An alternate strategy for reducing the large nasal base

The position of the dorsum directly influences the apparent size of the nasal base: the higher the bridge, the smaller the nasal base seems. This powerful optical illusion provides the surgeon with an alternate strategy for creating harmony in the nose with a low, straight dorsum and a disproportionately large nasal base. Instead of reducing the lower nose, the surgeon can augment the upper nose (and make whatever nasal base changes are independently necessary). This alternate strategy limits the amount of nasal skeletal reduction necessary, thereby limiting the potential for postoperative change and soft-tissue distortion and directly increasing the surgeon's control over the result.     

Effect of Phosphate on the Corrosion of Carbon Steel and on the Composition of Corrosion Products in Two-Stage Continuous Cultures of Desulfovibrio desulfuricans

A field isolate of Desulfovibrio desulfuricans was grown in defined medium in a two-stage continuous culture apparatus with different concentrations of phosphate in the feed medium. The first state (V1) was operated as a conventional chemostat (D = 0.045 h⁻¹) that was limited in energy source (lactate) or phosphate. The second stage (V2) received effluent from V1 but no additional nutrients, and contained a healthy population of transiently starved or resting cells. An increase in the concentration of phosphate in the medium fed to V1 resulted in increased corrosion rates of carbon steel in both V1 and V2. Despite the more rapid corrosion observed in growing cultures relative to that in resting cultures, corrosion products that were isolated under strictly anaerobic conditions from the two culture modes had similar bulk compositions which varied with the phosphate content of the medium. Crystalline mackinawite (Fe₉S₈), vivianite [Fe₃(PO₄)₂ · 8H₂O], and goethite [FeO(OH)] were detected in amounts which varied with the culture conditions. Chemical analyses indicated that the S in the corrosion product was almost exclusively in the form of sulfides, while the P was present both as phosphate and as unidentified components, possibly reduced P species. Some differential localization of S and P was observed in intact corrosion products. Cells from lactate-limited, but not from phosphate-limited, cultures contained intracellular granules that were enriched in P and Fe. The results are discussed in terms of several proposed mechanisms of microbiologically influenced corrosion.     

Brachial Neuralgia and the Carpal Tunnel Syndrome

The carpal tunnel syndrome can cause severe pain and disability, both of which are avoidable if the condition is diagnosed and treated early in its course. Two sets of circumstances—delay in the correct diagnosis and recurrence of symptoms after an apparently successful operation—may give rise to problems in these aspects of management and delay recovery.