecond laser platform. As the primary cut was very thick in the nasal quadrant, a piece of loose corneal tissue appeared during flap lifting which was fitted in its position and not removed. Despite this condition and considering the regularity of the new femtosecond laser cut, the treatment was uneventful. This case report shows the relevance of a detailed corneal analysis with an advanced imaging technique before performing a secondary flap in a cornea with a primary incomplete flap. The femtosecond laser technology seems to be an excellent tool to manage such cases successfully.

  2. The Internal Pudendal Artery Perforator Thigh Flap: A New Freestyle Pedicle Flap for the Ischial Region

    Ichiro Hashimoto, MD

    2014-05-01

    Conclusions: The perforator vessels of the internal pudendal artery are very close to the ischial tuberosity. Blood flow to the flap is reliable when careful debridement of the pressure sore is performed. The iPap thigh flap is a new option for soft-tissue defects in the ischial region, including ischial pressure sores.

  3. The prepuce free flap in 10 patients : modifications in flap design and surgical technique

    Werker, Paul M N

    The prepuce free flap was used in 10 oral and oropharyngeal reconstructions. During the course of this study, various modifications took place. Residual penile skin necrosis and skin island necrosis early in the series led to modification of flap design. This solved the donor-site problem by placing

  4. Free flap reconstruction for diabetic foot limb salvage.

    Sato, Tomoya; Yana, Yuichiro; Ichioka, Shigeru

    2017-12-01

    Although free flap is gaining popularity for the reconstruction of diabetic foot ulcers, it is unclear whether free flap reconstruction increases the chances of postoperative independent ambulation. The aim of this study is to evaluate the relationship between free flap success and postoperative ambulation. This study reviewed 23 cases of free flap reconstruction for diabetic foot ulcers between January 2007 and March 2014. Free rectus abdominis, latissimus dorsi, and anterolateral thigh flaps were used in ten, eight, and five patients, respectively. A comparison was made between free flap success and postoperative independent ambulation using Fisher's exact test. Two patients developed congestive heart failure with fatal consequences within 14 days postoperatively, resulting in an in-hospital mortality rate of 8.7%. Five patients lost their flaps (21.7%). Of the 16 patients who had flap success, 12 achieved independent ambulation. Five patients with flap loss did not achieve independent ambulation, except one patient who underwent secondary flap reconstruction using a distally based sural flap. Fisher's exact test revealed that independent ambulation was associated with free flap success (p = 0.047). The present study indicates that free flap reconstruction may increase the possibility of independent ambulation for patients with extensive tissue defects due to diabetic ulcers. Intermediate limb salvage rates and independent ambulation rates were favourable in patients with successful reconstruction. The use of foot orthoses and a team approach with pedorthists were effective to prevent recurrence.

  5. Chimeric superficial temporal artery based skin and temporal fascia flap plus temporalis muscle flap - An alternative to free flap for suprastructure maxillectomy with external skin defect

    Dushyant Jaiswal

    2011-01-01

    Full Text Available Flaps from temporal region have been used for mid face, orbital and peri-orbital reconstruction. The knowledge of the vascular anatomy of the region helps to dissect and harvest the muscle/fascia/skin/combined tissue flaps from that region depending upon the requirement. Suprastructure maxillectomy defects are usually covered with free flaps to fill the cavity. Here we report an innovative idea in which a patient with a supra structure maxillectomy with external skin defect was covered with chimeric flap based on the parietal and frontal branches of superficial temporal artery and the temporalis muscle flap based on deep temporal artery.

  6. Comparison of Dorsal Intercostal Artery Perforator Propeller Flaps and Bilateral Rotation Flaps in Reconstruction of Myelomeningocele Defects.

    Tenekeci, Goktekin; Basterzi, Yavuz; Unal, Sakir; Sari, Alper; Demir, Yavuz; Bagdatoglu, Celal; Tasdelen, Bahar

    2018-04-09

    Bilateral rotation flaps are considered the workhorse flaps in reconstruction of myelomeningocele defects. Since the introduction of perforator flaps in the field of reconstructive surgery, perforator flaps have been used increasingly in the reconstruction of various soft tissue defects all over the body because of their appreciated advantages. The aim of this study was to compare the complications and surgical outcomes between bilateral rotation flaps and dorsal intercostal artery perforator (DICAP) flaps in the soft tissue reconstruction of myelomeningocele defects. Between January 2005-February 2017, we studied 47 patients who underwent reconstruction of myelomeningocele defects. Patient demographics, operative data, and postoperative data were reviewed retrospectively and are included in the study. We found no statistically significant differences in patient demographics and surgical complications between these two groups; this may be due to small sample size. With regard to complications-partial flap necrosis, cerebrospinal fluid (CSF) leakage, necessity for reoperation, and wound infection-DICAP propeller flaps were clinically superior to rotation flaps. Partial flap necrosis was associated with CSF leakage and wound infection, and CSF leakage was associated with wound dehiscence. Although surgical outcomes obtained with DICAP propeller flaps were clinically superior to those obtained with rotation flaps, there was no statistically significant difference between the two patient groups. A well-designed comparative study with adequate sample size is needed. Nonetheless, we suggest using DICAP propeller flaps for reconstruction of large myelomeningocele defects.

  7. Modified cup flap for volar oblique fingertip amputations

    Ahmadli, A.

    2016-02-01

    Full Text Available We describe a modified volar “V-Y cup” flap for volar fingertip defects that do not exceed more than half of the distal phalanx for better aesthetic and functional outcome. In seven cases out of eight, the flap was elevated with a subdermal pedicle, whereas in one case, the flap was elevated as an island on the bilateral neurovascular bundle. The fingertips have been evaluated for sensibility using standard tests, hook nail deformity and patient satisfaction. Seven flaps have survived completely. The flap with skeletonized bilateral digital neurovascular bundle has shown signs of venous insufficiency on the 5 postoperative day with consecutive necrosis. Suturing the distal edges of the flap in a “cupping” fashion provided a normal pulp contour. The modified flap can be used for defects as mentioned above. Subdermally dissected pedicle-based flap is safe and easy to elevate. The aesthetic and functional outcomes have been reported to be satisfactory.

  8. Propeller Flap for Complex Distal Leg Reconstruction: A Versatile ...

    equipment, cost, steep learning curve, and prolonged operating ... A Versatile Alternative when Reverse Sural Artery Flap is .... He had wound debridement, fracture reduction, and .... flaps that were raised in the patient and the logistics of limb.

  9. Flow field of flexible flapping wings

    Sallstrom, Erik

    The agility and maneuverability of natural fliers would be desirable to incorporate into engineered micro air vehicles (MAVs). However, there is still much for engineers to learn about flapping flight in order to understand how such vehicles can be built for efficient flying. The goal of this study is to develop a methodology for capturing high quality flow field data around flexible flapping wings in a hover environment and to interpret it to gain a better understanding of how aerodynamic forces are generated. The flow field data was captured using particle image velocimetry (PIV) and required that measurements be taken around a repeatable flapping motion to obtain phase-averaged data that could be studied throughout the flapping cycle. Therefore, the study includes the development of flapping devices with a simple repeatable single degree of freedom flapping motion. The acquired flow field data has been examined qualitatively and quantitatively to investigate the mechanisms behind force production in hovering flight and to relate it to observations in previous research. Specifically, the flow fields have been investigated around a rigid wing and several carbon fiber reinforced flexible membrane wings. Throughout the whole study the wings were actuated with either a sinusoidal or a semi-linear flapping motion. The semi-linear flapping motion holds the commanded angular velocity nearly constant through half of each half-stroke while the sinusoidal motion is always either accelerating or decelerating. The flow fields were investigated by examining vorticity and vortex structures, using the Q criterion as the definition for the latter, in two and three dimensions. The measurements were combined with wing deflection measurements to demonstrate some of the key links in how the fluid-structure interactions generated aerodynamic forces. The flow fields were also used to calculate the forces generated by the flapping wings using momentum balance methods which yielded

  10. Biología pesquera de la langosta Panulirus gracilis en Playa Lagarto, Guanacaste, Costa Rica

    Helven Naranjo Madrigal

    2011-06-01

    Full Text Available Los parámetros biológicos y pesqueros analizados se fundamentaron en una muestra de 843 langostas provenientes de la actividad pesquera realizada en Playa Lagarto entre noviembre del 2007 y octubre del 2008. Las longitudes cefalotoráxicas de los machos estuvo comprendida entre los 143.6 y 42.8 y 115 y 35.8mm para hembras. El 74.9% de las langostas en los desembarques estuvo por debajo de la talla mínima legal de captura (80 mm de LC. La estructura de tallas muestra un considerable solapamiento de segmentos poblacionales y el incremento de las tallas con la profundidad en donde operan las dos modalidades de pesca estudiadas: el buceo a pulmón y el buceo con compresor. La proporción de sexos obtenida fue de 1.36 M:H. La relación entre LC y peso reveló que las hembras pesan más que los machos de una misma talla y que esta diferencia fue significativa (pBiology and fishery of the lobster Panulirus gracilis in Playa Lagarto, Guanacaste, Costa Rica. Panulirus gracilis is a high valuable lobster species with considerable captures along the tropical Pacific coast. In this study, I present some biological and fishery parameters described after a sample of 843 lobsters, landed in Playa Lagarto from November 2007 to October 2008. From landing records, a total of 74.9% of lobsters were below the minimum legal catch size (80mm CL. Carapace lengths were in the range of 42.8 and 143.6mm for males and 115 and 35.8mm for females. The size structure showed a wide overlapping of population segments, and a trend to increase with depth, where lung diving and “hooka” diving operations take place. Sex ratio was 1.36 M:H. The relationship between weight and LC revealed that females are heavier than males of the same size, and this difference was significant (p<0.05. The von Bertalanffy growth parameters for males and females respectively (K=0.45-0.38, LC∞=166.9-121.7 showed accelerated growth compared to other species. Males observed a higher growth rate

  11. Scrotal reconstruction with superomedial fasciocutaneous thigh flap

    DANIEL FRANCISCO MELLO

    2018-02-01

    Full Text Available ABSTRACT Objective: to describe the use of a superomedial fasciocutaneous thigh flap for scrotal reconstruction in open areas secondary to the surgical treatment of perineal necrotizing fasciitis (Fournier’s gangrene. Methods: retrospective analysis of cases treated at the Plastic Surgery Service of Santa Casa de Misericórdia, São Paulo, from 2009 to 2015. Results: fifteen patients underwent scrotal reconstruction using the proposed flap. The mean age was 48.9 years (28 to 66. Skin loss estimates in the scrotal region ranged from 60 to 100%. Definitive reconstruction was performed on average 30.6 days (22 to 44 after the initial surgical treatment. The mean surgical time was 76 minutes (65 to 90 to obtain the flaps, bilateral in all cases. Flap size ranged from 10cm to 13cm in the longitudinal direction and 8cm to 10cm in the cross-sectional direction. The complication rate was 26.6% (four cases, related to the occurrence of segmental and partial dehiscence. Conclusion: the superomedial fasciocutaneous flap of thigh is a reliable and versatile option for the reconstruction of open areas in the scrotal region, showing adequate esthetic and functional results.

  12. The forked flap repair for hypospadias

    Anil Chadha

    2012-01-01

    Full Text Available Context: Despite the abundance of techniques for the repair of Hypospadias, its problems still persist and a satisfactory design to correct the penile curvature with the formation of neourethra from the native urethral tissue or genital or extragenital tissues, with minimal postoperative complications has yet to evolve. Aim: Persisting with such an endeavor, a new technique for the repair of distal and midpenile hypospadias is described. Materials and Methods: The study has been done in 70 cases over the past 11 years. The "Forked-Flap" repair is a single stage method for the repair of such Hypospadias with chordee. It takes advantage of the rich vascular communication at the corona and capitalizes on the established reliability of the meatal based flip-flap. The repair achieves straightening of the curvature of the penis by complete excision of chordee tissue from the ventral surface of the penis beneath the urethral plate. The urethra is reconstructed using the native plate with forked flap extensions and genital tissue relying on the concept of meatal based flaps. Water proofing by dartos tissue and reinforcement by Nesbit′s prepucial tissue transfer completes the one stage procedure. Statistical Analysis: An analysis of 70 cases of this single stage technique of repair of penile hypospadias with chordee, operated at 3 to 5 years of age over the past 11 years is presented. Results and Conclusion: The Forked Flap gives comparable and replicable results; except for a urethrocutaneous fistula rate of 4% no other complications were observed.

  13. Gravitaxis in the flagellate Euglena gracilis--results from NiZeMi, clinostat and sounding rocket flights.

    Häder, D P

    1994-05-01

    Many motile microorganisms including flagellates such as the green Euglena gracilis move up and down within the water column and use a number of external clues for their orientation, the most important of which may be light and gravity. The cells use positive phototaxis and negative gravitaxis to move closer to the surface of the water column which for energetic reasons is vital for their survival. However, most phytoplankton organisms cannot tolerate the bright irradiance of unfiltered solar radiation at the surface which also bleaches the photosynthetic pigments, disables the photosynthetic apparatus and impairs phototaxis, gravitaxis and motility in Euglena. Thus, it is not surprising that at higher irradiances negative phototaxis operates antagonistically to the responses described above to guide the cells into deeper water where they are protected from excessive radiation. Phototaxis and gravitaxis are not independent from one another: in a vertically positioned cuvette negative gravitaxis can be "titrated" by light impinging from above and is compensated at about 30 W m-2. While the photoreceptor for phototaxis has been identified in Euglena gracilis biochemically and spectroscopically, the gravireceptor is not yet known. Young cultures of Euglena gracilis show a positive gravitaxis, the ecological signficance of which is not yet understood while older cultures show negative gravitaxis. One hypothesis concerning the nature of graviperception is based on a passive physical process such as an asymmetric distribution of the mass within the cell. However, the observation that short term UV irradiation decreases the precision of negative gravitaxis rather indicates the involvement of an active physiological gravireceptor. Furthermore, some heavy metal ions have been found to change the direction of movement from positive to negative gravitaxis in young cells.

  14. Applicability of Euglena gracilis for biorefineries demonstrated by the production of α-tocopherol and paramylon followed by anaerobic digestion.

    Grimm, Philipp; Risse, Joe M; Cholewa, Dominik; Müller, Jakob M; Beshay, Usama; Friehs, Karl; Flaschel, Erwin

    2015-12-10

    In this study the use of Euglena gracilis biomass for α-tocopherol, paramylon and biogas production in a value-added chain was investigated. Therefore, we analyzed the dry cell weight and product concentrations at different growth phases during heterotrophic, photoheterotrophic and photoautotrophic cultivation in a low-cost minimal medium. Furthermore, the specific biogas yields for differently derived biomass with and without product recovery were investigated. We demonstrate that growth phase and cultivation mode not only have a significant impact on product formation, but also influence the yield of biogas obtained from anaerobic digestion of Euglena gracilis biomass. The maximum dry cell weight concentration ranged from 12.3±0.14gL(-1) for heterotrophically to 3.4±0.02gL(-1) for photoautotrophically grown Euglena gracilis cells. The heterotrophically grown biomass accumulated product concentrations of 5.3±0.12mgL(-1) of α-tocopherol and 9.3±0.1gL(-1) of paramylon or 805±10.9mL of biogasgvs(-1) (per gram volatile solids). The results for photoautotrophically grown cells were 8.6±0.22mgL(-1) of α-tocopherol and 0.78±0.01gL(-1) of paramylon or 648±7.2mL of biogasgvs(-1). For an energy-saving downstream procedure the extracting agent methanol does not have to be removed strictly. Samples with residual methanol showed a significantly increased biogas yield, because the solvent can be used as an additional substrate for methane production by archaebacteria. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Experiencia en reconstrucción de tercio distal de pierna con colgajo libre de músculo gracilis

    A. Conejero

    2013-09-01

    Full Text Available En los defectos de cobertura distales de la pierna con exposición ósea o articular, la transferencia de tejidos libres es frecuentemente la única opción viable. Se utilizan en el rescate de extremidades inferiores en riesgo por trauma, infección, ulceración, quemaduras y tumores. El colgajo libre de músculo gracilis está descrito en la literatura como una excelente alternativa. El objetivo de este estudio es describir las características de los pacientes y resultados de la utilización del colgajo libre de músculo gracilis en la reconstrucción del tercio distal de la pierna. Se trata de un estudio retrospectivo, observacional, de revisión de archivo clínico y fotográfico de 7 pacientes operados por los autores entre los años 2007-2010, 4 hombres y 3 mujeres con un promedio de edad de 38,5 años. El defecto de cobertura que motivó la cirugía (de hasta de 20 x 6 cm fue secundario a fractura expuesta (tipo III de Gustilo y a osteomielitis crónica. La cobertura del colgajo se hizo en todos los casos con injerto dermo-epidérmico. No hubo complicaciones menores ni mayores del sitio donante ni del receptor, con resultados funcionales y estéticos satisfactorios. El colgajo libre de músculo gracilis es una muy buena alternativa para la reconstrucción distal de pierna con defectos de cobertura en fracturas expuestas y osteomielitis o en úlceras crónicas. Tras el seguimiento, todos nuestros pacientes lograron una cobertura completa y estable en el tiempo.

  16. Local climate and cultivation, but not ploidy, predict functional trait variation in Bouteloua gracilis (Poaceae)

    Butterfield, Bradley J.; Wood, Troy E.

    2015-01-01

    Efforts to improve the diversity of seed 18 resources for important restoration species has become a high priority for land managers in many parts of the world. Relationships between functional trait values and the environment from which seed sources are collected can provide important insights into patterns of local adaptation and guidelines for seed transfer. However, little is known about which functional traits exhibit genetic differentiation across populations of restoration species and thus may contribute to local adaptation. Here, we report the results of a common garden experiment aimed at assessing genetic (including ploidy level) and environmental regulation of several functional traits among populations of Bouteloua gracilis, a dominant C4 grass and the most highly utilized restoration species across much of the Colorado Plateau. We found that leaf size and specific leaf area (SLA) varied significantly among populations, and were strongly correlated with the source population environment from which seeds were collected. However, variation in ploidy level had no significant effect on functional traits. Leaves of plants grown from commercial seed releases were significantly larger and had lower SLA than those from natural populations, a result that is concordant with the overall relation between climate and these two functional traits. We suggest that the patterns of functional trait variation shown here may extend to other grass species in the western USA, and may serve as useful proxies for more extensive genecology research. Furthermore, we argue that care should be taken to develop commercial seed lines with functional trait values that match those of natural populations occupying climates similar to target restoration sites.

  17. Avian-like attributes of a virtual brain model of the oviraptorid theropod Conchoraptor gracilis

    Kundrát, Martin

    2007-06-01

    An almost complete adult endoneurocranium of Conchoraptor gracilis Barsbold 1986 (Oviraptoridae; ZPAL MgD-I/95), discovered at the Hermiin Tsav locality (the Upper Cretaceous) in Mongolia, is analyzed. A virtual model of the endoneurocranial cavity was derived from CT scans and represents the most complete maniraptoran endocast to date. It displays reduced olfactory bulbs, large cerebral hemispheres in contact with the expanded cerebellum, an epiphysial projection, optic lobes displaced latero-ventrally, presumptive cerebellar folia, enlarged cerebellar auricles, and a deep medulla oblongata with a prominent ventral flexure. Contrary to Archaeopteryx, the shortened olfactory tract and cerebellum overtopping cerebral hemispheres of Conchoraptor resemble conditions in modern birds. Calculating brain mass relative to body mass indicates that Conchoraptor falls within the range of extant birds, whereas Archaeopteryx occupies a marginal position. Most of the endoneurocranial attributes, however, have a less birdlike appearance in Conchoraptor than do corresponding structures in Archaeopteryx and modern birds in which 1) postero-laterally expanded hemispheral domains broadly overlap the optic lobes, 2) the epiphysis projects to the posterior cerebrum, 3) lateral extension of the optic lobes substantially decreases a brain length-to-width ratio, 4) optic lobe and anterior hindbrain are superposed in lateral view, and 5) cerebellar and midbrain compartments are in distinct superposition. The endoneurocranial characteristics of Conchoraptor, taken together, suggest that the animal had a keen sense of vision, balance, and coordination. The data presented in this study do not allow an unambiguous assessment whether the avian-like endoneurocranial characteristics of the flightless Conchoraptor evolved convergently to those of avian theropods, or indicate a derivation of oviraptorosaurs from volant ancestors.

  18. Spine micromorphology of normal and hyperhydric Mammillaria gracilis Pfeiff. (Cactaceae) shoots.

    Peharec, P; Posilović, H; Balen, B; Krsnik-Rasol, M

    2010-07-01

    Artificial conditions of tissue culture affect growth and physiology of crassulacean acid metabolism plants which often results in formation of hyperhydric shoots. In in vitro conditions Mammillaria gracilis Pfeiff. (Cactaceae) growth switches from organized to unorganized way, producing a habituated organogenic callus which simultaneously regenerates morphologically normal as well as altered hyperhydric shoots. In this study, influence of tissue culture conditions on morphology of cactus spines of normal and hyperhydric shoots was investigated. Spines of pot-grown Mammillaria plants and of in vitro regenerated shoots were examined with stereo microscope and scanning electron microscope. The pot-grown plants had 16-17 spines per areole. In vitro grown normal shoots, even though they kept typical shoot morphology, had lower number of spines (11-12) and altered spine morphology. This difference was even more pronounced in spine number (six to seven) and morphology of the hyperhydric shoots. Scanning electron microscopy analysis revealed remarkable differences in micromorphology of spine surface between pot-grown and in vitro grown shoots. Spines of in vitro grown normal shoots showed numerous long trichomes, which were more elongated on spines of the hyperhydric shoots; the corresponding structures on spine surface of pot-grown plants were noticed only as small protrusions. Scanning electron microscopy morphometric studies showed that the spines of pot-grown plants were significantly longer compared to the spines of shoots grown in tissue culture. Moreover, transverse section shape varies from elliptical in pot-grown plants to circular in normal and hyperhydric shoots grown in vitro. Cluster and correspondence analyses performed on the scanning electron microscope obtained results suggest great variability among spines of pot-grown plants. Spines of in vitro grown normal and hyperhydric shoots showed low level of morphological variation among themselves despite the

  19. Perforator plus flaps: Optimizing results while preserving function and esthesis

    Mehrotra Sandeep

    2010-01-01

    Full Text Available Background: The tenuous blood supply of traditional flaps for wound cover combined with collateral damage by sacrifice of functional muscle, truncal vessels, or nerves has been the bane of reconstructive procedures. The concept of perforator plus flaps employs dual vascular supply to flaps. By safeguarding perforators along with supply from its base, robust flaps can be raised in diverse situations. This is achieved while limiting collateral damage and preserving nerves, vessels, and functioning muscle with better function and aesthesis. Materials and Methods: The perforator plus concept was applied in seven different clinical situations. Functional muscle and fasciocutaneous flaps were employed in five and adipofascial flaps in two cases, primarily involving lower extremity defects and back. Adipofascial perforator plus flaps were employed to provide cover for tibial fracture in one patients and chronic venous ulcer in another. Results: All flaps survived without any loss and provided long-term stable cover, both over soft tissue and bone. Functional preservation was achieved in all cases where muscle flaps were employed with no clinical evidence of loss of power. There was no sensory loss or significant oedema in or distal to the flap in both cases where neurovascular continuity was preserved during flap elevation. Fracture union and consolidation were satisfactory. One patient had minimal graft loss over fascia which required application of stored grafts with subsequent take. No patient required re-operation. Conclusions: Perforator plus concept is holistic and applicable to most flap types in varied situations. It permits the exercise of many locoregional flap options while limiting collateral functional damage. Aesthetic considerations are also addressed while raising adipofascial flaps because of no appreciable donor defects. With quick operating times and low failure risk, these flaps can be a better substitute to traditional flaps and at

  20. Curative effect observation of n-flap and off-flap EPi-LASIK in ametropia

    Chao Liu

    2015-11-01

    Full Text Available AIM:To observe the clinical effect of on-flap and off-flap epipolis laser in situ keratomileusis(EPi-LASIKin ametropia.METHODS: Sixty-eight myopia patients(136 eyesreceiving surgical treatment were selected and divided into research group and control group according to different therapies. The patients in research group adopted off-flap EPi-LASIK and those in control group adopted on-flap EPi-LASIK. The index like uncorrected visual acuity, diopter and Haze of two groups before surgery, 1wk, 1 and 4mo after surgery was observed. RESULTS: One month after surgery, the uncorrected visual acuity of research group was 1.33±0.22 while that of control group was 1.22±0.19(PPPCONCLUSION:On-flap and off-flap EPi-LASIK are safe and effective surgery approaches in the clinical treatment of ametropia. The presence of corneal epithelial flap has a certain effect in the postoperative clinical outcome at early stage. The impact will be gradually reduced over time.

  1. Investigation of radiosensitivity and growth dynamics for callus tissues Crepis Capillaris, Haplopappus gracilis, Phasolium vulgaris exposed to gamma radiation

    Gatsek, Eh.; Glinkova, E.; Ismailova, Eh.N.

    1983-01-01

    Radiosensitivity of three kinds of callus tissues (Crepis capillaris, Haplopappus gracilis, Phasolium vulgaris) manifested in the change of fresh weight after γ-irradiation has been investigated. Irradiated callus arowth showed decrease with increasing doses. It is shown that the radiosensitivity of ''young'' callus tissues is determined by the kind of the plant. Callus of Phaseolis has been found to have the highest radioresistance, while that of Crepis has the lowest one. Radiosensitivity of ''old'' callus tissues is the same for all kinds. Potential mechanism of radiosensitivity of callus tissUes are discussed

  2. Reconstruction of eyelids with Washio flap in anophthalmia.

    Tvrdek, M; Kozák, J

    2014-01-01

    The authors present a case report of a patient with anophthalmia in whom retroauriculo-temporal flap (Washio flap) was used for reconstruction of eyelids. This flap, which is mostly used for reconstructions of nasal defects, was not used in this way according to available literature.

  3. Prospective evaluation of outcome measures in free-flap surgery.

    Kelly, John L

    2004-08-01

    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +\\/- 29 min) and in those that survived (92 +\\/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.

  4. Dual omental flap in obliterating post-pneumonectomy ...

    Background: Post-pneumonectomy bronchopleural fistulae is associated with high mortality and morbidity. The omental flap has been widely used to manage this condition either through laparoscopic or open surgery with varied degrees of success. We present a modification of the omental flap by using two flaps of the ...

  5. Blood flow autoregulation in pedicled flaps

    Bonde, Christian T; Holstein-Rathlou, Niels-Henrik; Elberg, Jens J

    2009-01-01

    was to evaluate if, and to what extent, a tissue flap could compensate a reduction in blood flow due to an acute constriction of the feed artery. Further, we wanted to examine the possible role of smooth muscle L-type calcium channels in the autoregulatory mechanism by pharmacological intervention with the L......, the flow in the pedicle was reduced and the flow was recorded. RESULTS: The flaps showed a strong autoregulatory response with complete compensation for flow reductions of up to 70-80%. Infusion of nimodipine caused a 28+/-10% increase in blood flow and removed the autoregulation. Papaverine caused...... a further increase in blood flow by 61+/-19%. The time control experiments proved that the experimental procedure was reproducible and stable over time. CONCLUSIONS: A tissue flap can nearly completely compensate for repeated flow reductions of up to 70-80%. This is due to a decrease in the peripheral...

  6. Double papilla flap technique for dual purpose

    P Mohan Kumar

    2012-01-01

    Full Text Available Marginal tissue recession exposes the anatomic root on the teeth, which gives rise to -common patient complaints. It is associated with sensitivity, tissue irritation, cervical abrasions, and esthetic concerns. Various types of soft tissue grafts may be performed when recession is deep and marginal tissue health cannot be maintained. Double papilla flap is an alternative technique to cover isolated recessions and correct gingival defects in areas of insufficient attached gingiva, not suitable for a lateral sliding flap. This technique offers the advantages of dual blood supply and denudation of interdental bone only, which is less susceptible to permanent damage after surgical exposure. It also offers the advantage of quicker healing in the donor site and reduces the risk of facial bone height loss. This case report presents the advantages of double papilla flap in enhancing esthetic and functional outcome of the patient.

  7. Structural Organization of Muscular Elements of a Skin-Muscular Sac of Trematodes: Literature Survey

    Kanat Kambarovich Akhmetov; Irina Yurievna Chidunchi

    2015-01-01

    The issue of structural organization of muscular elements of a trematodes’ skin-muscular sac is considered in the study. Special attention is paid to an analysis of materials of preceding researches, study of foreign authors and also to additional literature reflecting peculiarities of structure of a trematodes’ body muscular system. The stated issue is insufficiently studied and calls for further researches. A comparative analysis of places of trematodes’ localization, taking into considerat...

  8. Unit Advancement Flap for Lower Lip Reconstruction.

    Ogino, Akihiro; Onishi, Kiyoshi; Okada, Emi; Nakamichi, Miho

    2018-05-01

    Lower lip reconstruction requires consideration of esthetic and functional outcome in selecting a surgical procedure, and reconstruction with local tissue is useful. The authors reconstructed full-thickness defects with a unit advancement flap. Reconstruction was performed using this method in 4 patients with lower lip squamous cell carcinoma in whom tumor resection with preservation of the mouth angle was possible. The lower lip resection width was 30 to 45 mm, accounting for 50% to 68% of the entire width of the lower lip. The flap was prepared by lateral extension from above the mental unit and matched with the potential wrinkle line of the lower lip in order to design a unit morphology surrounded by the anterior margin of the depressor labii inferioris muscle. It was elevated as a full-thickness flap composed of the orbicularis oris muscle, skin, and mucosa of the residual lower lip from the bilateral sides, and advanced to the defect. Flap transfer was adjusted by small triangular resection of the skin on the lateral side of the mental unit. The postoperative scar was inconspicuous in all patients and there was no impairment of the mouth opening-closing or articulation functions. This was a relatively simple surgical procedure. A blood supply of the flap was stable, and continuity of the orbicularis oris muscle was reconstructed by transferred the residual lower lip advancement flap from the bilateral sides. The postoperative mouth opening-closing function was sufficient, and dentures could be placed from an early phase in elderly patients. The postoperative scar was consistent with the lip unit morphology, being esthetically superior. This procedure may be applicable for reconstruction of defects approximately 1/3 to 2/3 the width of the lower lip where the mouth angle is preserved.

  9. Flapping model of scalar mixing in turbulence

    Kerstein, A.R.

    1991-01-01

    Motivated by the fluctuating plume model of turbulent mixing downstream of a point source, a flapping model is formulated for application to other configurations. For the scalar mixing layer, simple expressions for single-point scalar fluctuation statistics are obtained that agree with measurements. For a spatially homogeneous scalar mixing field, the family of probability density functions previously derived using mapping closure is reproduced. It is inferred that single-point scalar statistics may depend primarily on large-scale flapping motions in many cases of interest, and thus that multipoint statistics may be the principal indicators of finer-scale mixing effects

  10. Hyperbaric oxygen therapy and surgical delay improve flap survival of reverse pedicle flaps for lower third leg and foot reconstruction

    Pradeoth Mukundan Korambayil

    2015-06-01

    Full Text Available Aim: The purpose of the study is to present a management protocol for various types of soft tissue defects of the distal third region of leg and foot treated with pedicle flaps, by including hyperbaric oxygen (HBO therapy in the treatment regimen with flap delay. Methods: We present a prospective study of 23 patients with various types of soft tissue defects of the foot, and lower third of leg managed in our institution from December 2012 to December 2013. All soft tissue defects were treated by a reverse pedicle flap. Twelve patients were managed with flap delay with HBO therapy and 11 patients with immediate flaps without HBO therapy. The postoperative period, hospital course, and follow-up were documented. Results: Of 12 patients with flap delay and HBO, 10 patients did not suffer any complications secondary to flap transfer. One patient had discoloration of the tip of the flap, which settled without the intervention, and 1 patient had recurrent abscess formation, which required debridement and closure. Of 11 patients with direct transfer, 6 patients presented with complications including flap congestion, partial flap loss, and tip necrosis, which required secondary intervention. Conclusion: HBO therapy is a useful adjunct in flap delay of the reverse pedicle flap for soft tissue reconstruction of the lower third of the leg and foot regions.

  11. "The Practical Perforator Flap": the sural artery flap for lower extremity soft tissue reconstruction in wounds of war

    O.J.F. van Waes (Oscar); J.A. Halm (Jens); J. Vermeulen (Jefrey); S. Ashford (Sofie)

    2012-01-01

    textabstractBackground: Sural artery perforator flaps have been described for use as both local flaps and in free tissue transfer. We present the use of this flap for compound soft tissue defects of the lower limb in civilian casualties of armed conflict in Afghanistan. Methods/results: Detailed

  12. Perforator anatomy of the radial forearm free flap versus the ulnar forearm free flap for head and neck reconstruction

    Hekner, D.D.; Roeling, TAP; van Cann, EM

    The aim of this study was to investigate the vascular anatomy of the distal forearm in order to optimize the choice between the radial forearm free flap and the ulnar forearm free flap and to select the best site to harvest the flap. The radial and ulnar arteries of seven fresh cadavers were

  13. Parasacral Perforator Flaps for Reconstruction of Sacral Pressure Sores.

    Lin, Chin-Ta; Chen, Shih-Yi; Chen, Shyi-Gen; Tzeng, Yuan-Sheng; Chang, Shun-Cheng

    2015-07-01

    Despite advances in reconstruction techniques, pressure sores continue to present a challenge to the plastic surgeon. The parasacral perforator flap is a reliable flap that preserves the entire contralateral side as a future donor site. On the ipsilateral side, the gluteal muscle itself is preserved and all flaps based on the inferior gluteal artery are still possible. We present our experience of using parasacral perforator flaps in reconstructing sacral defects. Between August 2004 and January 2013, 19 patients with sacral defects were included in this study. All the patients had undergone surgical reconstruction of sacral defects with a parasacral perforator flap. The patients' sex, age, cause of sacral defect, flap size, flap type, numbers of perforators used, rotation angle, postoperative complications, and hospital stay were recorded. There were 19 parasacral perforator flaps in this series. All flaps survived uneventfully except for 1 parasacral perforator flap, which failed because of methicillin-resistant Staphylococcus aureus infection. The overall flap survival rate was 95% (18/19). The mean follow-up period was 17.3 months (range, 2-24 months). The average length of hospital stay was 20.7 days (range, 9-48 days). No flap surgery-related mortality was found. Also, there was no recurrence of sacral pressure sores or infected pilonidal cysts during the follow-up period. Perforator-based flaps have become popular in modern reconstructive surgery because of low donor-site morbidity and good preservation of muscle. Parasacral perforator flaps are durable and reliable in reconstructing sacral defects. We recommend the parasacral perforator flap as a good choice for reconstructing sacral defects.

