Reconstruction using a three-dimensional orbitozygomatic skeletal model of titanium mesh plate and soft-tissue free flap transfer following total maxillectomy

The surgical strategy for maxillary reconstruction after maxillectomy has yet to be standardized. The authors developed a technique using a three-dimensional orbitozygomatic skeletal model of a titanium mesh for skeletal reconstruction after maxillectomy. From May of 1996 to September of 2000, 18 patients underwent reconstruction using the titanium mesh model in conjunction with a soft-tissue free flap following total maxillectomy for a maxillary malignancy. The soft-tissue free flap was conventional and consisted of two skin paddles to the maxillary defect. One skin paddle became the lateral nasal wall and the other was used to close the palatal defect. After modeling, the titanium mesh plate was implanted between the orbital contents and the upper edge of the free flap to lie over the front of the flap. The model was fixed to the residual zygoma laterally and to the nasal or frontal bone medially. The palatal skin paddle was anchored by three or four dermal stitches to the bottom edge of the titanium mesh to create a concave neopalate that allowed the patient to wear a denture. Thirteen of 18 patients who underwent implantation had good facial appearance and oral function. This procedure prevented lagophthalmos, facial deformity, and sagging of the palatal skin paddle caused by gravitational force. Five patients (27.8 percent) developed exposure or infection of the implant and lost the benefit of having the prosthesis. However, treatment did not require total removal of the implant. Maintaining adequate tissue volume during soft-tissue transfer on either side of the mesh plate may minimize the complication rate. Titanium mesh implantation for skeletal reconstruction after maxillectomy avoids the need for bone grafting and may be especially beneficial in fragile or aged patients.     

Radiographic analysis of the midface of a stillborn infant with a unilateral cleft lip and palate

The midface of a full-term stillborn infant with a right complete unilateral cleft lip and palate was studied with plain-film radiography and tomography, xeroradiography, and computerized axial tomography. Gross skeletal and soft-tissue deficiencies on the cleft side were evident as compared to the noncleft side and involved the entire bony maxillary complex and antrum, the orbit, and the nasal pyramid and intranasal structures. The area on the cleft side was 19 percent less than the noncleft side, and the maximal anteroposterior dimension was 16 percent less. The cleft bony palatal shelf was 12.5 mm wide compared to 20 mm on the noncleft side. The findings demonstrate the deficient and abnormal functional matrix inherent in the cleft condition.     

Health risk assessment in children living in an urban area with hydrofluorosis: San Luis Potosí Mexico case study

BackgroundFluoride is an inorganic element, which can be found in high concentrations in groundwater. Its consumption and exposure have consequences on human health. The objective of this study was to evaluate fluoride exposure and develop a health risk assessment in children from an urban area with hydrofluorosis in Mexico.MethodsWater fluoride levels in active wells were provided by the Water State Agency and divided into three zones: agriculture zone (Zone A), metallurgical zone (Zone B), and industrial zone (Zone C). Urinary fluoride levels were determined by potentiometric method using an ion-selective electrode. Health risk assessment was performed through Monte Carlo model analysis and hazard quotient was calculated.ResultsAccording to fluoride well concentration, all zones have high concentration especially Zone B (2.55 ± 0.98 mg/L). Urinary fluoride concentrations were highest in children in Zone B (1.42 ± 0.8 mg/L). The estimated median daily intake dose of fluoride was 0.084 mg/Kg-day for the children living in zone B. The highest mean HQ value was to Zone B (1.400 ± 0.980), followed by Zone C (0.626 ± 0.443).ConclusionThe levels of fluoride exposure registered are a potential risk to generate adverse health effects in children in the San Luis Potosi metropolitan area.     

The soft triangle revisited

Five cadaveric adult human noses were examined to further elucidate the region of the soft triangle of the nose. Three distinct zones were found. Zone 1, just caudad to the lower lateral cartilages, consists of the fibers of the dilator nares anterior as it inserts into the dermis. Zone 2 is the dermal layer. Zone 3 is at the nostril rim and consists of muscle fibers interdigitating within the dermis; laterally, these fibers are continuations of the nasalis muscle, whereas medially they are extensions of the depressor septii muscle. Perpendicular incisions through any of these zones may cause notching and tip deformity. Incisions in zone 1 may, in addition, alter external nasal valve function by interrupting the fibers of the dilator naris anterior.     

