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Lateral Aspect (lateral + aspect)
Selected AbstractsDouble-Blind, Randomized, Placebo-Controlled, Dose-Response Study of the Safety and Efficacy of Botulinum Toxin Type A in Subjects with Crow's FeetDERMATOLOGIC SURGERY, Issue 3 2005Nicholas J. Lowe MD Background Published evidence suggests that botulinum toxin type A (BTX-A) is an effective treatment for crow's feet. However, few dose-ranging studies have been performed. Objectives To assess the safety and efficacy of a single treatment with one of four doses of BTX-A (Botox/Vistabel, Allergan Inc) compared with placebo for the improvement of crow's feet. Methods Subjects received a single bilateral treatment of 18, 12, 6, or 3 U of BTX-A or placebo injected into the lateral aspect of the orbicularis oculi muscle (parallel-group, double,blind design). Investigators and subjects rated crow's feet severity at maximum smile on day 7 and at 30-day intervals from days 30 to 180. Results As observed by both investigators and subjects, all doses of BTX-A resulted in improvements in crow's feet severity when compared with placebo. A dose-dependent treatment effect for efficacy was observed, with higher doses having an increased magnitude and duration of effect. However, a clear differentiation between the 18 U and 12 U doses was not apparent. Few adverse events were reported, with no statistically significant differences between BTX-A and placebo in the incidence of subjects experiencing adverse events. Conclusion BTX-A is safe and effective in decreasing the severity of crow's feet, with 12 U per side suggested as the most appropriate dose. THIS STUDY WAS FUNDED BY ALLERGAN, WHICH WAS ALSO INVOLVED IN THE DESIGN AND CONDUCT OF THE STUDY; COLLECTION, MANAGEMENT, ANALYSIS, AND INTERPRETATION OF THE DATA; AND PREPARATION, REVIEW, AND APPROVAL OF THE MANUSCRIPT. DRS. LOWE AND FRACZEK ARE PAID CONSULTANTS FOR ALLERGAN, DRS. KUMAR AND EADIE ARE EMPLOYEES OF ALLERGAN, AND DRS. LOWE AND KUMAR HOLD STOCK OPTIONS. [source] A Method of Augmenting the Cheek Area Through SMAS, subSMAS, and Subcutaneous Tissue Recruitment During Facelift SurgeryDERMATOLOGIC SURGERY, Issue 3 2003Dominic A. Brandy MD BACKGROUND As the human face ages, there is a depletion of fat that occurs in the submalar region. Various techniques such as fat transfers, fillers, alloplastic implants, and composite rhytidectomies have been used to augment this area in the past. OBJECTIVE To describe a technique that augments the submalar areas during facelift surgery without the use of fat transfer, fillers, alloplastic implants, or a risky composite technique. METHOD An oval is scribed over the depressed submalar areas preoperatively. During facelift surgery, a fusiform area is scribed over the SMAS. This fusiform is scribed so that the medial end is directed at the center of the submalar depression, and the lateral end is toward the posterior earlobe. A defect is created within the lateral aspect of the fusiform, but not the medial portion. The fusiform is subsequently closed with a 2-0 Ethibond suture using three horizontal mattress sutures and two interrupted sutures. Upon closure of this defect, SMAS, subSMAS, and subcutaneous tissue overlying the SMAS are recruited into the submalar defect by the simple phenomenon of dog-ear formation. Additionally, there is a component of frank elevation of the tissues inferior to the medial aspect of the fusiform and submalar space. RESULTS The aforementioned technique has been performed on 123 patients over 7 years and has resulted in consistently good improvement in the submalar space. The procedure is not difficult to learn, and good results can be achieved with initial cases. The learning curve was not found to be steep, with good results being achieved quickly. CONCLUSION Depression of the submalar space plays a significant role in creating an aged face. In the past, various fillers and/or alloplastic implants have been used to augment this region. A low-risk method is described that mobilizes SMAS, subSMAS, and subcutaneous tissues into the submalar space through the phenomenon of dog-ear formation after fusiform closure. [source] Synaptically released 5-HT modulates the activity of tonically discharging neuronal populations in the rostral ventral medulla (RVM)EUROPEAN JOURNAL OF NEUROSCIENCE, Issue 8 2000Pascale Piguet Abstract There is substantial evidence