Planing off the inferior edge in the Frechet and Rose trichophytic closures

2008 ◽  
Vol 18 (6) ◽  
pp. 211-211 ◽  
Author(s):  
Dae-young Kim
Keyword(s):  
Inferior Edge

Polysomnographic studies in children undergoing adenoidectomy and/or tonsillectomy

2002 ◽  
Vol 116 (9) ◽  
pp. 711-715 ◽  
Author(s):  
Anubhav Jain ◽  
J. K. Sahni
Keyword(s):  
Soft Tissue ◽  
Obstructive Sleep Apnoea ◽  
Clinical Evaluation ◽  
Sleep Apnoea ◽  
Lateral View ◽  
Age Group ◽  
X Ray ◽  
Maximum Thickness ◽  
Obstructive Sleep ◽  
Inferior Edge

Forty children (age group four to 12 years) undergoing adenoidectomy and/or tonsillectomy were subjected to pre- and post-operative polysomnography. Thorough clinical evaluation and X-ray soft tissue nasopharynx lateral view was carried out for all the patients. The tonsils were clinically graded from grade I to IV, whereas the adenoids were measured radiographically (using three different measurements) in all children. Thirty out of 40 (75 per cent) children presented with predominant obstructive symptoms, out of whom 22 (73.3 per cent) were found to have obstructive sleep apnoea (OSA), i.e. apnoea index > five per hour. The remaining 10 (25 per cent) had predominantly inflammatory symptoms on presentation and out of these two (20 per cent) were found to have OSA. Relative adenoid size expressed as a ratio between the distance from the point of maximum thickness of adenoids along a line drawn along a straight part of the basiocciput and distance from the posterior nasal spine to the antero-inferior edge of the spheno-basioccipital synchondrosis, was found to have a highly significant correlation with the grade of OSA. In our study, all patients with this ratio greater than 0.64 were found to have OSA. No correlation between tonsil size and grade of OSA was found. There was a highly significant improvement in polysomnographic scores following surgery in all patients.

A radiographic computed tomography–based study to determine the ideal entry point, trajectory, and length for safe fixation using C-2 pars interarticularis screws

2010 ◽  
Vol 12 (6) ◽  
pp. 602-612 ◽  
Author(s):  
Daniel J. Hoh ◽  
Charles Y. Liu ◽  
Michael Y. Wang
Keyword(s):  
Entry Point ◽  
Ct Scans ◽  
Lateral Mass ◽  
Transverse Foramen ◽  
Inferior Aspect ◽  
Significant Difference ◽  
Pars Interarticularis ◽  
Entry Points ◽  
The Mean ◽  
Inferior Edge

Object Effective methods for fixation of the axis include C1–2 transarticular and C-2 pedicle screw placement. Both techniques pose a risk of vertebral artery (VA) injury in patients with narrow pedicles or an enlarged, high-riding VA. Pars screws at C-2 avoid the pedicle, but can cause VA injury with excessively long screws. Therefore, the authors evaluated various entry points and trajectories to determine ideal pars screw lengths that avoid breaching the transverse foramen. Methods Both pars were studied on 50 CT scans (100 total). Various pars lengths were assessed using 2 entry points and 3 trajectories (6 measurements). Entry point A was the superior one-fourth of the lateral mass. Entry point B was 3-mm rostral to the inferior aspect of the lateral mass. Using entry points A and B, Trajectory 1 was the minimum distance to the transverse foramen; Trajectory 2 was the maximum distance to the transverse foramen; and Trajectory 3 was the steepest angle to the pars/C-2 superior facet junction without transverse foramen breach. Results The mean patient age was 46 ± 17 years, and 84% of the CT scans reviewed were obtained in men. There was no significant difference in right or left measurements. Entry point B demonstrated greater pars lengths for each trajectory compared with entry point A (p < 0.0001). For both entry points, Trajectory 3 provided the greatest pars length. Using Trajectory 3 with entry point B, 84, 95, and 99% had a pars length that measured ≥ 18, 16, and 14 mm, respectively. Using Trajectory 3 with Entry point A, only 41, 64, and 87% had a pars length that measured ≥ 18, 16, and 14 mm, respectively. Conclusions Using an entry point 3-mm rostral to the inferior edge of the lateral mass and a trajectory directed toward the superior facet/pars junction, 99% of partes interarticularis in this study would tolerate a 14-mm screw without breach of the transverse foramen.

