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Operative Orthopadie Und Traumatologie Dec 2020Regional flap for the reconstruction of combined skin and soft-tissue defects of the fingers or the distal parts of the palm. (Review)
Review
OBJECTIVE
Regional flap for the reconstruction of combined skin and soft-tissue defects of the fingers or the distal parts of the palm.
INDICATIONS
Full-thickness soft-tissue defects of the fingers dorsally up to the distal interphalangeal joint, of the fingers palmarly up to the middle phalanx, or of the distal parts of the palm.
CONTRAINDICATIONS
Damage of the dorsal metacarpal artery or of the distal anastomosis by trauma or previous operation. Ongoing infections.
SURGICAL TECHNIQUE
Preoperative Doppler examination. Planning of a flap using the proximal or distal anastomosis of the metacarpal artery with the palmar system as its pivot point. Raising of an adipofascial flap including as many veins as possible. Alternatively, the metacarpal artery can be raised alone as a fascial flap. Tension-free insertion of the flap into the defect. To avoid venous congestion, we do not recommend subcutaneous tunneling of the flap. The skin bridge should be incised instead.
POSTOPERATIVE MANAGEMENT
Loose cotton dressing, periodic monitoring, bed rest for 5 days. After 3 days active and passive physiotherapy can start. Suture removal after 14 days.
RESULTS
Reliable and relatively secure flap with a flap loss rate up to 20% in literature. The donor site can be closed primarily up to a flap width of 2 cm. The fourth metacarpal artery is missing in up to 30% of the cases.
Topics: Arteries; Finger Injuries; Humans; Metacarpal Bones; Plastic Surgery Procedures; Soft Tissue Injuries; Surgical Flaps; Treatment Outcome
PubMed: 33201292
DOI: 10.1007/s00064-020-00685-5 -
Journal of Veterinary Internal Medicine Jul 2021The Chihuahua dog breed is known for frequent occurrence of a bregmatic fontanelle on the dorsal skull. A common conception is that this skull defect is a clinically...
BACKGROUND
The Chihuahua dog breed is known for frequent occurrence of a bregmatic fontanelle on the dorsal skull. A common conception is that this skull defect is a clinically irrelevant finding. No studies, however, describe its prevalence or whether it is accompanied by other persistent fontanelles (PFs). Although Chihuahuas are predisposed to Chiari-like malformation (CM) and syringomyelia (SM), it is unknown whether PFs occur more commonly in dogs with clinical signs that are caused by CM or SM.
HYPOTHESIS/OBJECTIVES
To describe the number and location of PFs at cranial sutures (CSs) and to compare the occurrence of these PFs in dogs with and without CM/SM-related clinical signs. We hypothesized that PFs also occur commonly at lateral and caudal cranial surfaces, affect a higher number of CSs, and are larger in dogs with CM/SM-related clinical signs.
ANIMALS
Fifty client-owned Chihuahuas with or without CM/SM-related clinical signs.
RESULTS
Of the 50 dogs evaluated, 46 (92%) had either 1 or several PFs. The mean ± SD number of PFs was 2.8 ± 3.0 (range, 0-13). A total of 138 PFs occupied 118 CSs with 57 (48%) located dorsally, 44 (37%) caudally, and 17 (14%) laterally. The number of CSs affected by PFs was significantly higher (P ≤ .001) and total PF area was significantly larger (P = .003) in dogs with CM/SM-related clinical signs.
CONCLUSIONS AND CLINICAL IMPORTANCE
Persistent fontanelles are very common in this group of Chihuahuas and appear at dorsal, lateral, and caudal cranial surfaces. They are more numerous and larger in Chihuahuas with CM/SM-related clinical signs.
Topics: Animals; Arnold-Chiari Malformation; Dog Diseases; Dogs; Magnetic Resonance Imaging; Skull; Syringomyelia
PubMed: 34028887
DOI: 10.1111/jvim.16151 -
Ticks and Tick-borne Diseases Jan 2021Females, nymphs, and larvae of Ixodes silvanus n. sp. collected from birds and from the vegetation in northwestern Argentina (Yungas Phytogeographic Province) are...
