scholarly journals Gummy Smile: Mercado-Rosso Classification System and Dynamic Restructuring with Hyaluronic Acid

2021 ◽  
Author(s):  
Jorge Mercado-García ◽  
Paula Rosso ◽  
Mar Gonzalvez-García ◽  
Jesús Colina ◽  
José Manuel Fernández
Keyword(s):  
Hyaluronic Acid ◽  
Classification System ◽  
Therapeutic Approach ◽  
Gingival Tissue ◽  
Level Of Evidence ◽  
Functional Aspects ◽  
Molar Teeth ◽  
Type 3 ◽  
Gummy Smile

Abstract Background Gummy smile (GS) is a nonpathological condition causing esthetic disharmony in which an excessive amount of gingival tissue is exposed when smiling. Nowadays, there is not unanimous agreement regarding both classification and management of GS. This study aimed to present an organized and comprehensive clinical classification of the GS, as well as to discuss a therapeutic approach, with hyaluronic acid dermal fillers. Methods This study is presenting the clinical experience of the authors regarding GS. Results The Mercado-Rosso GS classification has into account aesthetic aspects, etiopathogenetic criteria, and functional aspects of the smile. According to Mercado-Rosso GS-classification-system, GS is divided into 3-types: Type 1, characterized by a lack of support and/or a lack of projection of the upper maxilla; Type 2, due to an imbalance between the strength (excess) and the resistance (defect) of the levator muscles; and Type 3, defined by an excessive strength of the zygomatic muscles, which causes a wide smile and an excessive visualization of the molar teeth. Conclusions The Mercado-Rosso GS classification system is a tool that facilitates the diagnostic and therapeutic approach to the gummy smile. RD Dynamic Restructuring® constitutes a comprehensive therapeutic approach that makes reference to both the effect of the HA filler on the muscle movement and the balance between the muscle strength and the resistance of the soft tissue to be folded in different facial structures). Level of evidence: Level V.

scholarly journals A Novel Country Classification System for Choosing International Business Locations

2019 ◽  
Vol 13 (1) ◽  
pp. 29
Author(s):  
Mikidadu Mohammed ◽  
Jean Marie Luundo
Keyword(s):  
Political Economy ◽  
International Business ◽  
Classification System ◽  
New Classification ◽  
International Investments ◽  
Doing Business ◽  
Legal Risks ◽  
Political Economic ◽  
Type 3

This paper introduces a novel country classification system that rates the political economy risks of countries for the purpose of conducting international business. It is intended to provide investors, multinational companies, and business researchers a quick and efficient way of gauging the extent of political, economic, and legal risks associated with doing business in different countries. The study covers over 170 countries and identifies 24 country types. At the extremes are Type 1 countries (least risky) and Type 24 countries (most risky). Overall, the new classification system suggests that political economy risks associated with doing international business are relatively mild in Type 1, Type 3, and Type 4 countries. However, international businesses should temper their investment decisions with caution in Type 19, Type 20, Type 22, Type 23, and Type 24 countries due to high political, economic, and legal risks, especially Types 23 and 24 where these risks are excessive. At the same time, international businesses may want to refocus their attention to Type 11 countries who are now havens for international investments due to drastic reduction in political, economic, and legal risks associated with doing business. The twenty-four country types identified in this new classification system are time-invariant. Thus, countries may move up or down due to improvements or deteriorations in certain aspects of their political economy.

Cheek Dimpleplasty: A New Classification of Described Procedures

2020 ◽  
Vol 37 (3) ◽  
pp. 131-137
Author(s):  
Jude L. Opoku-Agyeman ◽  
Jamee E. Simone
Keyword(s):  
Classification System ◽  
Cosmetic Surgery ◽  
English Language ◽  
Cochrane Library ◽  
New Classification ◽  
Systematic Classification ◽  
Advantages And Disadvantages ◽  
Buccinator Muscle ◽  
Type 3