Single-Incision Proximal Gastrectomy With Double-Flap Esophagogastrostomy Using Novel Laparoscopic Instruments

2020 ◽  
pp. 155335062095823
Author(s):  
So Hyun Kang ◽  
Yongjoon Won ◽  
Kanghaeng Lee ◽  
Sang Il Youn ◽  
Sa-Hong Min ◽  
...  
Keyword(s):  
Single Incision ◽  
Proximal Gastrectomy ◽  
Anterior Wall ◽  
Abdominal Organ ◽  
Needle Holder ◽  
Novel Technique ◽  
Laparoscopic Instruments ◽  
Technical Report ◽  
Inferior Edge ◽  
Optimal Type

Background. The optimal type of anastomosis after proximal gastrectomy (PG) is still controversial. A novel technique termed “double-flap” esophagogastrostomy (EG) has been introduced. The application of this technique after PG is reported to have little gastroesophageal reflux without the need of creating an esophagojejunostomy. However, this procedure is technically challenging and hence difficult to apply in laparoscopic PG. This technical report describes in detail how to perform single-incision proximal gastrectomy (SIPG) with double-flap EG with the use of novel laparoscopic instruments. Methods. Two patients diagnosed with early gastric cancer underwent SIPG. A 2.5 cm incision was made, and a scope holder was used in place of a scopist. After performing PG with D1+ lymphadenectomy, double seromuscular flaps were created on the anterior wall of the stomach. After tagging the esophagus to the inferior edge of the flap window, the stomach and esophagus were opened through electrocautery. EG was performed intracorporeally using continuous barbed sutures, and the flap is then secured to the anastomosis. To facilitate this procedure, an intra-abdominal organ retractor and an articulating needle holder were used. The supplementary video illustrates in detail how these devices are used to perform the technique. Results. Total operation times were 190 and 110 minutes each, and anastomosis took 75 and 46 minutes each. Patients had no complications and were both discharged on postoperative day 6. Conclusion. Double-flap PG is technically feasible through a single incision with the use of articulating laparoscopic devices and intra-abdominal organ retractors to assist in intracorporeal anastomosis.

scholarly journals Portal placement for endoscopic surgery in the deep gluteal area: a cadaveric study

2020 ◽  
Vol 7 (1) ◽  
pp. 147-152
Author(s):  
F Bataillie ◽  
S Bataillie ◽  
N van Beek ◽  
K Corten
Keyword(s):  
Sciatic Nerve ◽  
Insertion Site ◽  
Proximal Part ◽  
Ischial Tuberosity ◽  
Reference Points ◽  
Horizontal Line ◽  
Safe Approach ◽  
Proximal Hamstring ◽  
Inferior Edge ◽  
Portal Placement

Abstract Partial or complete avulsion of the insertion of the proximal hamstrings at the level of the ischial tuberosity is most often treated by open exploration and reinsertion. However, endoscopic reinsertion could be considered to minimize the soft tissue damage. In this study, we aimed to determine the most optimal location of four endoscopic portals that allow for a safe exploration of the proximal hamstring insertion site. The reference points for the portals run vertically through the center of the sciatic tuberosity and through a horizontal line which lies on the inferior edge of the tuberosity. The distance and relationship between the sciatic, the inferior gluteal and posterior femoral cutaneous nerves and the four proposed endoscopic portals was documented. Our results showed that it was best to start with the inferior portal followed by the medial and lateral portal. The inferior portal allowed for a clear visualization of the sciatic nerve and was along with the medial portal at a distance of &gt;5 cm from any of the surrounding nerves. Care must be taken with the lateral portal, as the distance to the surrounding nerves varied between specimens. A fourth portal could be used as a viewing portal when necessary. Our study showed that the sequence and position of the proposed endoscopic portals provide a safe approach to the proximal part of the hamstrings and the ischial tuberosity. These findings can be helpful for endoscopic procedures to the ischium and the sciatic nerve in the gluteal region.