  14. An unusual variant of Becker muscular dystrophy

    de Visser, M.; Bakker, E.; Defesche, J. C.; Bolhuis, P. A.; van Ommen, G. J.

    1990-01-01

    We report on 5 brothers with slowly progressive limbgirdle weakness. Calf hypertrophy was absent. The levels of creatine kinase, electromyography, and findings from a muscle biopsy specimen were compatible with muscular dystrophy. The propositus's biopsy specimen also showed numerous rimmed

  15. Physical Therapy and Facioscapulohumeral Muscular Dystrophy (FSHD)

    Physical Therapy & FSHD Facioscapulohumeral Muscular Dystrophy A Guide for Patients & Physical Therapists Authors: Wendy M. King, P.T., Assistant ... Shree Pandya, P.T., M.S., Assistant Professor, Neurology & Physical Medicine and Rehabilitation A publication of the FSH ...

  16. How Do People Cope with Muscular Dystrophy?

    ... topic are answered in this section. How do people cope with muscular dystrophy (MD)? Although MD presents ... improve health and quality of life. Almost all people with any form of MD experience a worsening ...

  17. Duchenne muscular dystrophy: the management of scoliosis

    Gardner, Adrian C.; Roper, Helen P.; Chikermane, Ashish A.; Tatman, Andrew J.

    2016-01-01

    This study summaries the current management of scoliosis in patients with Duchenne Muscular Dystrophy. A literature review of Medline was performed and the collected articles critically appraised. This literature is discussed to give an overview of the current management of scoliosis within Duchenne Muscular Dystrophy. Importantly, improvements in respiratory care, the use of steroids and improving surgical techniques have allowed patients to maintain quality of life and improved life expectancy in this patient group. PMID:27757431

  18. Muscular Oxygen Uptake Kinetics in Aged Adults.

    Koschate, J; Drescher, U; Baum, K; Eichberg, S; Schiffer, T; Latsch, J; Brixius, K; Hoffmann, U

    2016-06-01

    Pulmonary oxygen uptake (V˙O2) kinetics and heart rate kinetics are influenced by age and fitness. Muscular V˙O2 kinetics can be estimated from heart rate and pulmonary V˙O2. In this study the applicability of a test using pseudo-random binary sequences in combination with a model to estimate muscular V˙O2 kinetics was tested. Muscular V˙O2 kinetics were expected to be faster than pulmonary V˙O2 kinetics, slowed in aged subjects and correlated with maximum V˙O2 and heart rate kinetics. 27 elderly subjects (73±3 years; 81.1±8.2 kg; 175±4.7 cm) participated. Cardiorespiratory kinetics were assessed using the maximum of cross-correlation functions, higher maxima implying faster kinetics. Muscular V˙O2 kinetics were faster than pulmonary V˙O2 kinetics (0.31±0.1 vs. 0.29±0.1 s; p=0.004). Heart rate kinetics were not correlated with muscular or pulmonary V˙O2 kinetics or maximum V˙O2. Muscular V˙O2 kinetics correlated with maximum V˙O2 (r=0.35; p=0.033). This suggests, that muscular V˙O2 kinetics are faster than estimates from pulmonary V˙O2 and related to maximum V˙O2 in aged subjects. In the future this experimental approach may help to characterize alterations in muscular V˙O2 under various conditions independent of motivation and maximal effort. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Suspension Bridge Flutter for Girder with Separate Control Flaps

    Huynh, T.; Thoft-Christensen, Palle

    Active vibration control of long span suspension bridge flutter using separated control flaps (SFSC) has shown to increase effectively the critical wind speed of bridges. In this paper, an SFSC calculation based on modal equations of the vertical and torsional motions of the bridge girder including...... the flaps is presented. The length of the flaps attached to the girder, the flap configuration and the flap rotational angles are parameters used to increase the critical wind speed of the bridge. To illustrate the theory a numerical example is shown for a suspension bridge of 1000m+2500m+1000m span based...... on the Great Belt Bridge streamlined girder....

  20. A tangled tale of two teal: Population history of the grey Anas gracilis and chestnut teal a. castanea of Australia

    Joseph, L.; Adcock, G.J.; Linde, C.; Omland, K.E.; Heinsohn, R.; Terry, Chesser R.; Roshier, D.

    2009-01-01

    Two Australian species of teal (Anseriformes: Anatidae: Anas), the grey teal Anas gracilis and the chestnut teal A. castanea, are remarkable for the zero or near-zero divergence recorded between them in earlier surveys of mitochondrial DNA (mtDNA) diversity. We confirmed this result through wider geographical and population sampling as well as nucleotide sampling in the more rapidly evolving mtDNA control region. Any data set where two species share polymorphism as is the case here can be explained by a model of gene flow through hybridization on one hand or by incomplete lineage sorting on the other hand. Ideally, analysis of such shared polymorphism would simultaneously estimate the likelihood of both phenomena. To do this, we used the underlying principle of the IMa package to explore ramifications to understanding population histories of A. gracilis and A. castanea. We cannot reject that hybridization occurs between the two species but an equally or more plausible finding for their nearly zero divergence is incomplete sorting following very recent divergence between the two, probably in the mid-late Pleistocene. Our data add to studies that explore intermediate stages in the evolution of reciprocal monophyly and paraphyletic or polyphyletic relationships in mtDNA diversity among widespread Australian birds. ?? 2009 J. Avian Biol.

  1. Clinical and radiological outcomes after a quasi-anatomical reconstruction of medial patellofemoral ligament with gracilis tendon autograft.

    Monllau, Joan C; Masferrer-Pino, Àngel; Ginovart, Gerard; Pérez-Prieto, Daniel; Gelber, Pablo E; Sanchis-Alfonso, Vicente

    2017-08-01

    To analyse the clinical and radiological outcomes of a quasi-anatomical reconstruction of the medial patellofemoral ligament (MPFL) with a gracilis tendon autograft. Patients with objective recurrent patellar instability that were operated on from 2006 to 2012 were included. A quasi-anatomical surgical technique was performed using a gracilis tendon autograft. It was anatomically attached at the patella, and the adductor magnus tendon was also used as a pulley for femoral fixation (non-anatomical reconstruction). The IKDC, Kujala and Lysholm scores as well as Tegner and VAS for pain were collected preoperatively and at final follow-up. Radiographic measurements of patellar position tilt and signs of osteoarthritis (OA) as well as trochlear dysplasia were also recorded. Thirty-six patients were included. The mean age at surgery was 25.6 years. After a minimum 27 months of follow-up, all functional scores significantly improved (p patellofemoral surfaces at the short term, as shown by the absence of radiological signs of OA in the CT scan. The procedure has been shown to be safe and suitable for the treatment of chronic patellar instability, including in adolescents with open physis. A new effective, inexpensive and easy-to-perform technique is described to reconstruct MPFL in the daily clinical practice. Therapeutic case series, Level IV.

  2. NÚMERO CROMOSSÔMICO DE Lippia gracilis Schauer (VERBENACEAE OCORRENTES NO ESTADO DO RIO GRANDE DO NORTE, BRASIL

    LUIS EDUARDO DE SOUSA SOARES

    2011-01-01

    Full Text Available The genus Lippia (Verbenaceae comprises about 200 species of pantropical distribution. Lippia gracilis Schauer, popularly known as the mountain balm, is an aromatic plant, native of northeastern Brazil, used in folk medicine as an antiseptic and to treat dermatitis. Although cytogenetic serve as a tool in taxonomy rate, cytogenetical studies of genus Lippia are restricted. Given the above, the present study aimed to determine, at the first time, the chromosome number of copies of L. gracilis, and thereby contribute to a better taxonomic understanding of this genus. In this sense root tips collected from newly planted specimens were pretreated with a solution of 2mM 8-hydroxyquinoline for 4 hours, fixed in Carnoy 3:1 (ethanol: acetic acid for 24 hours and stored in the same fixative for later analysis. The roots were hydrolyzed in 5N HCl for 20 minutes and the slides, prepared by squashing in acetic acid (45% and stained with 2% Giemsa. The best metaphases were photographed and pointed to the chromosome number 2n = 24. Moreover, were observed metacentric and submetacentric chromosomes. Because there are several chromosome numbers in the genus, from n=10 to n=30, and as the same is little known cytogenetically, f more comprehensive cytogenetic studies are necessary, involving a larger number of species, so these data may help to clarify taxonomic inconsistencies in the family Verbenaceae.

  3. Radiographic features of Golden Retriever muscular dystrophy.

    Brumitt, Jason W; Essman, Stephanie C; Kornegay, Joe N; Graham, John P; Weber, William J; Berry, Clifford R

    2006-01-01

    Golden Retriever muscular dystrophy is an inherited, degenerative myopathy due to the absence of dystrophin and is used as a model of Duchenne muscular dystrophy of young boys. This report describes the radiographic abnormalities of Golden Retriever muscular dystrophy in 26 dogs. The thoracic abnormalities included diaphragmatic asymmetry (18/26), diaphragmatic undulation (18/26), and gastro-esophageal hiatal hernia (6/26). Pelvic abnormalities included narrowing of the body of the ilia (14/19), ventral deviation and curvature of the tuber ischii (14/19), elongation of the obturator foramen with a decrease in opacity of the surrounding bone (12/19), and lateral flaring of the wings of the ilia (12/19). Abdominal abnormalities consisted of hepatomegaly (14/22) and poor serosal detail (12/22). The unique thoracic abnormalities were a consistent finding in affected Golden Retriever muscular dystrophy dogs. The diagnosis of muscular dystrophy should be included in the differential list if the combination of diaphragm undulation and asymmetry, and gastro-esophageal hiatal hernia are identified. These diaphragmatic abnormalities are related to hypertrophy and hyperplasia of the diaphragm. Additionally, the skeletal changes of pelvic tilt, elongation of the pelvis, widening of the obturator foramina and thinning of the ischiatic tables appear to be specific to Golden Retriever muscular dystrophy in dogs. These pelvic abnormalities are most likely secondary to bone remodeling associated with the progressive skeletal myopathy and subsequent contracture/fibrosis.

  4. Donor-site morbidity of the radial forearm free flap versus the ulnar forearm free flap.

    Hekner, Dominique D; Abbink, Jan H; van Es, Robert J; Rosenberg, Antoine; Koole, Ronald; Van Cann, Ellen M

    2013-08-01

    Donor-site morbidity following harvest of the radial forearm free flap was compared with that following harvest of the ulnar forearm free flap. Twenty-eight radial forearm and 27 ulnar forearm flaps were harvested in 55 patients with head and neck defects. Pressure perception was measured with Semmes-Weinstein monofilaments. Cold perception was tested with chloroethyl. Donor-site healing was evaluated. Patients were interviewed about grip and pinch strength and donor-site appearance. In the radial forearm free flap group, pressure perception and cold perception were reduced in the donor hand, whereas in the ulnar group, no differences were observed between the donor and unoperated hands. In the radial forearm group, 15 percent of patients experienced reduced strength in the donor hand, whereas in the ulnar forearm group, none of the patients reported reduced strength in the donor hand. In the radial forearm group, 14 percent had partial or complete loss of the skin graft, whereas in the ulnar forearm group, 4 percent had partial loss of the skin graft. In the radial forearm group, 18 percent of patients were dissatisfied with the appearance of the donor site, and no complaints were reported in the ulnar forearm group. The authors' study shows less donor site-morbidity following harvest of the ulnar forearm free flap than following harvest of the radial forearm free flap. These results emphasize that the ulnar forearm free flap should be considered as an alternative for the radial forearm free flap for reconstruction of soft-tissue defects. Therapeutic, III.

  5. "Apron" flap and re-creation of the inframammary fold following TRAM flap breast reconstruction.

    Amir, A; Silfen, R; Hauben, D J

    2000-03-01

    To the best of our knowledge, the recreation of an inframammary fold after TRAM flap breast reconstruction has not yet been described. This article offers a technique for the creation of an inframammary fold as a secondary procedure. The technique has been performed thus far in two patients with good aesthetic outcomes and no postoperative complications. It may also be suitable for adding bulk to the TRAM flap, especially in bilateral breast reconstruction, and for other minor chest deformities.

  6. Spinal and bulbar muscular atrophy.

    Lieberman, Andrew P

    2018-01-01

    Spinal and bulbar muscular atrophy (SBMA) is an adult-onset degenerative disorder of the neuromuscular system resulting in slowly progressive weakness and atrophy of the proximal limb and bulbar muscles. The disease is caused by the expansion of a CAG/glutamine tract in the amino-terminus of the androgen receptor. That SBMA exclusively affects males reflects the fact that critical pathogenic events are hormone-dependent. These include translocation of the polyglutamine androgen receptor from the cytoplasm to the nucleus and unfolding of the mutant protein. Studies of the pathology of SBMA subjects have revealed nuclear aggregates of the mutant androgen receptor, loss of lower motor neurons in the brainstem and spinal cord, and both neurogenic and myopathic changes in skeletal muscle. Mechanisms underlying disease pathogenesis include toxicity in both lower motor neurons and skeletal muscle, where effects on transcription, intracellular transport, and mitochondrial function have been documented. Therapies to treat SBMA patients remain largely supportive, although experimental approaches targeting androgen action or promoting degradation of the mutant androgen receptor protein or the encoding RNA are under active study. Copyright © 2018 Elsevier B.V. All rights reserved.

  7. Flap Lymphedema after Successful Reconstruction of the Chronic Inguinal Wound with a Vertical Rectus Abdominis Flap (VRAM

    Yalcin Kulahci

    2012-07-01

    Full Text Available The reconstruction of extensive and complex wounds represents a challenging problem for reconstructive surgeon. The reconstructive options to provide cover-age following debridment of these complicated wounds are local, distant flaps, or freetissue transfer. Vertical rectus abdominis flaps have been used succes-sully to repair defects in the groin, hip, perineal, trunk, and breast regions. We encountered flap lymphedema after successful reconstruction of the chronic in-guinal wound with a vertical rectus abdominis (VRAM flap. As far as were able to ascertain, there is no report in the literature related to flap lymphedema.

  8. Tubularized Penile-Flap Urethroplasty Using a Fasciocutaneous Random Pedicled Flap for Recurrent Anterior Urethral Stricture

    Yong Jig Lee

    2012-05-01

    Full Text Available This report describes the use of a tubularized random flap for the curative treatment of recurrent anterior urethral stricture. Under the condition of pendulous lithotomy and suprapubic cystostomy, the urethral stricture was removed via a midline ventral penile incision followed by elevation of the flap and insertion of an 18-Fr catheter. Subcutaneous buried interrupted sutures were used to reapproximate the waterproof tubularized neourethra and to coapt with the neourethra and each stump of the urethra, first proximally and then distally. The defect of the penile shaft was covered by advancement of the surrounding scrotal flap. The indwelling catheter was maintained for 21 days. A 9 month postoperative cystoscopy showed no flap necrosis, no mechanical stricture, and no hair growth on the lumen of the neourethra. The patient showed no voiding discomfort 6 months after the operation. The advantages of this procedure are the lack of need for microsurgery, shortening of admission, the use of only spinal anesthesia (no general anesthesia, and a relatively short operative time. The tubularized unilateral penile fasciocutaneous flap should be considered an option for initial flap urethroplasty as a curative technique.

  9. Machine Learning for Flapping Wing Flight Control

    Goedhart, Menno; van Kampen, E.; Armanini, S.F.; de Visser, C.C.; Chu, Q.

    2018-01-01

    Flight control of Flapping Wing Micro Air Vehicles is challenging, because of their complex dynamics and variability due to manufacturing inconsistencies. Machine Learning algorithms can be used to tackle these challenges. A Policy Gradient algorithm is used to tune the gains of a

  10. Oral cavity reconstruction with the masseter flap

    Mahieu, R.; Russo, S.; Gualtieri, T.; Colletti, G.; Deganello, A.

    The purpose of this report is to highlight how an unusual, outdated, unpopular and overlooked reconstructive method such as the masseter flap can be a reliable, straightforward and effective solution for oral reconstruction in selected cases. We report the transposition of the masseter crossover

  11. Omental Pedicled Flap for Pulmonary Tuberculosis Sequelae ...

    The omental flap should be prophylactically used in post-pneumonectomy bronchial stump reinforcement where the underlying chronic inflammatory condition poses high risk for bronchial dehiscence. We present a unique case of pulmonary tuberculosis (TB) complicated by empyema, chronic pulmonary aspergillosis and ...

  12. Accelerating recovery after trauma with free flaps.

    Harris, G D; Nagle, D J; Lewis, V L; Bauer, B S

    1987-08-01

    Free flap versatility and dependability make the final result of microvascular reconstruction highly predictable. Free tissue transplantation should be considered as a primary treatment after trauma. The early use of free tissue transfer will result in fewer operations and a shortened duration of hospitalization in the initial post-trauma period.

  13. Evaluación de la bioacumulación de cobre en Euglena gracilis mediante la técnica de fluorescencia de rayos X

    David Cervantes-Garcia

    2014-07-01

    Full Text Available En esta investigación se evaluó el efecto de la exposición de cobre en la capacidad de bioacumulación de metal en células de Euglena gracilis. La acumulación de metal medida con la técnica de fluorescencia de rayos X (XRF mostró que la acumulación de Cu+2 en E. gracilis fue dosis dependiente y se incrementó significativamente en las células tratadas con 0.4 y 0.8 mM de Cu+2 con respecto al control. No se descarta la presencia de una estrategia de acumulación en E. gracilis que podría involucrar la participación de una serie de múltiples procesos, como producción de vacuolas. Futuros estudios al respecto deberán orientarse a evaluar la capacidad de bioacumulación de E. gracilis para su aplicación en programas de biorremediación de sistemas acuáticos.

  14. Acaricidal efficacies of Lippia gracilis essential oil and its phytochemicals against organophosphate-resistant and susceptible strains of Rhipicephalus (Boophilus) microplus

    Plant-derived natural products can serve as an alternative to synthetic compounds for control of ticks of veterinary and medical importance. Lippia gracilis is an aromatic plant that produces essential oil with high content of carvacrol and thymol monoterpenes. These monoterpenes have high acaricida...

  15. Cardiac involvement in patients with limb-girdle muscular dystrophy type 2 and Becker muscular dystrophy

    Sveen, Marie-Louise; Thune, Jens Jakob; Køber, Lars

    2008-01-01

    OBJECTIVE: To investigate the extent of cardiac involvement in patients with 1 of the 12 groups of recessively inherited limb-girdle muscular dystrophy type 2 (LGMD2A-L) and Becker muscular dystrophy (BMD). DESIGN: Prospective screening. SETTING: Neuromuscular Clinic and Department of Cardiology...

  16. Muscular cystic hydatidosis: case report

    Naspetti Riccardo

    2007-03-01

    Full Text Available Abstract Background Hydatidosis is a zoonosis caused by Echinococcus granulosus, and ingesting eggs released through the faeces from infected dogs infects humans. The location of the hydatid cysts is mostly hepatic and/or pulmonary, whereas musculoskeletal hydatidosis is very rare. Case presentation We report an unusual case of primary muscular hydatidosis in proximity of the big adductor in a young Sicilian man. The patient, 34 years old, was admitted to the Department of Infectious and Tropical Diseases for ultrasonographic detection, with successive confirmation by magnetic resonance imaging, of an ovular mass (13 × 8 cm in the big adductor of the left thigh, cyst-like, and containing several small cystic formations. Serological tests for hydatidosis gave negative results. A second drawing of blood was done 10 days after the first one and showed an increase in the antibody titer for hydatidosis. The patient was submitted to surgical excision of the lesion with perioperatory prophylaxis with albendazole. The histopathological examination of the bioptic material was not diriment in the diagnosis, therefore further tests were performed: additional serological tests for hydatidosis for the evaluation of IgE and IgG serotype (Western Blot and REAST, and molecular analysis of the excised material. These more specific serological tests gave positive results for hydatidosis, and the sequencing of the polymerase chain reaction products from the cyst evidenced E. granulosus DNA, genotype G1. Any post-surgery complications was observed during 6 following months. Conclusion Cystic hydatidosis should always be considered in the differential diagnosis of any cystic mass, regardless of its location, also in epidemiological contests less suggestive of the disease. The diagnosis should be achieved by taking into consideration the clinical aspects, the epidemiology of the disease, the imaging and immunological tests but, as demonstrated in this case, without

  17. Reconstruction of pressure sores with perforator-based propeller flaps.

    Jakubietz, Rafael G; Jakubietz, Danni F; Zahn, Robert; Schmidt, Karsten; Meffert, Rainer H; Jakubietz, Michael G

    2011-03-01

    Perforator flaps have been successfully used for reconstruction of pressure sores. Although V-Y advancement flaps approximate debrided wound edges, perforator-based propeller flaps allow rotation of healthy tissue into the defect. Perforator-based propeller flaps were planned in 13 patients. Seven pressure sores were over the sacrum, five over the ischial tuberosity, and one on the tip of the scapula. Three patients were paraplegic, six were bedridden, and five were ambulatory. In three patients, no perforators were found. In 10 patients, propeller flaps were transferred. In two patients, total flap necrosis occurred, which was reconstructed with local advancement flaps. In two cases, a wound dehiscence occurred and had to be revised. One hematoma required evacuation. No further complications were noted. No recurrence at the flap site occurred. Local perforator flaps allow closure of pressure sores without harvesting muscle. The propeller version has the added benefit of transferring tissue from a distant site, avoiding reapproximation of original wound edges. Twisting of the pedicle may cause torsion and venous obstruction. This can be avoided by dissecting a pedicle of at least 3 cm. Propeller flaps are a safe option for soft tissue reconstruction of pressure sores. © Thieme Medical Publishers.

  18. Robot-Assisted Free Flap in Head and Neck Reconstruction

    Han Gyeol Song

    2013-07-01

    Full Text Available Background  Robots have allowed head and neck surgeons to extirpate oropharyngealtumors safely without the need for lip-split incision or mandibulotomy. Using robots inoropharyngealreconstruction is newbut essentialfor oropharyngeal defectsthatresultfromrobotic tumor excision. We report our experience with robotic free-flap reconstruction ofhead and neck defectsto exemplify the necessity forrobotic reconstruction.Methods  We investigated head and neck cancer patients who underwent ablation surgeryand free-flap reconstruction by robot. Between July 1, 2011 andMarch 31, 2012, 5 caseswereperformed and patient demographics, location of tumor, pathologic stage, reconstructionmethods, flap size, recipient vessel, necessary pedicle length, and operation time wereinvestigated.Results  Among five free-flap reconstructions, four were radial forearm free flaps and onewas an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and oneflap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flapinsetting and microanastomosis were achieved using a specially manufactured roboticinstrument. The total operation timewas 1,041.0 minutes(range, 814 to 1,132 minutes, andcomplicationsincluding flap necrosis, hematoma, andwound dehiscence did not occur.Conclusions  Thisstudy demonstratesthe clinically applicable use ofrobotsin oropharyngealreconstruction, especially using a free flap. A robot can assist the operator in insettingthe flap at a deep portion of the oropharynx without the need to perform a traditionalmandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methodsand is accepted asthemost up-to-datemethod.

  19. Defining the Role of Free Flaps in Partial Breast Reconstruction.

    Smith, Mark L; Molina, Bianca J; Dayan, Erez; Jablonka, Eric M; Okwali, Michelle; Kim, Julie N; Dayan, Joseph H

    2018-03-01

     Free flaps have a well-established role in breast reconstruction after mastectomy; however, their role in partial breast reconstruction remains poorly defined. We reviewed our experience with partial breast reconstruction to better understand indications for free tissue transfer.  A retrospective review was performed of all patients undergoing partial breast reconstruction at our center between February 2009 and October 2015. We evaluated the characteristics of patients who underwent volume displacement procedures versus volume replacement procedures and free versus pedicled flap reconstruction.  There were 78 partial breast reconstructions, with 52 reductions/tissue rearrangements (displacement group) and 26 flaps (replacement group). Bra cup size and body mass index (BMI) were significantly smaller in the replacement group. Fifteen pedicled and 11 free flaps were performed. Most pedicled flaps (80.0%) were used for lateral or upper pole defects. Most free flaps (72.7%) were used for medial and inferior defects or when there was inadequate donor tissue for a pedicled flap. Complications included hematoma, cellulitis, and one aborted pedicled flap.  Free and pedicled flaps are useful for partial breast reconstruction, particularly in breast cancer patients with small breasts undergoing breast-conserving treatment (BCT). Flap selection depends on defect size, location, and donor tissue availability. Medial defects are difficult to reconstruct using pedicled flaps due to arc of rotation and intervening breast tissue. Free tissue transfer can overcome these obstacles. Confirming negative margins before flap reconstruction ensures harvest of adequate volume and avoids later re-operation. Judicious use of free flaps for oncoplastic reconstruction expands the possibility for breast conservation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  20. Reconstruction of the Lower Extremity Using Free Flaps

    Min Jo Kang

    2013-09-01

    Full Text Available Background The aim of lower-extremity reconstruction has focused on wound coverage andfunctional recovery. However, there are limitations in the use of a local flap in cases of extensivedefects of the lower-extremities. Therefore, free flap is a useful option in lower-extremityreconstruction.Methods We performed a retrospective review of 49 patients (52 cases who underwentlower-extremity reconstruction at our institution during a 10-year period. In these patients,we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis,survival rate, and complications.Results There were 42 men and 10 women with a mean age of 32.7 years (range, 3-72years. The sites of defects included the dorsum of the foot (19, pretibial area (17, ankle(7, heel (5 and other sites (4. The types of free flap included latissimus dorsi muscle flap(10, scapular fascial flap (6, anterolateral thigh flap (6, and other flaps (30. There werefour cases of vascular complications, out of which two flaps survived after intervention. Theoverall survival of the flaps was 96.2% (50/52. There were 19 cases of other complications atrecipient sites such as partial graft loss (8, partial flap necrosis (6 and infection (5. However,these complications were not notable and were resolved with skin grafts.Conclusions The free flap is an effective method of lower-extremity reconstruction. Goodoutcomes can be achieved with complete debridement and the selection of appropriaterecipient vessels and flaps according to the recipient site.

  1. Reconstruction of the Lower Extremity Using Free Flaps

    Min Jo Kang

    2013-09-01

    Full Text Available BackgroundThe aim of lower-extremity reconstruction has focused on wound coverage and functional recovery. However, there are limitations in the use of a local flap in cases of extensive defects of the lower-extremities. Therefore, free flap is a useful option in lower-extremity reconstruction.MethodsWe performed a retrospective review of 49 patients (52 cases who underwent lower-extremity reconstruction at our institution during a 10-year period. In these patients, we evaluated causes and sites of defects, types of flaps, recipient vessels, types of anastomosis, survival rate, and complications.ResultsThere were 42 men and 10 women with a mean age of 32.7 years (range, 3-72 years. The sites of defects included the dorsum of the foot (19, pretibial area (17, ankle (7, heel (5 and other sites (4. The types of free flap included latissimus dorsi muscle flap (10, scapular fascial flap (6, anterolateral thigh flap (6, and other flaps (30. There were four cases of vascular complications, out of which two flaps survived after intervention. The overall survival of the flaps was 96.2% (50/52. There were 19 cases of other complications at recipient sites such as partial graft loss (8, partial flap necrosis (6 and infection (5. However, these complications were not notable and were resolved with skin grafts.ConclusionsThe free flap is an effective method of lower-extremity reconstruction. Good outcomes can be achieved with complete debridement and the selection of appropriate recipient vessels and flaps according to the recipient site.

  2. Catch composition of the spiny lobster Panulirus gracilis (Decapoda: Palinuridae off the western coast of Mexico Composición de la captura de la langosta espinosa Panulirus gracilis (Decapoda: Palinuridae en la costa oeste de México

    Raúl Pérez-González

    2011-07-01

    Full Text Available The lobster fishery in the Gulf of California and the south-central region of the western coast of Mexico consists of small-scale artisanal activity supported by Panulirus gracilis and P. inflatus, with an annual average catch of 132 ton. The present study analyzes the landing composition of this fishery and the population structure of P. gracilis. Carapace lengths (CL for this species ranged from 35 to 125 mm, and the most frequent sizes were between 60 and 85 mm. The size distribution was approximately normal. This implies that the fishery is composed of several size classes, with annual recruitment to the fishing areas. For the 1989-1990 and 1990-1991 fishing seasons, the mean monthly sizes of males were between 70.18 ± 11.74 and 81.11 ± 6.76 mm CL, whereas females averaged from 73.60 ± 8.95 to 80.28 ± 7.53 mm CL. Power-law relationships between carapace length (CL in mm and total weight (TW in g were determined, resulting in the following equations: PT = 0.0021 CL27689 for males and PT = 0.0009 CL³ 0038 for females. During certain periods of the year, males dominated the catch; however, the overall annual male:female ratio was near 1:1.La pesquería de langosta en el golfo de California y en el centro-sur de la costa occidental de México es una actividad artesanal a pequeña escala y es sostenida por Panulirus gracilis y P. inflatus, con una captura promedio anual de 132 ton. En este estudio se analiza la composición de los desembarques de esta pesquería y la estructura de la población de P. gracilis. El intervalo de talla de esta especie fue de 35 a 125 mm de longitud del cefalotórax (LC y el más frecuente se encontró entre 60 y 85 mm. La distribución de tallas fue aproximadamente normal. Esto implica que la pesquería está compuesta por varias clases de tallas, con un reclutamiento anual a las áreas de pesca. La talla media mensual de machos fue entre 70,18 ± 11,74 y 81,11 ± 6,76 mm LC y en hembras de 73,60 ± 8,95 a 80

  3. Muscle MRI in Duchenne muscular dystrophy: Evidence of a distinctive pattern.

    Polavarapu, Kiran; Manjunath, Mahadevappa; Preethish-Kumar, Veeramani; Sekar, Deepha; Vengalil, Seena; Thomas, PriyaTreesa; Sathyaprabha, Talakad N; Bharath, Rose Dawn; Nalini, Atchayaram

    2016-11-01

    The purpose of this study was to describe the pattern of muscle involvement using MRI findings and correlate with functional as well as muscle strength measurements. Fifty genetically confirmed DMD children with a mean age of 7.6 ± 2.8 (4-15 years) underwent muscle MRI and qualitative assessment was done for muscle changes using Mercuri staging for fibro-fatty replacement on T1 sequence and Borsato score for myoedema on STIR sequence. Detailed phenotypic characterisation was done with Manual muscle testing (modified MRC grading) and Muscular Dystrophy Functional Rating Scale (MDFRS). Mercuri scoring showed severe fibro-fatty changes in Gluteus medius, minimus and Adductor magnus followed by moderate to severe changes in Gluteus maximus and Quadriceps muscles. Total sparing of Gracilis, Sartorius and Semimembranosus muscles was observed. Superficial posterior and lateral leg muscles were preferentially involved with sparing of deep posterior and anterior leg muscles. Myoedema showed significant inverse correlation with fatty infiltration in thigh muscles. Similarly, significant inverse correlation was observed between Mercuri scores and MRC grading as well as MDFRS scores. A direct linear correlation was observed between duration of illness and fibro-fatty changes in piriformis, quadriceps and superficial posterior leg muscles. There was no correlation between MRI findings and genotypic characteristics. However, this specific pattern of muscle involvement in MRI could aid in proceeding for genetic testing when clinical suspicion is high, thus reducing the need for muscle biopsy. Fibro fatty infiltration as measured by Mercuri scoring can be a useful marker for assessing the disease severity and progression. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Use of alternative media and different types of recipients in a laboratory culture of Ankistrodesmus gracilis (Reinsch Korshikov (Chlorophyceae - doi: 10.4025/actascibiolsci.v33i3.8046 Use of alternative media and different types of recipients in a laboratory culture of Ankistrodesmus gracilis (Reinsch Korshikov (Chlorophyceae - doi: 10.4025/actascibiolsci.v33i3.8046

    Flávia de Almeida Berchielli

    2011-07-01

    Full Text Available A laboratory culture of Ankistrodesmus gracilis algae was evaluated by studying the biology of the species and its chemical composition in a traditional medium (CHU12 and in two alternative culture media, NPK (20-5-20 and macrophyte (Eichhornia crassipes + NPK, in three different types of recipients (fiberglass, carboy and plastic bag. First peak in the growth curve of Ankistrodesmus gracilis occurred on the ninth day in macrophyte + NPK medium (74.16 x 105 cells mL-1 in a fiberglass recipient. However, highest density (p 12 (122.87 x 105 cells mL-1 in a plastic bag on the twelfth day. Cell density was over 70 x 105 cells mL-1 starting on the twelfth day. Growth rate of A. gracilis was similar (p > 0.05 in culture media in the three recipients. Protein and fiber were similar (p > 0.05 in the treatments, but lipids were higher (p -1 in NPK (p A. gracilis cultured in three types of recipients. Costs are low, occupying less space when cultured in plastic bags and in the laboratory.A laboratory culture of Ankistrodesmus gracilis algae was evaluated by studying the biology of the species and its chemical composition in a traditional medium (CHU12 and in two alternative culture media, NPK (20-5-20 and macrophyte (Eichhornia crassipes + NPK, in three different types of recipients (fiberglass, carboy and plastic bag. First peak in the growth curve of Ankistrodesmus gracilis occurred on the ninth day in macrophyte + NPK medium (74.16 x 105 cells mL-1 in a fiberglass recipient. However, highest density (p 12 (122.87 x 105 cells mL-1 in a plastic bag on the twelfth day. Cell density was over 70 x 105 cells mL-1 starting on the twelfth day. Growth rate of A. gracilis was similar (p > 0.05 in culture media in the three recipients. Protein and fiber were similar (p > 0.05 in the treatments, but lipids were higher (p -1 in NPK (p A. gracilis cultured in three types of recipients. Costs are low, occupying less space when cultured in plastic bags and in the

  5. [Human myopathy and animal muscular dystrophy].

