Component dorsal hump reduction: the importance of maintaining dorsal aesthetic lines in rhinoplasty

Dorsal hump reduction can create both functional and aesthetic problems if performed incorrectly. Component dorsal hump reduction allows a graduated approach to the correction of the nasal dorsum by emphasizing the integrity of the upper lateral cartilages when performing dorsal reduction. Use of this approach can minimize the need for spreader grafts in primary rhinoplasty patients. Possible untoward sequelae of dorsal hump reduction include long-term dorsal irregularities caused by uneven resection or overresection or underresection of the osseocartilaginous hump irregularity; the inverted-V deformity; and excessive narrowing of the midvault. The component dorsal hump reduction technique is a five-step method: (1) separation of the upper lateral cartilages from the septum, (2) incremental reduction of the septum proper, (3) dorsal bony reduction, (4) verification by palpation, and (5) final modifications (spreader grafts, suturing techniques, osteotomies). A graduated approach is described that offers control and precision at each interval. Fundamental to the final outcome is the protection and formation of strong dorsal aesthetic lines that define the appearance of the dorsum on frontal view. Furthermore, preservation of the transverse portions of the upper lateral cartilages is essential to maintain patency of the internal nasal valve, maintain the shape of the dorsal aesthetic lines, and avoid the inverted-V deformity. Finally, if needed, spreader grafts are enormously adaptable and can be customized for any deformity (unilateral or bilateral, visible or invisible) to handle functional or aesthetic problems.     

AlloDerm for dorsal nasal irregularities

After nasal surgery, thinning of the nasal skin, bony irregularities, or adhesions of dorsal skin to underlying bone can all occur. These problems can be solved by using either alloplastic materials or various autogenous tissues. In this study, AlloDerm, a dermal replacement derived from cadaveric skin, has been used to cover the osseocartilaginous framework of the nose in an attempt to achieve a smooth contour and a natural feel in secondary rhinoplasties. Fifteen patients were treated and observed for a minimum of 24 months. Clinically palpable or visible bony irregularities were successfully covered, and adhesions of dorsal skin to nasal bones were diminished. Prolonged but not socially unacceptable dorsal nasal swelling, which resolved during the first 4 months, seemed to be the only problem related to its use. With this limited experience, AlloDerm was found to be useful in secondary nasal surgery to cover osseocartilaginous irregularities, to eliminate the adhesions between nasal bones and overlying skin, and to create a smooth nasal dorsum.     

Neurochemistry of the dorsal horn

The dorsal horn region of the spinal cord, particularly the dorsal root entry zone (DREZ), represents the first central integration center for nociceptive afferent impulses. Here, the excitatory neurotransmitters/modulators, products of the primary sensory neurons, are released, the segmental interneuronal influences pertain, and the descending bulbospinal tracts terminate. A vast variety of compounds are thus involved in the processing of nociceptive information in these areas, among which are the 'classical' neurotransmitters and the more recently described neuropeptides. A continued vast interest exists concerning the chemistry of the dorsal horn/DREZ region. The current developments and understanding regarding the pharmacology of this region are presented. Particular emphasis is given to the interactions among the various compounds, the coexistence of some of these within single neuronal populations, the importance of the opiate receptor subtypes, and the actions and localizations of some of the newly discovered neuropeptides.     

Distribution of dorsal carriage among simians

We surveyed the literature and obtained information from primate researchers and zookeepers to study the distribution of dorsal carriage among 77 simian species including New and Old World monkeys and apes in relation to arboreality and terrestriality, birth (litter) weight relative to maternal weight, and presence or absence of distinct natal coat colors. All New World monkeys are arboreal and commonly carry their infants dorsally. Conversely, arboreal Old World monkeys do not use dorsal carriage, and only some predominantly terrestrial Old World monkeys do so. Whereas lesser apes (which are highly arboreal) do not use dorsal carriage, arboreal as well as more terrestrial great apes commonly carry their infants dorsally. These findings indicate that simple arboreality or terrestriality is inadequate to explain dorsal carriage by monkeys. Infants of small- to medium-sized New World monkeys have relatively high birth weight compared with maternal weight, and are most likely to be carried dorsally than ventrally even on the first postnatal day. In contrast, infants of large-bodied New World monkeys are carried ventrally first and then dorsally up to the end of their second year, albeit increasingly infrequently. Among Old World monkeys, no association was found between mode of infant transport and birth weight relative to maternal weight, but some terrestrial Old World monkeys displaying dorsal carriage tend to do so with older infants, indicating that such behavior enables the mother to transport the infant with lower energy expenditure. Among terrestrial Old World monkeys, infants with distinctive natal coat colors are rarely carried dorsally until the natal coat color changes to adult coloration: infants with distinctive coat colors clinging to the backs of carriers could be highly visible and thus vulnerable to predation. Dorsal carriage by mothers may prolong the affiliative mother–infant relationship.     