for an important modulating role of monoamines (catecholamines and serotonin, 5-HT) in the rostral ventral medulla (RVM), a region which plays an important role in cardiovascular and nociceptive functions. We investigated in slices the role of endogenous monoamines in the synaptic control of the activity of rat RVM neuronal populations using intracellular recordings in the lateral RVM plus lateral aspect of nucleus paragigantocellularis lateralis. A triple-labelling protocol allowed us to identify the location of impaled neurons and their eventual monoaminergic phenotype within the serotonergic and catecholaminergic populations of the RVM. Focal electrical stimulation revealed the existence of a functional monoaminergic input onto RVM neurons which was mediated by endogenous 5-HT acting at inhibitory 5-HT1A receptors but did not involve noradrenergic neurotransmission. The slow 5-HT-mediated inhibitory postsynaptic potential (IPSP) was only observed in the regularly discharging neurons, which were found to be neither catecholaminergic nor serotonergic. The synaptic release of 5-HT was, itself, under an inhibitory control involving GABAA (,-aminobutyric acid) receptors. Moreover, we characterized the effect of the 5-HT-releasing agent fenfluramine on this functional 5-HT-mediated synaptic transmission. Our results show that the effect of fenfluramine is biphasic consisting of an initial prolongation of the serotonergic IPSP followed by a decrease in amplitude. Our data provide a basis for the previously reported inhibitory effects of exogenously applied serotonin agonists/antagonists on the autonomic functions controlled by the RVM. This 5-HT pathway, which functionally links the serotonergic and catecholaminergic regions, might play an important role in cardiovascular and nociceptive functions. [source] Pseudoepitheliomatous hyperplasia , an unusual reaction following tattoo: report of a case and review of the literatureINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2007Wei Cui MD A 59-year-old woman presented with an itchy and uncomfortable raised lesion at a tattoo site (Fig. 1) on the lateral aspect of the left leg, just above the ankle. The tattoo had been placed 2 years before her presentation and the tattoo site was sun exposed. Immediately after she had the tattoo, she noticed redness of the skin. After a week, a pruritic and red scaly nodule developed that continued to gradually enlarge until her presentation. The patient had tried topical vitamin A and D ointment with no relief. The patient also had tattoos on the arms without any noticeable skin changes. The patient reported that the tattoo procedure on her leg was more painful than that on her arms, and was performed by a different (and perhaps inexperienced) tattoo artist. The original tattoo contained red, green, and yellow pigments. Figure 1. Raised nodular lesion with irregular margins A diagnosis of tattoo granuloma was considered; squamous cell carcinoma and fungal infection were included in the differential diagnosis. A punch biopsy was performed, followed by complete surgical excision of the lesion with a split-thickness skin graft from the right thigh. The skin excision specimen showed a 3 × 2.5-cm granular and pitted pink lesion with well-demarcated, somewhat irregular borders. The lesion was raised 0.5 cm above the skin surface. The lesion was present in the center of the original tattoo. Portions of the original tattoo with green and blue,green pigmentation were visible on either side of the lesion. No satellite lesions were identified. Microscopically, the raised lesion demonstrated striking pseudoepitheliomatous hyperplasia, with irregular acanthosis of the epidermis and follicular infundibula, hyperkeratosis, and parakeratosis (Fig. 2). Follicular plugging was present with keratin-filled cystic spaces. There was a brisk mononuclear inflammatory infiltrate in the dermis, composed primarily of lymphocytes, with admixed plasma cells and histiocytes. Giant cells were occasionally identified. Dermal pigment deposition was noted both within the lesion and in the surrounding skin, corresponding to the original tattoo. Variable dermal fibrosis was noted, with thick collagen bundles in some areas. There was no evidence of epidermal keratinocytic atypia, dyskeratosis, or increased suprabasal mitotic activity. Special stains (periodic acid,Schiff and acid-fast) for microorganisms