Females, nymphs, and larvae of Ixodes silvanus n. sp. collected from birds and from the vegetation in northwestern Argentina (Yungas Phytogeographic Province) are described herein. The new species belongs to the subgenus Trichotoixodes (Acari: Ixodidae). The female is diagnosed by a combination of the following characters: scutum with setae moderately long and more numerous in central field, fewer and moderately long setae on lateral fields, and inconspicuous setae in anterior field; basis capituli subtriangular dorsally; porose areas large and irregular in shape, lacking distinct margins; auriculae with straight edges diverging posterolaterally and ending with small blunt processes; hypostome narrow and pointed with dental formula 4/4 in the anterior third, then 3/3 and 2/2 near the base; coxae I with two spurs, sub-equal in size, internal slightly slimmer than external. The nymph is diagnosed by notum with numerous and long setae, ventral surface covered by numerous whitish setae, scutum with short scapulae and few and shallow punctations, setae on scutum few, short and irregularly distributed, basis capituli sub-triangular dorsally with posterior margin straight, cornua large and directed postero-laterally, auriculae large and projected laterally, lateral margin of basis capituli above auriculae with a lateral and triangular projection, hypostome pointed with dental formula 3/3 in the anterior third and then 2/2, and coxa I with two short, sub-equal, triangular spurs. The diagnostic characters of the larva are: basis capituli dorsally sub-triangular with lateral angles acute and posterior margin straight, auriculae as large triangular lateral projections, hypostome with apex bluntly pointed and dental formula 3/3 in the anterior third and then 2/2, coxa I with two short, sub-equal, triangular spurs, and pattern of dorsal and ventral body setae. This new species is phylogenetically related to Ixodes brunneus, Ixodes turdus and Ixodes frontalis, and the principal hosts for all its parasitic stages are birds.
Topics: Animals; Argentina; DNA, Ribosomal Spacer; Electron Transport Complex IV; Female; Ixodes; Larva; Microscopy; Microscopy, Electron, Scanning; Nymph; Phylogeny; RNA, Ribosomal, 16S
PubMed: 33068841
DOI: 10.1016/j.ttbdis.2020.101572 -
HNO Aug 2020Until the 1990s, radical sinus surgery was considered a standard procedure for maxillary sinus diseases, but it is no longer favored due to the high morbidity. Today,... (Review)
Review
Until the 1990s, radical sinus surgery was considered a standard procedure for maxillary sinus diseases, but it is no longer favored due to the high morbidity. Today, functional endoscopic sinus surgery (FESS) is considered the gold standard in sinus surgery. Modifications of surgical approaches also allow access to regions of the maxillary sinus that were previously difficult to reach. Depending on anatomy and pathology, different methods for widening the maxillary ostium can be selected. In type I sinusotomy, the natural ostium is widened dorsally by a maximum of 1 cm. Sinusotomy type II involves widening the natural ostium up to a maximum diameter of 2 cm. In sinusotomy type III, the natural ostium is widened dorsally to the posterior wall of the maxillary sinus and caudally to the base of the inferior turbinate. Beside the prelacrimal approach, more invasive approaches are the medial maxillectomy, in which the dorsal part of the inferior turbinate and the adjacent medial wall of the maxillary sinus is resected, as well as its modifications "mega antrostomy" and "extended maxillary antrostomy." Correct selection of the size of the maxillary sinus window is prerequisite for successful treatment and long-term postoperative success. Isolated purulent maxillary sinusitis can usually be treated by a type I sinusotomy. Sinusotomy type II addresses nasal polyps with involvement of the mucosa of the ostium, recurrent stenosis after previous surgery, chronic maxillary sinusitis due to cystic fibrosis, and purulent maxillary sinusitis with involvement of other adjacent sinuses. Sinusotomy type III is required for choanal polyps with attachment to the floor of the maxillary sinus, for extensive polyposis and fungal sinusitis, and for inverted papilloma. Particularly for (recurrent) disease and extensive interventions in the maxillary sinus, medial maxillectomy or a modification thereof may be required.
Topics: Endoscopy; Humans; Maxillary Sinus; Maxillary Sinusitis; Nasal Polyps; Paranasal Sinus Diseases; Sinusitis
PubMed: 32405682
DOI: 10.1007/s00106-020-00870-9 -
Journal of Wrist Surgery Sep 2018This study aims to evaluate the long-term complications, results, and patient satisfaction rates of a dorsally approached ulnar shortening osteotomy for ulnar...