Predicting nose projection and pronasale position in facial approximation: a test of published methods and proposal of new guidelines

Many prediction guidelines exist in facial approximation for determining the soft-tissue features of the face, and the reliability of each is generally unknown. This study examines four published and commonly used soft-tissue prediction guidelines for estimating nose projection, two of which also estimate the position of the pronasale. The methods tested are those described by: 1) Gerasimov ([1971] The Face Finder; London: Hutchinson & Co.), using the distal third of the nasal bones and the nasal spine; 2) Krogman ([1962] The Human Skeleton in Forensic Medicine; Springfield: Charles C. Thomas), using the average soft-tissue depth at midphiltrum, plus three times the length of the nasal spine (and a variation of this technique: plus three times the distance of the tip of the nasal spine from the nasal aperture); 3) Prokopec and Ubelaker ([2002] Forensic Sci Commun 4:1-4), using the reflected profile line of the nasal aperture; and 4) George ([1987] J Forensic Sci 32:1305-1330), using a variation of the Goode method. Four identical hard-tissue tracings were made of 59 adult lateral head cephlograms (29 males, mean age 24, SD 10 years; 30 females, mean age 23, SD 5 years) on separate sheets of tracing paper. One soft-tissue tracing was also made for each radiograph. All tracings were marked with three identical reference points. Soft-tissue tracings were isolated from one of us (C.N.S.), who attempted under blind conditions to predict pronasale position and nose projection on the hard-tissue tracings, using the soft-tissue prediction guides above. Actual soft-tissue tracings were then compared to each of the predicted tracings, and differences in projection/pronasale position were measured. Results indicate that for nose projection, methods 3 and 4 performed well, while methods 1 and 2 performed poorly. Features which are most related to nose projection/pronasale are described in this paper, as are regression equations generated from these variables that predict pronasale/nose projection better than the traditional methods mentioned above. The results of this study are significant because they: 1) indicate that the popular facial approximation methods used to build the nose are inaccurate and produce incorrect nose anatomy; and 2) indicate that the new pronasale prediction methods developed here appear to have less error than traditional methods.     

Facial skeletal expansion: treatment strategies and rationale.

Forty-three nonconsecutive patients presenting with dentofacial deformity underwent surgical procedures designed intentionally to create skeletal disproportion in the sagittal and/or vertical dimensions. This was accomplished through expansion (enlargement) of the facial skeleton beyond normative standards. At the time of follow-up, which ranged from 14 to 36 months (mean 18.4 months), soft-tissue cephalometric analyses documented facial disproportion to exist in 37 of the 43 patients treated. Thirty-two patients had excessive anterior divergence (facial protrusion) at pogonion, and 17 patients had excessive lower face height as measured from subnasale to menton. All patients were judged to have had a favorable aesthetic outcome. This philosophy of facial skeletal expansion is predicated on two concepts: The first of these is that facial proportions and dimensions beyond those which are considered normal may be extremely attractive in a given individual. Second, the soft-tissue response to skeletal expansion is more favorable and predictable than it is to skeletal contraction in providing for well-supported soft tissues. This treatment planning approach is based on the dynamic interrelationship between the skeletal foundation and the soft-tissue facial mask. It relies on physical examination as the major determinant of aesthetic surgical options.     