were negative. Figure 2. (a) Raised lesion with marked pseudoepitheliomatous hyperplasia and follicular plugging (hematoxylin and eosin; magnification, ×2.5). (b) Irregularly elongated and thickened rete pegs with blunt ends associated with dermal chronic inflammation (hematoxylin and eosin; magnification, ×5). (c) Follicular dilation and plugging with keratin-filled cystic spaces (hematoxylin and eosin; magnification, ×5). (d) Dermal pigment and fibrosis (hematoxylin and eosin; magnification, ×10) [source] Lateral ridge augmentation by the use of grafts comprised of autologous bone or a biomaterial.JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2002An experiment in the dog Abstract Objective: The present investigation was performed to determine if a block of Bio-Oss® used as an onlay graft can be used as a scaffold for new bone formation. Material and methods: Five mongrel dogs were used. The mandibular premolars were extracted. On both sides of the mandible, the buccal bone plate was resected and defects, about 25 mm long, 8 mm high and 5 mm wide, were produced After 3 months of healing, a second surgical procedure was performed. In the left side, a block of Bio-Oss® was adjusted to the buccal bone wall. The graft had the shape of a cylinder and was retained with a miniscrew and covered with a collagen membrane. In the contra-lateral side of the mandible, a block biopsy was first obtained from the ascending ramus. This bone graft had the shape of a cylinder that was 8 mm in diameter and 3 mm thick. The graft was transferred to the experimental site, adjusted to the buccal wall, retained with a miniscrew, and covered with a membrane. The flaps were repositioned and closed with sutures to ensure a complete coverage of the experimental sites. After 6 months of healing, the dogs were sacrificed and the experimental sites dissected. The biopsies were processed for ground sectioning. The sections were stained in toluidine blue, examined in the microscope, and a number of histo- and morphometric assessments made. Results: The study demonstrated that cortical bone used as an onlay graft in the lateral aspect of the alveolar ridge, during a 6-month period of healing integrated with the host bone but underwent marked peripheral resorption. Thus, close to 30% of the height and 50% of the length of the graft was replaced with connective tissue. It was further observed that while the dimensions of a graft which contained a scaffold of cancellous bovine bone mineral remained unchanged, only moderate amounts of new bone formed at the base of this graft. Conclusion: Grafts of autologous cortical bone, placed on the surface of a one-wall defect, may undergo marked resorption during healing. A similar graft of Bio-Oss® may retain its dimension, and limited amounts of new bone will form within the biomaterial. [source] Depth-dependent swimbladder compression in herring Clupea harengus observed using magnetic resonance imagingJOURNAL OF FISH BIOLOGY, Issue 1 2009S. M. M. Fässler Changes in swimbladder morphology in an Atlantic herring Clupea harengus with pressure were examined by magnetic resonance imaging of a dead fish in a purpose-built pressure chamber. Swimbladder volume changed with pressure according to Boyle's Law, but compression in the lateral aspect was greater than in the dorsal aspect. This uneven compression has a reduced effect on acoustic backscattering than symmetrical compression and would elicit less pronounced effects of depth on acoustic biomass estimates of C. harengus. [source] The morphometric analysis of the central retinal arteryOPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2005Necdet Kocabiyik Abstract In this study, we aimed to investigate some features of the central retinal artery (CRA), which supplies the internal aspect of the retina. The CRA is the main vessel supplying blood to the retina. The origin, course and penetration point of the optic nerve by the CRA were studied in 30 human orbits. We compared the right sides to the left sides on the basis of gender in order to statistically analyse the relation between them. The CRA arose directly from the ophthalmic artery in 28 specimens. In two specimens, however, it arose in common with the medial posterior ciliary artery. When we observed the penetration point (site) of the CRA into the optic nerve, in 28 of 30 (93.3%) cases, the artery entered the nerve from the