Copper sensitivity in dorsal hippocampus slices

The action of copper on the pyramidal neurons in CA1 of the hippocampus is little understood. Our main aim was to study the possible interaction of copper on the synaptic network in CA1 pyramidal neurons. We used Wistar rats hippocampus slices in a recording chamber. The population response ("population of spikes") collected by an extracellular micropipette under baseline conditions served as control. Copper, GABA, bicuculline and picrotoxin were delivered in different experimental conditions to the slice. One, 10 and 100 microM of copper concentration decreased significantly the amplitude and duration of the population spikes in relation to the control response. This effect did not show concentration dependency. Copper in bicuculline medium decreased significantly the duration response in relation to the control response and in relation to copper effect in a free bicuculline medium. This phenomenon emphasizes the copper action on the GABA (B) and (C) receptors. Copper in a picrotoxin medium increased significantly the excitability of the response. This new effect suggests that copper acts on non-GABA receptors, an effect that could be detected when the GABA receptors were inactivated. As a result of these findings it appears that, under our experimental conditions, copper generated transient sensitivity changes in pyramidal neurons of CA1 dorsal hippocampus.     

A mathematical model for dorsal closure

During embryogenesis, drosophila embryos undergo epithelial folding and unfolding, which leads to a hole in the dorsal epidermis, transiently covered by an extraembryonic tissue called the amnioserosa. Dorsal closure (DC) consists of the migration of lateral epidermis towards the midline, covering the amnioserosa. It has been extensively studied since numerous physical mechanisms and signaling pathways present in DC are conserved in other morphogenetic events and wound healing in many other species (including vertebrates).We present here a simple mathematical model for DC that involves a reduced number of parameters directly linked to the intensity of the forces in the presence and which is applicable to a wide range of geometries of the leading edge (LE). This model is a natural generalization of the very interesting model proposed in Hutson et al. (2003). Being based on an ordinary differential equation (ODE) approach, the previous model had the advantage of being even simpler, but this restricted significantly the variety of geometries that could be considered and thus the number of modified dorsal closures that could be studied.A partial differential equation (PDE) approach, as the one developed here, allows considering much more general situations that show up in genetically or physically perturbed embryos and whose study will be essential for a proper understanding of the different components of the DC process. Even for native embryos, our model has the advantage of being applicable since an early stages of DC when there is no antero-posterior symmetry (approximately verified only in the late phases of DC).We validate our model in a native setting and also test it further in embryos where the zipping force is perturbed through the expression of spastin (a microtubule severing protein). We obtain variations of the force coefficients that are consistent with what was previously described for this setting.     

电刺激右后背海马诱导双侧前背海马网络癫痫

目的 :急性强直电刺激右侧后背HPC诱导双侧HPC癫痫电网络形成的细胞机制。方法 :强直电刺激 (6 0Hz,2s,0 .4～ 0 .6mA)大鼠右后背HPCCA1基树突区 ,每隔 10min刺激一次 ,施加 10个刺激串。结果 :①分别抑制双侧CA1神经元单位放电频率 ,对侧的抑制效应更明显 (对侧 :6 2 .94 %± 3.6 8% ;同侧 :36 .6 1%± 3.14 % ,P <0 .0 1) ,出现抑制后爆发式放电。随着刺激串数的增加 ,抑制作用逐渐减弱。②同步原发性网络和单位后放电 ,以同侧CA1多见 (P<0 .0 1)。③ 90Hz或 12 0Hz原发性或继发性网络后放电仅仅累及同侧CA1。④对侧CA3基树突区网络与下托神经元单位放电出现同步继发性后放电 ,反复发作 ,持续约数小时。结论 :电刺激诱导的对侧HPC抑制后爆发式放电和长时程、反复发作的网络与单个神经元同步继发性后放电可能是跨半球癫痫网络形成的重要表现形式。