Microbial encrustations from the Middle Oxfordian-earliest Kimmeridgian lithofacies in the Prebetic Zone (Betic Cordillera, southern Spain): characterization, distribution and controlling factors

Two main types of microbial encrustation were identified in Middle Oxfordian to lowermost Kimmeridgian deposits in the Prebetic Zone (southern Spain), showing existing relationships between skeletal content, fabric and morphology of these organosedimentary structures. Laminated planar and concentric encrustations relate to peloidal fabrics (mainly constituted of microbes = microbial laminated fabrics s. str. and microbial oncoids s. str.), as well as to dense microbial fabrics periodically colonized by encrusting foraminifera (microbial laminated fabrics with nubeculariids and microbial oncoids with nubeculariids). Sedimentation rates, substrate stability and grain size, as well as illumination, influenced microbial growth pattern as major controlling factors in low-energy conditions, and forced palaeogeographic and stratigraphic patterns of distribution. Significant encrustation was identified in terrigenous-poor lithofacies from the middle (Transversarium-Bifurcatus zones) to the outer (Transversarium-Bimammatum zones) shelf in the Prebetic Zone. Rare-to-absent encrustation characterized terrigenous-rich deposits (Bimammatum and Planula zones) in the area.     

Study of changes in life zone distribution in north-east China by climate–vegetation classification

Life zones and their changes in distribution in north-east China were studied based on climate–vegetation relationships. The warmth index (WI) and aridity index (the ratio of evaporation [evaporation rate, ER] to precipitation) were used to represent the site condition. The typical site condition of each vegetation type was determined as the classification criterion. The boundaries of the four potential vegetation zones were estimated based on the combinations of WI and ER in relation to vegetation (i.e. cold-temperate conifer forest zone, temperate broad-leaved conifer mixed forest zone, warm-temperate deciduous forest zone, and temperate steppe zone). The distribution changes in vegetation zone caused by human activities were estimated by comparing the potential vegetation with the actual one. The percentage cover of forest has shrunk from about 70% to the present 27%. About 23% of the study area was replaced by agricultural vegetation and industrial use. Nearly half of the region could have been covered by broad-leaved conifer mixed forest which was shrunk to a small area, less than 5% of the region. The broad-leaved deciduous forest zone in the southern part could have occupied about 7% of the area, and had almost no virgin stand.     

Brush-tailed possum (Trichosurus vulpecula) movements about an erosion-control planting of poplars

Abstract

Live-trapping and radio-tracking were used to monitor the movements of brush-tailed possums in and around an erosion-control planting of poplars. Possums' use of the planted area was monitored by traffic counters and by marking (with Rhodamine B dye) possums which climbed the poplars. The extent of browse damage to the poplars was also recorded. Over a period of 20 months, 358 individuals were trapped, marked, and released, and 50 were fitted with radio transmitter collars. The study area was mapped into nine 100-m-wide annular zones radiating out from the focus, Zone 0, which contained the poplars. Seventy percent of possums assigned to Zone 1 were caught in Zone 0, but only 24%, 5%, and 0% assigned to Zones 2, 3, and 4–8 respectively were caught in Zone 0. Trapping and radio-tracking revealed no increase in the use of the planted area during the spring flush although the poplars were being damaged. Traces of Rhodamine B dye on the possums showed that 87% of animals caught in Zone 0 had visited the poplars, but only 45%, 10%, and 0% of possums caught in Zones 1, 2, and 3–8 respectively. Possums in this area were sedentary and damage to the poplars during spring was attributed to local animals only. Protection of the poplars by fitting expandable plastic sleeves was found to be more cost-effective than aerial poisoning of the surrounding possum population.     

Dynamics of rhinoplasty

Nasal dynamics were studied on 87 patients undergoing rhinoplasty of one zone or two distant nasal zones. Statistical analysis of the result revealed that reduction of the nasion area, besides setting the soft tissue back, gave the appearance of increased intercanthal distance and lengthened the nose. Reduction of the nasal bridge resulted in a wider appearance on front view and a cephalically rotated tip on profile. Augmentation of the bridge affected the nose reversely. Tip cephalad rotation was achieved by resecting one of the three areas: the cephalad portion of the lower lateral cartilages (affecting the rims more), the caudal septum (affecting the central portion more), and the caudal portion of the medial crura of the lower lateral cartilages (affecting the central portion only). Resection of the alar base not only narrowed the nostrils but also moved the alar rim caudally. Furthermore, it reduced tip projection when a large alar base reduction was done. Reduction of the nasal spine increased the upper lip length on profile and reduced tip projection when a large reduction took place. Significant reduction in caudal nose projection resulted in widening of the alar base.     