    Schapira, G; Dreyfus, J C; Schapira, F

    1977-08-01

    Two hereditary muscular dystrophies similar to human progressive muscular dystrophy (P.M.D. Duchenne type) have been isolated in animals, one in mouse, the other in chicken. The decrease in the activity of glycogenolytic enzymes is similar to that observed in denervated muscle. Isozymic fetal types for several muscular enzymes have been observed as well in chicken as in man, but this fetal type may also be found in neurogenic atrophy. The release in circulation of muscle enzymes seems more specific. But the origin of the genetic lesion is still unknown. We describe here the three different theories about this problem: i.e. neurogenic, vascular, or myogenic. This last theory implies a trouble of membrane permeability.

  6. Mitochondrial disorders in progressive muscular dystrophies

    D. A. Kharlamov

    2014-01-01

    Full Text Available The literature review gives data on the role of mitochondrial disorders in the pathogenesis of different progressive muscular dystrophies. It describes changes in Duchenne, limb-girdle, facial scapulohumeral (Landuzi—Degerina muscular dystrophies. The review is based on both clinical and experimental animal studies. Along with the implication of mitochondria in the pathogenesis of the diseases, it describes muscular dystrophy treatment options compensating for energy disorders and overcoming oxidative stress and mitochondrial dysfunction. Mitochondrial studies in different muscle diseases hand physicians treatment modalities that fail to lead to recovery, but compensate for disorders caused by mutations in the genetic apparatus. 

  7. Muscular pathology: echographic and NMR imaging aspects

    Pascal-Suisse, P.; Beaurain, P.; Mougniot, C.

    1995-01-01

    A comparison of echographic techniques and NMR imaging has been done for the diagnosis of muscular trauma and tumor pathologies. In traumatic pathology, the echographic analysis allows to determine the complete assessment of recent muscular injuries. NMR imaging can be used in granuloma or fibrous callosity appreciation and for the analysis of deep injury (muscles and muscles-tendon junctions) and of muscular aponeurosis. Echography must be used together with color coding Doppler technique in the diagnosis of tumor pathology and for the study of slow fluxes. The recently available energy Doppler technique seems to be powerful in the study of vascularization of small expansive formations, but their extension to adjacent bone or tissue can only be appreciated using NMR imaging. (J.S.)

  8. Quality-of-life improvement after free gracilis muscle transfer for smile restoration in patients with facial paralysis.

    Lindsay, Robin W; Bhama, Prabhat; Hadlock, Tessa A

    2014-01-01

    Facial paralysis can contribute to disfigurement, psychological difficulties, and an inability to convey emotion via facial expression. In patients unable to perform a meaningful smile, free gracilis muscle transfer (FGMT) can often restore smile function. However, little is known about the impact on disease-specific quality of life. To determine quantitatively whether FGMT improves quality of life in patients with facial paralysis. Prospective evaluation of 154 FGMTs performed at a facial nerve center on 148 patients with facial paralysis. The Facial Clinimetric Evaluation (FaCE) survey and Facial Assessment by Computer Evaluation software (FACE-gram) were used to quantify quality-of-life improvement, oral commissure excursion, and symmetry with smile. Free gracilis muscle transfer. Change in FaCE score, oral commissure excursion, and symmetry with smile. There were 127 successful FGMTs on 124 patients and 14 failed procedures on 13 patients. Mean (SD) FaCE score increased significantly after successful FGMT (42.30 [15.9] vs 58.5 [17.60]; paired 2-tailed t test, P improved significantly in all subgroups (nonflaccid cohort, 37.8 [19.9] vs 52.9 [19.3]; P = .02; flaccid cohort, 43.1 [15.1] vs 59.6 [17.2]; P improved from a mean (SD) of 13.8 (7.46) to 4.88 (3.47) (P improvement in quality of life after FGMT in patients who could not recover a meaningful smile after facial nerve insult. Quality-of-life improvement was not statistically different between donor nerve groups or facial paralysis types.

  9. Flapping dynamics of a thin liquid sheet

    Vadivukkarasan, M.; Kumaran, Dhivyaraja; Panchagnula, Mahesh; Multi-phase flow physics Group Team

    2017-11-01

    We attempt to delineate and describe the complete evolution of a thin soap film when air is blown through a nozzle in the normal direction. The sequence of events and its intrinsic dynamics are captured using high speed imaging. By careful observation, it was observed that multiple mechanisms occur in the same system and each event is triggered by an independent mechanism. The events include (a) flapping of a liquid sheet and pinching of the bubble, (b) onset of rupture on the liquid sheet, (c) formation of ligaments and (d) ejection of drops. From this study, it is shown that these events are predominantly governed by Kelvin-Helmholtz instability, Taylor - Culick law, Rayleigh-Taylor instability and capillary instability, respectively. The present experiments can be considered as an extension to the previous studies on soap films as well as thin flapping sheets which has direct relevance to coaxial atomizers used in aircraft applications.

  10. Subcutaneous tissue flaps for hallux covering.

    Vaienti, Luca; Urzola, Victor; Scotti, Andrea; Masetto, L

    2010-03-01

    With the understanding of the extensive vascular supply of the subcutaneous tissue, of its efficacy in the protection of the anatomical structures and of its capability of promoting the adequate functioning of very stressed regions of the human body, the use of subcutaneous adipose flaps has become a valid and sometimes the only reasonable therapeutic weapon in the treatment of small and medium-sized tissue loss. Such a defect represents a common complication of great toe injuries and surgery. Here subcutaneous flap reconstruction is proposed for the treatment of dorsal and medial soft tissue losses of the hallux complicated with infection. Two case are reported. To the best of the authors' knowledge, this application has not been reported in this anatomical site so far. The technique might be worth knowing both for orthopedic and plastic surgeons, as it may represent a safe, less invasive solution for most tegumentary problems of the dorso-medial side of the first ray.

  11. Genetics Home Reference: spinal muscular atrophy with progressive myoclonic epilepsy

    ... myoclonic epilepsy Spinal muscular atrophy with progressive myoclonic epilepsy Printable PDF Open All Close All Enable Javascript ... boxes. Description Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) is a neurological condition that causes ...

  12. Diffusion-Tensor Imaging of Thigh Muscles in Duchenne Muscular Dystrophy: Correlation of Apparent Diffusion Coefficient and Fractional Anisotropy Values With Fatty Infiltration.

    Li, Gui Dian; Liang, Ying Yin; Xu, Ping; Ling, Jian; Chen, Ying Ming

    2016-04-01

    The purpose of this study is to investigate the correlation of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values with fatty infiltration in the thigh muscles of patients with Duchenne muscular dystrophy (DMD) using diffusion-tensor imaging (DTI). Twenty-one boys with DMD were recruited. The grade of fatty infiltration and the ADC and FA values of four thigh muscles (rectus femoris, semitendinosus, sartorius, and gracilis) were measured, and the FA and ADC values were compared with the grade of fatty infiltration. Twenty age-matched healthy boys were enrolled as the control group. The differences in the ADC and FA values of the thigh muscles between patients with DMD and the control group were compared. The patients with DMD showed lower FA values and higher ADC values in all measured muscles when compared with the control group. The FA and ADC values were correlated with the grade of fatty infiltration. For the rectus femoris muscle, r = -0.753 and p = 0.007 for FA, and r = 0.685 and p = 0.001 for ADC. For the semitendinosus muscle, r = -0.621 and p = 0.041 for FA, and r = 0.705 and p = 0.021 for ADC. For the sartorius muscle, r = -0.662 and p = 0.027 for FA, and r = 0.701 and p = 0.017 for ADC. For the gracilis muscle, r = -0.618 and p = 0.043 for FA, and r = 0.695 and p = 0.022 for ADC. Damage to the thigh muscles in patients with DMD can be detected by ADC and FA values using DTI. DTI can be used to assess the severity of the disease.

  13. Elbow Reconstruction Using Island Flap for Burn Patients

    Gi Yeun Hur

    2012-11-01

    Full Text Available BackgroundDeep burns of the elbow lead to soft tissue necrosis and infection, with exposure of deep structures. Adequate wound coverage of this area requires thin, pliable, and durable tissue, while optimal functional recovery requires early coverage and functional rehabilitation. We have found 3 types of island flaps that provide reliable coverage for the elbow.MethodsA retrospective study was performed on all patients who underwent flap coverage of an elbow defect at our hospital. The patients' data including age, sex, cause of injury, wound dimensions, timing of flap coverage, postoperative elbow motion, and complications were investigated.ResultsBetween 2001 and 2012, 16 patients were treated at our hospital. The mean age was 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral arm flaps, and 4 radial forearm flaps. The average defect size was 183.5 cm2 (range, 28 to 670 cm2. Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days. The mean postoperative active elbow flexion was 98° (range, 85° to 115°. Partial flap failure occurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%, hematoma (23.5%, seroma (35.3%, and wound infection (5.9%.ConclusionsFlap selection for elbow reconstruction is determined by the defect size and the extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a single-staged, reliable, and relatively simple procedure that permits initiation of early rehabilitation, thereby improving a patient's functional outcome.

  14. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK).

    Tsai, Tsung-Han; Peng, Kai-Ling; Lin, Chien-Jen

    2017-01-01

    Laser in situ keratomileusis (LASIK) is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK. A 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of -0.75 D to 1.0 D ×175° in her right eye 1 month later. We reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014. Traumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could mostly be restored with immediate and proper management.

  15. Robot-Assisted Free Flap in Head and Neck Reconstruction

    Han Gyeol Song

    2013-07-01

    Full Text Available BackgroundRobots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necessity for robotic reconstruction.MethodsWe investigated head and neck cancer patients who underwent ablation surgery and free-flap reconstruction by robot. Between July 1, 2011 and March 31, 2012, 5 cases were performed and patient demographics, location of tumor, pathologic stage, reconstruction methods, flap size, recipient vessel, necessary pedicle length, and operation time were investigated.ResultsAmong five free-flap reconstructions, four were radial forearm free flaps and one was an anterolateral thigh free-flap. Four flaps used the superior thyroid artery and one flap used a facial artery as the recipient vessel. The average pedicle length was 8.8 cm. Flap insetting and microanastomosis were achieved using a specially manufactured robotic instrument. The total operation time was 1,041.0 minutes (range, 814 to 1,132 minutes, and complications including flap necrosis, hematoma, and wound dehiscence did not occur.ConclusionsThis study demonstrates the clinically applicable use of robots in oropharyngeal reconstruction, especially using a free flap. A robot can assist the operator in insetting the flap at a deep portion of the oropharynx without the need to perform a traditional mandibulotomy. Robot-assisted reconstruction may substitute for existing surgical methods and is accepted as the most up-to-date method.

  16. [Pedicled versus free TRAM flap for breast reconstruction].

    Galla, T J; Lukas, B; Feller, A M

    1999-03-01

    In breast reconstruction, the free TRAM-flap offers many advantages over the pedicled TRAM-flap. Due to its superior perfusion, the free flap rarely develops necrosis. Shaping of the flap is easier due to the lack of the thick muscle pedicle. Because the rectus muscle is spared, there is minimal donor site morbidity. However, the necessary microvascular anastomoses reduced the acceptance of the free TRAM-flap. During a 13-months period, 51 breast reconstructions were performed in 41 patients, 31 unilateral and ten bilateral. 45 flaps served for delayed reconstruction and six flaps for immediate reconstruction. The operations were performed by two teams working simultaneously. The average operating time was 3.9 hours for unilateral and 6.9 hours for bilateral delayed reconstruction. For immediate reconstruction, 6.2 and 6.3 hours were required for uni- and bilateral procedures, respectively. In 38 flaps, the thoracodorsal vessels served as recipient vessels; 13 flaps were anastomosed to the internal mammary artery and vein. Postoperative complications were observed in 13 patients. Three vessel anastomoses had to be revised. In one flap, a partial necrosis occurred; in two flaps hematoma evacuation was necessary. Two patients suffered from fat necroses at the abdomen and one umbilicus was lost. Skin irritations and seromas at the abdomen occurred in five patients. Pulmonary embolism was diagnosed in one patient three weeks postoperatively. Abdominal hernias or bulging in the epigastric area were not observed up to 15 months after reconstruction. These results reveal a low complication rate for breast reconstruction with the free TRAM-flap. The advantages of this technique as compared to the pedicled technique are discussed.

  17. Muscular Imbalance Correction in the Power Fitness Training

    Olga E. Aftimichuk; Alexander V. Varvarich

    2013-01-01

    Muscular imbalance is one of the manifestations of pathological-biomechanical changes in muscular-skeletal system. It is the result of tonus-power imbalance of short and relaxed muscles. Muscle shortening is the most striking sign of muscular imbalance. Hypodynamia and passive lifestyle can cause such results. The paper justifies the experimental technique of women muscular imbalances correction by means of power training. Selection of exercises, weights and machines was made, taking into acc...

  18. Anatomy of vastus lateralis muscle flap.

    Tayfur, Volkan; Magden, Orhan; Edizer, Mete; Atabey, Atay

    2010-11-01

    A vastus lateralis muscle flap is used as a pedicled and free flap. In this study, the vastus lateralis muscles of 15 adult formalin-fixed cadavers (30 cases) were dissected. The dominant pedicle was found to be descending branch of the lateral circumflex femoral artery. The mean diameter of the artery was found to be 2.1 mm. This pedicle was located 119.4 mm distal to the pubic symphysis. The mean length of the major pedicle was found to be 56.8 mm when the dominant pedicle was chosen to nourish the flap. The dominant pedicle entered the muscle 155.8 and 213.7 mm from the greater trochanter and the anterior superior iliac spine, respectively. The muscle had proximal minor pedicles from the ascending and transverse branches of lateral circumflex femoral artery. These arteries had mean diameters of 1.8 and 2.0 mm, respectively. The distal minor branches were present in all of the dissections. The distal branch had a mean diameter of 1.8 mm. The origin of this distal branch was located 83.7 mm proximal to the intercondylar line. The motor nerve of the vastus lateralis was found to be originating from femoral nerve. The nerve entered the muscle 194.6 mm from the anterior superior iliac spine.

  19. Flapping inertia for selected rotor blades

    Berry, John D.; May, Matthew J.

    1991-01-01

    Aerodynamics of helicopter rotor systems cannot be investigated without consideration for the dynamics of the rotor. One of the principal properties of the rotor which affects the rotor dynamics is the inertia of the rotor blade about its root attachment. Previous aerodynamic investigation have been performed on rotor blades with a variety of planforms to determine the performance differences due to blade planform. The blades tested for this investigation have been tested on the U.S. Army 2 meter rotor test system (2MRTS) in the NASA Langley 14 by 22 foot subsonic tunnel for hover performance. This investigation was intended to provide fundamental information on the flapping inertia of five rotor blades with differing planforms. The inertia of the bare cuff and the cuff with a blade extension were also measured for comparison with the inertia of the blades. Inertia was determined using a swing testing technique, using the period of oscillation to determine the effective flapping inertia. The effect of damping in the swing test was measured and described. A comparison of the flapping inertials for rectangular and tapered planform blades of approximately the same mass showed the tapered blades to have a lower inertia, as expected.

  20. Medial circumflex femoral artery flap for ischial pressure sore

    Palanivelu S

    2009-01-01

    Full Text Available A new axial pattern flap based on the terminal branches of the medial circumflex femoral artery is described for coverage of ischial pressure sore. Based on the terminal branches of the transverse branch of medial circumflex femoral artery, which exit through the gap between the quadratus femoris muscle above and the upper border of adductor magnus muscle below, this fascio cutaneous flap is much smaller than the posterior thigh flap but extremely useful to cover ischeal pressure sores. The skin redundancy below the gluteal fold allows a primary closure of the donor defect. It can also be used in combination with biceps femoris muscle flap.

  1. Reconstruction of radionecrotic ulcer using a myocutaneous flap

    Takahashi, Hiroyuki; Okano, Shinji; Iwasaki, Yasumasa; Mori, Tamotsu; Miyamoto, Yoshihiro; Shigeki, Sadayuki

    1990-01-01

    Problems in the surgical treatment of radionecrotic ulcers, using a myocutaneous flap, have been reviewed in 21 patients. These problems included poor wound healing, radiation damage to important nerves and vessels there by making dissection difficult, malignant changes, infections, continuing necrosis of the tissue, and bleeding during surgery and secondary hemorrhaging. The use of a myocutaneous flap has many advantages when compared with conventional flaps and free skin grafts in the reconstruction of radionecrotic ulcers. Flap survival was good, but an incomplete excision of the ulcer delayed primary wound healing. Therefore, complete excision of the radionecrotic ulcer is imperative. (author)

  2. Reverse Saphenous Conduit Flap in 19 Dogs and 1 Cat.

    Cavalcanti, Jacqueline V J; Barry, Sabrina L; Lanz, Otto I; Barnes, Katherine; Coutin, Julia V

    2018-05-14

    The purpose of this retrospective study was to report the outcomes of 19 dogs and 1 cat undergoing reverse saphenous conduit flap between 1999 and 2016. Reverse saphenous conduit flap was used to treat traumatic wounds and wounds resulting from tumor excision in the hind limb; the majority of cases had medial shearing injuries. All animals had complete flap survival. In five animals (20%), minor donor site dehiscence occurred, which did not require surgery. Other postoperative complications included signs of severe venous congestion in one dog. Reverse saphenous conduit flap is a useful technique to repair skin defects of the distal hind limb.

  3. Development of a morphing flap using shape memory alloy actuators: the aerodynamic characteristics of a morphing flap

    Ko, Seung-Hee; Bae, Jae-Sung; Rho, Jin-Ho

    2014-01-01

    The discontinuous contour of a wing with conventional flaps diminishes the aerodynamic performance of an aircraft. A wing with a continuous contour does not experience extreme flow stream fluctuations during flight, and consequently has good aerodynamic characteristics. In this study, a morphing flap using shape memory alloy actuators is proposed, designed and fabricated, and its aerodynamic characteristics are investigated using aerodynamic analyses and wind tunnel tests. The ribs of the morphing flap are designed and fabricated with multiple elements joined together in a way that allows relative rotations of adjacent elements and forms a smooth contour of the morphing flap. The aerodynamic analyses of this multiple-element morphing-flap wing are performed using XFLR pro; its aerodynamic performance is compared with that of a mechanical-flap wing, and is measured through wind-tunnel tests. (papers)

  4. Impact of elevated CO2 concentrations on the growth and ultrastructure of non-calcifying marine diatom (Chaetoceros gracilis F.Schütt

    Hanan M. Khairy

    2014-01-01

    Full Text Available The impacts of different CO2 concentrations on the growth, physiology and ultrastructure of noncalcifying microalga Chaetoceros gracilis F.Schütt (Diatom were studied. We incubated Ch. gracilis under different CO2 concentrations, preindustrial and current ambient atmospheric concentrations (285 and 385 μatm, respectively or predicted year-2100 CO2 levels (550, 750 and 1050 μatm in continuous culture conditions. The growth of Ch. gracilis measured as cell number was decreased by increasing the pCO2 concentration from nowadays concentration (385 μatm to 1050 μatm. The lowest percentage changes of oxidizable organic matter, nitrite, nitrate, phosphate and silicate were recorded at a higher pCO2 (1050 μatm, and this is in consistence with the lowest recorded cell number indicating unsuitable conditions for the growth of Ch. gracilis. The minimum cell numbers obtained at higher levels of CO2 clearly demonstrate that, low improvement occurred when the carbon level was raised. This was confirmed by a highly negative correlation between cell number and carbon dioxide partial pressure (r = −0.742, p ⩽ 0.05. On the other hand, highest growth rate at pCO2 = 385 μatm was also confirmed by the maximum uptake of nutrient salts (NO3 = 68.96 μmol.l−1, PO4 = 29.75 μmol.l−1, Si2O3 = 36.99 μmol.l−1. Total protein, carbohydrate and lipid composition showed significant differences (p ⩽ 0.05 at different carbon dioxide concentrations during the exponential growth phase (day 8. Transmission Electron Microscopy of Ch. gracilis showed enlargement of the cell, chloroplast damage, disorganization and disintegration of thylakoid membranes; cell lysis occurs at a higher CO2 concentration (1050 μatm. It is concluded from this regression equation and from the results that the growth of Ch. gracilis is expected to decrease by increasing pCO2 and increasing ocean acidification.

  5. Cardiomyopathy in becker muscular dystrophy: Overview.

    Ho, Rady; Nguyen, My-Le; Mather, Paul

    2016-06-26

    Becker muscular dystrophy (BMD) is an X-linked recessive disorder involving mutations of the dystrophin gene. Cardiac involvement in BMD has been described and cardiomyopathy represents the number one cause of death in these patients. In this paper, the pathophysiology, clinical evaluations and management of cardiomyopathy in patients with BMD will be discussed.

  6. Respiratory muscle training in Duchenne muscular dystrophy.

    Rodillo, E; Noble-Jamieson, C M; Aber, V; Heckmatt, J Z; Muntoni, F; Dubowitz, V

    1989-01-01

    Twenty two boys with Duchenne muscular dystrophy were entered into a randomised double blind crossover trial to compare respiratory muscle training with a Triflow II inspirometer and 'placebo' training with a mini peak flow meter. Supine posture was associated with significantly impaired lung function, but respiratory muscle training showed no benefit.

  7. A Drosophila model for Duchenne muscular dystrophy

    Plas, Mariska Cathelijne van der

    2008-01-01

    Duchenne Muscular Dystrophy (DMD) is a severe X-linked disease characterized by progressive muscle wasting and sometimes mild mental retardation. The disease is caused by mutations in the dystrophin gene. DMD is correlated with the absence of Dp427, which is located along the sarcolemma in skeletal

  8. Duchenne muscular dystrophy models show their age

    Chamberlain, Jeffrey S.

    2010-01-01

    The lack of appropriate animal models has hampered efforts to develop therapies for Duchenne muscular dystrophy (DMD). A new mouse model lacking both dystrophin and telomerase (Sacco et al., 2010) closely mimics the pathological progression of human DMD and shows that muscle stem cell activity is a key determinant of disease severity.

  9. What Are the Treatments for Muscular Dystrophy?

    ... Child Neurology Society. (2005). Practice parameter: Corticosteroid treatment of Duchenne dystrophy. Neurology, 64 , 13-20. Retrieved June 22, 2012, ... Statement. (2004). Respiratory care of the patient with Duchenne muscular ... American Journal of Respiratory and Critical Care Medicine, 170, 456-465. ...

  10. Visuospatial Attention Disturbance in Duchenne Muscular Dystrophy

    De Moura, Maria Clara Drummond Soares; do Valle, Luiz Eduardo Ribeiro; Resende, Maria Bernadete Dutra; Pinto, Katia Osternack

    2010-01-01

    Aim: The cognitive deficits present in the Duchenne muscular dystrophy (DMD) are not yet well characterized. Attention, considered to be the brain mechanism responsible for the selection of sensory stimuli, could be disturbed in DMD, contributing, at least partially, to the observed global cognitive deficit. The aim of this study was to…

  11. Brain Function in Duchenne Muscular Dystrophy

    J. Gordon Millichap

    2002-02-01

    Full Text Available The role of dystrophin disorders in the CNS function of boys with Duchenne muscular dystrophy (DMD and the dystrophin-deficient mdx mouse, an animal model of DMD, is reviewed at the University of New South Wales, University of Sydney, Australia.

  12. Duchenne muscular dystrophy - a molecular service

    In 1987 a carrier detection and prenatal diagnostic service for. Duchenne muscular dystrophy using molecular technology was instituted at the Department of Human Genetics, Uni- versity of Cape Town, to serve affe.cted families in southern. Africa. DNA samples from 100 affected male subjects and. 350 of their relatives ...

  13. Skull development in the muscular dystrophic mouse

    Vilmann, H; Kirkeby, S; Moss, M L

    1989-01-01

    Roentgencephalometric tracings of skulls of 7-week-old normal and muscular dystrophic mice were compared. A marked size reduction of the dystrophic skulls relative to the normal ones was observed. However, the visceral parts of the dystrophic skull were more reduced in size than the neural parts....

  14. Hereditary muscular dystrophies and the heart

    Hermans, M. C. E.; Pinto, Y. M.; Merkies, I. S. J.; de Die-Smulders, C. E. M.; Crijns, H. J. G. M.; Faber, C. G.

    2010-01-01

    Cardiac disease is a common clinical manifestation of neuromuscular disorders, particularly of muscular dystrophies. Heart muscle cells as well as specialized conducting myocardial fibres may be affected by the dystrophic process. The incidence and nature of cardiac involvement vary with different

  15. Navier-Stokes Computations of a Wing-Flap Model With Blowing Normal to the Flap Surface

    Boyd, D. Douglas, Jr.

    2005-01-01

    A computational study of a generic wing with a half span flap shows the mean flow effects of several blown flap configurations. The effort compares and contrasts the thin-layer, Reynolds averaged, Navier-Stokes solutions of a baseline wing-flap configuration with configurations that have blowing normal to the flap surface through small slits near the flap side edge. Vorticity contours reveal a dual vortex structure at the flap side edge for all cases. The dual vortex merges into a single vortex at approximately the mid-flap chord location. Upper surface blowing reduces the strength of the merged vortex and moves the vortex away from the upper edge. Lower surface blowing thickens the lower shear layer and weakens the merged vortex, but not as much as upper surface blowing. Side surface blowing forces the lower surface vortex farther outboard of the flap edge by effectively increasing the aerodynamic span of the flap. It is seen that there is no global aerodynamic penalty or benefit from the particular blowing configurations examined.

  16. Identification of Flap Motion Parameters for Vibration Reduction in Helicopter Rotors with Multiple Active Trailing Edge Flaps

    Uğbreve;ur Dalli

    2011-01-01

    Full Text Available An active control method utilizing the multiple trailing edge flap configuration for rotorcraft vibration suppression and blade loads control is presented. A comprehensive model for rotor blade with active trailing edge flaps is used to calculate the vibration characteristics, natural frequencies and mode shapes of any complex composite helicopter rotor blade. A computer program is developed to calculate the system response, rotor blade root forces and moments under aerodynamic forcing conditions. Rotor blade system response is calculated using the proposed solution method and the developed program depending on any structural and aerodynamic properties of rotor blades, structural properties of trailing edge flaps and properties of trailing edge flap actuator inputs. Rotor blade loads are determined first on a nominal rotor blade without multiple active trailing edge flaps and then the effects of the active flap motions on the existing rotor blade loads are investigated. Multiple active trailing edge flaps are controlled by using open loop controllers to identify the effects of the actuator signal output properties such as frequency, amplitude and phase on the system response. Effects of using multiple trailing edge flaps on controlling rotor blade vibrations are investigated and some design criteria are determined for the design of trailing edge flap controller that will provide actuator signal outputs to minimize the rotor blade root loads. It is calculated that using the developed active trailing edge rotor blade model, helicopter rotor blade vibrations can be reduced up to 36% of the nominal rotor blade vibrations.

  17. Elbow Reconstruction Using Island Flap for Burn Patients

    Gi Yeun Hur

    2012-11-01

    Full Text Available Background Deep burns of the elbow lead to soft tissue necrosis and infection, with exposureof deep structures. Adequate wound coverage of this area requires thin, pliable, and durabletissue, while optimal functional recovery requires early coverage and functional rehabilitation.We have found 3 types of island flaps that provide reliable coverage for the elbow.Methods A retrospective study was performed on all patients who underwent flap coverageof an elbow defect at our hospital. The patients’ data including age, sex, cause of injury, wounddimensions, timing of flap coverage, postoperative elbow motion, and complications wereinvestigated.Results Between 2001 and 2012, 16 patients were treated at our hospital. The mean agewas 53.3 years. Three kinds of flaps were performed: 9 latissimus dorsi flaps, 4 lateral armflaps, and 4 radial forearm flaps. The average defect size was 183.5 cm2 (range, 28 to 670cm2. Wound coverage was performed at mean duration of 45.9 days (range, 14 to 91 days.The mean postoperative active elbow flexion was 98° (range, 85° to 115°. Partial flap failureoccurred in 1 latissimus dorsi flap. Minor complications included partial flap loss (11.8%,hematoma (23.5%, seroma (35.3%, and wound infection (5.9%.Conclusions Flap selection for elbow reconstruction is determined by the defect size andthe extent of the adjacent tissue injury. Elbow reconstruction using an island flap is a singlestaged,reliable, and relatively simple procedure that permits initiation of early rehabilitation,thereby improving a patient’s functional outcome.

  18. Folding in and out: passive morphing in flapping wings.

    Stowers, Amanda K; Lentink, David

    2015-03-25

    We present a new mechanism for passive wing morphing of flapping wings inspired by bat and bird wing morphology. The mechanism consists of an unactuated hand wing connected to the arm wing with a wrist joint. Flapping motion generates centrifugal accelerations in the hand wing, forcing it to unfold passively. Using a robotic model in hover, we made kinematic measurements of unfolding kinematics as functions of the non-dimensional wingspan fold ratio (2-2.5) and flapping frequency (5-17 Hz) using stereo high-speed cameras. We find that the wings unfold passively within one to two flaps and remain unfolded with only small amplitude oscillations. To better understand the passive dynamics, we constructed a computer model of the unfolding process based on rigid body dynamics, contact models, and aerodynamic correlations. This model predicts the measured passive unfolding within about one flap and shows that unfolding is driven by centrifugal acceleration induced by flapping. The simulations also predict that relative unfolding time only weakly depends on flapping frequency and can be reduced to less than half a wingbeat by increasing flapping amplitude. Subsequent dimensional analysis shows that the time required to unfold passively is of the same order of magnitude as the flapping period. This suggests that centrifugal acceleration can drive passive unfolding within approximately one wingbeat in small and large wings. Finally, we show experimentally that passive unfolding wings can withstand impact with a branch, by first folding and then unfolding passively. This mechanism enables flapping robots to squeeze through clutter without sophisticated control. Passive unfolding also provides a new avenue in morphing wing design that makes future flapping morphing wings possibly more energy efficient and light-weight. Simultaneously these results point to possible inertia driven, and therefore metabolically efficient, control strategies in bats and birds to morph or recover

  19. Cardiac involvement in children with neuro-muscular disorders

    E. N. Arkhipova

    2015-01-01

    Full Text Available Many inherited neuromuscular disorders include cardiac involvement as a typical clinical feature. Among the most common of them is the group of muscular dystrophies. Dilated cardiomyopathy, ventricular arrhythmias, atrial fibrillations, atrioventricular and intraventricular conduction abnormalities, and sudden cardiac death are well known pathological findings in Duchenne muscular dystrophies, myotonic dystrophy type I and 2, Emery-Dreifuss muscular dystrophies and different types of limb-girdle muscular dystrophies and other disorders. Detection of cardiac pathology in patients with different muscular dystrophies is possible with ECG, echocardiography and cardiovascular magnetic resonance imaging, which are recommended for screening and early cardioprotective treatment.

  20. In vitro activity of essential oils of Lippia sidoides and Lippia gracilis and their major chemical components against Thielaviopsis paradoxa, causal agent of stem bleeding in coconut palms

    Rejane Rodrigues da Costa e Carvalho

    2013-01-01

    Full Text Available Essential oils of Lippia sidoides, Lippia gracilis and their main chemical components were investigated for in vitro control of Thielaviopsis paradoxa. Mycelial growth and a number of pathogen conidia were inhibited by the essential oil of L. sidoides at all concentrations tested (0.2; 0.5; 1.0; 3.0 µL mL-1. L. sidoides oil contained 42.33% thymol and 4.56% carvacrol, while L. gracilis oil contained 10% thymol and 41.7% carvacrol. Mycelial growth and conidial production of T. paradoxa were completely inhibited by thymol at a 0.3 µL m-1 concentration. The results suggest that thymol could potentially be used for controlling coconut stem bleeding.

  1. Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities

    Ashok R Koul

    2011-01-01

    Full Text Available Background: A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD and anterolateral thigh (ALT flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Abdominis Myocutaneous (BERAM flap. This flap is the slightly modified and "free" version of a similar flap described by Ian Taylor in 1983. Materials and Methods: This is a retrospective study of patients who underwent free BERAM flap reconstruction of soft tissue defects of extremity over the last 3 years. We also did a clinical study on 30 volunteers to compare the length of flap available using our design of BERAM flap with the maximum available flap length of LD and ALT flaps, using standard markings. Results: Our clinical experience of nine cases combined with the results of our clinical study has confirmed that our design of BERAM flap consistently provides a flap length which is 32.6% longer than the standard LD flap and 42.2% longer than the standard ALT flap in adults. The difference is even more marked in children. The BERAM flap is consistently reliable as long as the distal end is not extended beyond the mid-axillary line. Conclusion: BERAM flap is simple in design, easy to harvest, reliable and provides the longest possible free skin/myocutaneous flap in the body. It is a useful new alternative for covering long soft tissue defects in the limbs.

  2. Free Boomerang-shaped Extended Rectus Abdominis Myocutaneous flap: The longest possible skin/myocutaneous free flap for soft tissue reconstruction of extremities.

