Rinoplastia secundaria en pacientes con fisura labiopalatina / Secondary Rhinoplasty in Patients with Clef lip and Palate

Introducción: La deformidad nasal asociada con el labio leporino ha sido vista como uno de los problemas reconstructivos más desafiantes en la rinoplastia, hasta el momento no se ha acordado ningún método único para cuantificar el éxito del tratamiento. En el año 2006 se aprobó oficialmente el protocolo para el tratamiento de las deformidades nasales complejas del Hospital Clínico Quirúrgico "Hermanos Ameijeiras", que están incluidas, las deformidades nasales congénitas secundarias en el adulto, no se recogen antecedentes de resultados en este grupo de pacientes basados en mediciones objetivas. Objetivo: Evaluar los resultados estéticos de la rinoplastia secundaria en pacientes con fisura labiopalatina. Métodos: Se realizó un estudio analítico a través de mediciones nasales angulares y de áreas, comparadas en fotografías estandarizadas entre el pre y posoperatorio y se determinó el índice de asimetría según la fórmula de Nakamura. Un panel de expertos usó la escala de Asher McDade y realizó la evaluación subjetiva de las imágenes, que permitió calcular el índice estético antes y después del tratamiento. Resultados: Se obtuvo una reducción marcada de todos los índices de asimetría nasal entre el pre y posoperatorio, así como una mejoría del índice estético posoperatorio pasándose de una apariencia pobre a muy buena apariencia. Conclusiones: Con la aplicación del protocolo para el tratamiento de las deformidades nasales del paciente fisurado adulto del Hospital Clínico Quirúrgico "Hermanos Ameijeiras" se obtienen buenos resultados estéticos(AU)

Introduction: Nasal deformity associated with cleft lip has been seen as one of the most challenging reconstructive problems in rhinoplasty; up to date, no single method has been agreed upon to quantify management success. In 2006, the protocol for managing complex nasal deformities was officially approved by Hermanos Ameijeiras Clinical Surgical Hospital, which includes secondary congenital nasal deformities in adults; however, there is no history of outcomes in this group of patients based on objective measurements. Objective: To assess the aesthetic outcomes of secondary rhinoplasty in patients with cleft lip and palate. Methods: An analytical study was carried out through linear and angular nasal measurements, compared in standardized photographs between the pre- and postoperative period; while the asymmetry index was determined according to Nakamura's formula. A panel of experts used the Asher McDade scale and performed the subjective assessment of the images, which allowed calculation of the esthetic index before and after the procedure. Results: A marked reduction was obtained in all nasal asymmetry indexes between the pre- and postoperative periods; as well as an improvement in the postoperative aesthetic index, from a poor appearance to a very good appearance. Conclusions: With the application of the protocol for managing nasal deformities of the adult cleft patient of Hermanos Ameijeiras Clinical Surgical Hospital, good esthetic outcomes are obtained(AU)

Leaf architecture and symmetry of understory tree species of anAraucaria forest / Arquitetura foliar e simetria de espécies do sub-bosque da floresta com Araucária

Shade plants of ombrophilous forests are subjected to light-limiting conditions and need toinvest in architectural structures associated with leaf symmetry to increase light capture. This study investigated the leaf architecture of six Araucaria forest tree species with distinct symmetry: Cupania vernalis, Casearia sylvestris, Schinus terebinthifolius, Piper gaudichaudianum, Roupala brasiliensis and Cedrela fissilis. We hypothesized that symmetry, associated with other traits, minimizes self-shading. Asymmetry index, petiole length, total leaf area, leaf angle, internode length and stem diameter were measured. The asymmetry index did not indicate a clear distinction between asymmetric and symmetric leaves. Leaves classified as asymmetric had higher values for the asymmetry index in the median and basal regions of the leaf, while symmetrical leaves had higher values in the apical region. The results also indicated an adjustment among structural leaf traits that facilitated a three-dimensional organization that produced an advantageous arrangement for light capture, which seems to be a response to selective pressure by the heterogeneous light conditions of the ombrophilous forest understory.