不同气候区生态系统服务权衡空间异质性及其驱动因素——以川滇-黄土高原生态屏障带为例

厘清生态系统服务权衡关系的驱动因素对实现生态系统高效管理至关重要。然而,在不同气候区生态系统服务权衡关系在空间上如何变化及其驱动机制是否一致,尚不清楚。以川滇-黄土高原生态屏障带为例,基于InVEST模型、CASA模型评估生态系统服务空间分布特征,采用RMSE量化生态系统服务权衡关系,利用地理探测器探究不同气候区生态系统服务权衡的驱动机制,以期为生态系统管理提供参考依据。结果如下：(1)不同生态系统服务在不同气候区存在明显差异,WY整体由东北向西南呈递减趋势,NPP和SC呈现由北向南递减的趋势。(2)WY∩NPP的权衡最高值在中温带为0.317,最低值在高原气候区为0.181。WY∩SC在不同气候区RMSE变化幅度较小,由南向北呈现递减趋势;中亚热带气候区WY∩SC的权衡程度最高,为0.295,南温带的权衡程度最低,为0.229。NPP∩SC的RMSE差值最小,仅有0.064,高原气候区权衡程度略低于温带和亚热带。(3)在不同气候区自然因素对权衡关系作用显著高于社会因素,但在人口密集区,人为活动可以部分突破自然因素的约束,使其对权衡的影响有所提升。因此,在制定不同气候区生态系统服务管理...     

Fractionation of nuclei from brain by zonal centrifugation and a study of the ribonucleic acid polymerase activity in the various classes of nuclei

1. The nuclei of the cells of the whole rat brain have been fractionated in a B-XIV zonal rotor with a discontinuous gradient of sucrose. Five fractions were obtained. Zone (I) contained neuronal nuclei (70%) and astrocytic nuclei (23%). Zone (II) contained astrocytic nuclei (81%) and neuronal nuclei (15%). Zone (III) contained astrocytic nuclei (84%) and oligodendrocytic nuclei (15%). Zone (IV) contained oligodendrocytic nuclei (92%) and zone (V) contained only oligodendrocytic nuclei. 2. The content of DNA, RNA and protein per nucleus was determined for each zone. Although the amount of DNA per nucleus is constant (7pg) the RNA varies from 4.5 to 2.5pg/nucleus and the protein from 38 to 17.6pg/nucleus. The neuronal nuclei have the greatest amounts of protein. The oligodendrocytic nuclei have the least content of RNA and protein. 3. The effects of pH, ionic strength, and Mg(2+) and Mn(2+) concentration on the activity of the nuclear system for synthesis in vitro of RNA have been investigated for unfractionated nuclei. From these studies a standard set of conditions for the assay of nuclear RNA polymerase has been established. 4. The activity of the RNA polymerase in each of the zonal fractions has been determined in the presence and in the absence of alpha-amanitin. Zone (II) is the most active, followed by zone (I). The nuclei of zones (IV) and (V) have comparable activity, which is 40% of that of zone (II). 5. The extent of incorporation of each of the four labelled nucleoside triphosphates by the nuclei from each zone has been measured. These values have been used to calculate the base composition of the RNA synthesized in vitro in each class of nucleus. 6. The effect of changes in the condition of assay of RNA polymerase in the different classes of nuclei has been investigated. Significant differences in the response to concentrations of metal ions and ammonium sulphate have been observed. 7. Homopolymer formation in each zone of brain nuclei has been determined. The extent of formation of the four homopolymers roughly parallels the RNA polymerase activity.     