    Koul, Ashok R; Nahar, Sushil; Prabhu, Jagdish; Kale, Subhash M; Kumar, Praveen H P

    2011-09-01

    A soft tissue defect requiring flap cover which is longer than that provided by the conventional "long" free flaps like latissimus dorsi (LD) and anterolateral thigh (ALT) flap is a challenging problem. Often, in such a situation, a combination of flaps is required. Over the last 3 years, we have managed nine such defects successfully with a free "Boomerang-shaped" Extended Rectus Abdominis Myocutaneous (BERAM) flap. This flap is the slightly modified and "free" version of a similar flap described by Ian Taylor in 1983. This is a retrospective study of patients who underwent free BERAM flap reconstruction of soft tissue defects of extremity over the last 3 years. We also did a clinical study on 30 volunteers to compare the length of flap available using our design of BERAM flap with the maximum available flap length of LD and ALT flaps, using standard markings. Our clinical experience of nine cases combined with the results of our clinical study has confirmed that our design of BERAM flap consistently provides a flap length which is 32.6% longer than the standard LD flap and 42.2% longer than the standard ALT flap in adults. The difference is even more marked in children. The BERAM flap is consistently reliable as long as the distal end is not extended beyond the mid-axillary line. BERAM flap is simple in design, easy to harvest, reliable and provides the longest possible free skin/myocutaneous flap in the body. It is a useful new alternative for covering long soft tissue defects in the limbs.

  3. Fungitoxicidade dos extratos vegetais e do óleo essencial de Lippia gracilis Schauer sobre o fungo Monosporascus cannonballus Pollack e Uecker

    Luciana Cristina Borges Fernandes

    2015-06-01

    Full Text Available Alecrim da Chapada (Lippia gracilis Schauer é considerada uma planta rica em óleo essencial e possui atividade antimicrobiana comprovada, devido aos monoterpenos fenólicos carvacrol e timol. O objetivo deste trabalho foi avaliar o efeito in vitro do óleo essencial e dos extratos etanólicos de raízes e folhas de L. gracilis no controle do fungo Monosporasccus cannonballus, causador do colapso do meloeiro. O extratos foram testados nas concentrações de 2500, 5000 e 7500 ppm e o óleo essencial de L. gracilis foi avaliado nas concentrações 255, 340 e 425 ppm tendo também um controle positivo com o fungicida comercial Captan(r e um negativo apenas com meio BDA (batata, dextrose, ágar. Discos de micélio com 3 mm de diâmetro foram inoculados no centro de placas de Petri e as medições do crescimento micelial do fungo foram realizadas 48 horas após a montagem do experimento. Verificou-se que o óleo essencial de L. gracilis nas três concentrações testadas foi eficiente para o controle do fungo, com percentuais de inibição de 100%, em comparação ao tratamento com o controle negativo (0% que não apresentou inibição. O extrato radicular, nas concentrações de 5000 e 7500 ppm e o extrato foliar na concentração de 7500 ppm também proporcionaram um percentual de inibição de 100%.

  4. Repair of nostril stenosis using a triple flap combination: boomerang, nasolabial, and vestibular rotation flaps.

    Bozkurt, Mehmet; Kapi, Emin; Kuvat, Samet Vasfi; Selçuk, Caferi Tayyar

    2012-11-01

    Tissue losses within the nose due to various reasons result in the loss of normal anatomy and function. The external nasal valve area is one of the most important functional components of the nose. The columella, lobule, nostril, and alar region are among the components forming the external nasal valve area. Deformities of the nostrils are among the most frequently observed features that interfere with the functional anatomy of the nose. Malformations of the nostrils often emerge subsequent to cleft lip repairs. Stenoses are a common type of pathology among nostril deformities. In cases where a stenosis has formed, breathing problems and developmental anomalies may occur. In the patient with nostril stenosis presented in this report, there was a serious alar collapse and contracture subsequent to a cleft lip repair. In order to repair the nostril stenosis, a "boomerang flap" was chosen. This boomerang flap was used in combination with a nasolabial flap, a vestibular rotation flap, and a conchal cartilage graft to achieve a satisfactory repair.

  5. Repair of large palatal fistula using tongue flap

    Fejjal Nawfal

    2014-01-01

    Full Text Available Large palatal fistulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue flap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fistula closure with anteriorly based tongue flap.

  6. Treatment of ischial pressure sores with double adipofascial turnover flaps.

    Lin, Haodong; Hou, Chunlin; Xu, Zhen; Chen, Aiming

    2010-01-01

    Despite a variety of flap reconstruction options, the ischium remains the most difficult pressure sore site to treat. This article describes the authors' successful surgical procedure for coverage of ischial ulcers using double adipofascial turnover flaps.After debridement, the adipofascial flaps are harvested both cephalad and caudal to the defect. The flaps are then turned over to cover the exposed bone in a manner so as to overlap the 2 flaps. The skin is then closed with sutures in 2 layers. A total of 15 patients with ischial sores were treated using this surgical procedure.The follow-up period ranged from 11 to 159 months, with a mean of 93.6 months. Overall, 86.7% of the flaps (13 of 15) healed primarily. One patient had a recurrent grade II ischial pressure sore again 11 months after the operation. The other 14 patients did not have a recurrence.Treatment of ischial pressure sores with adipofascial turnover flaps provides an easy, minimally invasive procedure, with preservation of future flap options, and a soft-tissue supply sufficient for covering the bony prominence and filling dead space. This technique is a reliable and safe reconstructive modality for the management of minor ischial pressure sores.

  7. Upper lip reconstruction using a pedicel superficial temporal artery flap

    Mohammad M. Al-Qattan

    2018-01-01

    Conclusion: We demonstrate that the pedicle flap is much simpler than the free flap and is adequate for reconstruction of partial upper lip defects. We also demonstrate a good cosmetic and functional outcome; and highlight several technical points to ensure a satisfactory outcome.

  8. Accuracy of Visual Estimation of LASIK Flap Thickness.

    Brenner, Jason E; Fadlallah, Ali; Hatch, Kathryn M; Choi, Catherine; Sayegh, Rony R; Kouyoumjian, Paul; Wu, Simon; Frangieh, George T; Melki, Samir A

    2017-11-01

    To assess the accuracy of surgeons' visual estimation of LASIK flap thickness when created by a femtosecond laser by comparing it to ultrasound measurements. Surgeons were asked to visually estimate the thickness of a femtosecond flap during the procedure. Total corneal thickness was measured by ultrasound pachymetry prior to the procedure and the stromal bed was similarly measured after flap lifting. The estimates from three experienced surgeons (cornea fellowship trained and more than 5 years in practice) were compared to those of three cornea fellows, with each surgeon evaluating 20 eyes (120 total). Surgeons were not told the thickness of the flaps unless required for safety reasons. The average difference between visual and ultrasonic estimation of LASIK flap thickness was 15.20 μm. The flap was 10 μm thicker than estimated in 37% of eyes, 20 μm thicker in 17% of eyes, and 30 μm thicker in 10% of eyes. The largest deviation was 53 μm. There was no statistically significant difference between the accuracy of experienced surgeons and fellows (P = .51). There are significant differences between surgeons' visual estimates and ultrasonic measurements of LASIK flap thickness. Relying on these visual estimates may lead to deeper excimer laser ablation than intended. This could lead to thinner residual stromal beds and higher percent tissue altered than planned. The authors recommend that surgeons measure flaps intraoperatively to maximize accuracy and safety. [J Refract Surg. 2017;33(11):765-767.]. Copyright 2017, SLACK Incorporated.

  9. Experimental and numerical study of an autonomous flap

    Bernhammer, L.O.; Navalkar, S.T.; Sodja, J.; De Breuker, R.; Karpel, M.

    2015-01-01

    This paper presents the experimental and numerical study of an autonomous load alleviation concept using trailing edge flaps. The flaps are autonomous units, which for instance can be used for gust load alleviation. The unit is self-powered and self-actuated through trailing edge tabs which are

  10. Preoperative CT angiography reduces surgery time in perforator flap reconstruction

    Smit, Jeroen M.; Dimopoulou, Angeliki; Liss, Anders G.; Zeebregts, Clark J.; Kildal, Morten; Whitaker, Iain S.; Magnusson, Anders; Acosta, Rafael

    The use of perforator flaps in breast reconstructions has increased considerably in the past decade. A disadvantage of the perforator flap is difficult dissection, which results in a longer procedure. During spring 2006, we introduced CT angiography (CTA) as part of the diagnostic work-up in

  11. The management of pelvic pressure ulcers by myocutaneous flaps ...

    Pressure ulcers or ischaemic necrosis of tissues over bony eminences due to pressure, heal very slowly. Vascularised tissues such as myocutaneous flaps are necessary to cover the ulcer and accelerate healing. This study was done to share our experience with methods of myocutaneous flaps in the treatment of pressure ...

  12. Regional Myocutaneous Flaps for Head and Neck Reconstruction ...

    Regional myocutaneous pedicle flaps (RMF) are known to be relevant in the reconstruction of major head and neck oncologic defects with pectoralis major myocutaneous pedicle flap (PMMC) being the best-known RMF. For over three decades, since first described by Ariyan in 1979, PMMC has continually been used in the ...

  13. Propeller flaps for lower-limb trauma | Rogers | South African ...

    The propeller flap has become a versatile and important component in our reconstructive algorithm following complex lower limb trauma. First described by Hyakusoku in 1991, it has since been adapted and modified by Hallock and Teo. This article outlines our experience specifically with perforator pedicled propeller flaps ...

  14. Peri-Vesical Fat Interposition Flap Reinforcement in High Vesico ...

    Background and Aim: The urinary bladder becomes small, contracted and is associated with excess pelvic fat in long standing cases of vesico-vaginal fistulas (VVFs). The aim of this new technique was to use this excess pelvic fat for harvesting an interposition flap. Materials and Methods: An interposition flap of peri-vesical ...

  15. A study of atriphos (ATP) action on muscular circulation in progressive muscular dystrophy by the radioactive xenon clearance technique

    Chakyrov, B.; Samardzhiev, A.

    1977-01-01

    The effect of intramuscularly and intravenously adminostered atriphos on the muscular circulation was studied with radioactive xenon in 12 children with progressive muscular dystrophy. After combined local intramuscular injection of ATP (atriphos) with the radioactive marker a 12-fold increment of muscular circulation ensues, lasting about 15 minutes. No vasodilatating effect on the muscular flow was oberved after intravenous injection of 20-40 mg of atriphos. It is believed that intramuscular administration of atriphos produced dilatation of capillaries and of the venous part of the muscular circulation. (author)

  16. The impact of Manjil and Tarik dams (Sefidroud River, southern Caspian Sea basin on morphological traits of Siah Mahi Capoeta gracilis (Pisces: Cyprinidae

    Adeleh Heidari

    2013-08-01

    Full Text Available It has been postulated that the building of the Manjil and Tarik dams on Sefidroud River has led to the body shape variation of Capoeta gracilis in up- and downstream populations due to the isolation. In this study, Geometric morphometric approach was used to explore body shape variations of Capoeta gracilis populations in up- and downstream Manjil and Tarik dams in Sefidroud River from south of the Caspian Sea basin. The shape of 90 individuals from three sampling sites was extracted by recording the 2-D coordinates of 13 landmark points. PCA, CVA, DFA and CA analysis were used to examine shape differences among the populations. The significant differences were found among the shape of the populations and these differences were observed in the snout, the caudal peduncle and head. The present study indicated the body shape differences in the populations of Capoeta gracilis in the Sefidroud River across the Manjil and Tarik dams, probably due to the dam construction showing anthropogenic transformation of rivers influences body shape in an aquatic organism.

  17. Optic chiasm in the species of order Clupeiformes, family Clupeidae: optic chiasm of Spratelloides gracilis shows an opposite laterality to that of Etrumeus teres.

    Mogi, Kazue; Misawa, Kazuya; Utsunomiya, Kentaro; Kawada, Yuta; Yamazaki, Toshihisa; Takeuchi, Shigeo; Toyoizumi, Ryuji

    2009-09-01

    In most teleost fishes, the optic nerves decussate completely as they project to the mesencephalic region. Examination of the decussation pattern of 25 species from 11 different orders in Pisces revealed that each species shows a specific chiasmic type. In 11 species out of the 25, laterality of the chiasmic pattern was not determined; in half of the individuals examined, the left optic nerve ran dorsally to the right optic nerve, while in the other half, the right optic nerve was dorsal. In eight other species the optic nerves from both eyes branched into several bundles at the chiasmic point, and intercalated to form a complicated decussation pattern. In the present study we report our findings that Spratelloides gracilis, of the order Clupeiformes, family Clupeidae, shows a particular laterality of decussation: the left optic nerve ran dorsally to the right (n=200/202). In contrast, Etrumeus teres, of the same order and family, had a strong preference of the opposite (complementary) chiasmic pattern to that of S. gracilis (n=59/59), revealing that these two species display opposite left-right optic chiasm patterning. As far as we investigated, other species of Clupeiformes have not shown left-right preference in the decussation pattern. We conclude that the opposite laterality of the optic chiasms of these two closely related species, S. gracilis and E. teres, enables investigation of species-specific laterality in fishes of symmetric shapes.

  18. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK

    Tsai TH

    2017-04-01

    Full Text Available Tsung-Han Tsai,1 Kai-Ling Peng,1 Chien-Jen Lin2 1Department of Ophthalmology, 2Department of Radiology, Chi Mei Medical Center, Tainan, Taiwan Background: Laser in situ keratomileusis (LASIK is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK.Case presentation: A 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of −0.75 D to 1.0 D ×175° in her right eye 1 month later.Literature review: We reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014.Conclusion: Traumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could

  19. LASIK flap buttonhole treated immediately by PRK with mitomycin C.

    Kymionis, George D; Portaliou, Dimitra M; Karavitaki, Alexandra E; Krasia, Maria S; Kontadakis, Georgios A; Stratos, Aimilianos; Yoo, Sonia H

    2010-03-01

    To describe the visual outcomes of three patients who had LASIK flap buttonhole and were treated immediately with photorefractive keratectomy (PRK) and topical mitomycin C (MMC) 0.02%. Three patients underwent bilateral LASIK with the SCHWIND Carriazo-Pendula 90 microm head microkeratome. In all three cases, a buttonhole flap occurred in the left eye. The flap was repositioned and phototherapeutic keratectomy for 50 microm was used for epithelial removal while immediate PRK with MMC was performed to treat the buttonhole flap. Three months after the procedure, uncorrected distance visual acuity and corrected distance visual acuity were 20/20 with regular topographic findings. Using PRK with MCC immediately after the occurrence of the LASIK flap buttonhole may be an effective treatment.

  20. Clinical application of scrotal flap on penis lengthening.

    Zhuo, Qinqiang; Li, Shirong; Wu, Julong; Wang, Zhenxiang; Yang, Dongyun; Tao, Ling

    2009-03-01

    To investigate the clinical application of the scrotal flap on penis lengthening. One hundred and fifty-two patients were operated using the scrotal flap from July 1998 to January 2008 at the Department of Plastic and Aesthetic, Surgery Southwest Hospital, Chongqing, China. The procedure consisted of designing a positive sign shaped incision 1.5cm above the root of the penis, dissect and release the superficial suspensory ligament and part of the deep suspensory ligament, then cover the elongated cavernosum with proper scrotal flap. Six-month to 5-year follow-up showed that all patients were satisfied with the good contour and function of the penis. The operation was successful. The method of using scrotal flap on penis lengthening has the following advantages: simple operation, reliable blood supply of the flap, one-stage operation, and satisfactory postoperative results. It is a preferable operation technique for penis lengthening.

  1. Study of Flapping Flight Using Discrete Vortex Method Based Simulations

    Devranjan, S.; Jalikop, Shreyas V.; Sreenivas, K. R.

    2013-12-01

    In recent times, research in the area of flapping flight has attracted renewed interest with an endeavor to use this mechanism in Micro Air vehicles (MAVs). For a sustained and high-endurance flight, having larger payload carrying capacity we need to identify a simple and efficient flapping-kinematics. In this paper, we have used flow visualizations and Discrete Vortex Method (DVM) based simulations for the study of flapping flight. Our results highlight that simple flapping kinematics with down-stroke period (tD) shorter than the upstroke period (tU) would produce a sustained lift. We have identified optimal asymmetry ratio (Ar = tD/tU), for which flapping-wings will produce maximum lift and find that introducing optimal wing flexibility will further enhances the lift.

  2. The expanded "BAT" flap for treatment of male pattern baldness.

    Anderson, R D

    1993-11-01

    A new combination of expanded simultaneous transposition and advancement flaps is reported for the treatment of extensive male pattern baldness. Although vertical transposition and parieto-occipital advancement flaps in themselves are not new, their combination and simultaneous bilateral use combined with the use of expansion is new. The advantages of the expanded bilateral advancement transposition flap procedure are presented, along with the technique and results. The results are predictable, providing a more pleasing result, with a natural immediate temporal recession, avoidance of temporal dog-ears, and desirable anterior-superior direction of hair growth. Although flaps do require surgical skill and training, and there are risks and possible complications involved, the results are achieved in a relatively short time compared with grafting techniques. Flaps also provide the advantages of a full and natural hairline contrasted with the sparse look afforded by multiple grafts. The described procedures are very effective and reliable when properly planned and properly executed.

  3. Ciclo reproductivo de Liolaemus gracilis Bell, 1843 (Iguanidae: Tropidurinae en las dunas costeras de Buenos Aires, Argentina

    Vega, Laura Estela

    2005-02-01

    Full Text Available Estudiamos la fenología y edad de madurez reproductiva y el tamaño y la frecuencia de la puesta de una población de Liolaemus gracilis de las dunas costeras de Buenos Aires, Argentina. Examinamos las gónadas de 93 ejemplares coleccionados mensualmente a lo largo de un año en la localidad de Mar del Sur (provincia de Buenos Aires y medimos 11 caracteres morfométricos en 39 adultos en búsqueda de dimorfismo sexual. Las hembras se consideraron maduras si poseían folículos yemados mayores a 2 mm, o huevos oviductales, u oviductos claramente distendidos. En los machos los indicadores de madurez sexual fueron la presencia de testículos agrandados y el estado convoluto de los epidídimos, midiéndose el ancho y largo del testículo izquierdo en cada uno. L. gracilis exhibió un patrón reproductivo estacional con características del tipo parcial de otoño. El tamaño medio de las hembras en actividad reproductiva fue de 48,9 mm ± 3,5 (largo hocico-cloaca (n = 19 y la menor madura sexualmente midió 43,8 mm. El tamaño de la puesta varió de 4 a 6 huevos ( X = 4,75 ± 0,95, n = 4. El macho de menor tamaño con testículos agrandados midió 40,5 mm. (largo hocico-cloaca. Tanto los machos como las hembras estuvieron reproductivamente activos desde comienzos del otoño hasta comienzos del verano. Las hembras producirían una puesta por año entre fines de la primavera y comienzos del verano y las crías nacerían a mediados de esta estación. Encontramos dimorfismo sexual en la mayor distancia entre los miembros anteriores y posteriores de las hembras y en la mayor longitud de la cabeza, tibio-fíbula y pie de los machos. We studied the reproductive phenology, size at maturity, frequency and clutch size of a lizard population of Liolaemus gracilis from coastal sand dunes of Buenos Aires, Argentina. We examined 93 specimens collected monthly throughout a year in the locality of Mar del Sur (Buenos Aires province and measured 11 morphometric

  4. Tensor fascia lata flap versus tensor fascia lata perforator-based island flap for the coverage of extensive trochanteric pressure sores.

    Kim, Youn Hwan; Kim, Sang Wha; Kim, Jeong Tae; Kim, Chang Yeon

    2013-06-01

    Tensor fascia lata (TFL) musculocutaneous flaps often require a donor site graft when harvesting a large flap. However, a major drawback is that it also sacrifices the muscle. To overcome this disadvantage, we designed a TFL perforator-based island flap that was harvested from a site near the defect and involved transposition within 90 degrees without full isolation of the pedicles. We performed procedures on 17 musculocutaneous flaps and 23 perforator-based island flaps, and compared the outcomes of these surgeries. The overall complication rate was 27.5% (11 regions). There were 7 complications related to the musculocutaneous flaps and 4 complications related to the perforator flaps. Although there were no statistical differences between those groups, lower complication rates were associated with procedures involving perforator flaps. The TFL perforator procedure is a simple and fast operation that avoids sacrificing muscle. This decreases complication rates compared to true perforator flap techniques that require dissection around the perforator or pedicle.

  5. Desferrioxamine: a practical method for improving neovascularization of prefabricated flaps.

    Li, Bin; Li, Hua; Jin, Rui; Cheng, Chen; Wang, Jing; Zhu, Hainan; Zan, Tao; Li, Qingfeng; Hao, Lijun

    2015-02-01

    Prefabricated flaps are an ideal alternative to repair massive and complex tissue defects. Nevertheless, the risk of necrosis due to unpredictable blood supplies is a major obstacle to the application of prefabricated flaps. The survival of a prefabricated flap depends on the neovascularization between the vascular carrier and the donor tissue. Here, we proposed that the iron chelator, desferrioxamine (DFX), owned therapeutic effects that promoted the neovascularization of prefabricated flaps. An abdominal prefabricated flap model was created in rats via a 2-stage operation. The rats were allocated into 4 groups as follows: 2 groups of rats received DFX treatments during the first or the second stage of the operation, respectively; 1 group of rats received a delay procedure 1 week before the second operation; and the final group was used as a blank control. Flap survival rates and capillary densities were evaluated between groups. The influence of DFX on the dermal fibroblasts was also studied in vitro. Desferrioxamine treatment during the first stage of the operation greatly increased flap survival rate compared to the blank control. The results were similar to those produced by the delay treatment. The vessel count results were consistent with the flap survival rate findings. In vitro, DFX treatment up-regulated the expression levels of several angiogenic factors in the dermal fibroblasts. Nevertheless, DFX treatment during the second stage of the operation was therapeutically detrimental. The application of DFX around the time of vascular carrier implantation greatly promoted neovascularization of prefabricated flaps, but was therapeutically detrimental after the flaps had been elevated.

  6. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

    N. Lumen

    2008-01-01

    Full Text Available Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF or the pedicled anterolateral thigh flap (ALTF has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months. Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula. Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

  7. 50 CFR Figure 16 to Part 223 - Escape Opening and Flap Dimensions for the Double Cover Flap TED

    2010-10-01

    ... 50 Wildlife and Fisheries 7 2010-10-01 2010-10-01 false Escape Opening and Flap Dimensions for the Double Cover Flap TED 16 Figure 16 to Part 223 Wildlife and Fisheries NATIONAL MARINE FISHERIES SERVICE, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE MARINE MAMMALS THREATENED MARINE AND ANADROMOUS SPECIES Pt. 223, Fig. 1...

  8. HPLC-DAD analysis, antioxidant potential and anti-urease activity of Asparagus gracilis collected from District Islamabad.

    Shah, Naseer Ali; Khan, Muhammad Rashid; Sattar, Saadia; Ahmad, Bushra; Mirza, Bushra

    2014-09-23

    Asparagus gracilis subspecie of Asparagus capitatus Baker, is described as food and medicine for various ailments. In this study we investigated, its phenolic constituents, in vitro antioxidant potential against various free radicals and anti-urease potential. Asparagus gracilis aerial parts collected from District Islamabad, Pakistan were extracted with crude methanol which was further fractionated into n-hexane, ethyl acetate, n-butanol and aqueous fraction. Total phenolic and flavonoid contents were estimated for extract and all the derived fractions. Diverse in vitro antioxidants assays such as DPPH, H2O2, •OH, ABTS, β-carotene bleaching assay, superoxide radical, lipid peroxidation, reducing power, and total antioxidant capacity were studied to assess scavenging potential. Antiurease activity of methanol extract and its derived fractions was also investigated. HPLC-DAD analysis of crude methanol extract was performed by using different phenolic standards. Ethyl acetate fraction expressed maximum content of flavonoids (240.6 ± 6.1 mg RE/g dry sample), phenolics (615 ± 13 mg GAE/g dry sample) and best antioxidant potential among different fractions of crude methanol extract. Hydrogen peroxide assay and hydroxyl, supeoxide, nitric oxide free radicals antioxidant assays as well as beta carotene assay showed significant correlation with flavonoid content while hydrogen peroxide, ABTS and lipid peroxidation assay displayed significant correlation with phenolic content. HPLC analysis showed the presence of important phenolics i.e. catechin (4.04 ± 0.02 μg/mg sample), caffeic acid (0.89 ± 0.003 μg/mg sample), rutin (24.58 ± 0.1 μg/mg sample), myricetin (1.13 ± 0.07 μg/mg sample) and quercetin (14.91 ± 0.09 μg/mg sample). Ethyl acetate fraction expressed lowest IC50 in antiurease activity. Correlation analysis of antiurease activity expressed significant correlation with flavonoids (P < 0.004) and phenolics (P < 0.02) proposing multipotent activity of

  9. Experience with Perforator Based Flaps for Wound Cover of the Leg ...

    Background: Open fractures of the distal third of the tibia and fibular offer a challenge to the orthopedic surgeon because of skin coverage. The reconstructive surgeon's help is often required in trying to achieve this. There are several options: - local flap, free flap or a cross leg flap. Local flaps have always had limitations ...

  10. Reconstruction of the anterior floor of the mouth with the inferiorly based nasolabial flap

    van Wijk, MP; Damen, A; Nauta, JM; Lichtendahl, DHE; Dhar, BK

    The results of reconstruction of the anterior floor of the mouth, using 105 nasolabial flaps in 79 patients were reviewed in a retrospective study. Of those flaps, 82% healed uneventfully; flap survival was 95%. Considerable flap loss occurred in 5%. Primary dehiscence was observed in 5% of all

  11. Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction

    Carolyn L. Mulvey, BS

    2013-05-01

    Conclusions: Flaps with increasing weight have increased risk of fat necrosis. These data suggest that inclusion of more than 1 perforator may decrease odds of fat necrosis in large flaps. Perforator flap breast reconstruction can be performed safely; however, considerations concerning race, body mass index, staging with tissue expanders, perforator number, and flap weight may optimize outcomes.

  12. Modulating effects of orally supplied Euglena gracilis on the physiological responses of the freshwater mussel Diplodon chilensis, exposed to sewage water pollution in a Patagonian river (Argentina).

    Bianchi, Virginia A; Castro, Juan M; Rocchetta, Iara; Conforti, Visitación; Pascual, Mariano; Luquet, Carlos M

    2016-04-01

    In order to test if orally supplied Euglena sp. cells modulate the physiological status of bivalves during bioremediation procedures, we evaluated the effect of Euglena gracilis diet on the immune response, oxidative balance and metabolic condition of Diplodon chilensis exposed to sewage water pollution. Mussels were fed for 90 days with E. gracilis (EG) or Scenedesmus vacuolatus (SV, control diet), and then exposed for 10 days at three sites along the Pocahullo river basin: 1) an unpolluted site, upstream of the city (control, C); 2) upstream (UpS) and 3) downstream (DoS) from the main tertiary-treated sewage discharge, in the city of San Martín de los Andes, Northwest Patagonia, Argentina. Our results show that the total hemocyte number decreases while pollution load increases along the river course for both, EG and SV mussels. Phagocytic activity is higher in EG mussels than in SV ones under all conditions. Reactive oxygen species (ROS) production in hemocytes increases with the increase in the pollution load, being significantly higher for EG mussels than for SV ones at DoS; no changes are observed for total oxyradical scavenging capacity (TOSC). Hemocytes' viability is increased for E. gracilis diet at C and remains unchanged in this group of mussels when exposed at the polluted sites. Lysosomal membrane stability is higher in EG mussels than in SV ones for all conditions, although it is decreased at polluted sites compared with that at C. Antioxidant (catalase) and detoxifying (gluthatione S-transferase) defenses are generally lower in gills and digestive gland of EG mussels than in SV ones. Lipid peroxidation (TBARS) is evident in gills of EG mussels at C, and in digestive gland of the same group, at all the sites. Gill mass factor (GF) is affected by the E. gracilis diet; it is increased at C and decreased at polluted sites when compared with that of SV ones. Digestive gland mass factor (DGF) is higher in EG mussels than in SV ones. In D

  13. Muscular cysticercosis: Case report and imaging findings

    Olmo, Neide Regina Simoes; Fiorio, Ulysses Ferreira; Clemente, Marcel Andreazza, E-mail: neideolmo@yahoo.com.br [Clinica Mult Imagem, Santos, SP (Brazil); Bastos, Eder Amaral [Universidade Metropolitana de Santos (UNIMES), Santos, SP (Brazil); Mendes, Gustavo Gomes [AC Camargo Cancer Center, Sao Paulo, SP (Brazil)

    2016-11-15

    Cysticercosis is a parasitic disease caused by a worm of the Cestoda class. The most prevalent form affects the nervous system. This case report is from a 78-year old female patient evaluated at Clinica Mult Imagem, in the city of Santos, Brazil, who presented a form of the disease that differed from the classic neurocysticercosis, in this case muscular cysticercosis. This and other forms of manifestation justify further studies to ensure adequate recognition, diagnosis and treatment of this parasitic disease. (author)

  14. Defective myoblasts identified in Duchenne muscular dystrophy.

    Blau, H M; Webster, C; Pavlath, G K

    1983-01-01

    A defect in the proliferative capacity of satellite cells, mononucleated precursors of mature muscle fibers, was found in clonal analyses of cells cultured from Duchenne muscular dystrophy (DMD) patients. The total yield of myoblasts per gram of muscle biopsy was decreased to 5% of normal. Of the DMD myoblast clones obtained, a large proportion contained a morphological class of flat distended cells that had an increased generation time and ceased to proliferate beyond 100-1,000 cells but cou...

  15. Intra-muscular hemangioma: A review

    Shruti Nayak

    2014-01-01

    Full Text Available Intra-muscular hemangiomas (IMH are relatively uncommon benign vascular tumors, which account for less than 1% of all hemangiomas. IMH may be presented as a perceived sporting injury. Diagnosis of this lesion is important not only because of its rarity, but also due to dangers posed by misdiagnosis and mismanagement. They must be considered in the differential diagnosis of unexplained pain and swelling in muscles. IMH occurring in the oral cavity is reviewed below.

  16. Urological manifestations of Duchenne muscular dystrophy.

    Askeland, Eric J; Arlen, Angela M; Erickson, Bradley A; Mathews, Katherine D; Cooper, Christopher S

    2013-10-01

    Duchenne muscular dystrophy is a dystrophinopathy affecting males that is associated with multiple organ system complications. To our knowledge urological complications of Duchenne muscular dystrophy have been described only anecdotally to date. We reviewed the medical charts of 135 patients with Duchenne or Duchenne-Becker muscular dystrophy for demographics and disease progression, urological diagnoses, intervention and followup. Of 135 patients 67 (50%) had at least 1 documented urological diagnosis and 38 (28%) had multiple manifestations. Lower urinary tract symptoms were the most common urological diagnosis (32% of patients). Survival analysis revealed a median age at onset of lower urinary tract symptoms of 23 years (95% CI 17.7-23.9). Intervention was required in 12 patients (9%), most commonly due to nephrolithiasis. Urological morbidity increased with Duchenne muscular dystrophy progression when stratified by clinical progression. Lower urinary tract symptoms were more common in nonambulatory patients (40.7% vs 19%, p = 0.007), those with a diagnosis of scoliosis (44% vs 19.7%, p = 0.003) and/or scoliosis spine surgery (60% vs 22%, p <0.001), and those on invasive respiratory support (53% vs 29%, p = 0.046). Likewise, nephrolithiasis was more common in nonambulatory patients (10% vs 0%, p = 0.017), those with scoliosis (12% vs 0%, p = 0.004) and/or scoliosis spine surgery (20% vs 1%, p <0.001), and those on invasive respiratory support (29% vs 3%, p <0.001). Only 28% of patients with a urological manifestation were referred to urology. As these patients transition into adolescence and adulthood, the increased prevalence of urological manifestations warrants increased awareness and referral to urologists. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  17. Disability and Survival in Duchenne Muscular Dystrophy

    Kohler, M; Clarenbach, C F; Bahler, C; Brack, T; Russi, E W; Bloch, K E

    2009-01-01

    BACKGROUND: Duchenne muscular dystrophy (DMD) leads to progressive impairment of muscle function, respiratory failure and premature death. Longitudinal data on the course of physical disability and respiratory function are sparse. OBJECTIVES: To prospectively assess physical impairment and disability, respiratory function and survival in DMD patients over several years in order to describe the course of the disease with current care. METHODS: In 43 patients with DMD, aged 5-35 years, yearly a...

  18. A lesão muscular na miastenia grave: estudo de 17 casos com histoquimica muscular

    Lineu Cesar Werneck

    1982-03-01

    Full Text Available Estudo de 17 biópsias musculares de pacientes com miastenia grave, utilizando técnicas de coloração a fresco e histoquímica muscular. Foram encontradas 15 biópsias musculares anormais, sendo que as principais alterações foram fibras musculares angulares escuras atróficas, excesso de gotículas de gordura na membrana externa das fibras, variação no diâmetro das fibras e atrofia de fibras do tipo II. Os achados foram interpretados como denervação em 11 biópsias, atrofia de fibras do tipo II em 7, infiltrado linfocitário em 4, necrose de fibras musculares com fagocitose em 1 e em 2 biópsias não foi encontrada qualquer anormalidade. Quanto maior o tempo de doença, mais severa foi a anormalidade encontrada. Dois pacientes apresentavam timoma, um miastenia grave congênita, um artrite reumatoide, um neurite hipertrófica intersticial, um tireoidite de Hashimoto e um com síndrome miastênica concomitante. São discutidos os achados anatomopatológicos e sua possível explicação.