This study aims to evaluate the long-term complications, results, and patient satisfaction rates of a dorsally approached ulnar shortening osteotomy for ulnar impaction syndrome. A retrospective chart review of 20 patients was performed. Primary outcomes of interest were subjective, measured using the Patient-Rated Wrist Evaluation (PRWE) score, Disability of the Arm, Shoulder, and Hand (DASH) score, and the third questionnaire about patient satisfaction, composed by the authors. Secondary outcomes included hardware removal due to irritation and other complications. Mean postoperative functional score of PRWE was 28 (standard deviation [SD], 30) and DASH 20 (SD, 26), respectively. Fifteen patients were satisfied with the operation. Removal of hardware was noted in six patients. In one patient plate breakage occurred. Similar postoperative functional scores and complications were seen in patients undergoing an ulnar shortening osteotomy with a dorsally placed plate for ulnar impaction syndrome, compared with other plate placement localizations. The incidence of plate removal is also comparable to previously described results. As the dorsally placed plate and freehand technique, are relatively easy, we feel that it has a place in the treatment of ulnar impaction syndrome. Level IV, retrospective cohort study.
PubMed: 30302301
DOI: 10.1055/s-0037-1608636 -
Journal of Children's Orthopaedics Jun 2020Forearm and distal radius fractures are among the most common fractures in children. Many fractures are definitively treated with closed reduction and casting, however,... (Review)
Review
PURPOSE
Forearm and distal radius fractures are among the most common fractures in children. Many fractures are definitively treated with closed reduction and casting, however, the risk for re-displacement is high (7% to 39%). Proper cast application and the three-point moulding technique are modifiable factors that improve the ability of a cast to maintain the fracture reduction. Many providers univalve the cast to accommodate swelling. This study describes how the location of the univalve cut impacts the pressure at three-point mould sites for a typical dorsally displaced distal radius fracture.
METHODS
We placed nine force-sensing resistors on an arm model to collect pressure data at the three-point mould sites. Sensory inputs were sampled at 15 Hz. Cast padding and a three-point moulded short arm fibreglass cast was applied. The cast was then univalved on the dorsal, volar, radial or ulnar aspect. Pressure recordings were obtained throughout the procedure.
RESULTS
A total of 24 casts were analyzed. Casts univalved in the sagittal plane (dorsal or volar surface) retained up to 16% more pressure across the three moulding sites compared with casts univalved in the coronal plane (radial or ulnar border).
CONCLUSION
Maintaining pressure at the three-point mould prevents loss of reduction at the fracture site. This study shows that univalving the cast dorsally or volarly results in less pressure loss at moulding sites. This should improve the chances of maintaining fracture reductions when compared with radial or ulnar cuts in the cast. Sagittal plane univalving of forearm casts is recommended.
PubMed: 32582392
DOI: 10.1302/1863-2548.14.200034 -
PloS One 2016Several genera belonging to the nematode family Diplogastridae show characteristic dimorphism in their feeding structures; specifically, they have microbial feeding...
Several genera belonging to the nematode family Diplogastridae show characteristic dimorphism in their feeding structures; specifically, they have microbial feeding stenostomatous and predatory eurystomatous morphs. A diplogastrid satellite model species, Pristionchus pacificus, and its close relatives have become a model system for studying this phenotypic plasticity, with intensive physiological and structural studies having been undertaken. However, the many other species that are morphologically and phylogenetically divergent from P. pacificus have not been examined to date. In the present study, the detailed stomatal structure and induction of dimorphism in Neodiplogaster acaloleptae were examined. N. acaloleptae has a fungal feeding stenostomatous morph and a predatory eurystomatous morph. The predatory morph was induced by starvation, high population density, and co-culturing with its potential prey, Caenorhabditis elegans. The feeding behavior of the stenostomatous and eurystomatous morphs of N. acaloleptae was confirmed, demonstrating that 1) the stomatal and pharyngeal movements of the two morphs were basically identical, and 2) the stomatal elements were protracted to cut open the hyphae and/or prey to feed when a N. acaloleptae flips its dorsal movable tooth dorsally and tilts its subventral stegostomatal cylinder ventrally, forming a pair of scissors to cut the food source. The stoma morphology of N. acaloleptae with a single movable tooth and a long stoma is markedly different from that of Pristionchus, which has two movable teeth and a short stoma. It is, however, similar to that of Mononchoides, tentatively a sister to Neodiplogaster.
Topics: Animals; Caenorhabditis elegans; Coculture Techniques; Feeding Behavior; Female; Male; Nematoda; Pharynx; Phenotype; Phylogeny; Polymerase Chain Reaction; Population Density; Predatory Behavior
PubMed: 27196730
DOI: 10.1371/journal.pone.0155715 -
Neurosurgical Focus: Video Oct 2021The course of the facial nerve (FN) has been extensively investigated in patients with vestibular schwannomas (VSs). FN running dorsally to the tumor capsule accounts...