lower medial aspect and in two (6.7%) cases from the upper lateral aspect. The CRA penetrated the optic nerve between 6.4 and 15.2 mm behind the eyeball and reached the eyeball through the centre of the optic nerve. Because of the small diameter of the artery, it has a high risk of getting damaged during a surgical approach to the orbit. Therefore the anatomical relationships of this artery must be well known. [source] Inheritance of sutural pattern at the pterion in rhesus monkey skullsTHE ANATOMICAL RECORD : ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, Issue 10 2006Qian Wang Abstract Five of the bones that characteristically comprise the cranial vault articulate on the lateral aspect of the skull at or near the cephalometric landmark referred to as the pterion. The pattern of articulation in the sutures associated with these bones varies among and within primate species and has been used as a criterion for classification in taxonomic studies, as well as in archeological and forensic studies. Within species, the sutural patterns found within the region of the pterion have remarkable consistency, which lead to the hypothesis that these patterns have a genetic basis. Sutural pattern variations were investigated at the pterion in 422 skulls from 66 rhesus monkey families with known genealogies from the long-standing colony on Cayo Santiago. Four specific types of articulation patterns were recorded. The results demonstrated that the most common suture pattern at the pterion of Cayo Santiago rhesus monkeys (86%; similar to that seen in some other anthropoid species but not humans and some apes) was characterized by an articulation between the temporal bone and parietal bone. Articulation between the sphenoid and parietal bones (type SP) accounted for 14% of the specimens and was concentrated in a dozen families. Mothers with the SP phenotype had a high incidence of offspring with SP phenotypes. Most non-SP mothers having SP offspring had siblings or family members from previous generations with the SP type. This is the first study to examine variation in sutural patterns at the pterion in pedigrees. Variation of sutural patterns shows familial aggregation, suggesting that this variation is heritable. Future work will be focused on defining the inheritance patterns of variation at the pterion, with the ultimate objective of identifying the specific genes involved and their mechanism of action. Anat Rec Part A, 288A:1042,1049, 2006. © 2006 Wiley-Liss, Inc. [source] ORIGINAL RESEARCH,EJACULATORY DISORDERS: Quantitative Sensory Testing of Peripheral Thresholds in Patients with Lifelong Premature Ejaculation: A Case-Controlled StudyTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2009Andrea Salonia MD ABSTRACT Introduction., The main functional factors related to lifelong premature ejaculation (PE) etiology have been suggested to be penile hypersensitivity, greater cortical penile representation, and disturbance of central serotoninergic neurotransmission. Aims., To quantitatively assess penile sensory thresholds in European Caucasian patients with lifelong PE using the Genito-Sensory Analyzer (GSA, Medoc, Ramat Yishai, Israel) as compared with those of an age-comparable sample of volunteers without any ejaculatory compliant. Methods., Forty-two consecutive right-handed, fully potent patients with lifelong PE and 41 right-handed, fully potent, age-comparable volunteers with normal ejaculatory function were enrolled. Each man was assessed via comprehensive medical and sexual history; detailed physical examination; subjective scoring of sexual symptoms with the International Index of Erectile Function; and four consecutive measurements of intravaginal ejaculatory latency time with the stopwatch method. All men completed a detailed genital sensory evaluation using the GSA; thermal and vibratory sensation thresholds were computed at the pulp of the right index finger, and lateral aspect of penile shaft and glans, bilaterally. Main Outcome Measures., Comparing quantitatively assessed penile thermal and vibratory sensory thresholds between men with lifelong PE and controls without any ejaculatory compliant. Results., Patients showed significantly higher (P < 0.001) thresholds at the right index finger but similar penile and glans thresholds for warm sensation as compared with controls. Cold sensation thresholds were not significantly different