Cheek dimpleplasty has become a popular request amongst patients requesting cosmetic surgery. Since the first reported dimpleplasty in 1962, there have been many reported procedures in the literature for cheek dimple creation. Some of the procedures described by various authors as “novel” are actually similar if not identical to existing procedures. This study reviews the different procedures of cheek dimple creation and provides the first ever systematic classification for these techniques. EMBASE, Cochrane library, Ovid medicine, and PubMed databases were searched from its inception to June of 2019. We included all studies describing the surgical creation of cheek dimples. The studies were reviewed, and the different procedures were cataloged. We then proposed a new classification system for these procedures based on their common characteristics. The study included 12 articles published in the English language that provided a descriptive procedure for cheek dimple creation. We classified the procedures into 3 broad categories and subcategories. Type 1 procedures are nonexcisional myocutaneous dimpleplasties. In these procedures, the buccinator muscle is not excised. In type 1A, the suture used to create the adhesion traverses the epidermis. In type 1B, the suture does not traverse the epidermis, rather, the suture travels up into the dermis and returned back to the mucosa. Type 2 procedures are excisional dimpleplasties. In these procedures, the buccinator muscle is excised with (open) or without (closed) the excision of the mucosa. Type 3 procedures are incisional dimpleplasty. In these procedures, the muscle is incised and fixed to the dermis. Each of these groups of procedures has potential unique advantages and disadvantages. There are multiple procedures reported in the English language literature for the creation of cheek dimples. Most of the procedures are based on similar concept with minor variations. Our classification system, the Opoku-Simone Classification, will help facilitate communication when describing the different configurations of these procedures. Procedure within each group has similar potential advantages and disadvantages.

scholarly journals Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques

2019 ◽  
Author(s):  
Jude Opoku-Agyeman ◽  
David Matera ◽  
Jamee Simone
Keyword(s):  
Classification System ◽  
English Language ◽  
Pectoralis Major ◽  
Cochrane Library ◽  
New Classification ◽  
Pectoralis Major Flap ◽  
Defect Reconstruction ◽  
Type 3

Abstract Objectives The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. Methods EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures. Results The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b). Conclusion There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.

Proposal of Venous Drainage–Based Classification System for Carotid Cavernous Fistulae With Validity Assessment in a Multicenter Cohort

Neurosurgery ◽  
2015 ◽  
Vol 77 (3) ◽  
pp. 380-385 ◽  
Author(s):  
Ajith J. Thomas ◽  
Michelle Chua ◽  
Matthew Fusco ◽  
Christopher S. Ogilvy ◽  
R. Shane Tubbs ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Classification System ◽  
Internal Carotid ◽  
Treatment Approach ◽  
Venous Drainage ◽  
Validity Assessment ◽  
Drainage Channels ◽  
Type 3

Abstract BACKGROUND: Carotid cavernous fistulae (CCFs) are most commonly classified based on arterial supply. Symptomatology and treatment approach, however, are largely influenced by venous drainage. OBJECTIVE: To propose an updated classification system using venous drainage. METHODS: CCFs with posterior/inferior drainage only, posterior/inferior and anterior drainage, anterior drainage only, and retrograde drainage into cortical veins with/without other drainage channels were designated as types 1, 2, 3, and 4, respectively. CCFs involving a direct connection between the internal carotid artery and cavernous sinus were designated as type 5. This system was retrospectively applied to 29 CCF patients. RESULTS: Our proposed classification was significantly associated with symptomatology (P.001). Type 2 was significantly associated with coexisting ocular/orbital and cavernous symptoms only (P.001), type 3 with ocular/orbital symptoms only (P.01), and type 4 demonstrated cortical symptoms with/without ocular/orbital and cavernous symptoms (P.01), respectively. There was a significant association of our classification system with the endovascular treatment approach (P.001). Types 1 and 2 were significantly associated with endovascular treatment through the inferior petrosal sinus (P.01). Type 3 was significantly associated with endovascular treatment through the ophthalmic vein (P.01) and type 5 with transarterial approach (P.01), respectively. Types 2 (27.6%) and 3 (34.5%) were most prevalent in this series, whereas type 1 was rare (6.9%), suggesting that some degree of thrombosis is present, with implications for spontaneous resolution. Type 2 CCFs demonstrated a trend toward partial resolution after endovascular treatment (P = .07). CONCLUSION: Our proposed classification system is easily applicable in clinical practice and demonstrates correlation with symptomatology, treatment approach, and outcome.