Second Place — Resident Basic Science Award 1995: Mitochondrial Role in Hair Cell Survival after Injury

1995 ◽  
Vol 113 (5) ◽  
pp. 530-540 ◽  
Author(s):  
Gregory E. Hyde ◽  
Edwin W. Rubel
Keyword(s):  
Hair Cell ◽  
Cell Survival ◽  
Mitochondrial Biogenesis ◽  
Noise Exposure ◽  
Mitochondrial Protein ◽  
Cell Loss ◽  
Control Group ◽  
Cell Integrity ◽  
Hair Cell Loss ◽  
Inferior Edge

The role of mitochondrial biogenesis in hair cell survival after injury was evaluated by inhibiting mitochondrial protein synthesis with chloramphenicol and then studying the effects on hair cell survival after exposure to two different types of ototoxins, gentamicin and acoustic trauma. Seven- to 10-day-old chicks were treated with either a single injection of gentamicin (250 mg/kg) or noise (1500 Hz at 120 dB sound pressure level for 14 hours). A subset of the gentamicin- and noise-treated animals also received chloramphenicol (1200 mg/kg during a 24-hour period) through a subcutaneous osmotic pump. A control group received chloramphenicol alone (1200 mg/kg during a 24-hour period). All animals were sacrificed after 5 days, and their basilar papillae (cochleas) were prepared for scanning electron microscopy. Hair cell loss was quantified with stereologic techniques. Animals treated with chloramphenicol alone did not have any evidence of hair cell loss. Gentamicin-treated animals had characteristic hair cell loss beginning at the basal tip and tapering out along the inferior edge more distally. The addition of chloramphenicol to gentamicin treatment significantly increased hair cell loss by 30%, extending the area of hair cell loss into the superior hair cell region at the distal boundary of the lesion. Pure-tone noise exposure characteristically produced hair cell loss along the inferior edge and occasionally included hair cells along the most superior edge. Addition of chloramphenicol to noise exposure significantly increased hair cell loss by 80%, with extension of the lesion across the full width of the sensory epithelium and basally. These results demonstrate that mitochondrial biogenesis is involved in cellular responses to injury. They suggest that mitochondrial function may regulate the probability of survival after metabolic challenges to hair cell integrity.

Nonuniform retinal expansion during the formation of the rabbit's visual streak: Implications for the ontogeny of mammalian retinal topography

1989 ◽  
Vol 2 (3) ◽  
pp. 201-219 ◽  
Author(s):  
Stephen R. Robinson ◽  
Bogdan Dreher ◽  
Murray J. McCall
Keyword(s):  
Retinal Ganglion Cells ◽  
Ganglion Cells ◽  
Density Ratio ◽  
Retinal Ganglion ◽  
Retinal Area ◽  
Small Component ◽  
Retinal Topography ◽  
Visual Streak ◽  
Density Ratios ◽  
Inferior Edge