  19. The effect of atorvastatin on survival of rat ischemic flap

    Jian-Xun Chen

    2013-04-01

    Full Text Available Management of skin avulsion with tissue exposure is a challenge for plastic surgeons. Clinical observations have suggested that longer survival of skin flap prevents further contamination and infection. Less well known is the role of atorvastatin in avulsion skin flap. Therefore, we attempted to determine whether atorvastatin could alleviate avulsion skin flap in a rat model. Twenty male Sprague–Dawley rats were randomized into two groups: the atorvastatin group and the control. Before operation, each rat received an initial blood perfusion scan as baseline data. Then, each rat received an operation of skin flap incision, elevation, and resuturing to the original position under general anesthesia. Another blood perfusion scan was performed on each rat 30 minutes, 4 days, and 7 days postoperatively. On the 7th postoperative day, the necrotic area of skin flap was measured as the skin flap viability. The skin flap tissues at 2.5 and 5 cm distal to the skin flap base were collected for histopathological analysis, as well as measurement of vascular endothelial growth factor (VEGF mRNA expression, and vascular density. Compared with 30 minutes postoperation, there was a significant increase in the ratio of skin flap blood perfusion on the 4th and 7th days postoperation in both control and atorvastatin groups (p<0.05. Compared with the control group, there was a significant decrease in necrotic area, significant increase in ratio of skin flap blood perfusion on postoperation days 4 and 7, and significant increase in vascular density under high field at 2.5 cm distal to the base of skin flap in the atorvastatin group (p<0.05. The VEGF121 and VEGF165 mRNA expression at 2.5 cm distal to the base of skin flap differed significantly between the two groups (p<0.05. Compared with the control group, atorvastatin treatment improved skin flap blood perfusion, vascular density, and necrotic area dependent on VEGF mRNA expression.

  20. Use if a soecuak sokubt ub reverse syrak artery flap to reduce venous congestion and flap necrosis

    Masood, T.; Ahmed, R.; Obaidullah, M.

    2016-01-01

    Background: Distally based sural fascio-cutaneous flap is a commonly performed plastic surgery procedure for the coverage of distal third of leg, ankle and foot defects. However congestion is the main complication of this flap which results into partial or complete loss of the flap. We devised a special splint to reduce this complication and retrospectively reviewed its effect on this complication between two groups. Methods: This retrospective study was carried out at Northwest General hospital between 1995 and 2012. Group-A included 30 patients who were managed without the splint between 1995 and 2005 and group B comprised of 35 patients were treated with the splint between 2006 and 2012. Complications like venous congestion, epidermolysis, and partial and complete flap failure were documented. Data were analyzed by SPSS.16.5 software. Chi- square test was used for data analysis. P value less than 0.05 was considered as the level of significance. Results: Total 65 patients were operated. Age of the patients ranged from 7 to 60 years. Road traffic accident and spoke wheel injury was the main cause of soft tissue loss in our patients. In group A 12 patients suffered from venous congestion. Out of 12, three patients had epidermolysis while partial flap necrosis occurred in 9 patients. Only 3 patients had venous congestion in group B. Two patients suffered from epidermolysis and one had partial flap necrosis. None of patient suffered from complete flap loss in both groups. Conclusion: Reverse sural artery flap continues to be a versatile flap for distal lower extremity reconstruction. By using a special splint to reduce pressure on the pedicle site as a modification, flap complication rate can be decreased significantly. (author)

  1. Proximal spinal muscular atrophy: current orthopedic perspective

    Haaker G

    2013-11-01

    Full Text Available Gerrit Haaker, Albert Fujak Department of Orthopaedic Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany Abstract: Spinal muscular atrophy (SMA is a hereditary neuromuscular disease of lower motor neurons that is caused by a defective "survival motor neuron" (SMN protein that is mainly associated with proximal progressive muscle weakness and atrophy. Although SMA involves a wide range of disease severity and a high mortality and morbidity rate, recent advances in multidisciplinary supportive care have enhanced quality of life and life expectancy. Active research for possible treatment options has become possible since the disease-causing gene defect was identified in 1995. Nevertheless, a causal therapy is not available at present, and therapeutic management of SMA remains challenging; the prolonged survival is increasing, especially orthopedic, respiratory and nutritive problems. This review focuses on orthopedic management of the disease, with discussion of key aspects that include scoliosis, muscular contractures, hip joint disorders, fractures, technical devices, and a comparative approach of conservative and surgical treatment. Also emphasized are associated complications including respiratory involvement, perioperative care and anesthesia, nutrition problems, and rehabilitation. The SMA disease course can be greatly improved with adequate therapy with established orthopedic procedures in a multidisciplinary therapeutic approach. Keywords: spinal muscular atrophy, scoliosis, contractures, fractures, lung function, treatment, rehabilitation, surgery, ventilation, nutrition, perioperative management

  2. Management of myocardial damage in muscular dystrophy

    Tamura, Takuhisa

    2011-01-01

    Heart failure (HF) is a fatal complication in many muscular dystrophy cases and has become the most common cause of death in Duchenne muscular dystrophy (DMD) since 2001. HF deaths in DMD occur in young patients and increase, along with respiratory failure, in older patients. Managing HF, therefore, is the most important component of DMD treatment. Management of HF is necessary in DMD patients of all ages because myocardial damage progresses regardless of age and disability. Electrocardiography, echocardiography, myocardial single-photon emission computed tomography (SPECT), and natriuretic peptides are used for the diagnosis of myocardial damage and chronic HF. Tissue Doppler echocardiography is in particularly useful for early detection of minute myocardial damage and dysfunction in DMD. The first-line drugs for chronic HF are angiotensin-converting enzyme inhibitors, and the prognosis of DMD patients has been improved using these drugs and beta-blockers. Diuretics are added in the presence of pulmonary congestion. Digoxin is most effective at a blood level of 0.5-0.8 ng/mL because of its pharmacokinetics in DMD. Surgical treatment may be necessary in cases of intractable HF. Cardiac resynchronization therapy (biventricular pacing), a treatment with an artificial pacemaker, is indicated for cases that meet specific criteria, including HF with ventricular dyssynchrony. Applications of partial left ventriculectomy (Batista procedure) and left ventricular assist devices in muscular dystrophy are likely in the near future. (author)

  3. Complications Following Autologous Latissimus Flap Breast Reconstruction

    Mufid Burgić

    2010-02-01

    Full Text Available Use of an autologous latissimus flap in breast reconstruction accounts for a supple and natural look of reconstructed breast. Most common postoperative complication, seroma, became more of a rule then an exception when it comes to postoperative evaluation of the patients who underwent this reconstructive procedure. A retrospective study analysing and evaluating different complication rates in 20 patients who underwent breast reconstruction by autologous latissimus flap, was conducted. All patients included in the study were operated at the Department of plastic surgery of Hôpital Civil in Strasbourg, France, between 1996 and 2008. The complication rates were noted as follows: seroma in 19 of our 20 patients (95%, late hypertrophic scarring in 3 patients (15%, postoperative surgical site hematoma in 3 patients (15%, and 2 patients (10% presented postoperative chronic back pain. Different options used in seroma treatment and prevention (subcutaneous-fascia anchor sutures of donor site, application of corticosteroids by injection into donor site postoperatively, passive drainage can reduce seroma formation and thus overall complication rates, leading to much faster patient’s recovery time and return to normal daily activities.

  4. Improvement of kinetics, yield, and colloidal stability of biogenic gold nanoparticles using living cells of Euglena gracilis microalga

    Dahoumane, Si Amar; Yéprémian, Claude; Djédiat, Chakib; Couté, Alain; Fiévet, Fernand; Coradin, Thibaud; Brayner, Roberta

    2016-03-01

    Recent years have witnessed a boom in the biosynthesis of a large variety of nanomaterials using different biological resources among which algae-based entities have been gaining much more attention within the community of material scientists worldwide. In our previously published findings, we explored some factors that governed the biofabrication of gold nanoparticles using living cultures of microalgae, such as the utilized microalgal genera, the phylum they belong to, and the impact of tetrachloroauric acid concentrations on the ability of these strains to perform the biosynthesis of gold nanoparticles once in contact with these cations. As a follow-up, we present in this paper an improvement of the features of bioproduced gold colloids using living cells of Euglena gracilis microalga when this species is grown under either mixotrophic or autotrophic conditions, i.e., exposed to light and grown in an organic carbon-enriched culture medium versus under autotrophic conditions. As an outcome to this alteration, the growth rate of this photosynthetic microorganism is multiplied 7-8 times when grown under mixotrophic conditions compared to autotrophic ones. Therefore, the yield, the kinetics, and the colloidal stability of the biosynthesized gold nanoparticles are dramatically enhanced. Moreover, the shape and the size of the as-produced nano-objects via this biological method are affected. In addition to round-shaped gold nanoparticles, particular shapes, such as triangles and hexagons, appear. These findings add up to the amassed knowledge toward the design of photobioreactors for the scalable and sustainable production of interesting nanomaterials.

  5. Improvement of kinetics, yield, and colloidal stability of biogenic gold nanoparticles using living cells of Euglena gracilis microalga

    Dahoumane, Si Amar, E-mail: sa.dahoumane@gmail.com [Paris-Diderot University, Sorbonne Paris Cité, Interfaces, Traitements, Organisation et Dynamique des Systèmes (ITODYS), UMR 7086, CNRS (France); Yéprémian, Claude; Djédiat, Chakib; Couté, Alain [Muséum National d’Histoire Naturelle, Département RDDM, UMR 7245, Unité MCAM (France); Fiévet, Fernand [Paris-Diderot University, Sorbonne Paris Cité, Interfaces, Traitements, Organisation et Dynamique des Systèmes (ITODYS), UMR 7086, CNRS (France); Coradin, Thibaud, E-mail: thibaud.coradin@upmc.fr [UPMC—Paris 06, CNRS, Chimie de la Matière Condensée de Paris, Collège de France (France); Brayner, Roberta, E-mail: roberta.brayner@univ-paris-diderot.fr [Paris-Diderot University, Sorbonne Paris Cité, Interfaces, Traitements, Organisation et Dynamique des Systèmes (ITODYS), UMR 7086, CNRS (France)

    2016-03-15

    Recent years have witnessed a boom in the biosynthesis of a large variety of nanomaterials using different biological resources among which algae-based entities have been gaining much more attention within the community of material scientists worldwide. In our previously published findings, we explored some factors that governed the biofabrication of gold nanoparticles using living cultures of microalgae, such as the utilized microalgal genera, the phylum they belong to, and the impact of tetrachloroauric acid concentrations on the ability of these strains to perform the biosynthesis of gold nanoparticles once in contact with these cations. As a follow-up, we present in this paper an improvement of the features of bioproduced gold colloids using living cells of Euglena gracilis microalga when this species is grown under either mixotrophic or autotrophic conditions, i.e., exposed to light and grown in an organic carbon-enriched culture medium versus under autotrophic conditions. As an outcome to this alteration, the growth rate of this photosynthetic microorganism is multiplied 7–8 times when grown under mixotrophic conditions compared to autotrophic ones. Therefore, the yield, the kinetics, and the colloidal stability of the biosynthesized gold nanoparticles are dramatically enhanced. Moreover, the shape and the size of the as-produced nano-objects via this biological method are affected. In addition to round-shaped gold nanoparticles, particular shapes, such as triangles and hexagons, appear. These findings add up to the amassed knowledge toward the design of photobioreactors for the scalable and sustainable production of interesting nanomaterials.

  6. Cranial pneumatization and auditory perceptions of the oviraptorid dinosaur Conchoraptor gracilis (Theropoda, Maniraptora) from the Late Cretaceous of Mongolia

    Ramanah, D.; Raghunath, S.; Mee, D. J.; Rösgen, T.; Jacobs, P. A.

    2007-09-01

    The distribution of air-filled structures in the craniofacial and neurocranial bones of the oviraptorid ZPAL MgD-I/95, discovered at the Hermiin Tsav locality, Mongolia, is restored. Based on the complete obliteration of most of the cranial sutures, the specimen is identified as an adult individual of Conchoraptor gracilis Barsbold 1986. Except for the orbitosphenoids and epipterygoids, the preserved bones of the neurocranium are hollow. Three types of tympanic recess are present in Conchoraptor, a characteristic shared with troodontids, dromaeosaurids, and avian theropods. The contralateral middle ear cavities are interconnected by the supraencephalic pathway that passes through the dorsal tympanic recesses, the posterodorsal prootic sinuses and the parietal sinus. The spatial arrangements of the middle ear cavity and a derived neurocranial pneumatic system in Conchoraptor indicate enhancements of acoustic perception in the lower-frequency registers and of auditory directionality. We further speculate that this improvement of binaural hearing could be explained as an adaptation required for accurate detection of prey and/or predators under conditions of low illumination. The other potentially pneumatic structures of the Conchoraptor cranium include (1) recessus-like irregularities on the dorsal surface of the nasal and frontal bones (a putative oviraptorid synapomorphy; pos); (2) a subotic recess; (3) a sub-condylar recess; and (4) a posterior condylar recess (pos).

  7. Effects of chronic exposure in populations of Koeleria gracilis Pers. from the Semipalatinsk nuclear test site, Kazakhstan.

    Geras'kin, S A; Oudalova, A A; Dikarev, V G; Dikareva, N S; Mozolin, E M; Hinton, T; Spiridonov, S I; Copplestone, D; Garnier-Laplace, J

    2012-02-01

    Morphological and cytogenetic abnormalities were examined in crested hairgrass (Koeleria gracilis Pers.) populations inhabiting the Semipalatinsk nuclear test site (STS), Kazakhstan. Sampling of biological material and soil was carried out during 3 years (2005-2007) at 4 sites within the STS. Activity concentrations of 10 radionuclides and 8 heavy metals content in soils were measured. Doses absorbed by plants were estimated and varied, depending on the plot, from 4 up to 265 mGy/y. The frequency of cytogenetic alterations in apical meristem of germinated seeds from the highly contaminated plot significantly exceeded the level observed at other plots with lower levels of radioactive contamination during all three years of the study. A significant excess of chromosome aberrations, typical for radiation exposure, as well as a dependence of the frequency of these types of mutations on dose absorbed by plants were revealed. The results indicate the role radioactive contamination plays in the occurrence of cytogenetic effects. However, no radiation-dependent morphological alterations were detected in the progeny of the exposed populations. Given that the crested hairgrass populations have occupied the radioactively contaminated plots for some 50 years, adaptation to the radiation stress was not evident. The findings obtained were in agreement with the benchmark values proposed in the FASSET and ERICA projects to restrict radiation impacts on biota. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Chemical mechanism of D-amino acid oxidase from Rhodotorula gracilis: pH dependence of kinetic parameters.

    Ramón, F; Castillón, M; De La Mata, I; Acebal, C

    1998-01-01

    The variation of kinetic parameters of d-amino acid oxidase from Rhodotorula gracilis with pH was used to gain information about the chemical mechanism of the oxidation of D-amino acids catalysed by this flavoenzyme. d-Alanine was the substrate used. The pH dependence of Vmax and Vmax/Km for alanine as substrate showed that a group with a pK value of 6.26-7.95 (pK1) must be unprotonated and a group with a pK of 10.8-9.90 (pK2) must be protonated for activity. The lower pK value corresponded to a group on the enzyme involved in catalysis and whose protonation state was not important for binding. The higher pK value was assumed to be the amino group of the substrate. Profiles of pKi for D-aspartate as competitive inhibitor showed that binding is prevented when a group on the enzyme with a pK value of 8.4 becomes unprotonated; this basic group was not detected in Vmax/Km profiles suggesting its involvement in binding of the beta-carboxylic group of the inhibitor. PMID:9461524

  9. The different phenotypes of phot- photosynthetic deficient mutants in Euglena gracilis: the frequency of production by ultraviolet irradiation

    Nicolas, Paul; Heizmann, Philippe; Nigon, Victor

    1982-01-01

    In Euglena gracilis, pigment-less mutants appear spontaneously with a frequency of about 2-5x10 -3 . Ultraviolet-irradiation increases the proportion of chlorophyll-less colonies to an upper limit where green colonies represent 4x10 -4 of the surviving ones. This limit might indicate the occurrence of processes involving repair of the chloroplastic DNA. Most of the photosynthetic-deficient (phot - ) mutants induced by ultraviolet irradiation are characterized by the presence of a reduced number of chloroplast DNA molecules showing deletions (phi - class). Most of the phi - mutants present the phenotype phi - chlo - car - , where neither chlorophyll nor carotenoids are obvious: the phi - chlo - car + mutants, devoid of chlorophyll but containing carotenoids, are obtained among the phi - strains with a frequency lower than 10 -3 . The phot - mutants which belong to the cp - class are characterized by the maintenance of a great number of chloroplastic DNA molecules, where large deletions are absent: their occurrence after ultraviolet irradiation is low [fr

  10. Parental attitudes toward newborn screening for Duchenne/Becker muscular dystrophy and spinal muscular atrophy.

    Wood, Molly F; Hughes, Sarah C; Hache, Lauren P; Naylor, Edwin W; Abdel-Hamid, Hoda Z; Barmada, M Michael; Dobrowolski, Steven F; Stickler, David E; Clemens, Paula R

    2014-06-01

    Disease inclusion in the newborn screening (NBS) panel should consider the opinions of those most affected by the outcome of screening. We assessed the level and factors that affect parent attitudes regarding NBS panel inclusion of Duchenne muscular dystrophy (DMD), Becker muscular dystrophy (BMD), and spinal muscular atrophy (SMA). The attitudes toward NBS for DMD, BMD, and SMA were surveyed and compared for 2 categories of parents, those with children affected with DMD, BMD, or SMA and expectant parents unselected for known family medical history. The level of support for NBS for DMD, BMD, and SMA was 95.9% among parents of children with DMD, BMD, or SMA and 92.6% among expectant parents. There was strong support for NBS for DMD, BMD, and SMA in both groups of parents. Given advances in diagnostics and promising therapeutic approaches, discussion of inclusion in NBS should continue. Copyright © 2013 Wiley Periodicals, Inc.

  11. Colgajo perforante tóracodorsal Toracodorsal perforator flap

    C. Angrigiani

    2006-12-01

    Full Text Available La espalda es una excelente zona dadora de colgajos. El colgajo perforante tóracodorsal basado en ramas cutáneas de la arteria y vena tóracodorsales que perforan el músculo dorsal ancho, es una modifica ción del tradicional colgajo musculocutáneo de dorsal ancho que permite lograr una mayor flexibilidad en su traslado y una disminución de su volumen. Puede emplearse como colgajo libre o en isla. Presentamos su anatomía, disección e indicaciones.Back is an excellent donor site for flaps. The tora codorsal perforator flap, based on cutaneous vessels from toracodorsal artery and vein that pass through Latissimus Dorsi muscle, is a modified conventional musculocutaneous Latissimus Dorsi flap that allows easier movility and a volume reduction. This flap can be used both, free flap or island flap. We present the anatomy, dissection and applica tions of this flap.

  12. Droplet ejection and sliding on a flapping film

    Xi Chen

    2017-03-01

    Full Text Available Water recovery and subsequent reuse are required for human consumption as well as industrial, and agriculture applications. Moist air streams, such as cooling tower plumes and fog, represent opportunities for water harvesting. In this work, we investigate a flapping mechanism to increase droplet shedding on thin, hydrophobic films for two vibrational cases (e.g., ± 9 mm and 11 Hz; ± 2 mm and 100 Hz. Two main mechanisms removed water droplets from the flapping film: vibrational-induced coalescence/sliding and droplet ejection from the surface. Vibrations mobilized droplets on the flapping film, increasing the probability of coalescence with neighboring droplets leading to faster droplet growth. Droplet departure sizes of 1–2 mm were observed for flapping films, compared to 3–4 mm on stationary films, which solely relied on gravity for droplet removal. Additionally, flapping films exhibited lower percentage area coverage by water after a few seconds. The second removal mechanism, droplet ejection was analyzed with respect to surface wave formation and inertia. Smaller droplets (e.g., 1-mm diameter were ejected at a higher frequency which is associated with a higher acceleration. Kinetic energy of the water was the largest contributor to energy required to flap the film, and low energy inputs (i.e., 3.3 W/m2 were possible. Additionally, self-flapping films could enable novel water collection and condensation with minimal energy input.

  13. The anatomy of forearm free flap phalloplasty for transgender surgery.

    Kim, S; Dennis, M; Holland, J; Terrell, M; Loukas, M; Schober, J

    2018-03-01

    Transgender surgeries are becoming more frequent and visual interpretation of anatomy is essential for both surgeons and patients. Since the forearm free flap phalloplasty was introduced in 1984, it has been known to provide reliable cosmetic and functional results for transitioning men compared with phalloplasty by different flaps. Surgical text descriptions were enhanced by the creation of new anatomic illustrations. The forearm free flap consists of the anterior forearm skin, subcutaneous tissue, fascia containing the radial artery as the perforator and its venae comitantes, cephalic and basilic veins, and lateral and medial antebrachial cutaneous nerves are demonstrated in relation to the surgically derived flap. Song's forearm free flap phalloplasty requires two surgical stages with a three-month interval between the stages: prelamination of a neourethra and construction of a neophallus. The neophallus created by forearm flap phalloplasty is reported to achieve acceptable aesthetical and psychological satisfaction, appropriate size and shape, and satisfying sexual intercourse. Despite increasing experiences in gender confirming surgery with modifications made by many authors, urethral complications including fistula and/or stricture formation are the leading causes of reoperation. The poor esthetic outcome of the forearm donor site and a decrease in rigidity of the neophallus are the main limitations. Illustrations of anatomy help inform surgical choice and understanding of risks and benefits by patients. The anatomy of the free forearm flap phalloplasty supports creation of a neophallus for transsexual anatomy revision. Clin. Anat. 31:145-151, 2018. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  14. EXTENDED REVERSE SURAL FLAP FOR LOWER LIMB COVERAGE

    Biswajit Mishra

    2018-12-01

    Full Text Available BACKGROUND The reverse sural artery flap has been a workhorse for the reconstruction of distal third of leg, ankle, sole and foot. Major limitation of reverse sural flap has been venous congestion particularly when harvested from proximal third of the leg. Objective- To evaluate the efficacy, safety of the extended reverse sural flap from proximal third of the leg. MATERIALS AND METHODS A prospective study was conducted at the department of plastic surgery on twenty patients who needed soft tissue reconstruction in the distal third of the leg, ankle, heel, forefoot and midfoot due to various cause. In all cases flap was extended proximally to the upper third of the calf and neurovenoadipo fascial pedicled sural fasciocutaneous flap was harvested. RESULTS There were only two cases of marginal necrosis. None of the patients had complete necrosis. Two patients developed hypertrophy of the flap margin. CONCLUSION Distally based neuroveno adipofascial pedicled sural fasciocutaneous flap can be safely extended to proximal third of the leg and is a reliable option for reconstruction of the defects in the foot, ankle and sole.

  15. Adipofascial Anterolateral Thigh Flap Safety: Applications and Complications

    Tommaso Agostini

    2013-03-01

    Full Text Available BackgroundA thinned anterolateral thigh (ALT flap is often harvested to achieve optimal skin resurfacing. Several techniques have been described to thin an ALT flap including an adipocutaneous flap, an adipofascial flap and delayed debulking.MethodsBy systematically reviewing all of the available literature in English and French, the present manuscript attempts to identify the common surgical indications, complications and donor site morbidity of the adipofascial variant of the ALT flap. The studies were identified by performing a systematic search on Medline, Ovid, EMBASE, the Cochrane Database of Systematic Reviews, Current Contents, PubMed, Google, and Google Scholar.ResultsThe study selection process was adapted from the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement, and 15 articles were identified using the study inclusion criteria. These articles were then reviewed for author name(s, year of publication, flap dimensions and thickness following defatting, perforator type, type of transfer, complications, thinning technique, number of cases with a particular area of application and donor site morbidity.ConclusionsThe adipofascial variant of the ALT flap provides tissue to fill large defects and improve pliability. Its strong and safe blood supply permits adequate immediate or delayed debulking without vascular complications. The presence of the deep fascia makes it possible to prevent sagging by suspending and fixing the flap for functional reconstructive purposes (e.g., the intraoral cavity. Donor site morbidity is minimal, and thigh deformities can be reduced through immediate direct closure or liposuction and direct closure. A safe blood supply was confirmed by the rate of secondary flap debulking.

  16. "Internet of Things" Real-Time Free Flap Monitoring.

    Kim, Sang Hun; Shin, Ho Seong; Lee, Sang Hwan

    2018-01-01

    Free flaps are a common treatment option for head and neck reconstruction in plastic reconstructive surgery, and monitoring of the free flap is the most important factor for flap survival. In this study, the authors performed real-time free flap monitoring based on an implanted Doppler system and "internet of things" (IoT)/wireless Wi-Fi, which is a convenient, accurate, and efficient approach for surgeons to monitor a free flap. Implanted Doppler signals were checked continuously until the patient was discharged by the surgeon and residents using their own cellular phone or personal computer. If the surgeon decided that a revision procedure or exploration was required, the authors checked the consumed time (positive signal-to-operating room time) from the first notification when the flap's status was questioned to the determination for revision surgery according to a chart review. To compare the efficacy of real-time monitoring, the authors paired the same number of free flaps performed by the same surgeon and monitored the flaps using conventional methods such as a physical examination. The total survival rate was greater in the real-time monitoring group (94.7% versus 89.5%). The average time for the real-time monitoring group was shorter than that for the conventional group (65 minutes versus 86 minutes). Based on this study, real-time free flap monitoring using IoT technology is a method that surgeon and reconstruction team can monitor simultaneously at any time in any situation.

  17. Prevalence of muscular dystrophy in patients with muscular disorders in Tehran, Iran

    Khadijeh Hajinaghi Tehrani

    2018-05-01

    Full Text Available Muscular dystrophy is a group of diseases that is characterized by progressive muscle wasting and the weakness of variable distribution and severity. On the basis of the distribution of predominant muscle weakness, there are many different kinds of muscular dystrophy. Some dystrophies are especially frequent in certain populations. There are no studies on the prevalence of muscular dystrophy in Iran. This study was aimed to survey the prevalence of muscular dystrophy among Iranian patients with muscular disorders. This analytical cross-sectional study was conducted on 1000 patients with musculoskeletal disorders who visited the dystrophy association of Bou-Ali Hospital (Tehran from June 2014 to June 2016. Patients’ data were extracted using a checklist that included age, gender, age of onset, family history, findings from clinical diagnostic tests and types of muscular dystrophy. The clinical findings were the results of genetic tests; EMG-NCV; para-clinical findings, including LDH and CPK; and pathological findings. All data were analyzed by SPSS V.22 (IBM Inc., NY with Chi Square and One way ANOVA tests. All analyses were performed with P = 0.05 considered as the threshold of statistical significant. Out of the 337 patients studied, 262 (77.7% were male and 75 (22.3% were female. Subjects had a mean (± SD age of 26.08 (± 11.86 years with an age range of 3 to 59 years. The most common types of muscular dystrophy were found to be Duchenne dystrophy (131 cases, 38.9%, limb-girdle dystrophy (91 cases, 27%, Becker dystrophy (58 cases, 17.2%, FSHD dystrophy (31 cases, 9.2%, and SMA (26 cases, 7.7%, respectively. The results showed that a statistically significant relationship between dystrophy types and gender, age, family history, age of diagnosis, CPK and LDH levels (P < 0.001. There were no statistical relationship between dystrophy types and pathological findings (P = 0.57, EMG-NCV test results (P = 0.062, and genetic findings (P = 0

  18. Distrofia muscular de Emery-Dreifuss: relato de caso Emery-Dreifuss muscular dystrophy: case report

    Ana Lucila Moreira Carsten

    2006-06-01

    Full Text Available A distrofia muscular de Emery-Dreifuss é uma forma de distrofia muscular freqüentemente associada a contraturas articulares e defeitos de condução cardíaca, que pode ser causada pela deficiência da proteína emerina na membrana nuclear interna das fibras musculares. Descrevemos o caso de um homem de 19 anos com diminuição de força muscular, hipotrofia nas cinturas escapular e pélvica, disfagia, contraturas articulares em cotovelos e tornozelos, apresentando história familiar compatível com herança ligada ao cromossomo X. A investigação mostrou creatinaquinase sérica elevada, eletrocardiograma com bloqueio atrioventricular de primeiro grau e bloqueio de ramo direito, eletroneuromiografia normal, biópsia muscular com alterações miopáticas e a análise por imuno-histoquímica mostrou deficiência de emerina. São discutidas as manifestações clínicas e genéticas, alterações laboratoriais e eletroneuromiográficas, bem como, a importância do estudo do padrão de herança no aconselhamento genético destas famílias.The Emery-Dreifuss muscular dystrophy is a form of muscular dystrophy that frequently presents early contractures and cardiac conduction defects, caused by emerin deficiency in the inner nuclear membrane of the muscular fibers. A 19-years-old man it presented muscle weakness and hypotrophy in the proximal upper and lower limbs, dysphagia and early contractures in elbows and ankles, with familiar history compatible with X-linked inheritance form. The investigation showed increased serum creatinekinase levels electrocardiogram had a first degree atrioventricular block and right bundle branch block normal electromyography and nerve conduction study muscle biopsy disclosed myopathic characteristics and nuclear protein immunohystochemical analysis showed deficiency of emerin. The clinical and genetics manifestations, laboratorial and electromyography changes, as well as, the study of the pattern of inheritance for

  19. Recent developments in the treatment of Duchenne muscular dystrophy and spinal muscular atrophy

    Liew, Wendy K. M.

    2013-01-01

    Pediatric neuromuscular disorders comprise a large variety of disorders that can be classified based on their neuroanatomical localization, patterns of weakness, and laboratory test results. Over the last decade, the field of translational research has been active with many ongoing clinical trials. This is particularly so in two common pediatric neuromuscular disorders: Duchenne muscular dystrophy and spinal muscular atrophy. Although no definitive therapy has yet been found, numerous active areas of research raise the potential for novel therapies in these two disorders, offering hope for improved quality of life and life expectancy for affected individuals. PMID:23634188

  20. Osteoradionecrosis of the olecranon: treatment by radial forearm flap

    Thornton, J.W.; Stevenson, T.R.; VanderKolk, C.A.

    1987-01-01

    Osteoradionecrosis of the olecranon is an unusual pathologic entity, treated best by debridement and wound closure using vascularized tissue. Local skin is often unavailable for flap design and transposition. The radial forearm flap can be isolated on a proximal vascular pedicle and transposed to cover the wound. In the case presented, healing was brisk and complete, allowing early elbow mobilization. Although the donor site is not easily concealed, no functional impairment results from flap elevation and all full-thickness wounds are confined to the involved extremity

  1. Management of a Traumatic Flap Dislocation Seven Years after LASIK

    Majid Moshirfar

    2011-01-01

    Full Text Available Seven years after uneventful laser in situ keratomileusis (LASIK, a 48-year-old woman presented one week after being hit with an iron cord with blurry vision, pain, and irritation. The injury resulted in traumatic flap dislocation, epithelial ingrowth, and macrostriae. Following epithelial removal, the flap was refloated and repositioned. Nine interrupted sutures were used to secure the flap. Three-weeks after surgery with no sutures remaining, the epithelial ingrowth and macrostriae had resolved with a visual acuity of 20/20.

  2. Optimization of morphing flaps based on fluid structure interaction modeling

    Barlas, Athanasios; Akay, Busra

    2018-01-01

    This article describes the design optimization of morphing trailing edge flaps for wind turbines with ‘smart blades’. A high fidelity Fluid Structure Interaction (FSI) simulation framework is utilized, comprised of 2D Finite Element Analysis (FEA) and Computational Fluid Dynamics (CFD) models....... A coupled aero-structural simulation of a 10% chordwise length morphing trailing edge flap for a 4 MW wind turbine rotor is carried out and response surfaces are produced with respect to the flap internal geometry design parameters for the design conditions. Surrogate model based optimization is applied...

  3. Cognitive and Neurobehavioral Profile in Boys With Duchenne Muscular Dystrophy.

    Banihani, Rudaina; Smile, Sharon; Yoon, Grace; Dupuis, Annie; Mosleh, Maureen; Snider, Andrea; McAdam, Laura

    2015-10-01

    Duchenne muscular dystrophy is a progressive neuromuscular condition that has a high rate of cognitive and learning disabilities as well as neurobehavioral disorders, some of which have been associated with disruption of dystrophin isoforms. Retrospective cohort of 59 boys investigated the cognitive and neurobehavioral profile of boys with Duchenne muscular dystrophy. Full-scale IQ of Duchenne muscular dystrophy. © The Author(s) 2015.

  4. Complete Lower Lip Reconstruction with a Large Lip Switch Flap and a Composite Modiolus Advancement Flap

    Gudjon L. Gunnarsson, MD

    2017-12-01

    Full Text Available Summary:. Total loss of the lower lip is debilitating and poses a reconstructive challenge. Aiming to restore oral continence and function and also cosmetic appearance, a successful reconstruction has a huge impact on the quality of life for the individual patient. Early sources of local tissue rearrangement for lip reconstruction date back 3000 years, with earliest reports of lip switch procedures more than 2 centuries ago in Europe, when noma was still endemic in Europe, indicating that the anatomy was better understood by the barber surgeons of the past than we like to acknowledge. We are still faced with such challenging cases all over the world where resources are limited. Our current understanding of perforator anatomy and blood supply makes more frequent revisits to flaps of the past with modern advances. Innovative solutions are imperative for salvage, and old ideas tend to reappear when they prove to be useful. Herein, we describe in open access a new reconstructive method where we combined a large lip switch flap together with a composite advancement modiolus flap to reconstruct a whole lower lip and the donor defect of the upper lip all at once, a procedure that is simple to perform and works in settings where it is greatly needed.

  5. Comparison of 5468 retreatments after laser in situ keratomileusis by lifting the flap or performing photorefractive keratectomy on the flap.