scholarly journals Persistent cloaca: persistence of the challenge

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Amr Abdelhamid AbouZeid ◽  
Ahmed Bassiouny Radwan ◽  
Mohamed Eldebeiky ◽  
Sameh Abdel Hay
Keyword(s):  
Case Series ◽  
Pubic Symphysis ◽  
Urinary Continence ◽  
Level Of Evidence ◽  
Renal Anomalies ◽  
Persistent Cloaca ◽  
Type 3 ◽  
Common Association

Abstract Background Persistent cloaca or cloacal anomalies represent a special category of anorectal anomalies affecting the female sex with a reported incidence of about one in 25,000 live birth. The study included 34 cases of cloaca that were managed at our unit between 2003 through 2017. We retrospectively reviewed patients’ records that included clinical presentation, investigations, operative data, and follow-up notes. Anatomically, we stratified cloaca into three types according to the level of urogenital confluence. A low confluence (type 1) was defined by being at or below the level of the lower border of pubic symphysis with a short common channel (11 cases). A high confluence (type 3) was defined by being at or above the level of the upper border of pubic symphysis (9 cases). Between the low and high types, we defined an intermediate type (type 2) where the urogenital confluence was behind the mid-portion of pubic symphysis (14 cases). Results Renal anomalies were common association: solitary kidney in seven, pelvic kidney in two, and urinary tract dilatation (hydroureteronephrosis) in 12 cases. At follow-up, chronic renal insufficiency was detected in seven cases The prognosis for urinary continence was excellent in low confluence (type 1) cloaca. On the other hand, urinary incontinence was common among type 3 (high confluence) cloaca (62.5%). Conclusion Renal anomalies represent a common association with cloaca and a major cause of morbidity. Efforts should be directed to preserve renal function during the initial management, and to preserve the continence potential following the definitive repair. Level of evidence This is a case series with no comparison group (level IV).

scholarly journals Correction to: Gummy Smile: Mercado-Rosso Classification System and Dynamic Restructuring with Hyaluronic Acid

2021 ◽  
Author(s):  
Jorge Mercado-García ◽  
Paula Rosso ◽  
Mar Gonzalvez-García ◽  
Jesús Colina ◽  
José Manuel Fernández
Keyword(s):  
Hyaluronic Acid ◽  
Classification System ◽  
Gummy Smile

A correction to this paper has been published: https://doi.org/10.1007/s00266-021-02229-z

FUNCTIONAL STATUS AND ADAPTIVE POTENTIAL IN FOREIGN STUDENTS WITH DIFFERENT TYPES OF VEGETATIVE REGULATION DURING TUITION

2020 ◽  
pp. 118-126
Author(s):  
A.M. Satarkulova
Keyword(s):  
Heart Rate ◽  
Foreign Students ◽  
Autonomic Regulation ◽  
The Body ◽  
Functional Changes ◽  
Different Types ◽  
Type 3 ◽  
Adaptive Abilities