between groups at the right index finger or penile shaft, but glans thresholds for cold sensation were bilaterally significantly lower (P = 0.01) in patients. Patients showed significantly higher (all P , 0.04) vibratory sensation thresholds for right index finger, penile shaft, and glans, bilaterally, as compared with controls. Conclusions., Quantitative sensory testing analysis suggests that patients with lifelong PE might have a hypo- rather than hypersensitivity profile in terms of peripheral sensory thresholds. The peripheral neuropathophysiology of lifelong PE remains to be clarified. Salonia A, Saccà A, Briganti A, Carro UD, Dehò F, Zanni G, Rocchini L, Raber M, Guazzoni G, Rigatti P, and Montorsi F. Quantitative sensory testing of peripheral thresholds in patients with lifelong premature ejaculation: A case-controlled study. J Sex Med 2009;6:1755,1762. [source] Cortical Sensorimotor Control in Vocalization: A Functional Magnetic Resonance Imaging Study,THE LARYNGOSCOPE, Issue 11 2008Arno Olthoff MD Abstract Background: Verbal communication is a human feature and volitional vocalization is its basis. However, little is known regarding the cortical areas involved in human vocalization. Methods: Therefore, functional magnetic resonance imaging at 3 Tesla was performed in 16 healthy adults to evaluate brain activations related to voice production. The main experiments included tasks involving motor control of laryngeal muscles with and without intonation. In addition, reference mappings of the sensorimotor hand area and the auditory cortices were performed. Results: Related to vocalization, in addition to activation of the most lateral aspect of the primary sensorimotor cortex close to the Sylvian fissure (M1c), we found activations medially (M1a) and laterally (M1b) of the well-known sensorimotor hand area. Moreover, the supplementary motor area and the anterior cingulate cortex were activated. Conclusions: Although M1a could be ascribed to motor control of breathing, M1b has been associated with laryngeal motor control. Consequently, even though M1c represents a laryngeal sensorimotor area, its exclusiveness as suggested previously could not be confirmed. Activations in the supplementary motor area and anterior cingulate cortex were ascribed to "vocal-motor planning." The present data provide the basis for further functional magnetic resonance imaging studies in patients with neurological laryngeal disorders. [source] Significance of primary stability for osseointegration of dental implantsCLINICAL ORAL IMPLANTS RESEARCH, Issue 3 2006Natalia Lioubavina-Hack Abstract Aim: To investigate the significance of the initial stability of dental implants for the establishment of osseointegration in an experimental capsule model for bone augmentation. Material and methods: Sixteen male rats were used in the study. In each rat, muscle-periosteal flaps were elevated on the lateral aspect of the mandibular ramus on both sides, resulting in exposure of the bone surface. Small perforations were then produced in the ramus. A rigid, hemispherical Teflon® capsule with a diameter of 6 mm and a height of 4 mm and with a hole in its middle portion, prepared to fit the circumference of an ITI® HC titanium implant of 2.8 mm in diameter, was fixed to the ramus using 4 mini-screws. On one side of the jaw, the implant was placed through the hole in such a way that its apex did not make contact with the mandibular ramus (test). This placement of the implant did not ensure primary stability. On the other side of the jaw, a similar implant was placed through the hole of the capsule in such a way that contact was made between the implant and the surface of the ramus (control). This provided primary stability of the implant. After placement of the implants, the soft tissues were repositioned over the capsules and sutured. After 1, 3, 6 and 9 months, four animals were sacrificed and subjected to histometric analysis. Results: The mean height of direct bone-to-implant contact of implants with primary stability was 38.8%, 52.9%, 64.6% and 81.3% of the implant length at 1, 3, 6 and 9 months, respectively. Of the bone adjacent to the implant surface, 28.1%, 28.9%, 52.6% and 69.6%, respectively, consisted of mineralized bone. At the test implants, no bone-to-implant contact was observed at any observation time or in any of these non-stabilized specimens. Conclusion: The findings of