    Ortega-Usobiaga, J; Llovet-Osuna, F; Katz, T; Djodeyre, M R; Druchkiv, V; Bilbao-Calabuig, R; Baviera, J

    2018-02-01

    To assess visual outcomes of retreatment after laser in situ keratomileusis (LASIK) by lifting the flap or performing photorefractive keratectomy (PRK) on the flap, as well as to establish whether there was an increased risk of epithelial ingrowth (EIG) when LASIK and lifting of the flap are separated by a long time interval and to determine the incidence of corneal haze after PRK. Retrospective study of 4077 patients (5468 eyes) who underwent LASIK and subsequent retreatment were reviewed in order to study their visual results and identify cases of EIG and corneal haze. Enhancements included 5196 eyes from 3876 patients that were retreated by lifting the flap, and 272 eyes from 201 patients that were retreated by PRK on the flap. No statistically significant differences were found between the retreatments in terms of predictability, efficacy, and safety. A total of 704 cases of EIG were found after lifting the flap, for which surgical cleansing was necessary in 70. Surgical cleansing decreased the efficacy index when compared with patients with EIG who did not need cleansing (P=.01). Differences in terms of safety and predictability were not statistically significant. The incidence of corneal haze after ablation of the surface of the previous flap was 14.34%, although none of these cases were clinically relevant. Visual outcomes were similar between patients who were retreated by lifting the flap and those who underwent PRK. The incidence of EIG when the flap was lifted was 13.55%. The incidence of EIG increases with the time elapsed between the primary procedure and retreatment. Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Positioning the 5'-flap junction in the active site controls the rate of flap endonuclease-1-catalyzed DNA cleavage

    Song, Bo

    2018-02-09

    Flap endonucleases catalyze cleavage of single-stranded DNA flaps formed during replication, repair and recombination, and are therefore essential for genome processing and stability. Recent crystal structures of DNA-bound human flap endonuclease (hFEN1) offer new insights into how conformational changes in the DNA and hFEN1 may facilitate the reaction mechanism. For example, previous biochemical studies of DNA conformation performed under non-catalytic conditions with Ca2+ have suggested that base unpairing at the 5\\'-flap:template junction is an important step in the reaction, but the new structural data suggest otherwise. To clarify the role of DNA changes in the kinetic mechanism, we measured a series of transient steps - from substrate binding to product release - during the hFEN1-catalyzed reaction in the presence of Mg2+. We found that while hFEN1 binds and bends DNA at a fast, diffusion-limited rate, much slower Mg2+-dependent conformational changes in DNA around the active site are subsequently necessary and rate-limiting for 5\\'-flap cleavage. These changes are reported overall by fluorescence of 2-aminopurine at the 5\\'-flap:template junction, indicating that local DNA distortion (e.g., disruption of base stacking observed in structures), associated with positioning the 5\\'-flap scissile phosphodiester bond in the hFEN1 active site, controls catalysis. hFEN1 residues with distinct roles in the catalytic mechanism, including those binding metal ions (Asp-34, Asp-181), steering the 5\\'-flap through the active site and binding the scissile phosphate (Lys-93, Arg-100), and stacking against the base 5\\' to the scissile phosphate (Tyr-40), all contribute to these rate-limiting conformational changes, ensuring efficient and specific cleavage of 5\\'-flaps.

  7. Retention of a reconstructed nipple using a C-V flap with different layer thicknesses in the C-flap.

    Sowa, Yoshihiro; Itsukage, Sizu; Sakaguchi, Kouichi; Taguchi, Tetsuya; Numajiri, Toshiaki

    2018-04-01

    The C-V flap for nipple reconstruction is now one of standard surgical techniques. But decreased projection is still a problem. In recent years, it has been suggested that projection can be more easily maintained when raising of the C-flap is performed with a split thickness dermis. In this study, we examined whether decrease of projection can be prevented by raising of a C-flap with a split dermis rather than with full dermis. A total of 49 consecutive patients who underwent reconstruction of a nipple using the C-V flap technique were enrolled. The patients included 22 who underwent surgery using a C-flap with a full thickness dermis (Group F), and 27 who underwent surgery with raising of a flap with a split thickness dermis (Group S). The size of the reconstructed nipple was measured at 2 weeks, 6 months and 1 year postoperatively for comparison between Groups F and S. Partial necrosis of the C-flap end occurred in 4 subjects in only Group S. The decrease in projection after 1 year postoperatively in Group S was significantly lower than that in Group F. In contrast, the teat base size in Group F tended to be greater than that in Group S, suggesting a tendency for an expanded base using a flap with a full dermis. Our results indicated that it is recommended to use a C-flap with a split dermis for cases with high projection of the nipple on the contralateral side.

  8. Positioning the 5'-flap junction in the active site controls the rate of flap endonuclease-1-catalyzed DNA cleavage

    Song, Bo; Hamdan, Samir; Hingorani, Manju M

    2018-01-01

    Flap endonucleases catalyze cleavage of single-stranded DNA flaps formed during replication, repair and recombination, and are therefore essential for genome processing and stability. Recent crystal structures of DNA-bound human flap endonuclease (hFEN1) offer new insights into how conformational changes in the DNA and hFEN1 may facilitate the reaction mechanism. For example, previous biochemical studies of DNA conformation performed under non-catalytic conditions with Ca2+ have suggested that base unpairing at the 5'-flap:template junction is an important step in the reaction, but the new structural data suggest otherwise. To clarify the role of DNA changes in the kinetic mechanism, we measured a series of transient steps - from substrate binding to product release - during the hFEN1-catalyzed reaction in the presence of Mg2+. We found that while hFEN1 binds and bends DNA at a fast, diffusion-limited rate, much slower Mg2+-dependent conformational changes in DNA around the active site are subsequently necessary and rate-limiting for 5'-flap cleavage. These changes are reported overall by fluorescence of 2-aminopurine at the 5'-flap:template junction, indicating that local DNA distortion (e.g., disruption of base stacking observed in structures), associated with positioning the 5'-flap scissile phosphodiester bond in the hFEN1 active site, controls catalysis. hFEN1 residues with distinct roles in the catalytic mechanism, including those binding metal ions (Asp-34, Asp-181), steering the 5'-flap through the active site and binding the scissile phosphate (Lys-93, Arg-100), and stacking against the base 5' to the scissile phosphate (Tyr-40), all contribute to these rate-limiting conformational changes, ensuring efficient and specific cleavage of 5'-flaps.

  9. Extra and intracelular activities of carbonic anhydrase of the marine microalga Tetraselmis gracilis (Chlorophyta Atividade extra e intracelular da Anidrase Carbônica na microalga marinha Tetraselmis gracilis (Chlorophyta

    Marilda Rigobello-Masini

    2003-07-01

    Full Text Available The activities of extra and intracellular carbonic anhydrases (CA were studied in the microalgae Tetraselmis gracilis (Kylin Butcher (Chlorophyta, Prasinophyceae growing in laboratory cultivation. During ten days of batch cultivation, daily determinations of pH, cell number, enzymatic activity, and total dissolved inorganic carbon (DIC, as well as its main species, CO2 and HCO3-, were performed. Enzymatic activity increased as the growing cell population depleted inorganic carbon from the medium. Carbon dioxide concentration decreased quickly, especially in the third day of cultivation, when a significant increase of the intracellular enzymatic activity was observed. Bicarbonate concentration had its largest decrease in the cultivation medium in the fourth day, when the activity of the extracellular enzyme had its largest increase, suggesting its use by the alga through CA activity. After the fourth cultivation day, half of the cultures were aerated with CO2-free atmospheric air, which caused an increase in the total and external activity of the enzyme, although, in this condition, the stationary growth phase began earlier than in cultures aerated with atmospheric air. The pH of the media was measured daily, increasing from the first to the fourth day, and remaining almost constant until the end of the cultivation. Algal material transferred to the dark lost all enzymatic activity.As atividades da Anidrase Carbônica (AC extra e intracelular foram estudadas na microalga marinha Tetraselmis gracilis (Kylin Butcher (Chlorophyta, Prasinophyceae crescendo em cultivos laboratoriais. Durante dez dias de cultivo, determinações diárias do pH, número de células, atividades enzimáticas, carbono inorgânico total dissolvido (CID e suas principais espécies CO2 e HCO3- foram feitas. A atividade enzimática aumentou na medida em que a população celular em crescimento retirava carbono inorgânico do meio de cultivo. A concentração de dióxido de

  10. Soap films burst like flapping flags.

    Lhuissier, Henri; Villermaux, Emmanuel

    2009-07-31

    When punctured, a flat soap film bursts by opening a hole driven by liquid surface tension. The hole rim does not, however, remain smooth but soon develops indentations at the tip of which ligaments form, ultimately breaking and leaving the initially connex film into a mist of disjointed drops. We report on original observations showing that these indentations result from a flaglike instability between the film and the surrounding atmosphere inducing an oscillatory motion out of its plane. Just like a flag edge flaps in the wind, the film is successively accelerated on both sides perpendicularly to its plane, inducing film thickness modulations and centrifuging liquid ligaments that finally pinch off to form the observed spray. This effect exemplifies how the dynamics of fragile objects such as thin liquid films is sensitive to their embedding medium.

  11. Anomalous Hydrodynamic Drafting of Interacting Flapping Flags

    Ristroph, Leif; Zhang, Jun

    2008-11-01

    In aggregates of objects moving through a fluid, bodies downstream of a leader generally experience reduced drag force. This conventional drafting holds for objects of fixed shape, but interactions of deformable bodies in a flow are poorly understood, as in schools of fish. In our experiments on “schooling” flapping flags, we find that it is the leader of a group who enjoys a significant drag reduction (of up to 50%), while the downstream flag suffers a drag increase. This counterintuitive inverted drag relationship is rationalized by dissecting the mutual influence of shape and flow in determining drag. Inverted drafting has never been observed with rigid bodies, apparently due to the inability to deform in response to the altered flow field of neighbors.

  12. Muscular anatomy of the Podocoryna carnea hydrorhiza.

    Buss, Leo W; Anderson, Christopher; Bolton, Edward W

    2013-01-01

    The muscular anatomy of the athecate hydroid Podocoryna carnea hydrorhiza is elucidated. The polyp-stolon junction is characterized by an opening, here called the chloe, in the otherwise continuous hydrorhizal perisarc. The chloe is elliptical when the polyp first arises, but takes on a more complex outline as multiple stolons anastomose to communicate with that polyp. Surrounding the polyp base are spots, here called anchors, which autofluoresce at the same wavelengths as perisarc and which, like perisarc, contain chitin as assessed by Calcofluor White, Congo Red and wheat germ agglutinin staining. Anchors remain after living tissues are digested using KOH. Collagen IV staining indicates that the mesoglea is pegged to the anchors and rhodamine phallodin staining detects cytoskeletal F-actin fibers of the basal epidermis surrounding the anchors. Longitudinal muscle fibers of the polyp broaden at the polyp base and are inserted into the mesoglea of the underlying stolon, but were neither observed to extend along the stolonal axis nor to attach to the anchors. Circular muscular fibers of the polyp extend into stolons as a dense collection of strands running along the proximal-distal axis of the stolon. These gastrodermal axial muscular fibers extend to the stolon tip. Epidermal cells at the stolon tip and the polyp bud display a regular apical latticework of F-actin staining. A similar meshwork of F-actin staining was found in the extreme basal epidermis of all stolons. Immunohistochemical staining for tubulin revealed nerves at stolon tips, but at no other hydrorhizal locations. These studies bear on the mechanisms by which the stolon tip and polyp bud pulsate, the manner in which the stolon lumen closes, and on the developmental origin of the basal epidermis of the hydrorhiza.

  13. Nose muscular dynamics: the tip trigonum.

    Figallo, E E; Acosta, J A

    2001-10-01

    In 1995, the senior author (E.E.F.) published an article in which he described the musculus digastricus septi nasi labialis. In the article presented here, work carried out by anatomists and other researchers who, over the last two centuries, studied nose muscular dynamics is described. The present study is based on Gray's Anatomy, which, in 1858, first described the nasal tip muscles, along with the other nasal muscles. Later works not only used different terminology for these muscles but also ignored some, creating tremendous confusion. The study presented here provides an update of the exact terms, location, insertions, and muscle functions of the muscles of the nose. Each nose muscle is described with regard to the two portions able to produce separate contractions. In this study, the term "dual function" is used and characterizes the nasal mimetic muscles that do not have well-defined fascia. Therefore, there is doubt about the existence of a real nasal superficial muscle aponeurotic system. The musculus myrtiformis seems to have a dual function, inserting in the canine fosse and in the periosteum of the central incisors, forming two portions-one to the septum and the other to the nostril-each of which has specific functions. This study has been based on research in physiognomy, the science of expression. With regard to the basis for nose expressions, common anatomical research is excluded because it provides a different view of the dynamics studied to date. The term trigonum musculare apicis nasi defines the interaction of the musculi compressor narium minor and dilator naris anterior, connecting with the columellar bundle of the musculus digastricus and levering the nasal spine. This muscular trigone creates circular concentric and eccentric movements of the nasal tip.

  14. A comparison of swallowing dysfunction in Becker muscular dystrophy and Duchenne muscular dystrophy.

    Yamada, Yuka; Kawakami, Michiyuki; Wada, Ayako; Otsuka, Tomoyoshi; Muraoka, Kaori; Liu, Meigen

    2018-06-01

    Swallowing dysfunction has been reported in Duchenne muscular dystrophy (DMD), but has not been studied in Becker muscular dystrophy (BMD). The aims of this study were to report the characteristics of swallowing dysfunction in BMD compared with DMD. The study participants were 18 patients with BMD and 18 patients with DMD. All the patients were examined using videofluorography during swallowing of 5 mL of fluid. The penetration-aspiration scale (P-A scale) and the videofluorographic dysphagia scale (VDS) were used to evaluate dysphagia. Swinyard functional ability stage was not significantly different between the BMD and DMD groups. Rate of aspiration, P-A scale score, and total VDS score did not differ across groups, but the VDS item score for laryngeal elevation was lower in the BMD group than in the DMD group (median scores 4.5 and 9, respectively; p Becker muscular dystrophy (BMD) was not well known. Eighteen patients with BMD and 18 patients with Duchenne muscular dystrophy were examined with videofluorography. Patients with BMD have swallowing problems similar to those observed in patients with DMD.

  15. Força e arquitetura muscular do gémeo interno na bomba muscular venosa

    Peixoto, Flávia; Pinto, Ângela; Kozlova, Veronika; Crisóstomo, Rute

    2015-01-01

    Objetivo: Avaliar e comparar a Força Muscular (FM), Amplitude de Movimento (ADM) e Arquitetura Muscular da bomba muscular venosa em sujeitos com e sem Insuficiência Venosa Crónica (IVC). Relevância: A IVC provoca alterações na função da bomba muscular venosa, no entanto, pouco se conhece acerca das suas repercussões físicas e funcionais. Amostra: Sujeitos com IVC (alterações da tróficas, e úlcera ativa/cicatrizada) e saudáveis. Foram avaliados 33 sujeitos dos quais foram analis...

  16. Application analysis on different suture of scleral flap in trabeculectomy

    Ning Liu

    2014-05-01

    Full Text Available AIM: To research the application of scleral flap suture in trabeculectomy. METHODS: Totally 114 primary angle-closure glaucoma patients, aged from 36-72 years old, were selected as the objects, and randomly divided into research group and control group. The two groups received different administration methods. Traditional sewing method of sclera flap was used in research group and improved sewing method of sclera flap was used in control group. RESULTS: There was statistical differences between postoperative intraocular pressure of the patients in the observation group and the control group after 1d; 2wk; 1, 3mo(PPP>0.05.CONCLUSION: It is safe and effective that the improved sewing method of sclera flap for trabeculectomy of acute angle-closure glaucoma, and it is a better method to avoid the occurrence of shallow anterior chamber than the traditional sewing method in the early stage after operation.

  17. Shape optimisation and performance analysis of flapping wings

    Ghommem, Mehdi; Collier, Nathan; Niemi, Antti; Calo, Victor M.

    2012-01-01

    optimised shapes produce efficient flapping flights, the wake pattern and its vorticity strength are examined. This work described in this paper should facilitate better guidance for shape design of engineered flying systems.

  18. A Novel Perforator Flap Training Model Using a Chicken Leg.

    Cifuentes, Ignacio J; Yañez, Ricardo A; Salisbury, Maria C; Rodriguez, José R; Varas, Julian E; Dagnino, Bruno L

    2016-04-01

    Living animal models are frequently used for perforator flap dissection training, but no ex vivo models have been described. The aim of this study is to present a novel nonliving model for perforator flap training based on a constant perforator in the chicken leg. A total of 15 chicken legs were used in this study. Anatomical dissection of the perforator was performed after its identification using ink injection, and in four of these specimens a perforator-based flap was raised. The anatomical dissection revealed a constant intramuscular perforator with a median length of 5.7 cm. Median proximal and distal vessel diameters were 0.93 and 0.4 mm, respectively. The median dissection time was 77.5 minutes. This study introduces a novel, affordable, and reproducible model for the intramuscular dissection of a perforator-based flap using an ex vivo animal model. Its consistent perforator and appropriate-sized vessels make it useful for training.

  19. Modeling of Airfoil Trailing Edge Flap with Immersed Boundary Method

    Zhu, Wei Jun; Shen, Wen Zhong; Sørensen, Jens Nørkær

    2011-01-01

    The present work considers incompressible flow over a 2D airfoil with a deformable trailing edge. The aerodynamic characteristics of an airfoil with a trailing edge flap is numerically investigated using computational fluid dynamics. A novel hybrid immersed boundary (IB) technique is applied...... to simulate the moving part of the trailing edge. Over the main fixed part of the airfoil the Navier-Stokes (NS) equations are solved using a standard body-fitted finite volume technique whereas the moving trailing edge flap is simulated with the immersed boundary method on a curvilinear mesh. The obtained...... results show that the hybrid approach is an efficient and accurate method for solving turbulent flows past airfoils with a trailing edge flap and flow control using trailing edge flap is an efficient way to regulate the aerodynamic loading on airfoils....

  20. Reconstruction of hand contracture by reverse ulnar perforator flap

    Cengiz Eser

    2016-04-01

    Full Text Available Hand burn scar contractures affect patients in aesthetic and functional aspects. After releasing these scars, the defects should be repaired. The reconstruction methods include primary suturation, Z plasty, skin grafting, local or free flaps, etc. All methods have their own advantages and disadvantages. One of the most useful flaps is the reverse ulnar perforator flap. We performed a two-staged procedure for repairing a post-burn contracture release defect in a 40-year-old male. In the first stage we applied reverse ulnar perforator flap for the hand defect, and ulnar artery and vein repair in the second stage. In conclusion, this two-staged procedure is a non-primary but useful option for hand and finger defects and prevents major vascular structure damage of the forearm. [Hand Microsurg 2016; 5(1.000: 40-43

  1. [Complete atrioventricular block in Duchenne muscular dystrophy].

    Kuru, Satoshi; Tanahashi, Tamotsu; Matsumoto, Shinjirou; Kitamura, Tetsuya; Konagaya, Masaaki

    2012-01-01

    We report a case of complete atrioventricular (AV) block in a 40-year-old patient with Duchenne muscular dystrophy (DMD). While he was bed-ridden and required mechanical ventilation, his cardiac involvement was mild. He had the deletion of exon 45-52 in the dystrophin gene. He underwent transient complete AV block and came to require pacemaker implantation due to recurrence of complete AV block ten days after the first attack. Electrophysiological study revealed mild prolonged AH and HV interval. Although DMD patients with AV block have been rarely reported so far, attention should be paid to AV block for patients who prolonged their lives.

  2. Spinal muscular atrophy present in children

    Garófalo Gómez, Nicolás; Zaldívar Vaillant, Tatiana; Vargas Díaz, José; Rojas Massipe, Edelsia; Novoa López, Lucía

    2009-01-01

    INTRODUCCIÓN. Las atrofias musculares espinales en la infancia (AME) son trastornos genéticos autosómicos recesivos, caracterizados por degeneración de las motoneuronas espinales y bulbares. El presente estudio tuvo el objetivo principal de describir las principales características clínicas en una serie de niños con AME. MÉTODOS. Se realizó un estudio retrospectivo de los pacientes con AME atendidos en el Instituto de Neurología y Neurocirugía de Cuba, entre enero de 1997 y diciembre de 2001....

  3. Merosin/laminin-2 and muscular dystrophy

    Wewer, U M; Engvall, E

    1996-01-01

    structural organization of domains, some of which have been assigned biological activities, including self-assembly and interactions with other proteins. The particular importance of laminins for the formation and stability of cell adhesion complexes is highlighted in severe inherited diseases of muscle...... and skin. Merosin is the collective name for laminins that share a common subunit, the laminin alpha 2 chain. Merosin-deficient congenital muscular dystrophy (CMD) is caused by mutations in the laminin alpha 2 chain gene. The skin disease Herlitz junctional epidermolysis bullosa is caused by mutations...

  4. Muscular cysticercosis: Case report and imaging findings

    Neide Regina Simões Olmo

    Full Text Available Summary Cysticercosis is a parasitic disease caused by a worm of the Cestoda class. The most prevalent form affects the nervous system. This case report is from a 78-year-old female patient evaluated at Clínica Mult Imagem, in the city of Santos, Brazil, who presented a form of the disease that differed from the classic neurocysticercosis, in this case muscular cysticercosis. This and other forms of manifestation justify further studies to ensure adequate recognition, diagnosis and treatment of this parasitic disease.

  5. Flap Side Edge Liners for Airframe Noise Reduction

    Jones, Michael G. (Inventor); Khorrami, Mehdi R. (Inventor); Choudhari, Meelan M. (Inventor); Howerton, Brian M. (Inventor)

    2014-01-01

    One or more acoustic liners comprising internal chambers or passageways that absorb energy from a noise source on the aircraft are disclosed. The acoustic liners may be positioned at the ends of flaps of an aircraft wing to provide broadband noise absorption and/or dampen the noise producing unsteady flow features, and to reduce the amount of noise generated due to unsteady flow at the inboard and/or outboard end edges of a flap.

  6. Surgeon-Based 3D Printing for Microvascular Bone Flaps.

    Taylor, Erin M; Iorio, Matthew L

    2017-07-01

    Background  Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods  Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models. These were printed in the surgeon's office as 3D models for the planned reconstruction. Vascularized bone flaps were designed intraoperatively based on the 3D printed models. Results  Three-dimensional models were created for intraoperative use in vascularized bone flaps, including (1) medial femoral trochlea (MFT) flap for scaphoid avascular necrosis and nonunion, (2) MFT flap for lunate avascular necrosis and nonunion, (3) medial femoral condyle (MFC) flap for wrist arthrodesis, and (4) free fibula osteocutaneous flap for distal radius septic nonunion. Templates based on the 3D models allowed for the precise and rapid contouring of well-vascularized bone flaps in situ, prior to ligating the donor pedicle. Conclusions  Surgeon-based 3D printing is a feasible, innovative technology that allows for the precise and rapid contouring of models that can be created in various configurations for pre- and intraoperative planning. The technology is easy to use, convenient, and highly economical as compared with traditional send-out manufacturing. Surgeon-based 3D printing is a useful adjunct in vascularized bone transfer. Level of Evidence  Level IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  7. An international comparison of reimbursement for DIEAP flap breast reconstruction.

    Reid, A W N; Szpalski, C; Sheppard, N N; Morrison, C M; Blondeel, P N

    2015-11-01

    The deep inferior epigastric artery perforator (DIEAP) flap is currently considered the gold standard for autologous breast reconstruction. With the current economic climate and health cutbacks, we decided to survey reimbursement for DIEAP flaps performed at the main international centres in order to assess whether they are funded consistently. Data were collected confidentially from the main international centres by an anonymous questionnaire. Our results illustrate the wide disparity in international DIEAP flap breast reconstruction reimbursement: a unilateral DIEAP flap performed in New York, USA, attracts €20,759, whereas the same operation in Madrid, Spain, will only be reimbursed for €300. Only 35.7% of the surgeons can set up their own fee. Moreover, 85.7% of the participants estimated that the current fees are insufficient, and most of them feel that we are evolving towards an even lower reimbursement rate. In 55.8% of the countries represented, there is no DIEAP-specific coding; in comparison, 74.4% of the represented countries have a specific coding for transverse rectus abdominis (TRAM) flaps. Finally, despite the fact that DIEAP flaps have become the gold standard for breast reconstruction, they comprise only a small percentage of all the total number of breast reconstruction procedures performed (7-15%), with the only exception being Belgium (40%). Our results demonstrate that DIEAP flap breast reconstruction is inconsistently funded. Unfortunately though, it appears that the current reimbursement offered by many countries may dissuade institutions and surgeons from offering this procedure. However, substantial evidence exists supporting the cost-effectiveness of perforator flaps for breast reconstruction, and, in our opinion, the long-term clinical benefits for our patients are so important that this investment of time and money is absolutely essential. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons

  8. Ornithopter Type Flapping Wings for Autonomous Micro Air Vehicles

    Sutthiphong Srigrarom; Woei-Leong Chan

    2015-01-01

    In this paper, an ornithopter prototype that mimics the flapping motion of bird flight is developed, and the lift and thrust generation characteristics of different wing designs are evaluated. This project focused on the spar arrangement and material used for the wings that could achieves improved performance. Various lift and thrust measurement techniques are explored and evaluated. Various wings of insects and birds were evaluated to understand how these natural flyers with flapping wings a...

  9. Water Tunnel Studies of Dynamic Wing Flap Effects

    2016-06-01

    NAVAL POSTGRADUATE SCHOOL MONTEREY, CALIFORNIA THESIS Approved for public release; distribution is unlimited WATER TUNNEL...Master’s Thesis 4. TITLE AND SUBTITLE WATER TUNNEL STUDIES OF DYNAMIC WING FLAP EFFECTS 5. FUNDING NUMBERS 6. AUTHOR(S) Edgar E. González 7. PERFORMING...ABSTRACT (maximum 200 words ) The flow features developing over a two-element NACA 0012 airfoil, with the rear portion serving as a trailing edge flap

  10. Free tissue transfer versus pedicled flap reconstruction of head and neck malignancy defects.

    O'Neill, J P

    2012-02-01

    BACKGROUND: With the advent of microsurgery the pedicled flap is considered by many to be an outdated surgical option. AIMS: To explore the relationship between flap survival and pre-morbid risk factors, conduct a comparative analysis of flap and systemic morbidities and complete a cosmesis and functionality assessment for oral and oropharyngeal reconstruction patients. METHODS: 114 patients, over a 13-year period, who had a one-stage reconstructive procedure employing the pectoralis major myocutaneous flap (PMMF) or radial forearm-free flap (RFFF). RESULTS: Variables, including age, smoking and radiation exposure were not statistically significant predictors of flap survival probability. Atelectasis was a significant post-op finding of RFFF patients. Flap dehiscence of >50% was a significant morbidity of PMMF. No statistical difference in cosmetic deformity, diet and socialisation was noted. CONCLUSIONS: Pectoralis major myocutaneous flap remains an enduring and safe flap; however, the RFFF has markedly improved speech performance over the PMMF.

  11. Relaci??n entre la masa muscular, la densidad mineral ??sea, la fuerza muscular, la aptitud funcional y la calidad muscular en personas mayores

    Pati??o Villada, Fredy Alonso

    2015-01-01

    294 p. La tesis pretende determinar la frecuencia de la sarcopenia y osteporosis , problemas que afectan a la salud de las personas mayores, y analizar la relaci??n entre la masa muscular, la densidad mineral ??sea (DMO), la fuerza muscular, la aptitud funcional y la calidad muscular (CM). La muestra estudiada fue la formada por un grupo de 83 hombres y 175 mujeres mayores de Le??n (Espa??a). El estudio transversal eval??a ??ndices de masa grasa y densidad mineral ??sea y niveles d...

  12. Eupafolin and Ethyl Acetate Fraction of Kalanchoe gracilis Stem Extract Show Potent Antiviral Activities against Enterovirus 71 and Coxsackievirus A16

    Wang, Ching-Ying; Huang, Shun-Chueh; Lai, Zhen-Rung; Ho, Yu-Ling; Jou, Yu-Jen; Kung, Szu-Hao; Zhang, Yongjun; Chang, Yuan-Shiun; Lin, Cheng-Wen

    2013-01-01

    Enterovirus 71 (EV71) and coxsackievirus A16 (CoxA16) are main pathogens of hand-foot-and-mouth disease, occasionally causing aseptic meningitis and encephalitis in tropical and subtropical regions. Kalanchoe gracilis, Da-Huan-Hun, is a Chinese folk medicine for treating pain and inflammation, exhibiting antioxidant and anti-inflammatory activities. Our prior report (2012) cited K. gracilis leaf extract as moderately active against EV71 and CoxA16. This study further rates antienteroviral potential of K. gracilis stem (KGS) extract to identify potent antiviral fractions and components. The extract moderately inhibits viral cytopathicity and virus yield, as well as in vitro replication of EV71 (IC50 = 75.18 μg/mL) and CoxA16 (IC50 = 81.41 μg/mL). Ethyl acetate (EA) fraction of KGS extract showed greater antiviral activity than that of n-butanol or aqueous fraction: IC50 values of 4.21 μg/mL against EV71 and 9.08 μg/mL against CoxA16. HPLC analysis, UV-Vis absorption spectroscopy, and plaque reduction assay indicate that eupafolin is a vital component of EA fraction showing potent activity against EV71 (IC50 = 1.39 μM) and CoxA16 (IC50 = 5.24 μM). Eupafolin specifically lessened virus-induced upregulation of IL-6 and RANTES by inhibiting virus-induced ERK1/2, AP-1, and STAT3 signals. Anti-enteroviral potency of KGS EA fraction and eupafolin shows the clinical potential against EV71 and CoxA16 infection. PMID:24078828

  13. Eupafolin and Ethyl Acetate Fraction of Kalanchoe gracilis Stem Extract Show Potent Antiviral Activities against Enterovirus 71 and Coxsackievirus A16

    Ching-Ying Wang

    2013-01-01

    Full Text Available Enterovirus 71 (EV71 and coxsackievirus A16 (CoxA16 are main pathogens of hand-foot-and-mouth disease, occasionally causing aseptic meningitis and encephalitis in tropical and subtropical regions. Kalanchoe gracilis, Da-Huan-Hun, is a Chinese folk medicine for treating pain and inflammation, exhibiting antioxidant and anti-inflammatory activities. Our prior report (2012 cited K. gracilis leaf extract as moderately active against EV71 and CoxA16. This study further rates antienteroviral potential of K. gracilis stem (KGS extract to identify potent antiviral fractions and components. The extract moderately inhibits viral cytopathicity and virus yield, as well as in vitro replication of EV71 (IC50 = 75.18 μg/mL and CoxA16 (IC50 = 81.41 μg/mL. Ethyl acetate (EA fraction of KGS extract showed greater antiviral activity than that of n-butanol or aqueous fraction: IC50 values of 4.21 μg/mL against EV71 and 9.08 μg/mL against CoxA16. HPLC analysis, UV-Vis absorption spectroscopy, and plaque reduction assay indicate that eupafolin is a vital component of EA fraction showing potent activity against EV71 (IC50 = 1.39 μM and CoxA16 (IC50 = 5.24 μM. Eupafolin specifically lessened virus-induced upregulation of IL-6 and RANTES by inhibiting virus-induced ERK1/2, AP-1, and STAT3 signals. Anti-enteroviral potency of KGS EA fraction and eupafolin shows the clinical potential against EV71 and CoxA16 infection.

  14. Unsteady Aerodynamics of Flapping Wing of a Bird

    M. Agoes Moelyadi

    2013-04-01

    Full Text Available The unsteady flow behavior and time-dependent aerodynamic characteristics of the flapping motion of a bird’s wing were investigated using a computational method. During flapping, aerodynamic interactions between bird wing surfaces and surrounding flow may occur, generating local time-dependent flow changes in the flow field and aerodynamic load of birds. To study the effect of flapping speed on unsteady aerodynamic load, two kinds of computational simulations were carried out, namely a quasi-steady and an unsteady simulation. To mimic the movement of the down-stroke and the upstroke of a bird, the flapping path accorded to a sinus function, with the wing attitude changing in dihedral angle and time. The computations of time-dependent viscous flow were based on the solution of the Reynolds Averaged Navier-Stokes equations by applying the k-e turbulence model. In addition, the discretization for the computational domain around the model used multi-block structured grid to provide more accuracy in capturing viscous flow, especially in the vicinity of the wing and body surfaces, to obtain a proper wing-body geometry model. For this research, the seagull bird was chosen, which has high aspect ratio wings with pointed wing-tips and a high camber wing section. The results include mesh movement, velocity contours as well as aerodynamic coefficients of the flapping motion of the bird at various flapping frequencies.

  15. Temporalis myo-osseous flap: an experimental study

    Antonyshyn, O.; Colcleugh, R.G.; Hurst, L.N.; Anderson, C.