Nas florestas ombrófilas, as plantas de sombra estão sujeitas a condições limitantes de luz enecessitam investir em atributos estruturais associados à simetria foliar para maximizar a captura da luz. Esse estudo investigou a arquitetura foliar de seis espécies arbóreas (Cupania vernalis, Casearia sylvestris, Schinus terebinthifolius, Piper gaudichaudianum, Roupala brasiliensis e Cedrela fissilis) da Floresta com Araucária. Nossa hipótese é que a simetria foliar, associada a outros atributos foliares, minimiza o autosombreamento. Foram mensurados o índice de assimetria, o comprimento do pecíolo, a área foliar total, ângulo foliar, o comprimento do internó e o diâmetro do caule. O índice de assimetria não indicou uma distinção clara entre folhas assimétricas e simétricas. Folhas classificadas como assimétricas apresentaram maior índice na região mediana e basal da folha, enquanto as folhas simétricas apresentaram maior índice na região apical. Os resultados também indicaram um ajuste entre os atributos estruturais que permitiram um arranjo tridimensional das folhas vantajoso para a captura de luz, o que parece ser uma resposta à pressão seletiva pelas condições heterogêneas de luz do sub-bosque de floresta ombrófila.

Effect of bandage contact lens on the corneal epithelium healing, degree of pain and corneal surface after recurrent pterygium excision / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To assess the effect of bandage contact lens on the corneal epithelium healing condition,degree of pain and corneal surface after recurrent pterygium excision.· METHODS:Retrospective case-series study.A total of 64 patients (64 eyes) with recurrent pterygium who received treatment in the First Affiliated Hospital of Huzhou University from September 2015 to September 2017 were divided into Group A (34 cases with bandage contact lens group) and Group B (30 cases without bandage contact lens group).The healing status of corneal epithelium was evaluated by fluorescent staining between the two groups at 1d and 1wk after surgery.The degree of pain was assessed between the two groups at 2h,1d and 1wk after recurrent pterygium excision by visual analogue score.Computerized corneal topography was performed on all cases with recurrent pterygium before and 1 mo after successful excision surgery.Statistical analysis of surface regularity index (SRI),surface asymmetry index (SAI) and corneal astigmatism (CA),was done before and 1mo after surgery.· RESULTS:Average scores of corneal epithelium healing condition at 1d and 1wk were better in Group A than that in Group B (P＜0.01).The mean scores of pain values at 2h,1d and 1wk after surgery in Group A were significantly lower than that in Group B respectively (P＜ 0.01).The indicators reflecting corneal surface at 1mo after surgery,including SRI,SAI,CA,were significantly lower in Group A than that in Group B (P＜0.01),while they were not significantly different before surgery between the two groups (P＞0.05).· CONCLUSION:Bandage contact lenses could significantly promote the healing status of corneal epithelium,release pain response and improve corneal refractive status after recurrent pterygium excision.

Intrachromosomal karyotype asymmetry in Orchidaceae

Abstract The asymmetry indexes have helped cytotaxonomists to interpret and classify plant karyotypes for species delimitation efforts. However, there is no consensus about the best method to calculate the intrachromosomal asymmetry. The present study aimed to compare different intrachromosomal asymmetry indexes in order to indicate which are more efficient for the estimation of asymmetry in different groups of orchids. Besides, we aimed to compare our results with the Orchidaceae phylogenetic proposal to test the hypothesis of Stebbins (1971). Through a literature review, karyotypes were selected and analyzed comparatively with ideal karyotypes in a cluster analysis. All karyotypes showed some level of interchromosomal asymmetry, ranging from slightly asymmetric to moderately asymmetric. The five tested intrachromosomal asymmetry indexes indicated Sarcoglottis grandiflora as the species with the most symmetrical karyotype and Christensonella pachyphylla with the most asymmetrical karyotype. In the cluster analysis, the largest number of species were grouped with the intermediary ideal karyotypes B or C. Considering our results, we recommend the combined use of at least two indexes, especially Ask% or A1 with Syi, for cytotaxonomic analysis in groups of orchids. In an evolutionary perspective, our results support Stebbins' hypothesis that asymmetric karyotypes derive from a symmetric karyotypes.