the present study indicate that primary implant stability is a prerequisite for successful osseointegration, and that implant instability results in fibrous encapsulation, thus confirming previously made clinical observations. [source] Bone formation by enamel matrix proteins and xenografts: an experimental study in the rat ramusCLINICAL ORAL IMPLANTS RESEARCH, Issue 2 2005Nikolaos Donos Abstract: The aim of this study was to evaluate whether the use of enamel matrix proteins with or without the use of deproteinized bovine bone influences bone formation when used as an adjunct to guided bone regeneration (GBR). Twenty rats, divided into four groups of five animals each, were used in this study. Group A1: A hemispherical PTFE capsule was placed empty on the lateral aspect of the mandibular ramus (GBR). At the contralateral side of the jaw, the capsule was filled with an enamel matrix derivative (EMD) before its placement. The healing period was 60 days. Group A2: The animals were treated in the same manner as in Group A1 but with a healing period of 120 days. Group B1: The animals were treated in the same manner as in Group A1 with the difference that deproteinized bovine bone mineral (DBBM) particles were packed in the capsule. At the contralateral side of the jaw, the capsule was filled with a mixture of EMD and DBBM. The healing period was 60 days. Group B2: The same treatment as in B1 but with a healing period of 120 days. The histological analysis revealed that in Groups A1 and A2 newly formed bone was covering a significant part of the empty capsules (GBR). The use of EMD in the capsule did not offer any added benefit to the use of the capsule alone in terms of new bone formation. At Groups B1 and B2, the presence of DBBM and/or EMD did not positively affect the amount of new bone formation. It can be suggested that neither the application of EMD nor the use of DBBM or the combination of EMD and DBBM results in enhanced amounts of bone formation in comparison with the GBR procedure alone. Résumé Le but de cette étude a été d'évaluer si l'utilisation des protéines de la matrice amélaire avec ou sans l'utilisation d'os bovin déprotéiné influençait la formation osseuse lorsqu'il était utilisé comme complément à la régénération osseuse guidée (GBR). Vingt rats divisés en groupe de cinq ont servi lors de cette étude. Le groupe A1 : une caspule hémisphérique en téflon a été placée vide sur la face latérale de la branche montante mandibulaire (GBR). Du côté contralatéral de la mandibule, une capsule remplie de dérivés de la matrice amélaire (EMD) a été saturée avant son placement. La période de guérison a été de 60 J. Le groupe A2 : les animaux ont été traités de la même manière que dans le groupe A1 mais avec une période de guérison de 120 J. Le groupe B1 : les animaux ont été traités de la même manière que dans le groupe A1 avec la différence que les particules d'os déprotéiné (DBBM) ont été placées dans la capsule. Dans le côté contralatéral de la mandibule, les capsules ont été remplies avec un mélange d'EMD-DBBM. La période de guérison était de 60 J. Le groupe B2 : le même traitement que B1 mais avec une période de guérison de 120 J. L'analyse histologique a révélé que dans les groupes A1 et A2 de l'os néoformé recouvrait une partie significative des capsules (GBR). L'utilisation de EMD dans la capsule n'ajoutait aucune amélioration à l'utilisation de la capsule seule en tant que néoformation osseuse. Dans les groupes B1 et B2, la présence de DBBM et de EMD ou des deux ne changeait pas de manière positive la quantité de nouvel os formé. Ni l'application de EMD ni l'utilisation de DBBM ou d'une combinaison EMD-DBBM ne résulte en une augmentation des quantités de formation osseuse comparée au processus de GBR utilisé seul. Zusammenfassung Das Ziel dieser Studie war, auszuwerten, ob Schmelzmatrixproteine mit oder ohne Verwendung von deproteiniertem bovinem Knochen die Knochenbildung beeinflussen, wenn sie als Zusatz bei der gesteuerten Knochenregeneration (GBR) verwendet werden. Zwanzig Ratten, aufgeteilt in 4 Gruppen mit je 5 Tieren, wurden für die Studie verwendet. Gruppe A1: Eine halbkugelförmige PTFE-Kapsel wurde leer auf die laterale Fläche des Unterkiefer Ramus platziert. Auf der gegenüberliegenden Seite wurde die Kapsel vor der Platzierung mit Schmelzmatrixproteinderivat (EMD) gefüllt. Die Heilungszeit betrug 60 Tage. Gruppe A2: Die Tiere wurden