    1986-01-01

    The present paper investigates the anatomy and vascularization of the temporalis myo-osseous flap. This is a calvarial bone flap that employs temporalis muscle and its distal pericranial extension as a pedicle. In six human cadavers the flap was raised as an island on the anterior deep temporal artery after transecting the zygomatic arch and coronoid process. Maximal mobilization was thus obtained, allowing rotation of the flap into the mouth for intraoral reconstruction. The arc of rotation and potential surgical applications were noted. A comparative study of the temporalis myo-osseous flap and free calvarial bone graft was then conducted in a rabbit model. Vascularization of the calvarial bone flap was confirmed by technetium scintigraphy performed on the first postoperative day. The uptake of fluorochrome labels immediately after transfer verified the adequacy of the periosteal circulation in maintaining viability and new osteoid formation throughout the full thickness of calvarial bone. The transplantation of free calvarial bone grafts was followed by necrosis of most cellular elements. This was demonstrated by an absence of fluorochrome uptake up to 19 days postoperatively and a predominance of empty lacunae and nonviable marrow

  16. Prefabricated fibula free flap with dental implants for mandibular reconstruction.

    Pauchet, D; Pigot, J-L; Chabolle, F; Bach, C-A

    2018-03-02

    Free fibula transplant is routinely used for mandibular reconstruction in head and neck cancer. Dental rehabilitation, the objective of mandibular reconstruction, requires the use of dental implants as supports for fixed or removable dentures. Positioning of fibular bone grafts and implants determines implant osseointegration and the possibilities of dental rehabilitation. Prefabrication of a fibula free flap with dental implants prior to harvesting as a free flap can promote implant osseointegration. The position of the implants must then be precisely planned. Virtual surgery and computer-assisted design and prefabrication techniques are used to plan the reconstruction and then reproduce this planning by means of tailored fibula and mandible cutting guides, thereby ensuring correct positioning of fibular bone fragments and implants. The prefabricated fibula free flap technique requires two surgical procedures (prefabrication and flap transfer) and precise preoperative planning. Prefabricated fibula free flap with dental implants, by improving the quality of osseointegration of the implants before flap transfer, extends the possibilities of prosthetic rehabilitation in complex secondary mandibular reconstructions. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

  17. Use of various free flaps in progressive hemifacial atrophy.

    Baek, Rongmin; Heo, Chanyeong; Kim, Baek-kyu

    2011-11-01

    Romberg disease is an uncommon condition manifested by progressive hemifacial atrophy of the skin, soft tissue, and bone. Facial asymmetry with soft tissue deficiency in Romberg disease causes a significant disability affecting the social life and can bring about many psychological problems. The aim of surgical treatment is cosmetic amelioration of the defect. Several conventional reconstructive procedures have been used for correcting facial asymmetry. They include fat injections, dermal fat grafts, filler injections, cartilage and bone grafts, and pedicled and free flaps. We report our experiences with 11 patients involving 11 free flaps with a minimum 1-year follow-up. All patients were classified as having moderate to severe atrophy. The average age at disease onset was 4.5 years; the average duration of atrophy was 5.2 years. No patients were operated on with a quiescent interval of less than 1 year. The average age at operation was 20.1 years, ranging from 10 to 55 years. Reconstruction was performed using 4 groin dermofat free flaps, 4 latissimus dorsi muscle free flaps, and 3 other perforator flaps. To achieve the finest symmetrical and aesthetic results, several ancillary procedures were performed in 4 patients. These procedures included Le Fort I leveling osteotomy, sagittal split ramus osteotomy, reduction malarplasty and angle plasty, rib and calvarial bone graft, correction of alopecia, and additional fat graft. All patients were satisfied with the results. We believe that a free flap transfer is the requisite treatment modality for severe degree of facial asymmetry in Romberg disease.

  18. RANS Simulations of Aerodynamic Performance of NACA 0015 Flapped Airfoil

    Sohaib Obeid

    2017-01-01

    Full Text Available An analysis of 2D subsonic flow over an NACA 0015 airfoil with a 30% trailing edge flap at a constant Reynolds number of 106 for various incidence angles and a range of flap deflections is presented. The steady-state governing equations of continuity and momentum conservation are solved combined with the realizable k-ε turbulence model using the ANSYS-Fluent code (Version 13.7, ANSYS, Inc., Canonsburg, PA, USA. The primary objective of the study is to provide a comprehensive understanding of flow characteristics around the NACA 0015 airfoil as a function of the angle of attack and flap deflection at Re = 106 using the realizable k-ε turbulence model. The results are validated through comparison of the predictions with the free field experimental measurements. Consistent with the experimental observations, the numerical results show that increased flap deflections increase the maximum lift coefficient, move the zero-lift angle of attack (AoA to a more negative value, decrease the stall AoA, while the slope of the lift curve remains unchanged and the curve just shifts upwards. In addition, the numerical simulations provide limits for lift increment Δ C l and Cl, max values to be 1.1 and 2.2, respectively, obtained at a flap deflection of 50°. This investigation demonstrates that the realizable k-ε turbulence model is capable of predicting flow features over an airfoil with and without flap deflections with reasonable accuracy.

  19. Restart capability of resting-states of Euglena gracilis after 9 months of dormancy: preparation for autonomous space flight experiments

    Strauch, Sebastian M.; Becker, Ina; Pölloth, Laura; Richter, Peter R.; Haag, Ferdinand W. M.; Hauslage, Jens; Lebert, Michael

    2018-04-01

    Dormant states of organisms are easier to store than the living state because they tolerate larger variations in temperature, light, storage space etc., making them attractive for laboratory culture stocks and also for experiments under special circumstances, especially space flight experiments. Like several other organisms, Euglena gracilis is capable of forming desiccation tolerant resting states in order to survive periods of unfavourable environmental conditions. In earlier experiments it was found that dormant Euglena cells must not become completely desiccated. Some residual moisture is required to ensure recovery of the resting states. To analyse the water demand in recovery of Euglena resting states, cells were transferred to a defined amount of cotton wool (0.5 g). Subsequently different volumes of medium (1, 2, 3, 4, 5, 8, 10 and 20 ml) were added in order to supply humidity; a control was set up without additional liquid. Samples were sealed in transparent 50 ml falcon tubes and stored for 9 months under three different conditions: • Constant low light conditions in a culture chamber at 20°C, • In a black box, illuminated with short light emitting diode-light pulses provided by joule thieves and • In darkness in a black box. After 9 months, cells were transferred to fresh medium and cell number, photosynthetic efficiency and movement behavior was monitored over 3 weeks. It was found that cells recovered under all conditions except in the control, where no medium was supplied. Transcription levels of 21 genes were analysed with a Multiplex-polymerase chain reaction. One hour after rehydration five of these genes were found to be up-regulated: ubiquitin, heat shock proteins HSP70, HSP90, the calcium-sensor protein frequenin and a distinct protein kinase, which is involved in gravitaxis. The results indicate a transient general stress response of the cells.

  20. Effects of chronic exposure in populations of Koeleria gracilis Pers. from the Semipalatinsk nuclear test site, Kazakhstan

    Geras'kin, S.A.; Oudalova, A.A.; Dikarev, V.G.; Dikareva, N.S.; Mozolin, E.M.; Hinton, T.; Spiridonov, S.I.; Copplestone, D.; Garnier-Laplace, J.

    2012-01-01

    Morphological and cytogenetic abnormalities were examined in crested hairgrass (Koeleria gracilis Pers.) populations inhabiting the Semipalatinsk nuclear test site (STS), Kazakhstan. Sampling of biological material and soil was carried out during 3 years (2005–2007) at 4 sites within the STS. Activity concentrations of 10 radionuclides and 8 heavy metals content in soils were measured. Doses absorbed by plants were estimated and varied, depending on the plot, from 4 up to 265 mGy/y. The frequency of cytogenetic alterations in apical meristem of germinated seeds from the highly contaminated plot significantly exceeded the level observed at other plots with lower levels of radioactive contamination during all three years of the study. A significant excess of chromosome aberrations, typical for radiation exposure, as well as a dependence of the frequency of these types of mutations on dose absorbed by plants were revealed. The results indicate the role radioactive contamination plays in the occurrence of cytogenetic effects. However, no radiation-dependent morphological alterations were detected in the progeny of the exposed populations. Given that the crested hairgrass populations have occupied the radioactively contaminated plots for some 50 years, adaptation to the radiation stress was not evident. The findings obtained were in agreement with the benchmark values proposed in the FASSET and ERICA projects to restrict radiation impacts on biota. - Highlights: ► Morphological and cytogenetic abnormalities were examined in plants from the STS. ► Annual doses absorbed by plants varied from 4 up to 265 mGy. ► Cytogenetic alterations in plants from the explosions epicenter exceeded the control. ► No radiation-dependent morphological alterations were detected in the progeny. ► Radio-adaptation in plant populations in 50 years of chronic exposure was not evident.

  1. The effect of 60Co γ-rays on the contents of paramylon and trehalose in Euglena gracilis

    Furuta, M.; Maruyama, A.; Nakazawa, M.; Ueda, M.; Miyatake, K.; Kato, A.; Enomoto, T.

    2003-01-01

    Full text: It is reported that the non-reducing disaccharide trehalose is accumulated in various organisms and protects biomolecules against various environmental stresses including heat shock, osmotic shock, and oxidative stresses. Euglena (Euglena gracilis) is photosynthetic unicellular organisms which is classified both as animal and as plant because of its motility. In our previous study, it was shown that salt stress causes degradation of paramylon, the reserve carbohydrate of Euglena, and trehalose, the degraded product of paramylon, accumulated simultaneously to maintain the osmotic pressure of Euglena cells. Euglena is known to be radiation-resistant more than Escherichia coli and other bacteria. Therefore, we have investigated whether or not the same phenomenon could be observed in Euglena after 60 Co-gamma irradiation. Exposure of the native Z strain and chloroplast-deficient SM-ZK strain of Euglena to a dose of 500 kGy induced significant paramylon degradation and trehalose accumulation during the incubation in the Koren-Hunter culture medium containing glucose as carbon source after the irradiation. Forty percent of the paramylon was degraded within 10-hr incubation after the irradiation but accumulated trehalose content was about one sixth of that by salt stress. Trehlose accumulation disappeared when the irradiated cells were incubated in phosphate buffer but it recovered when glucose is added to the buffer to the same concentration as K-H media. These results suggest that trehalose accumulation in irradiated Euglena cells plays a role in protecting cellular constituents from oxidative damage caused by gamma-irradiation independently of the response to salt stress

  2. Analgesic and anti-inflammatory activities of the methanol extract of Kalanchoe gracilis (L.) DC stem in mice.

    Lai, Zhen-Rung; Peng, Wen-Huang; Ho, Yu-Ling; Huang, Shun-Chieh; Huang, Tai-Hung; Lai, Shang-Chih; Ku, Yoe-Ray; Tsai, Jen-Chieh; Wang, Ching-Ying; Chang, Yuan-Shiun

    2010-01-01

    In this study, we evaluated the analgesic effect of the methanol extract of Kalanchoe gracilis (MKGS) stem in animal models by inducing writhing response with acetic acid and conducting formalin test. The anti-inflammatory effect of MKGS was also estimated on mice with lambda-carrageenan induced paw edema model. In order to investigate the anti-inflammatory mechanism of MKGS, we analyzed the activities of glutathione peroxidase (GPx) and glutathione reductase (GRx) in the liver, and the levels of interleukin-1beta (IL-1beta), tumor necrosis factor (TNF-alpha), malondialdehyde (MDA) and nitric oxide (NO) in the edema paw tissue. In the analgesic tests, MKGS (0.5 and 1.0 g/kg) decreased both the acetic acid-induced writhing response and the licking time in the late phase of the formalin test. In the anti-inflammatory test, MKGS (0.1, 0.5 and 1.0 g/kg) decreased paw edema at the third, fourth, fifth and sixth hours after lambda-carrageenan had been administrated. Furthermore, MKGS increased the activities of SOD and GRx in liver tissues and decreased MDA level in the edema paws three hours after lambda-carrageenan was injected. MKGS also affected the levels of IL-1beta, TNF-alpha and NO induced by lambda-carrageenan. All these results suggested that MKGS possessed analgesic and anti-inflammatory effects. The anti-inflammatory mechanism of MKGS might be related to the lowering of MDA level in the edema paw via increasing the activities of superoxide dismutase (SOD) and GRx in the liver, as well as the decreases in the levels of TNF-alpha and NO, and the production of IL-1beta in inflamed tissues.

  3. Island Latissimus Dorsi Muscle Flap and a Perforator Flap in Repairing Post-Gunshot Thoracic Spine CSF Fistula: Case Presentation

    Nangole F. Wanjala

    2015-01-01

    Full Text Available Persistent posttraumatic CSF fluid leakage may present a challenge to manage. Failure to address the leakage may result in complications such as meningitis, septicemia, radiculopathy, muscle weakness, and back pains. While the majority of the leakages may be managed conservatively, large dura defects as a result of gunshot wounds or motor vehicle accidents are best managed by surgical interventions. This may range from primary closure of the defect to fascial grafts, adhesive glues, and flaps. We present our experience with the use of flaps in a patient who had sustained such wounds in the thoracic spine. An island latissimus dorsal flap and a perforator fasciocutaneous flap were used to close the defect. Postoperatively the patient recovered well and the wounds healed without any complications.

  4. Effects of Euglena (Euglena gracilis) supplemented to diet (forage: concentrate ratios of 60:40) on the basic ruminal fermentation and methane emissions in in vitro condition

    Aemiro, Ashagrie; Watanabe, Shota; Suzuki, Kengo; Hanada, Masaaki; Umetsu, Kazutaka

    2016-01-01

    An in vitro study was conducted to investigate the effect of different concentrations of Euglena (Euglena gracilis) on CH4 production, dry matter (DM) digestibility, volatile fatty acid (VFA) and ammonia N(NH3-N) concentration as well as on the protozoa population. The treatments considered were Euglena at concentrations of 0.0, 50, 100, 200, 400 and 1000 g/kg dry matter (DM) of the substrate (60:40 forage: concentrate ratio) incubated for 24 and 96 h using an in vitro continuous gas producti...

  5. Biologia floral e sistema reprodutivo de duas espécies de marantaceae no Nordeste do Brasil : Ischnosiphon gracilis (Rudge) Köern. e Stromanthe porteana A. Gris

    Virgínia de Lima Leite, Ana

    2002-01-01

    As espécies de Marantaceae apresentam um elaborado mecanismo de polinização caracterizado pela apresentação secundária de pólen associada a um mecanismo explosivo do estilete. Neste trabalho foram feitas análises da biologia floral e do sistema reprodutivo em populações naturais de Ischnosiphon gracilis (Rudge) Köern. e Stromanthe porteana A. Gris ocorrentes no Parque Estadual Dois Irmãos (8º7 30 S 34º52 30 W), estado de Pernambuco, Brasil. A inflorescência de I. gracil...

  6. Novel insights into pathological changes in muscular arteries of radiotherapy patients

    Russell, Nicola S.; Hoving, Saske; Heeneman, Sylvia; Hage, J. Joris; Woerdeman, Leonie A.E.; Bree, Remco de; Lohuis, Peter J.F.M.; Smeele, Ludi; Cleutjens, Jack; Valenkamp, Addy; Dorresteijn, Lucille D.A.; Dalesio, Otilia; Daemen, Mat J.; Stewart, Fiona A.

    2009-01-01

    Background and purpose: Vascular disease is increased after radiotherapy and is an important determinant of late treatment-induced morbidity and excess mortality. This study evaluates the nature of underlying pathologic changes occurring in medium-sized muscular arteries following irradiation. Materials and methods: Biopsies of irradiated medium-sized arteries and unirradiated control arteries were taken from 147 patients undergoing reconstructive surgery with a vascularised free flap following treatment for head and neck (H and N) or breast cancer (BC). Relative intimal thickening was derived from the ratio of the thickness of the intima to the thickness of the media (IMR) on histological sections. Proteoglycan, collagen and inflammatory cell content were also scored. Results: Intimal thickness was significantly increased in irradiated vessels: in the H and N group the IMR was 1.5-fold greater without correction for the control artery (p = 0.018); in the BC group the IMR increased 1.4-fold after correction for the control artery (p = 0.056) at a mean of 4 years following irradiation. There was an increase in the proteoglycan content of the intima of the irradiated IMA vessels, from 65% to 73% (p = 0.024). Inflammatory cell content was increased in the intima of the irradiated H and N vessels (p = 0.014). Conclusions: Radiation-induced vascular pathology differs quantitatively and qualitatively from age-related atherosclerosis.

  7. Ornithopter Type Flapping Wings for Autonomous Micro Air Vehicles

    Sutthiphong Srigrarom

    2015-05-01

    Full Text Available In this paper, an ornithopter prototype that mimics the flapping motion of bird flight is developed, and the lift and thrust generation characteristics of different wing designs are evaluated. This project focused on the spar arrangement and material used for the wings that could achieves improved performance. Various lift and thrust measurement techniques are explored and evaluated. Various wings of insects and birds were evaluated to understand how these natural flyers with flapping wings are able to produce sufficient lift to fly. The differences in the flapping aerodynamics were also detailed. Experiments on different wing designs and materials were conducted and a paramount wing was built for a test flight. The first prototype has a length of 46.5 cm, wing span of 88 cm, and weighs 161 g. A mechanism which produced a flapping motion was fabricated and designed to create flapping flight. The flapping flight was produced by using a single motor and a flexible and light wing structure. A force balance made of load cell was then designed to measure the thrust and lift force of the ornithopter. Three sets of wings varying flexibility were fabricated, therefore lift and thrust measurements were acquired from each different set of wings. The lift will be measured in ten cycles computing the average lift and frequency in three different speeds or frequencies (slow, medium and fast. The thrust measurement was measure likewise but in two cycles only. Several observations were made regarding the behavior of flexible flapping wings that should aid in the design of future flexible flapping wing vehicles. The wings angle or phase characteristic were analyze too and studied. The final ornithopter prototype weighs only 160 g, has a wing span of 88.5 cm, that could flap at a maximum flapping frequency of 3.869 Hz, and produce a maximum thrust and lift of about 0.719 and 0.264 N respectively. Next, we proposed resonance type flapping wing utilizes the near

  8. Muscle MRI findings in facioscapulohumeral muscular dystrophy

    Gerevini, Simonetta; Caliendo, Giandomenico; Falini, Andrea [IRCCS San Raffaele Scientific Institute, Neuroradiology Unit, Head and Neck Department, Milan (Italy); Scarlato, Marina; Previtali, Stefano Carlo [IRCCS San Raffaele Scientific Institute, Department of Neurology, INSPE and Division of Neuroscience, Milan (Italy); Maggi, Lorenzo; Pasanisi, Barbara; Morandi, Lucia [Fondazione IRCCS Istituto Neurologico ' ' Carlo Besta' ' , Neuromuscular Diseases and Neuroimmunology Unit, Milan (Italy); Cava, Mariangela [IRCCS San Raffaele Scientific Institute, Department of Radiology and Center for Experimental Imaging, Milan (Italy)

    2016-03-15

    Facioscapulohumeral muscular dystrophy (FSHD) is characterized by extremely variable degrees of facial, scapular and lower limb muscle involvement. Clinical and genetic determination can be difficult, as molecular analysis is not always definitive, and other similar muscle disorders may have overlapping clinical manifestations. Whole-body muscle MRI examination for fat infiltration, atrophy and oedema was performed to identify specific patterns of muscle involvement in FSHD patients (30 subjects), and compared to a group of control patients (23) affected by other myopathies (NFSHD). In FSHD patients, we detected a specific pattern of muscle fatty replacement and atrophy, particularly in upper girdle muscles. The most frequently affected muscles, including paucisymptomatic and severely affected FSHD patients, were trapezius, teres major and serratus anterior. Moreover, asymmetric muscle involvement was significantly higher in FSHD as compared to NFSHD patients. In conclusion, muscle MRI is very sensitive for identifying a specific pattern of involvement in FSHD patients and in detecting selective muscle involvement of non-clinically testable muscles. Muscle MRI constitutes a reliable tool for differentiating FSHD from other muscular dystrophies to direct diagnostic molecular analysis, as well as to investigate FSHD natural history and follow-up of the disease. (orig.)

  9. Clinico-epidemiologic characteristics of spinal muscular atrophy ...

    Rabah M. Shawky

    Deletion;. Chromosome 5;. Mutations. Abstract Spinal muscular atrophy (SMA) is characterized by progressive hypotonia and muscular weakness because of progressive degeneration of alpha motor neuron from anterior horn cells in the spinal cord. It is inherited by an autosomal recessive pattern. The precise frequency of ...

  10. Morphologic imaging in muscular dystrophies and inflammatory myopathies

    Degardin, Adrian; Lacour, Arnaud; Vermersch, Patrick; Morillon, David; Cotten, Anne; Stojkovic, Tanya

    2010-01-01

    To determine if magnetic resonance imaging (MR imaging) is useful in the diagnostic workup of muscular dystrophies and idiopathic inflammatory myopathies for describing the topography of muscle involvement. MR imaging was performed in 31 patients: 8 with dystrophic myotony types 1 (n = 4) or 2 (n = 4); 11 with limb-girdle muscular dystrophy, including dysferlinopathy, calpainopathy, sarcoglycanopathy, and dystrophy associated with fukutin-related protein mutation; 3 with Becker muscular dystrophy; and 9 with idiopathic inflammatory myopathies, including polymyositis, dermatomyositis, and sporadic inclusion body myositis. Analysis of T1 images enabled us to describe the most affected muscles and the muscles usually spared for each muscular disease. In particular, examination of pelvis, thigh, and leg muscles demonstrated significant differences between the muscular diseases. On STIR images, hyperintensities were present in 62% of our patients with muscular dystrophies. A specific pattern of muscular involvement was established for each muscular disease. Hyperintensities observed on STIR images precede fatty degeneration and are not specific for inflammatory myopathies. (orig.)

  11. Dysphagia in Duchenne Muscular Dystrophy Assessed by Validated Questionnaire

    Archer, Sally K.; Garrod, Rachel; Hart, Nicholas; Miller, Simon

    2013-01-01

    Background: Duchenne muscular dystrophy (DMD) leads to progressive muscular weakness and death, most typically from respiratory complications. Dysphagia is common in DMD; however, the most appropriate swallowing assessments have not been universally agreed and the symptoms of dysphagia remain under-reported. Aims: To investigate symptoms of…

  12. Upper limb function in adults with Duchenne muscular dystrophy

    B. Bartels (Bart); R.F. Pangalila (Robert); M.P. Bergen (Michael); N.A.M. Cobben (Nicolle); H.J. Stam (Henk); M.E. Roebroeck (Marij)

    2011-01-01

    textabstractTo determine upper limb function and associated factors in adults with Duchenne muscular dystrophy. Design: Cross-sectional study. Subjects: A sample of 70 men with Duchenne muscular dystrophy (age range 20-43 years). Methods: General motor function and, in particular, upper limb distal

  13. Limb girdle muscular dystrophy due to mutations in POMT2

    Østergaard, Sofie Thurø; Johnson, Katherine; Stojkovic, Tanya

    2018-01-01

    BACKGROUND: Mutations in the gene coding for protein O-mannosyl-transferase 2 (POMT2) are known to cause severe congenital muscular dystrophy, and recently, mutations in POMT2 have also been linked to a milder limb-girdle muscular dystrophy (LGMD) phenotype, named LGMD type 2N (LGMD2N). Only four...

  14. Morphologic imaging in muscular dystrophies and inflammatory myopathies

    Degardin, Adrian; Lacour, Arnaud; Vermersch, Patrick [CHU de Lille, Clinique neurologique, Lille (France); Morillon, David; Cotten, Anne [CHRU de Lille, Service de Radiologie Osteoarticulaire, Hopital Roger Salengro, Lille (France); Stojkovic, Tanya [G-H Pitie-Salpetriere, Institut de Myologie, Paris (France)

    2010-12-15

    To determine if magnetic resonance imaging (MR imaging) is useful in the diagnostic workup of muscular dystrophies and idiopathic inflammatory myopathies for describing the topography of muscle involvement. MR imaging was performed in 31 patients: 8 with dystrophic myotony types 1 (n = 4) or 2 (n = 4); 11 with limb-girdle muscular dystrophy, including dysferlinopathy, calpainopathy, sarcoglycanopathy, and dystrophy associated with fukutin-related protein mutation; 3 with Becker muscular dystrophy; and 9 with idiopathic inflammatory myopathies, including polymyositis, dermatomyositis, and sporadic inclusion body myositis. Analysis of T1 images enabled us to describe the most affected muscles and the muscles usually spared for each muscular disease. In particular, examination of pelvis, thigh, and leg muscles demonstrated significant differences between the muscular diseases. On STIR images, hyperintensities were present in 62% of our patients with muscular dystrophies. A specific pattern of muscular involvement was established for each muscular disease. Hyperintensities observed on STIR images precede fatty degeneration and are not specific for inflammatory myopathies. (orig.)

  15. Upper Body Muscular Endurance Among Children 2-5 Years.

    Gabbard, Carl P.; And Others

    The upper body muscular endurance of males and females 2-5 years of age was assessed, and relationships relative to sex, age, endurance and selected anthropometric measures were investigated. None of the relationships were found to be of practical predicative value; while upper body muscular strength increased with age, no significant differences…

  16. Primary muscular hydatid: preoperative diagnosis Throught computerized tomography and ultrasonography

    Macho Fernandez, J.M.; Marin Cardenas, M.A.; Mazas Artasona, L.; Lample Lacasa, C.; Otero Sierra, C.; Hernandez Navarrete, M.J.; Gomez-Pereda, R.

    1995-01-01

    Primary muscular hydatid disease, is extremely rare,- but not exceptional-, comparatively with other atypical localization. In this article the authors revised 474 patients with hydatid disease over a ten years period. Three cases of primary muscular localization were found. The ultrasonography and computed tomography facilitates the preoperative diagnosis. (Author) 40 refs

  17. Muscular hamartoma of the breast: a case report

    Kang, Byeong Seong; Park, Jeong Mi

    2002-01-01

    Muscular hamartoma is a variant of breast hamartoma shown at microscopic examination to be composed of abundant smooth muscle cells. We report a case of muscular hamartoma occurring in a 35-year-old woman with an incidentally discovered breast mass, and confirmed by excisional biopsy. We also describe the radiologic and pathologic findings

  18. Identification of Flap Motion Parameters for Vibration Reduction in Helicopter Rotors with Multiple Active Trailing Edge Flaps

    Dalli, Uğbreve;ur; Yüksel, Şcedilefaatdin

    2011-01-01

    An active control method utilizing the multiple trailing edge flap configuration for rotorcraft vibration suppression and blade loads control is presented. A comprehensive model for rotor blade with active trailing edge flaps is used to calculate the vibration characteristics, natural frequencies and mode shapes of any complex composite helicopter rotor blade. A computer program is developed to calculate the system response, rotor blade root forces and moments under aerodynamic forcing condit...

  19. A lining vomer flap for palate pushback in unilateral cleft palate repair.

    Clavin, H D; Owsley, J Q

    1978-01-01

    A combinaation vomer mucoperiosteal flap and nasal floor mucoperiosteal flap is described which is used to achieve nasal coverage in unilateral cleft palate patients requiring pushbacks. A posteriorly based readily accessible vomer flap is raised on the cleft side and used as nasal lining for the palatal mucoperiosteal flap on the non-cleft side. On the cleft side, a symmetrically sized nasal floor flap is easily elevated under direct vision and used to cover the nasal aspect of the corresponding mucoperiosteal palatal flap.

  20. Genetic modifiers of Duchenne and facioscapulohumeral muscular dystrophies.

    Hightower, Rylie M; Alexander, Matthew S

    2018-01-01

    Muscular dystrophy is defined as the progressive wasting of skeletal muscles that is caused by inherited or spontaneous genetic mutations. Next-generation sequencing has greatly improved the accuracy and speed of diagnosis for different types of muscular dystrophy. Advancements in depth of coverage, convenience, and overall reduced cost have led to the identification of genetic modifiers that are responsible for phenotypic variability in affected patients. These genetic modifiers have been postulated to explain key differences in disease phenotypes, including age of loss of ambulation, steroid responsiveness, and the presence or absence of cardiac defects in patients with the same form of muscular dystrophy. This review highlights recent findings on genetic modifiers of Duchenne and facioscapulohumeral muscular dystrophies based on animal and clinical studies. These genetic modifiers hold great promise to be developed into novel therapeutic targets for the treatment of muscular dystrophies. Muscle Nerve 57: 6-15, 2018. © 2017 Wiley Periodicals, Inc.

  1. Why is muscularity sexy? Tests of the fitness indicator hypothesis.

    Frederick, David A; Haselton, Martie G

    2007-08-01

    Evolutionary scientists propose that exaggerated secondary sexual characteristics are cues of genes that increase offspring viability or reproductive success. In six studies the hypothesis that muscularity is one such cue is tested. As predicted, women rate muscular men as sexier, more physically dominant and volatile, and less committed to their mates than nonmuscular men. Consistent with the inverted-U hypothesis of masculine traits, men with moderate muscularity are rated most attractive. Consistent with past research on fitness cues, across two measures, women indicate that their most recent short-term sex partners were more muscular than their other sex partners (ds = .36, .47). Across three studies, when controlling for other characteristics (e.g., body fat), muscular men rate their bodies as sexier to women (partial rs = .49-.62) and report more lifetime sex partners (partial rs = .20-.27), short-term partners (partial rs = .25-.28), and more affairs with mated women (partial r = .28).

  2. Perforator anatomy of the radial forearm free flap versus the ulnar forearm free flap for head and neck reconstruction.

    Hekner, D D; Roeling, T A P; Van Cann, E M

    2016-08-01

    The aim of this study was to investigate the vascular anatomy of the distal forearm in order to optimize the choice between the radial forearm free flap and the ulnar forearm free flap and to select the best site to harvest the flap. The radial and ulnar arteries of seven fresh cadavers were injected with epoxy resin (Araldite) and the perforating arteries were dissected. The number of clinically relevant perforators from the radial and ulnar arteries was not significantly different in the distal forearm. Most perforators were located in the proximal half of the distal one third, making this part probably the safest location for flap harvest. Close to the wrist, i.e. most distally, there were more perforators on the ulnar side than on the radial side. The ulnar artery stained 77% of the skin surface area of the forearm, showing the ulnar forearm free flap to be more suitable than the radial forearm free flap for the restoration of large defects. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  3. Cannula-Assisted Flap Elevation (CAFE): a novel technique for developing flaps during skin-sparing mastectomies.

    Grant, Michael D

    2015-02-01

    One of the most challenging procedures in breast surgery is the skin-sparing mastectomy (SSM). Various techniques and incisions have evolved that characterize this procedure; however, what is common in all of them is the smaller the incision, the more difficult it is to develop the skin flaps. A procedure was developed that incorporates the use of liposuction cannulas (without suction) to create the skin flaps. The technique and results are described in this manuscript. From October of 2012 to April 2014, 289 mastectomies (171 patients) were performed using the CAFE procedure on women of all shapes and sizes. Postoperatively, no problems were experienced with flap viability using this technique. The main difference in side effects between the CAFE technique and other standard techniques for developing flaps in SSMs was more bruising than normal, but this resolved rapidly. The results for use of this technique were consistently impressive. The learning curve for this procedure is very short, especially for those who perform SSMs using sharp technique (scissors). Residents and fellows became proficient with the CAFE technique in a relatively short amount of time. Plastic surgeons were pleased with the cosmetic outcomes of their reconstructions that follow this type of mastectomy. Patients were extremely satisfied with their reconstructions as well. Incorporating the use of liposuction cannulas (without suction) makes the creation of flaps for SSM a relatively simple and rapid method. It is especially useful to assist in developing skin flaps with even the smallest of skin incisions.

  4. Atrofia muscular espinal en el niño Spinal muscular atrophy present in children

    Nicolás Garófalo Gómez

    2009-09-01

    Full Text Available INTRODUCCIÓN. Las atrofias musculares espinales en la infancia (AME son trastornos genéticos autosómicos recesivos, caracterizados por degeneración de las motoneuronas espinales y bulbares. El presente estudio tuvo el objetivo principal de describir las principales características clínicas en una serie de niños con AME. MÉTODOS. Se realizó un estudio retrospectivo de los pacientes con AME atendidos en el Instituto de Neurología y Neurocirugía de Cuba, entre enero de 1997 y diciembre de 2001. Se recopilaron los datos de 35 pacientes, 4 de ellos, fetos con confirmación prenatal de AME. Se precisaron las principales características clínicas, electromiográficas, de la biopsia muscular y de los estudios genéticos moleculares realizados en cada caso. RESULTADOS. La AME de tipo II resultó la forma clínica más frecuente (58 %, seguida por la AME de tipo I (42 %. Las principales manifestaciones clínicas resultaron la debilidad muscular generalizada con predominio proximal en extremidades, asociada a hipotonía y arreflexia osteotendinosa. La deleción de los exones 7 y 8 del gen SMN1 se detectó en 20 de 23 casos estudiados (87 %.INTRODUCTION: Spinal muscular atrophies (SMA in childhood are autosomal recessive genetic disorders, characterized by spinal and bulbar motoneurons degenerations. Aim of present paper was to describe the main clinical features in a series of children presenting SMA. METHODS: A retrospective study of patients with SMA seen in the Neurology and Neurosurgery Institute of Cuba from January, 2997 and December, 2001 was made. Data from 35 patients were available; four of them were fetus with prenatal confirmation of SMA. Main clinical, electromyography, muscular biopsy, and of molecular genetic studies performed in each case were determined. RESULTS: Type II SMA was the more frequent clinical presentation (58%, followed by type I SMA (42,%. Main clinical manifestations were a systemic muscular weakness with

  5. Use of alternative media and different types of recipients in a laboratory culture of Ankistrodesmus gracilis (Reinsch Korshikov (Chlorophyceae = Utilização de meios alternativos e diferentes tipos de recipientes no cultivo de Ankistrodesmus gracilis (Reinsch Korshikov (Chlorophyceae em laboratório.

    Lucia Helena Sipauba-Tavares

    2011-07-01

    Full Text Available A laboratory culture of Ankistrodesmus gracilis algae was evaluated by studying the biology of the species and its chemical composition in a traditional medium (CHU12 and in two alternative culture media, NPK (20-5-20 and macrophyte (Eichhornia crassipes + NPK, in three different types of recipients (fiberglass, carboy and plastic bag. First peak in the growth curve of Ankistrodesmus gracilis occurred on the ninth day in macrophyte + NPK medium (74.16 x 105 cells mL-1 in a fiberglass recipient. However, highest density (p 0.05 in culture media in the three recipients. Protein and fiber were similar (p > 0.05 in the treatments, but lipids were higher (p O objetivo do estudo foi avaliar os aspectos biológicos e a composição química da alga Ankistrodesmus gracilis em laboratório utilizando um meio tradicional (CHU12 e dois meios alternativos, NPK (20-5-20 e macrófita (Eichhornia crassipes + NPK em três diferentes tipos de recipientes (cuba de fibra de vidro translúcido, garrafões e saco plástico. O primeiro pico de densidade celular de Ankistrodesmus gracilis ocorreu no nono dia da curva de crescimento em meio macrófita+NPK (74,16 x 105 células mL-1 no recipiente de fibra de vidro, porém a maior densidade (p 0,05 nos três recipientes e meios de cultivo. Os teores de proteína e fibra foram similares (p > 0,05 nos tratamentos utilizados, já os de lipídios foram mais elevados (p < 0,05 no meio NPK. Os teores médios de nitrato, amônia, fósforo total e ortofosfato estiveram acima de 1 mg L-1 no meio NPK (p < 0,01. Os resultados obtidos neste estudo indicam a possibilidade do uso de meios alternativos como o NPK e macrophyte +NPK para o cultivo de A. gracilis em larga escala cultivados nos três tipos de recipientes, porém, em saco plástico o custo é baixo e ocupa menos espaço em cultivo de laboratório.