AbstractWe have studied the distribution of retinal ganglion cells (RGCs) which have been retrogradely labeled from massive bilateral injections of the enzyme horseradish peroxidase into the retino-recipient nuclei of foetal and postnatal albino rabbits aged from the 24th postconceptional day (24PCD) to adulthood. The number of labeled RGCs increases from about 447,000 on the 24PCD to a peak of about 525,000 on the 27PCD. From the 29PCD to birth (31/32PCD), the number of RGCs rapidly declines to about 375,000. During the next 20 d, the number of RGCs stabilizes at about 335,000. After the 51PCD, the number of RGCs gradually declines to the adult value of about 280,000. Retinal area steadily increases from about 40 mm2 on the 24PCD to about 500 mm2 in the adult, while RGC density decreases. However, the reduction in RGC density is nonuniform: RGC density in the visual streak drops from 18,600 RGCs mm2 on the 24PCD to 4700 RGCs/mm2 in the adult, whereas RGC densities at the superior and inferior edges of the retina decrease proportionally much more (from 9300 to 105 RGCs/mm2 and from 12,000 to 170 RGCs/mm2, respectively). As a result of this differential reduction in RGC density, the streak:superior edge RGC density ratio changes from 2.0:1 on the 24PCD to about 45:1 in the adult, while the streak/inferior edge ratio changes from 1.6:1 to about 28:1. In the periods from the 24PCD to the 29PCD and from the 32PCD to adulthood, the proportional increases in the streak/superior edge and streak/inferior edge RGC density ratios are linearly related to the proportional increases in retinal area. However, between the 29PCD and 32PCD, the RGC density ratios increase at a greater rate than retinal area. We conclude that (1) the centro-peripheral difference in RGC density that is already present on the 24PCD might be attributable to differential RGC generation; (2) the redistribution of RGCs between the 24PCD and adulthood is mainly due to nonuniform expansion of the retina, with minimal expansion of the visual streak and maximal expansion at the superior and inferior retinal edges; and (3) a small component of the increase in the centro-peripheral RGC density ratio, which becomes apparent between the 29PCD and 32PCD, is probably due to differential RGC loss. We discuss the pattern of retinal expansion in the rabbit and the factors which might contribute to it.

Modification of a nasal speculum for transsphenoidal surgery

2000 ◽  
Vol 92 (2) ◽  
pp. 359-360 ◽  
Author(s):  
Hiroji Miyake ◽  
Tomio Ohta
Keyword(s):  
Transsphenoidal Surgery ◽  
Sphenoid Sinus ◽  
Anterior Wall ◽  
Surgical Instruments ◽  
Content Type ◽  
Inferior Portion ◽  
Surgical Field ◽  
The Individual ◽  
Inferior Edge ◽  
Fine Print

✓ The authors modified a Hardy nasal speculum to improve the access to surgical fields and the handling of various instruments during transsphenoidal surgery. A section of the inferior edge of the speculum was cut out 2 cm from its orifice on both sides. The thickness of the tip of the speculum was also reduced. The authors are prepared to operate using a variety of speculum lengths (the distance between the tip and the cutting level), and this length is selected depending on the distance between the anterior wall of the sphenoid sinus and the surface of the gingiva in the individual patient.A modified nasal speculum was used in transsphenoidal surgery for a pituitary adenoma. With use of this device, the protrusion of the speculum above the gingiva was markedly decreased. Because most instruments are inserted into the inferior portion of the speculum orifice, this approach facilitated the handling of all surgical instruments through the modified nasal speculum. The actual surgical field became shallow and wide, and the long surgical instruments that are generally used for transsphenoidal surgery were unnecessary in most cases.

The Influence of Articular Morphology on Non-Traumatic Degenerative Changes of the Distal Radioulnar Joint. A Radiographic Study

2006 ◽  
Vol 31 (2) ◽  
pp. 221-225 ◽  
Author(s):  
N. HOLLEVOET ◽  
R. VERDONK ◽  
G. VAN MAELE
Keyword(s):  
Joint Space Narrowing ◽  
Joint Space ◽  
Distal Radioulnar Joint ◽  
Ulnar Variance ◽  
Degenerative Changes ◽  
X Rays ◽  
Radioulnar Joint ◽  
Ulnar Head ◽  
Sigmoid Notch ◽  
Inferior Edge

We examined 248 wrist X-rays of patients over 50 years of age to find out if ulnar variance, orientation of the sigmoid notch and ulnar head inclination play a role in the development of non-traumatic osteoarthritis of the distal radioulnar joint. Minor degenerative changes, viz. focal joint space narrowing and/or lipping, or small osteophytes at the inferior edge of the ulnar head, were present in 13% of the X-rays of these wrists. They were significantly more frequent in wrists with a more inclined ulnar head and significantly less present in wrists with an oblique, distally orientated sigmoid notch. There was no significant association with ulnar variance or age. This study suggests that articular morphology may play a role in the development of degenerative changes of the distal radioulnar joint.

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