auf die gleiche Art behandelt wie in Gruppe A1, aber die Heilungszeit betrug 120 Tage. Gruppe B1: Die Tiere wurden behandelt wie in Gruppe A1 mit dem Unterschied, dass deproteinierte bovine Knochenpartikel (DBBM) in die Kapsel gepackt wurden. Auf der gegenüberliegenden Seite des Kiefers wurde die Kapsel mit einem Gemisch aus EMD und DBBM gefüllt. Die Heilungszeit betrug 60 Tage. Gruppe B2: Es wurden die selben Behandlungen wie in Gruppe B1 durchgeführt, aber die Heilungszeit betrug 120 Tage. Die histologische Analyse zeigte, dass in den Gruppe A1 und A2 neugebildeter Knochen einen signifikanten Anteil der leeren Kapseln bedeckte (GBR). Der Einsatz von EMD in der Kapsel ergab gegenüber der leeren Kapsel keinen zusätzlichen Nutzen bezüglich Bildung von neuem Knochen. Bei den Gruppen B1 und B2 hatte der Einsatz von DBBM und/oder EMD keinen positiven Effekt auf die Menge an neu gebildetem Knochen. Es kann angenommen werden, dass weder die Applikation von EMD noch die Verwendung von DBBM oder einer Kombination EMD und DBBM im Vergleich zum GBR Verfahren allein zu einer geseigerten Knochenbildung führt. Resumen La intención de este estudio fue evaluar si el uso de proteína de la matriz del esmalte con o sin el uso de hueso bovino desproteinizado influye en la formación de hueso cuando se usa junto a regeneración ósea guiada (GBR). En este estudio se usaron veinte Ratas divididas en 4 grupos de 5 animales cada uno. Grupo A1: Se colocó una capsula hemiesférica vacía en el aspecto lateral de la rama mandibular (GBR). En el lado contralateral de la mandíbula, la capsula se rellenó con un derivado de la matriz del esmalte (EMD) antes de su colocación. El periodo de cicatrización fue de 60 días. Grupo A2: Los animales se trataron de la misma manera que en el grupo A1 pero con un periodo de cicatrización de 120 días. Grupo B1: Los animales se trataron en el mismo modo que en el grupo A1 con la diferencia que las cápsulas se rellenaron de partículas de hueso bovino desproteinizado (DBBM). En el lado contralateral de la mandíbula, la cápsula se rellenó con una mezcla de EMD y DBBM. El periodo de cicatrización fue de 60 días. Grupo B2: El mismo tratamiento que en B1 pero con 120 días de cicatrización. El análisis histológico reveló que en los grupos A1 y A2 un hueso neoformado cubría una parte significativa de las cápsulas vacías (GBR). El uso de EMD en la cápsula no ofreció ningún beneficio adicional al uso de la cápsula por si sola en términos de formación de nuevo hueso. En los grupos B1 y B2, la presencia de DBBM y/o EDM no afectó positivamente a la cantidad de hueso neoformado. Se puede sugerir que ni la aplicación de EMD o el uso de DBBM o la combinación de EMD y DBBM resultaron en cantidades mejoradas de formación de hueso en comparación con el procedimiento de GBR por si solo. [source] Decreased Dopamine D2/D3-Receptor Binding in Temporal Lobe Epilepsy: An [18F]Fallypride PET StudyEPILEPSIA, Issue 8 2006Konrad J. Werhahn Summary:,Purpose: Although animal data are suggestive, evidence for an alteration of the extrastriatal dopaminergic system in human focal epilepsy is missing. Methods: To quantify D2/D3-receptor density, we studied seven patients with temporal lobe epilepsy (TLE) and nine age-matched controls with positron emission tomography (PET) by using the high-affinity dopamine D2/D3-receptor ligand [18F]Fallypride ([18F]FP) suitable for imaging extrastriatal binding. TLE was defined by interictal and ictal video-EEG, magnetic resonance imaging (MRI), and [18F]fluorodeoxyglucose ([18F]FDG)-PET and was due to hippocampal sclerosis (HS), based on histology in all patients. Primary analysis was based on regions of interest (ROIs) defined on individual MRIs. For each patient, binding potential (BP) was calculated by using the simplified reference tissue model, and the epileptogenic was compared with the unaffected hemisphere in each ROI. To confirm the results, an additional voxel-based group analysis was performed by using statistical parametric mapping. Results: Compared with controls, [18F]FP BP was significantly decreased in the epileptogenic temporal lobe in all patients. On ROI analysis, this reduction was evident in areas surrounding the seizure-onset zone at the pole (,34.2%) and lateral aspects (,32.9%) of the temporal lobe. Although the hippocampus [18F]FDG uptake (,8.1%) and hippocampal MR volume (,35.1%) were significantly reduced, no significant