The course of the facial nerve (FN) has been extensively investigated in patients with vestibular schwannomas (VSs). FN running dorsally to the tumor capsule accounts for less than 3% of the cases. Diffusion tensor imaging (DTI)-based fiber tracking helps to preoperatively identify the FN. During surgery, a higher risk of injury is associated with the dorsal location of the FN. The authors demonstrate the nuances and tricks to identify and preserve a dorsal displaced FN during resection of a large VS, T3b according to the Hannover classification, through the retrosigmoid-transmeatal approach. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID2182.
PubMed: 36285236
DOI: 10.3171/2021.7.FOCVID2182 -
Systematic Parasitology Jun 2020Ixodes acer n. sp., Ixodes giluwensis n. sp., Ixodes mirzai n. sp., Ixodes planiscutatus n. sp. and Ixodes stellae n. sp. (Acari: Ixodidae), are described based on...
Description of five new species of Ixodes Latreille, 1795 (Acari: Ixodidae) and redescription of I. luxuriosus Schulze, 1935, I. steini Schulze, 1935 and I. zaglossi Kohls, 1960, parasites of marsupials, rodents and echidnas in New Guinea Island.
Ixodes acer n. sp., Ixodes giluwensis n. sp., Ixodes mirzai n. sp., Ixodes planiscutatus n. sp. and Ixodes stellae n. sp. (Acari: Ixodidae), are described based on females ex various marsupials (Dasyuromorphia: Dasyuridae, Diprotodontia: Petauridae, Peramelemorphia: Peramelidae), rodents (Rodentia: Muridae) and a bird (Galliformes: Megapodiidae) from Indonesia (Papua Province) and Papua New Guinea. Females of all new species are similar to those of I. luxuriosus Schulze, 1935, I. steini Schulze, 1935 and I. zaglossi Kohls, 1960, but can be distinguished from them and each other by the distinctness of lateral carinae and cervical grooves on the scutum, length of setae on the idiosoma, sculpture of the basis capituli and palpal segment I dorsally, size of the dorsal cornua, shape and sculpture of the palpal segment I ventrally, size of ventral spur on the palpal segment I, dental formula on the hypostome and measurements of various structures and their proportions. For comparative purposes the female of I. luxuriosus, I. steini and I. zaglossi is redescribed and lectotypes for I. luxuriosus and I. steini have been designated. Studied females of I. luxuriosus, I. steini and I. zaglossi were found on marsupials (Dasyuromorphia: Dasyuridae; Diprotodontia: Macropodidae, Petauridae, Phalangeridae, Pseudocheiridae; Peramelemorphia: Peramelidae), rodents (Rodentia: Muridae) and echidnas (Monotremata: Tachyglossidae) in Indonesia (Papua Province) and Papua New Guinea.
Topics: Animals; Female; Ixodes; Marsupialia; New Guinea; Rodentia; Species Specificity; Tachyglossidae
PubMed: 32328810
DOI: 10.1007/s11230-020-09909-5 -
Proceedings. Biological Sciences Feb 2018Butterflies have evolved different colour patterns on their dorsal and ventral wing surfaces to serve different signalling functions, yet the developmental mechanisms...
Butterflies have evolved different colour patterns on their dorsal and ventral wing surfaces to serve different signalling functions, yet the developmental mechanisms controlling surface-specific patterning are still unknown. Here, we mutate both copies of the transcription factor in butterflies using CRISPR/Cas9 and show that expressed dorsally, functions both as a repressor and modifier of ventral wing colour patterns, as well as a promoter of dorsal sexual ornaments in males. We propose that the surface-specific diversification of wing patterns in butterflies proceeded via the co-option of or its downstream effectors into various gene regulatory networks involved in the differentiation of discrete wing traits. Further, interactions between and sex-specific factors such as may have contributed to the origin of sexually dimorphic surface-specific patterns. Finally, we discuss the evolution of eyespot number diversity in the family Nymphalidae within the context of developmental constraints due to regulation.
Topics: Animals; Biological Evolution; Butterflies; Clustered Regularly Interspaced Short Palindromic Repeats; Color; Gene Expression; Gene Regulatory Networks; Insect Proteins; Mutation; Phenotype; Pigmentation; Transcription Factors; Wings, Animal
PubMed: 29467265
DOI: 10.1098/rspb.2017.2685