Dynamics in rhinoplasty

Nasal dynamics were studied on 87 patients undergoing rhinoplasty of one zone or two distant nasal zones. Statistical analysis of the results revealed that reduction of the nasion area, besides setting the soft tissue back, gave the appearance of increased intercanthal distance and lengthened the nose. Reduction of the nasal bridge resulted in a wider appearance on frontal view and a cephalically rotated tip on profile. Augmentation of the bridge affected the nose reversely. Tip cephalad rotation was achieved by resecting one of the three areas: the cephalad portion of the lower lateral cartilages (affecting the rims more), the caudal septum (affecting the central portion more), and the caudal portion of the medial crura of the lower lateral cartilages (affecting the central portion only). Resection of the alar base not only narrowed the nostrils but also moved the alar rim caudally. Furthermore, it reduced tip projection when a large alar base reduction was done. Reduction of the nasal spine increased the upper lip length on profile and reduced tip projection when a large reduction took place. Significant reduction in caudal nose projection resulted in widening of the alar base.     

Spatiotemporal distribution of growth releases and suppressions along a landslide body

Our study analyzes the growth response (release or suppression) of Norway spruce trees growing along a landslide zone in eastern Czech Republic. A total of one hundred and eighty-six increment cores were extracted from Norway spruce (Picea abies (L.) Karst.) individuals, which were affected by two different disturbances, the Girová landslide in May 2010 and an anthropogenic cut-off in the neighborhood of the landslide later the same year. Growth changes were analysed in three zones that were defined according to the type of effect the disturbance had on the surrounding vegetation. The aims of our study are to (i) detect growth changes in trees that survived the disturbances in 2010, (ii) evaluate the delay time of the growth reaction to the disturbances, (iii) compare how growth changes differed in response to the two different disturbance types (natural landslide vs. anthropogenic harvesting and deforestation), and (iv) investigate spatio-temporal differences in the growth changes. Our results indicate that tree growth changed in response to the altered environmental conditions following the 2010 disturbances. The changes vary depending on the intensity of the disturbance and its effect on the forest stand. Trees in Zone 1 responded with a slight growth release (14.6 % of responding trees), which was strongest after 2013. However, growth suppression (85.4 %) was the dominant reaction in Zone 1; with the majority of trees showing growth suppression in 2014, four years after the events. The strongest and most abrupt growth release (66.1 %) occurred in Zone 2 in 2011, after a one-year delay. Since 2010, we have observed a trend of growth suppression (33.9 %) in this zone. In Zone 3, following a one-year delay, growth release has occurred gradually in about a third of the trees (37.0 %). The majority of trees in this zone have responded with growth suppression (63.0 %) in 2010 and with a three-year delay after 2013. We also found differences in how tree growth responds to anthropogenic and landslide disturbances, as well as spatio-temporal differences related to the extent of post-disturbance changes.     

The response of macroinvertebrates to experimental episodes of low pH with different forms of aluminium,during a natural spate

24 h experimental episodes were created in a soft-water stream in upland Wales, by the simultaneous addition at separate points of sulphuric acid, aluminium sulphate and citric acid. In an upstream reference zone (A) the pH remained above 7, while in the treatment zones, B, C and D successively downstream, it was reduced to c. pH 4.9. Concentrations of filterable aluminium were 0.05 mg l^-1 in Zone B, 0.27 mg l^-1 (0.11 mg l^-1 ‘labile’) in Zone C, and 0.23 mg l^-1 (0.00 mg l^-1 ‘labile’) in Zone D. Chemical manipulation coincided with a spate, during which flow increased from 0.02 m³s ^-1 to a maximum of 0.07 m³s^-1. Only the ephemeropteran B. rhodani showed a drift response: drift density was not affected by flow (Zone A) or by organically bound aluminium (Zone D), but increased approximately 6-fold in both the acid (B) and ‘labile’ aluminium (C) zones; its benthic density declined significantly in Zones C and D, by 78% and 89% respectively. We relate these results to the biological importance of aluminium chemistry during natural acidic episodes.     