decrease of [18F]FP BP was found. Reduction of [18F]FP BP did not correlate with hippocampal atrophy. Conclusions: D2/D3-receptor binding is reduced at the pole and in lateral aspects of the epileptogenic temporal lobe in patients with mesial TLE and HS. This area might correspond to "the irritative zone," indicating that D2/D3 receptors might play a specific role in the pathophysiology of mesial TLE. [source] Leg ulcers and hydroxyurea: report of three cases with essential thrombocythemiaINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 12 2002Zeynep Demirçay MD Case 1,A 65-year-old woman with essential thrombocythemia (ET) had been taking oral hydroxyurea (HU), 1000 mg daily, for 7 years. Six months ago, she developed an ulcer on the outer part of her left ankle, which healed spontaneously within 2 months. She presented with a new, tender, shallow ulcer, 2 cm × 2 cm in size, at the same site. Doppler examination revealed thrombosis of the left common femoral vein and a calcified atheroma plaque of the left common femoral artery. The dosage of HU was decreased to 500 mg daily when the platelet counts were found to be within normal levels. The ulcer completely healed within 2 months with occlusive wound dressings, and has not recurred within the follow-up period of 1 year. Case 2,A 56-year-old women presented with multiple, painful, leg ulcers of 1 year duration. She had been diagnosed as having ET and had been on HU therapy, 1500 mg/day, for the past 5 years. Interferon-,-2b was started 3 months ago, in addition to HU, which was tapered to 1000 mg daily. She had suffered from hypertension for 20 years treated with nifedipine and enalapril, and had recently been diagnosed with diabetes mellitus which was controlled by diet. Examination revealed three ulcers located on the lateral aspects of both ankles and right distal toe. Arterial and venous Doppler examinations were within normal limits. Histopathology of the ulcer revealed nonspecific changes with a mixed inflammatory cell infiltrate around dermal vessels. The ulcers completely healed within 10 weeks with topical hydrocolloid dressings. After healing, she was lost to follow-up. A year later, it was learned that she had developed a new ulcer at her right heel, 3 months after her last visit (by phone call). This ulcer persisted for 8 months until HU was withdrawn. Case 3,A 64-year-old woman with ET presented with a painful leg ulcer of 6 months' duration. She had been taking oral HU for 5 years. She had a 20-year history of hypertension treated with lisinopril. Examination revealed a punched-out ulcer of 2 cm × 2 cm over the right lateral malleolus (Fig. 1). Doppler examination of the veins revealed insufficiency of the right greater saphenous and femoral veins. Angiography showed multiple stenoses of the right popliteal and femoral arteries. As her platelet count remained high, HU was continued. During the follow-up period of 13 months, the ulcer showed only partial improvement with local wound care. Figure 1. Punched-out ulcer surrounded by an erythematous border over the right malleolus (Case 3) [source] The role of the calcar femorale in stress distribution in the proximal femurORTHOPAEDIC SURGERY, Issue 4 2009Qi Zhang MD Objective:, To investigate the role of the calcar femorale in stress distribution in the proximal femur. Methods:, Twenty-five specimens of proximal femurs were fixed to simulate single-limb stance. Strain gauges were applied to record the strain under different loads. Strain values of 27 selected sites in the proximal femur were recorded and analyzed at the level of 100 N, 200 N, 300 N, 400 N, 500 N, 600 N and 700 N, respectively before and after disruption of the calcar femorale. Results:, When a normal load was being borne, strain values measured in the posterior and medial aspects of the proximal femur were greater than those measured in the anterior and lateral aspects, no matter whether the calcar femorale was disrupted or not. However after disruption of the calcar femorale, strain values in the posterior and medial aspects of the proximal femur increased significantly, whereas those of the anterior and lateral aspects decreased significantly. Conclusion:, The calcar femorale redistributes stress in the proximal femur by decreasing the load in the posterior and medial aspects and increasing the load in the anterior and lateral aspects. [source] | |||||||||||||