  6. Signs and symptoms of Duchenne muscular dystrophy and Becker muscular dystrophy among carriers in the Netherlands : a cohort study

    Hoogerwaard, EM; Bakker, E; Ippel, PF; Oosterwijk, JC; Majoor-Krakauer, DF; Leschot, NJ; Van Essen, AJ; Brunner, HG; van der Wouw, PA; Wilde, AAM; de Visser, Marianne

    1999-01-01

    Background Carriers of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) may show muscle weakness or dilated cardiomyopathy. Studies focusing on skeletal-muscle involvement were done before DNA analysis was possible. We undertook a cross-sectional study in a population of

  7. Signs and symptoms of Duchenne muscular dystrophy and Becker muscular dystrophy among carriers in The Netherlands: a cohort study

    Hoogerwaard, E. M.; Bakker, E.; Ippel, P. F.; Oosterwijk, J. C.; Majoor-Krakauer, D. F.; Leschot, N. J.; van Essen, A. J.; Brunner, H. G.; van der Wouw, P. A.; Wilde, A. A.; de Visser, M.

    1999-01-01

    BACKGROUND: Carriers of Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) may show muscle weakness or dilated cardiomyopathy. Studies focusing on skeletal-muscle involvement were done before DNA analysis was possible. We undertook a cross-sectional study in a population of

  8. Rate-determining Step of Flap Endonuclease 1 (FEN1) Reflects a Kinetic Bias against Long Flaps and Trinucleotide Repeat Sequences.

    Tarantino, Mary E; Bilotti, Katharina; Huang, Ji; Delaney, Sarah

    2015-08-21

    Flap endonuclease 1 (FEN1) is a structure-specific nuclease responsible for removing 5'-flaps formed during Okazaki fragment maturation and long patch base excision repair. In this work, we use rapid quench flow techniques to examine the rates of 5'-flap removal on DNA substrates of varying length and sequence. Of particular interest are flaps containing trinucleotide repeats (TNR), which have been proposed to affect FEN1 activity and cause genetic instability. We report that FEN1 processes substrates containing flaps of 30 nucleotides or fewer at comparable single-turnover rates. However, for flaps longer than 30 nucleotides, FEN1 kinetically discriminates substrates based on flap length and flap sequence. In particular, FEN1 removes flaps containing TNR sequences at a rate slower than mixed sequence flaps of the same length. Furthermore, multiple-turnover kinetic analysis reveals that the rate-determining step of FEN1 switches as a function of flap length from product release to chemistry (or a step prior to chemistry). These results provide a kinetic perspective on the role of FEN1 in DNA replication and repair and contribute to our understanding of FEN1 in mediating genetic instability of TNR sequences. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

  9. Para-muscular and trans-muscular approaches to the lumbar inter-vertebral foramen: an anatomical comparison.

    Poetscher, Arthur Werner; Ribas, Guilherme Carvalhal; Yasuda, Alexandre; Nishikuni, Koshiro

    2005-03-01

    Foraminal and extra-foraminal disc herniations comprise up to 11.7% of all lumbar disc herniations. Facetectomy, which had been the classic approach, is now recognized as cause of pain and instability after surgery. Otherwise, posterior lateral approaches through a trans-muscular or a para-muscular technique offer no significant damage to key structures for spinal stability. The surgical anatomy of these approaches has already been described, but they were not compared. In order to quantify the angle of vision towards the intervertebral foramen offered by each technique, 12 fresh cadavers were dissected and studied regarding these approaches. The angle presented by trans-muscular approach was wider in all studied lumbar levels. Surgery through the trans-muscular approach is performed with a better working angle, requiring a smaller resection of surrounding tissues. Therefore, minor surgical trauma can be expected. Our measurements support previously published data that point the trans-muscular approach as the best surgical option.

  10. RECONSTRUCTION OF FACIAL SKIN DEFECT BY VARIOUS FLAPS : OUR EXPERIENCE

    Atishkumar B.

    2015-08-01

    Full Text Available INTRODUCTION : Face represents complete personality of human being. Cosmetically it is very important part of a person especially for woman. There are many situations when due to disease or trauma, facial defect arises, which requires reconstruction by either local or distant surgical flaps . METHODS AND MATERIALS : In rural places, we come across many patients suffering from trauma and skin malignancy of face. These patients require reconstruction done esthetically with local flaps. Objective of this study is to share our exper ience of providing esthetically good results at our secondary referral care center. Hereby, we present case series of 14 patients operated at our institute. These patients were analyzed according to the age, sex, nature of injury and anatomical location of lesion on the face. All these patients were operated and reconstruction of defect was done with various local flaps best suited for respective lesion, under local anesthesia or sedation. Post - operative nature of wound was analyzed for flap viability or fl ap necrosis . RESULTS : Amongst them were 7 male and 7 female, ages ranging from 4 to 80 years. 7out of 14 patients were of basal cell carcinoma, 4 were due to trauma, 2 were due to dog bite and 1 case of recurrent pleomorphic adenoma at root of nose. All patients had excellent flap viability at end of 6 months and flap achieving almost similar color and contour as that of surrounding skin. CONCLUSION : Reconstruction of facial defects by local flaps is very easy and cost effective technique. This can be don e even at secondary referral care centre with minimal availability of facilities

  11. Application of Indocyanine Green in Flap Surgery: A Systematic Review.

    Li, Ke; Zhang, Zheng; Nicoli, Fabio; D'Ambrosia, Christopher; Xi, Wenjing; Lazzeri, Davide; Feng, Shaoqing; Su, Weijie; Li, Hua; Ciudad, Pedro; Tremp, Mathias; Zhang, Yi Xin

    2018-02-01

     The vascularization of the distal portions of transferred tissue represents the most critical factor in the success of reconstructive surgery. In recent years, indocyanine green (ICG) fluorescence imaging techniques have been applied during surgery to evaluate flap perfusion. However, this investigation has found that there is little consensus regarding the standard dose of ICG as well as the pre-operative requirements of ICG allergy testing. The aim of this study is to summarize the applications of ICG to tissue transfers and safe dosing practices and to provide insight to the possible adverse effects of ICG on flap surgery with the goal of helping clinicians apply ICG safely and efficiently to tissue transfer procedures.  A literature search was performed using, Wiley InterScience, and Springer with the key words, 'Flap,' 'indocyanine green,' 'surgery,' and related mesh words for all publications between 2005 and 2015. Title and abstract screening was performed using predefined in- and exclusion criteria.  Seventy-three articles were included. These were classified as "application of ICG in flap surgery" and "the security of applying ICG in flap surgery".  ICG fluorescence imaging preoperatively facilitates the detection of perforators in tissue flaps with thickness <20 mm, aids in the evaluation of flap microcirculation and perfusion, and allows surgeons to select dominant cutaneous nerves while evaluating the quality of vascular anastomoses and locating thromboses. The literature also concluded that potential allergic reactions to ICG should be taken into consideration. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Serum creatinine level: a supplemental index to distinguish Duchenne muscular dystrophy from Becker muscular dystrophy.

    Zhang, Huili; Zhu, Yuling; Sun, Yiming; Liang, Yingyin; Li, Yaqin; Zhang, Yu; Deng, Langhui; Wen, Xingxuan; Zhang, Cheng

    2015-01-01

    To improve assessment of dystrophinopathy, the aim of this study was to identify whether serum creatinine (Crn) level reflects disease severity. Biochemical, Vignos score, and genetic data were collected on 212 boys with dystrophinopathy. Serum Crn level had a strong inverse correlation with Vignos score by simple correlation (r = -0.793) and partial correlation analysis after adjustment for age, height, and weight (r = -0.791; both P Becker muscular dystrophy (BMD) patients than Duchenne muscular dystrophy (DMD) patients at ages 4, 5, 7, and 9 yr (all P < 0.0125). After adjusting for age, height, and weight, BMD patients still had a significantly higher serum Crn level than DMD patients (β = 7.140,  t = 6.277,  P < 0.01). Serum Crn level reflected disease severity and may serve as a supplemental index to distinguish DMD from BMD in clinical practice.

  13. Guidelines for the Perianesthesia Care of the Duchenne Muscular Dystrophy/Becker Muscular Dystrophy Patient.

    Alliod, Barbara A; Ash, Rebecca A

    2016-12-01

    More patients suffering with Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are presenting to perianesthesia settings for emergent and nonemergent treatment and care. A group of collaborative health care providers at Rush University Medical Center in Chicago developed a multidisciplinary DMD/BMD Task Force to study this disorder and create a set of guidelines to aid those engaging in the planning, execution of care, and recovery of this unique population in the perianesthesia setting. Attention to detail, well-executed preplanning, meticulous awareness of the patient, and prearranged implementation and intervention has proven to offset potential problems and complications and is the key to a successful perianesthesia period. Copyright © 2016 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. All rights reserved.

  14. Muscular response to the first three months of deflazacort treatment in boys with Duchenne muscular dystrophy

    Jensen, L; Petersson, S J; Illum, N O

    2017-01-01

    OBJECTIVE: Duchenne muscular dystrophy (DMD) patients are often treated with glucocorticoids; yet their precise molecular action remains unknown. METHODS: We investigated muscle biopsies from nine boys with DMD (aged: 7,6±2,8 yrs.) collected before and after three months of deflazacort treatment...... into the molecular actions of glucocorticoids in DMD at the mRNA level, and we show that multiple regulatory pathways are influenced. This information can be important in the development of new treatments....

  15. Pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy.

    Lager, Christina; Kroksmark, Anna-Karin

    2015-09-01

    The purpose of this study was to explore the prevalence, nature and scope of pain in adolescents with spinal muscular atrophy and Duchenne and Becker muscular dystrophy and whether the pain differs between diagnostic groups or between adolescents with different ambulation status. Furthermore to study the consequences of pain and to identify pain-exacerbating and pain-relieving factors. In a national survey, fifty-five adolescents with spinal muscular atrophy and dystrophinopathy completed a questionnaire assessing pain frequency, duration, location using a body map, intensity and discomfort using visual analogue scales, pain interference using a modified version of Brief Pain Inventory and factors exacerbating and relieving pain. Sixty-nine per cent of the adolescents reported pain during the past three months and 50% reported chronic pain. The pain prevalence did not differ significantly between diagnostic groups or between ambulators and non-ambulators. The average pain intensity was graded as mild and the worst pain as moderate. The pain typically occurred weekly, most frequently in the neck/back or legs. General activity and mood were the areas that were most affected by pain. Common pain-exacerbating factors were sitting, too much movement/activity and being lifted or transferred. Pain is a frequent problem in adolescents with spinal muscular atrophy and dystrophinopathy. The assessments used enable an understanding both of the nature and scope of pain and of the impact of pain in everyday life. The study highlights the importance of assessing pain in a systematic manner and offering an individual approach to interventions designed to reduce pain in this population. Copyright © 2015 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

  16. Fibroblast cultures in duchenne muscular dystrophy

    Ionasescu, V.; Lara-Braud, C.; Zellweger, H.; Ionasescu, R.; Burmeister, L.

    1977-01-01

    Primary skin fibroblast cultures were grown from forearm pinch skin biopsies obtained from 24 patients with Duchenne muscular dystrophy (DMD) and ten normal controls matched for sex and age. The first subcultures were grown for 7 days and incubated with L-( 3 H)-proline for 24 hours. Intracellular collagen incoption was significantly decreased (2.2 X) and extracellular collagen incorporation significantly increased (1.8 X) in fibroblast cultures from patients with DMD by both collagenase assay and polyacrylamide gel electrophoresis. The synthesis of noncollagen proteins showed low values from the DMD fibroblast cultures. The alterations in synthesis and secretion of collagen and noncollagen proteins were characteristic only for the log phase of DMD fibroblasts. (author)

  17. Natural history of Duchenne muscular dystrophy

    Qing KE

    2015-05-01

    Full Text Available Duchenne muscular dystrophy (DMD is X-linked recessive hereditary disease. DMD gene mutations result in dystrophin deficiency, which causes not only muscle movement disorders but also scoliosis, cognitive dysfunction, urinary tract diseases, respiratory diseases and heart diseases. Most patients die in early adult for respiratory and circulatory failure. Early multidisciplinary therapies will significantly delay disease progression and improve patients' quality of life. However, DMD diagnosis and treatment exist significantly time delay now. In this study, we review the natural history of DMD, including motor, cognitive, respiratory and heart function, for improving DMD early recognition, diagnosis and treatment, so as to benefit DMD patients. DOI: 10.3969/j.issn.1672-6731.2015.05.004

  18. The Importance of Muscular Strength: Training Considerations.

    Suchomel, Timothy J; Nimphius, Sophia; Bellon, Christopher R; Stone, Michael H

    2018-04-01

    This review covers underlying physiological characteristics and training considerations that may affect muscular strength including improving maximal force expression and time-limited force expression. Strength is underpinned by a combination of morphological and neural factors including muscle cross-sectional area and architecture, musculotendinous stiffness, motor unit recruitment, rate coding, motor unit synchronization, and neuromuscular inhibition. Although single- and multi-targeted block periodization models may produce the greatest strength-power benefits, concepts within each model must be considered within the limitations of the sport, athletes, and schedules. Bilateral training, eccentric training and accentuated eccentric loading, and variable resistance training may produce the greatest comprehensive strength adaptations. Bodyweight exercise, isolation exercises, plyometric exercise, unilateral exercise, and kettlebell training may be limited in their potential to improve maximal strength but are still relevant to strength development by challenging time-limited force expression and differentially challenging motor demands. Training to failure may not be necessary to improve maximum muscular strength and is likely not necessary for maximum gains in strength. Indeed, programming that combines heavy and light loads may improve strength and underpin other strength-power characteristics. Multiple sets appear to produce superior training benefits compared to single sets; however, an athlete's training status and the dose-response relationship must be considered. While 2- to 5-min interset rest intervals may produce the greatest strength-power benefits, rest interval length may vary based an athlete's training age, fiber type, and genetics. Weaker athletes should focus on developing strength before emphasizing power-type training. Stronger athletes may begin to emphasize power-type training while maintaining/improving their strength. Future research should

  19. Long anterior urethral stricture: Reconstruction by dorsally quilted penile skin flap

    Mohammad Sayed Abdel-Kader

    2013-01-01

    Conclusion: Free penile skin flaps offer good results (functional and cosmetic in long anterior urethral stricture. Meticulously fashioned longitudinal, circular or spiral penile skin flaps could bridge urethral defects up to 15 cm long.

  20. Non-invasive tissue oximetry following unilateral DIEP-flap reconstruction: A pilot evaluation

    N.P.A. Vranken

    2017-06-01

    Conclusion: Continuous non-invasive tissue oxygen saturation is suitable for postoperative monitoring of DIEP-flaps, and StO2 pattern may aid in early identification of vascular compromise in DIEP-flaps.

  1. [The influence of estradiol on histomorphology of skin flaps with ischemia reperfusion injury].

    Jianlong, Wu; Ruixing, Hou; Guangliang, Zhou; Jihui, Ju

    2015-09-01

    To study the influence of estradiol on histomorphology of skin flaps with ischemia reperfusion injury. 48 adult male Wistar rats aged 12-14 weeks old, were randomly divided into control group (group I), ischemia-reperfusion group (group II), saline group (group III), estradiol group (group IV). Superficial epigastric artery axial flap, 3 cm x 6 cm in size, was made in the left lower quadrant abdominal of each rat. Flap model with ischemia-reperfusion injury was established by using the nondestructive micro vascular clamp to clamp the superficial epigastric artery. The general condition of the flap was observed after operation. At 7 days after operation, the survival rate of the flap was detected, the flaps were harvested to receive histology and ultrastructural observation. The neutrophils level of the superficial epigastric vein were tested. 7 days after operation, the survival rate of the flap in group IV was significantly higher than that in group II, III (P organization structure in flap.

  2. Paralytic Ectropion Treatment with Lateral Periosteal Flap Canthoplasty and Introduction of the Ectropion Severity Score

    Steven F. S. Korteweg, MD

    2014-05-01

    Conclusions: The ESS is a useful instrument to score the severity of paralytic ectropion. The periosteal flap canthoplasty is an effective procedure, with durable results in paralytic ectropion patients. The same periosteal flap can be used in a revision procedure.

  3. Flapping and flexible wings for biological and micro air vehicles

    Shyy, Wei; Berg, Mats; Ljungqvist, Daniel

    1999-07-01

    Micro air vehicles (MAVs) with wing spans of 15 cm or less, and flight speed of 30-60 kph are of interest for military and civilian applications. There are two prominent features of MAV flight: (i) low Reynolds number (10 4-10 5), resulting in unfavorable aerodynamic conditions to support controlled flight, and (ii) small physical dimensions, resulting in certain favorable scaling characteristics including structural strength, reduced stall speed, and low inertia. Based on observations of biological flight vehicles, it appears that wing motion and flexible airfoils are two key attributes for flight at low Reynolds number. The small size of MAVs corresponds in nature to small birds, which do not glide like large birds, but instead flap with considerable change of wing shape during a single flapping cycle. With flapping and flexible wings, birds overcome the deteriorating aerodynamic performance under steady flow conditions by employing unsteady mechanisms. In this article, we review both biological and aeronautical literatures to present salient features relevant to MAVs. We first summarize scaling laws of biological and micro air vehicles involving wing span, wing loading, vehicle mass, cruising speed, flapping frequency, and power. Next we discuss kinematics of flapping wings and aerodynamic models for analyzing lift, drag and power. Then we present issues related to low Reynolds number flows and airfoil shape selection. Recent work on flexible structures capable of adjusting the airfoil shape in response to freestream variations is also discussed.

  4. Orbital floor reconstruction with free flaps after maxillectomy.

    Sampathirao, Leela Mohan C S R; Thankappan, Krishnakumar; Duraisamy, Sriprakash; Hedne, Naveen; Sharma, Mohit; Mathew, Jimmy; Iyer, Subramania

    2013-06-01

    Background The purpose of this study is to evaluate the outcome of orbital floor reconstruction with free flaps after maxillectomy. Methods This was a retrospective analysis of 34 consecutive patients who underwent maxillectomy with orbital floor removal for malignancies, reconstructed with free flaps. A cross-sectional survey to assess the functional and esthetic outcome was done in 28 patients who were alive and disease-free, with a minimum of 6 months of follow-up. Results Twenty-six patients had bony reconstruction, and eight had soft tissue reconstruction. Free fibula flap was the commonest flap used (n = 14). Visual acuity was normal in 86%. Eye movements were normal in 92%. Abnormal globe position resulted in nine patients. Esthetic satisfaction was good in 19 patients (68%). Though there was no statistically significant difference in outcome of visual acuity, eye movement, and patient esthetic satisfaction between patients with bony and soft tissue reconstruction, more patients without bony reconstruction had abnormal globe position (p = 0.040). Conclusion Free tissue transfer has improved the results of orbital floor reconstruction after total maxillectomy, preserving the eye. Good functional and esthetic outcome was achieved. Though our study favors a bony orbital reconstruction, a larger study with adequate power and equal distribution of patients among the groups would be needed to determine this. Free fibula flap remains the commonest choice when a bony reconstruction is contemplated.

  5. Reconstruction of Nasal Skin Cancer Defects with Local Flaps

    A. C. Salgarelli

    2011-01-01

    Full Text Available Reconstruction of nasal defects must preserve the integrity of complex facial functions and expressions, as well as facial symmetry and a pleasing aesthetic outcome. The reconstructive modality of choice will depend largely on the location, size, and depth of the surgical defect. Individualized therapy is the best course, and numerous flaps have been designed to provide coverage of a variety of nasal-specific defects. We describe our experience in the aesthetic reconstruction of nasal skin defects following oncological surgery. The use of different local flaps for nasal skin cancer defects is reported in 286 patients. Complications in this series were one partial flap dehiscence that healed by secondary intention, two forehead flaps, and one bilobed flap with minimal rim necrosis that resulted in an irregular scar requiring revision. Aesthetic results were deemed satisfactory by all patients and the operating surgeons. The color and texture matches were aesthetically good, and the nasal contour was distinct in all patients. All scars were inconspicuous and symmetrical. No patient had tenting or a flat nose.

  6. Ipsilateral fasciocutaneous flaps for leg and foot defects

    Bhattacharya V

    2003-01-01

    Full Text Available It was a revolutionary enhancement for lower limb reconstruction when fasciocutaneous flaps were first described and used in clinical practice in 1981. Subsequently persistent studies were made to emphasize and confirm the rich vascular network associated with deep fascia. Thereafter studies were directed to identify the various types of perforators supplying the deep fascia and the overlying subcutaneous tissue and skin. Accordingly the scientists classified these flaps keeping in mind their clinical applications. The authors of this article have also performed extensive research on various aspects. This has led to better understanding about the finer details of vascularity. Based on this various modifications have been made for safe application of reconstruction for defects extending from knee to sole. To avoid complications the clinician should be able to select the proper procedure as regards the donor site and the possible preoperative and postoperative technical faults. A well-designed and meticulously executed flap usually has smooth recovery. Both Colour Doppler and Audio Doppler are useful tools in planning a safe flap. Now these flaps have proved to be standard technique without requiring a special set up extensive training.

  7. Reconstruction of Nasal Skin Cancer Defects with Local Flaps

    Salgarelli, A. C.; Bellini, P.; Multinu, A.; Consolo, U.; Magnoni, C.; Francomano, M.; Fantini, F.; Seidenari, S.

    2011-01-01

    Reconstruction of nasal defects must preserve the integrity of complex facial functions and expressions, as well as facial symmetry and a pleasing aesthetic outcome. The reconstructive modality of choice will depend largely on the location, size, and depth of the surgical defect. Individualized therapy is the best course, and numerous flaps have been designed to provide coverage of a variety of nasal-specific defects. We describe our experience in the aesthetic reconstruction of nasal skin defects following oncological surgery. The use of different local flaps for nasal skin cancer defects is reported in 286 patients. Complications in this series were one partial flap dehiscence that healed by secondary intention, two forehead flaps, and one bilobed flap with minimal rim necrosis that resulted in an irregular scar requiring revision. Aesthetic results were deemed satisfactory by all patients and the operating surgeons. The color and texture matches were aesthetically good, and the nasal contour was distinct in all patients. All scars were inconspicuous and symmetrical. No patient had tenting or a flat nose.

  8. Internal-external flow integration for a thin ejector-flapped wing section

    Woolard, H. W.

    1979-01-01

    Thin airfoil theories of an ejector flapped wing section are reviewed. The global matching of the external airfoil flow with the ejector internal flow and the overall ejector flapped wing section aerodynamic performance are examined. Mathematical models of the external and internal flows are presented. The delineation of the suction flow coefficient characteristics are discussed. The idealized lift performance of an ejector flapped wing relative to a jet augmented flapped wing are compared.

  9. Immediate Bilateral Breast Reconstruction with Unilateral Deep Superior Epigastric Artery and Superficial Circumflex Iliac Artery Flaps

    Keith S. Hansen

    2016-09-01

    Full Text Available Autologous breast reconstruction utilizing a perforator flap is an increasingly popular method for reducing donor site morbidity and implant-related complications. However, aberrant anatomy not readily visible on computed tomography angiography is a rare albeit real risk when undergoing perforator flap reconstruction. We present an operative case of a patient who successfully underwent a bilateral breast reconstruction sourced from a unilateral abdominal flap divided into deep superior epigastric artery and superficial circumflex iliac artery flap segments.

  10. [COMPARISON OF REPAIR EFFECT BETWEEN CHIMERIC ANTEROLATERAL THIGH FLAP AND SERIES-WOUND FLAPS FOR DEFECT AFTER RESECTION OF ORAL AND MAXILLOFACIAL CANCER].

    Yang, Heping; Zhang, Hongwu; Chen, Haidi; Yang, Shuxiong; Wang, Jun; Hu, Dawang

    2016-04-01

    To compare the effectiveness of complex defects repair between using chimeric anterolateral thigh flap and series-wound flaps after resection of oral and maxillofacial cancer. After resection of oral and maxillofacial cancer, defect was repaired with chimeric anterolateral thigh flap in 39 patients between January 2011 and July 2014 (chimeric anterolateral thigh flap group); and defect was repaired with series-wound flaps in 35 patients between January 2009 and December 2010 (series-wound flaps group). There was no significant difference in gender, age, duration of disease, tumor type, tumor staging, defect location, and defect area between 2 groups (P > 0.05). The operation time, flap harvesting and microvascular anastomosis time, stomach tube extraction time, and oral feeding time were recorded and compared between 2 groups, and postoperative complications were observed; the effectiveness was evaluated according to clinical efficacy evaluation table of bone and soft tissue defects reconstruction surgery in oral and maxillofacial region. Vascular crisis occurred in 2 cases of chimeric anterolateral thigh flap group, and 4 cases of series-wound flaps group. Partial necrosis appeared at distal end of a series-wound flaps, and oral fistula and infection developed in 3 series-wound flaps. The other flaps and the grafted skin at donor site survived; wounds at recipient site healed by first intention. The operation time, stomach tube extraction time, and oral feeding time of chimeric anterolateral thigh flap group were significantly shorter than those of series-wound flaps group (P oral closure function, chew, language performance, and swallowing scores of the chimeric anterolateral thigh-flap group were significantly better than those of the series-wound flaps group (P oral cavity holding water test, and occlusion scores between the 2 groups (P > 0.05). Using chimeric anterolateral thigh flap for defect repair after resection of oral and maxillofacial cancer can

  11. Genetics and emerging treatments for Duchenne and Becker muscular dystrophy.

    Wein, Nicolas; Alfano, Lindsay; Flanigan, Kevin M

    2015-06-01

    Mutations in the DMD gene result in Duchenne or Becker muscular dystrophy due to absent or altered expression of the dystrophin protein. The more severe Duchenne muscular dystrophy typically presents around ages 2 to 5 with gait disturbance, and historically has led to the loss of ambulation by age 12. It is important for the practicing pediatrician, however, to be aware of other presenting signs, such as delayed motor or cognitive milestones, or elevated serum transaminases. Becker muscular dystrophy is milder, often presenting after age 5, with ambulation frequently preserved past 20 years and sometimes into late decades. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. CT finding and cerebrospinal fluid proteins in muscular dystrophy patients

    Hirase, Tsutomu; Ide, Masami; Araki, Shukuro; Okamoto, Hiroshi; Kawasaki, Shoichiro; Imamura, Shigehiro.

    1983-01-01

    We analyzed the microcomponents of protein fractions in the cerebrospinal fluid of patients with various types of muscular dystrophy. The degenerative pattern is characterized by an increase in the prealbumin and a decrease in the γ-globulin fraction is shown in the Duchenne and congenital muscular dystrophy. The increase in CSF IgG, γ-globulin fraction is shown in the myotonic dystrophy. In addition to the abnormality of IQ, EEG, and brain CT, abnormal CSF proteins obviously suggest the presence of CNS involvement in muscular dystrophy. (author)

  13. CT finding and cerebrospinal fluid proteins in muscular dystrophy patients

    Hirase, Tsutomu; Ide, Masami; Araki, Shukuro; Okamoto, Hiroshi (Kumamoto Univ. (Japan). School of Medicine); Kawasaki, Shoichiro; Imamura, Shigehiro

    1983-06-01

    We analyzed the microcomponents of protein fractions in the cerebrospinal fluid of patients with various types of muscular dystrophy. The degenerative pattern is characterized by an increase in the prealbumin and a decrease in the ..gamma..-globulin fraction is shown in the Duchenne and congenital muscular dystrophy. The increase in CSF IgG, ..gamma..-globulin fraction is shown in the myotonic dystrophy. In addition to the abnormality of IQ, EEG, and brain CT, abnormal CSF proteins obviously suggest the presence of CNS involvement in muscular dystrophy.

  14. MR imaging of fukuyama congenital muscular dystrophy; a case report

    Yoo, Jeong Hyun; Kim, Yoo Kyung; Koo, Hae Soo; Park, Ki Deuk

    2000-01-01

    Fukuyama congenital muscular dystrophy is a genetic disease and common in Japan. The typical clinical features are hypotonia with an early infantile onset and severe developmental delay. The diagnosis is based on pathologic evidence of muscular dystrophy revealed by biopsy or an increased serum creatine kinase levels. Involvement of the brain is characterized by abnormal cerebral cortical dysplasia, cerebellar dysplasia, and white matter changes. We encountered a case of Fukuyama congenital muscular dystrophy in which brain MRI findings were typical, and present this case together with a review of the literature

  15. Resistance training in patients with limb-girdle and becker muscular dystrophies

    Sveen, Marie-Louise; Andersen, Søren P; Ingelsrud, Lina H

    2013-01-01

    In this study we investigated the effect of strength training in patients with limb-girdle muscular dystrophy (LGMD) and Becker muscular dystrophy (BMD).......In this study we investigated the effect of strength training in patients with limb-girdle muscular dystrophy (LGMD) and Becker muscular dystrophy (BMD)....

  16. [Supplementary device for a dynamometer to evaluate and register muscular endurance indices].

    Timoshenko, D A; Bokser, O Ia

    1986-01-01

    In practice of psychophysiologic research muscular endurance index is used for estimation of CNS function. Muscular endurance index is defined as relative time needed for maintaining the preset muscular effort. The described device widens the possibilities of a digital dynamometer for automatic estimation and recording of muscular endurance index in real time.

  17. Effects of hyperbaric oxygen and irradiation on experimental skin flaps in rats

    Nemiroff, P.M.; Merwin, G.E.; Brant, T.; Cassisi, N.J.

    1985-01-01

    This study investigated the effects of hyperbaric oxygen (HBO) and irradiation (RT) on experimental skin flaps in rats under varying conditions. Animals were assigned at random to 1 of 15 groups that represented all possible ordering effects of HBO, RT, and flap, as well as controls that included flap-only, RT-only, and HBO-only groups. Cranially based skin flaps measuring 3 x 9 cm were elevated on the dorsum. The surviving length was evaluated with fluorescein dye 7 days after the operation. Depending on the treatment condition, HBO was given either 48 hours or 24 hours before flap elevation, or within 4 hours or 48 hours after flap elevation. Rats receiving RT ( 60 Co) were given a single dose of 1000 rads to the dorsum. Results showed that all groups receiving HBO within 4 hours after flap elevation had significantly greater flap survival length, with as much as a 22% greater length of surviving flap. HBO given 48 hours before flap elevation also significantly improved flap survival over controls. RT appeared to have no immediate significant effect on flap survival. However, rats receiving RT, regardless of other factors, gained significantly less weight than did controls. Findings clearly indicate that, to be effective, HBO needs to be given as soon after surgery as possible

  18. Contralateral lumbo-umbilical flap: A versatile technique for volar finger coverage

    Akram Hussain Bijli

    2017-01-01

    Full Text Available Background: While contemplating any difficult soft tissue reconstruction, patient comfort and compliance is of paramount importance. Reconstruction of the volar aspect of fingers and hand by the ipsilateral pedicled flaps (groin flap, abdominal flaps is demanding as the flap inset is difficult for the surgeon and very uncomfortable for the patient. This often leads to flap complications. For the comfort of the patient, better compliance and ease of complete inset, we planned to manage soft tissue defects of the volar aspect of fingers and hand by a new contralateral pedicled lumbo-umbilical flap. This flap is based on the paraumbilical perforators of deep inferior epigastric artery. Materials and Methods: The contralateral pedicled lumbo-umbilical flap was used in eight patients with high-tension electrical burn injuries involving the volar aspect of fingers and hand. The patients were closely observed for first 6 weeks for any flap or donor site complications and then followed monthly to assess donor and recipient site characteristics for 6 months to 2 years. Results and Conclusion: Large flaps up to 8 cm × 16 cm were raised. All but one flaps survived completely. All patients were mobilised within 48 h and five were discharged in less than a week after initial inset. The flap is reliable, easy to harvest and easy to inset on the volar aspect of fingers. The arm is positioned in a very comfortable position. The main disadvantage, however, is a conspicuous abdominal scar.

  19. The effects of epinephrine and dobutamine on skin flap viability in rats

    Krammer, Caspar W; Ibrahim, Rami Mossad; Hansen, Tom G

    2015-01-01

    BACKGROUND: Intraoperative reduction in arterial pressure may cause hypoperfusion of skin flaps, which may increase the risk of flap failure. There is no international consensus regarding the use of vasoactive or inotropic agents to restore or maintain flap perfusion. The purpose of this study...

  20. Reconstruction of various perinasal defects using facial artery perforator-based nasolabial island flaps.

    Yoon, Tae Ho; Yun, In Sik; Rha, Dong Kyun; Lee, Won Jai

    2013-11-01

    Classical flaps for perinasal defect reconstruction, such as forehead or nasolabial flaps, have some disadvantages involving limitations of the arc of rotation and two stages of surgery. However, a perforator-based flap is more versatile and allows freedom in flap design. We introduced our experience with reconstruction using a facial artery perforator-based propeller flap on the perinasal area. We describe the surgical differences between different defect subtypes. Between December 2005 and August 2013, 10 patients underwent perinasal reconstruction in which a facial artery perforator-based flap was used. We divided the perinasal defects into types A and B, according to location. The operative results, including flap size, arc of rotation, complications, and characteristics of the perforator were evaluated by retrospective chart review and photographic evaluation. Eight patients were male and 2 patients were female. Their mean age was 61 years (range, 35-75 years). The size of the flap ranged from 1 cm×1.5 cm to 3 cm×6 cm. Eight patients healed uneventfully, but 2 patients presented with mild flap congestion. However, these 2 patients healed by conservative management without any additional surgery. All of the flaps survived completely with aesthetically pleasing results. The facial artery perforator-based flap allowed for versatile customized flaps, and the donor site scar was concealed using the natural nasolabial fold.