A comparative study on the thermal decomposition of four cereal straws in an oxidizing atmosphere

The thermal decomposition characteristics of four types (wheat, barley, oats and rye) of cereal straws were studied. Two varieties from each type of straw were used. The thermal degradation behaviours and kinetic parameters (order of reaction, activation energy and preexponential factor) of the straws were compared. Two distinct reaction zones were observed for all types and varieties of straws. Thermal degradation rates in the first reaction zone were significantly higher than those in the second reaction zone. The activation energy was in the ranges of 80–102 kJ/mol and 34–75 kJ/mol, whereas the order of reaction was in the ranges of 1·3–2·3 and 0·1–0·7 for the first and second reaction zones, respectively. The Shaw variety of oats straw had the highest activation energies (102 and 75 kJ/mol) and reaction orders (2·3 and 0·7) in both the first and second reaction zones, respectively. The lowest activation energy (80 kJ/mol) and order of reaction (1·3), in the first reaction zone, corresponded to Absolvant and Monopol wheat straws. The activation energies and reaction orders of barley and rye straws were in the ranges of 85–94 kJ/mol and 1·9–2·3, respectively. There was not any significant difference between the rate constants of the straw varieties, in the first reaction zone. However, oats straws had significantly higher rate constants in the second reaction zone as compared to the rate constants of wheat, barley and rye straws.     

Long-term outcome of autogenous rib graft nasal reconstruction.

Whereas reconstruction of the hypoplastic nose with rib grafting is common, the long-term outcomes of nasal growth and aesthetics are unknown. This study assessed nasal morphometrics, patient satisfaction, and the perception of nasal appearance by others up to 15 years after nasal reconstruction using cantilevered autogenous chondro-osseous rib grafting with rigid internal fixation in children. Records of all patients who received nasal rib grafts between 1983 and 1998 by one senior surgeon were reviewed. Patients in this study were operated on before their late teens and had greater than 1-year follow-up including serial photographic documentation. Nasal growth was determined by comparing anthropometric measurements preoperatively, perioperatively, and postoperatively. Patient satisfaction was determined through a questionnaire that addressed memory, donor-site morbidity, and nasal perception. Independent, blinded skilled observers who reviewed frontal and lateral photographs of the preoperative, perioperative, and postoperative intervals assessed nasal aesthetics. Thirty-two patients who underwent 38 rib graft reconstructions of the nasal dorsum and tip at an average age of 8.8 years constitute the study population. Six patients underwent secondary augmentation. The average interval between initial nasal reconstruction and evaluation for this study was 7.9 years. Comparative anthropometric measurements before and after surgery documented increases in both tip projection (2.3 percent) and nasal length (3.0 percent) and a decrease in nasolabial angle (1.9 percent). Patient satisfaction interview response rate was 100 percent of those whom we were able to contact (28 of 32). The average age at interview was 17.2 years. Most patients recalled the operation and denied recollection of pain. Donor-site long-term morbidity was not an issue for 86 percent of patients. Sixty-four percent of patients remembered their preoperative nasal appearance and 89 percent of these preferred the postoperative change and were not concerned with nasal scars or texture. Almost two-thirds of the patients had fixation screws removed from the nasal dorsum because of skin erosion, easy palpability, or visibility. Although several patients expressed a desire to make minor additional changes to their nose, only one of these elected offered presurgical consultation and none have had such surgery. The postoperative nasal appearance compared with that preoperatively was rated as improved for 66.3 percent of responses, 26.5 percent as unchanged, and 7.2 percent as deteriorated. Cantilevered autogenous chondro-osseous rib graft reconstruction of the nasal dorsum is an effective means of reconstruction for the hypoplastic nose in childhood with respect to morphometric measurements, patient self-perception, and the assessment of nasal appearance by others.     

The pepsins of normal human gastric juice

1. The frequency of occurrence, under defined conditions, of the different human pepsins in the gastric juices of 50 normal subjects was investigated by agar-gel electrophoresis. 2. From a total of eight proteolytic zones located in the zymograms, no significant differences of occurrence existed between the sexes, or between subjects with or without gastric symptoms. 3. Two zones, numbered 3 and 5, occurred in all normal gastric juices. Zone 3 always exhibited the greatest proteolytic activity, then zone 5. The remaining enzymic zones were less well-marked and occurred less frequently. 4. A minor zone, 3a, was demonstrated within zone 3. The corresponding pepsin, 3a, has a mobility towards the anode 6-7% greater than has pepsin 3. 5. Of the eight zones, 1,2,3,3a and 5, at least, represent unique pepsins.