The assessment and dynamic control over students’ status is a very important task. It allows timely detection of prenosological status prior to pathology and health maintenance in students. The objective of the paper is to assess the adaptive abilities of the body, to analyze changes in heart rate variability indicators in students with various types of autonomic regulation, to identify prenosological status and precursory pathological symptoms. Materials and Methods. The study enrolled 302 students from India, aged 21.54±1.43. Programming complex «Psychophysiologist» was used to register the main HRV parameters within 5 minutes. Health status was evaluated according to the index of functional changes and the scale of functional states. Results. N.I. Shlyk (2009) distinguished two groups of students with different types of autonomic regulation: type 1 (53 %) with moderate and type 2 (5 %) with marked characteristics of central regulation profile, type 3 (35 %) with moderate and type 4 (7 %) with marked characteristics of autonomous regulation profile. Main parameters of HRV and adaptation potential were defined for each student.All the parameters characterized functional and health status. Conclusions. It was shown that 82 % of trial subjects (type 1), 53 % (type 2), 94 % (type 3) and 95 % (type 4) demonstrated satisfactory adaptation and their physiological processes were at an optimal level. 18 % of students (type 1) demonstrated reduced adaptive abilities of the body. Moreover, they were under moderate stress. 47 % of subjects (type 2) were also under a significant stress, which was proven by excessively high SI, low SDNN and TP, and an increased index of functional changes. 5 % of students (type 4) revealed dysfunctional characteristics in the heart rhythm, peculiar to pathology. Keywords: foreign students, heart rate variability, types of autonomic regulation, adaptation potential, functional status. Оценка состояния студентов и динамический контроль за ним является важной задачей, поскольку позволяет своевременно выявлять у студентов донозологические состояния, предшествующие патологии, и способствовать сохранению здоровья. Цель. Оценка адаптивных возможностей организма, анализ изменений показателей вариабельности сердечного ритма у студентов с различными типами вегетативной регуляции, выявление донозологических состояний и ранних признаков патологии. Материалы и методы. В исследовании участвовало 302 студента в возрасте 21,54+1,43 года из Индии. Регистрировались основные параметры ВСР в течение 5 мин с использованием программно-аппаратного комплекса «Психофизиолог». Состояние и уровень здоровья оценивались по индексу функциональных изменений и шкале функциональных состояний. Результаты. По способу, предложенному Н.И. Шлык, выделены группы студентов с различными типами вегетативной регуляции: I (53 %) и II типы (5 %) – с умеренным и выраженным преобладанием центрального контура регуляции соответственно, III (35 %) и IV типы (7 %) – с умеренным и выраженным преобладанием автономного контура регуляции соответственно. У каждого из студентов определены основные параметры ВСР и адаптационного потенциала, характеризующие функциональное состояние и уровень здоровья. Выводы. Показано, что для 82 % обследуемых с I типом, 53 % со II типом, 94 % c III типом и 95 % с IV типом регуляции характерно состояние удовлетворительной адаптации, физиологические процессы сохраняются на оптимальном уровне. В группе студентов I типа у 18 % студентов адаптивные возможности организма снижены, выявлено состояние умеренного напряжения. У 47 % обследуемых II типа также зафиксировано состояние резко выраженного напряжения, индикатором которого является чрезмерно высокое значение SI, низкие величины SDNN и ТP, повышенное значение индекса функциональных изменений. В группе студентов с IV типом у 5 % учащихсяв регуляции ритма сердца выявлены дисфункциональные признаки, характерные для патологии. Ключевые слова: иностранные студенты, вариабельность сердечного ритма, типы вегетативной регуляции, адаптационный потенциал, функциональное состояние.

Does Adjunctive Use of Hyaluronic Acid Improve Clinical Outcome of Mechanical Therapy for Cases of Mild Aggressive Periodontitis

2017 ◽  
Vol 68 (3) ◽  
pp. 612-614
Author(s):  
Andreea A. Pogan ◽  
Roxana Buzatu ◽  
Dan Onisei ◽  
Doina Onisei
Keyword(s):  
Hyaluronic Acid ◽  
Antimicrobial Effect ◽  
Aggressive Periodontitis ◽  
Gingival Tissue ◽  
Potential Benefits ◽  
Therapeutic Properties ◽  
Acid Gel ◽  
Mechanical Therapy ◽  
Improve Clinical Outcome ◽  
Hyaluronic Acid Gel

Hyaluronic acid is an essential component of the periodontal ligament matrix and it has shown a number of clinical therapeutic properties, especially an anti-inflammatory effect on the gingival tissue. The aim of this study is to evaluate the potential benefits of using hyaluronic acid gel in topical application as an adjunct to mechanical therapy in the management of aggressive periodontitis. Results show an obvious improvement of clinical parameters, especially regarding the evolution of healing of the gingival tissue after periodontal therapy. Nevertheless, the antimicrobial effect needs to be proven in further studies.

POLIOMYELITIS IN CANADIAN ESKIMOS: LABORATORY STUDIES. V. TYPE 1 AND TYPE 3 POLIOMYELITIS ANTIBODY LEVELS IN BAFFIN ISLAND ESKIMOS

1954 ◽  
Vol 32 (1) ◽  
pp. 119-125
Author(s):  
W. Wood ◽  
Eina M. Clark ◽  
F. T. Shimada ◽  
A. J. Rhodes
Keyword(s):  
Medical Records ◽  
Baffin Island ◽  
Tissue Cultures ◽  
Laboratory Studies ◽  
Poliomyelitis Virus ◽  
Antibody Titers ◽  
Antibody Levels ◽  
Type 3

Studies on the basic immunology of poliomyelitis in Canadian Eskimos have been continued. Some 87 sera collected from Eskimos at Pangnirtung, Baffin Island, have been examined for the presence of Type 1 and Type 3 poliomyelitis antibody by quantitative tests in tissue cultures. The same sera were previously examined for Type 2 antibody by quantitative tests in mice. The results of the three determinations are now presented together for comparison. These sera came from Eskimos aged 2 to 72 years of age. None of the Eskimos showed any evidence of paralysis. Examination of the medical records did not suggest that any paralytic disease had been present in this part of Baffin Island. Very few of the sera showed the presence of poliomyelitis antibody; thus, Type 1 antibody was demonstrated in the sera of 8%, Type 2 antibody in the sera of 9%, and Type 3 antibody in the sera of 14%. No significant number of Eskimos below the age of 45 years had acquired poliomyelitis antibody. The antibody titers mostly ranged between 10−1.0 and 10−2.0, and were significantly lower than the titers customarily found in recently paralyzed cases. These findings suggest that poliomyelitis infection occurred in Pangnirtung Eskimos many years before the date on which the samples were taken (1951). These results point to the worldwide prevalence of the three types of poliomyelitis virus.

Toward Personalized Treatment for Patients with Low von Willebrand Factor and Quantitative von Willebrand Disease

2021 ◽  
Vol 47 (02) ◽  
pp. 192-200
Author(s):  
James S. O'Donnell
Keyword(s):  
Von Willebrand Factor ◽  
Bleeding Risk ◽  
Von Willebrand Disease ◽  
Personalized Treatment ◽  
Treatment Plans ◽  
Type 3 ◽  
Von Willebrand ◽  
Willebrand Factor

AbstractThe biological mechanisms involved in the pathogenesis of type 2 and type 3 von Willebrand disease (VWD) have been studied extensively. In contrast, although accounting for the majority of VWD cases, the pathobiology underlying partial quantitative VWD has remained somewhat elusive. However, important insights have been attained following several recent cohort studies that have investigated mechanisms in patients with type 1 VWD and low von Willebrand factor (VWF), respectively. These studies have demonstrated that reduced plasma VWF levels may result from either (1) decreased VWF biosynthesis and/or secretion in endothelial cells and (2) pathological increased VWF clearance. In addition, it has become clear that some patients with only mild to moderate reductions in plasma VWF levels in the 30 to 50 IU/dL range may have significant bleeding phenotypes. Importantly in these low VWF patients, bleeding risk fails to correlate with plasma VWF levels and inheritance is typically independent of the VWF gene. Although plasma VWF levels may increase to > 50 IU/dL with progressive aging or pregnancy in these subjects, emerging data suggest that this apparent normalization in VWF levels does not necessarily equate to a complete correction in bleeding phenotype in patients with partial quantitative VWD. In this review, these recent advances in our understanding of quantitative VWD pathogenesis are discussed. Furthermore, the translational implications of these emerging findings are considered, particularly with respect to designing personalized treatment plans for VWD patients undergoing elective procedures.

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