Effects of Corneal Surface Shape and Optical Quality on the Results of Trial Fitting in Orthokeratology / 中国医科大学学报

Objective To determine the parameters of corneal surface shape and optical quality that affect the results of trial fitting in overnight orthokeratology (OK lenses) in adolescents with myopia.Methods Thirty-eight subjects (67 eyes) who met the inclusion criteria were enrolled in this study.The parameters of corneal surface shape including surface regularity index (SRI),surface asymmetry index (SAI),and Q value were assessed with a corneal topographer before beginning orthokemtology.The Strehl ratio (SR) and the root-mean-square (RMS) of the total higherorder aberrations in a 4-mm pupil were measured before the trial fitting.Participants who had tried orthokeratology were divided into two groups according to the success or failure of trial fitting.Then,we compared the differences in the comeal surface shape and optical quality between the two groups.Results There were 45 eyes in the success group,and 22 eyes in the failure group.There were no statistically significant differences for SRI (P =0.188),SAI (P =0.338),Q value (P =0.657),RMS (P =0.456),and SR (P =0.479) in the two groups.Conclusion The result of trial fitting in orthokemtology is not correlated with the parameters of comeal status and optical quality (SRI,SAI,Q value,RMS,SR).

Clinical observation of Danzhi Xiaoyao Capsule with hypromellose 2910, dextran 70 and glycerol eye drops for dry eye in menopausal patients / 国际眼科杂志(Guoji Yanke Zazhi)

?AIM: To evaluate the clinical effects, corneal surface shape and corneal thickness variation after treated by Danzhi Xiaoyao Capsule combined with hypromellose 2910, dextran 70 and glycerol eye drops for dry eye in menopausal patients.?METHODS: Eighty menopausal patients ( 160 eyes ) diagnosed as dry eye were randomly divided into groups A and B ( 40 patients each ) . Group A was treated with hypromellose 2910,dextran 70 and glycerol eye drops only and group B was treated with Danzhi Xiaoyao Capsule and eye drops. Before and 1mo after treatment, the clinical effects were evaluated by symptom scores, fluorescein staining ( FL ) , tear film breakup time ( BUT ) and Schirmer Ⅰ test. While the corneal surface regularity index (SRI), surface asymmetry index (SAI) and central corneal thickness ( CCT) were observed.? RESULTS: At 1mo after treatment, the symptoms scores and FL scores of the 2 groups decreased significantly( P0. 05).?CONCLUSION: Combination therapy of Danzhi Xiaoyao Capsule and hypromellose 2910, dextran 70 and glycerol eye drops for menopausal patients with dry eye is more effective than single eye drops, and can improve the symptoms and signs.

Bilateral asymmetry of knee and ankle isokinetic torque in soccer players u20 category / Assimetria bilateral no torque isocinético do joelho e tornozelo em jogadores de futebol da categoria sub 20

Abstract Bilateral asymmetries and muscle imbalances are associated with increased risk for lower limb injuries and still seem to imply in athletes performance. This study aimed to analyze bilateral asymmetry of soccer players in age category below 20 years old (peak torque and conventional and functional reason in extensor/flexors of knee and inverter/ eversion of ankle) and to compare these variables between defending, midfield and attacker players. The study included 22 athletes in age category below 20, which underwent a five maximal isokinetic testing with repetitions at 180°/s for knee and 120°/s for ankle, both concentric and eccentric actions. T test for dependent data was used to compare values of torque between dominant and non-dominant limbs and one-way ANOVA was used to compare neuromuscular variables between players of different positions, both at p <0.05. No significant differences were observed in any neuromuscular variable (peak torque and functional and conventional ratio) between dominant and non-dominant sides (p> 0.05). It was found that defensive players had eccentric torque values of extensors knee higher than midfield players (p <0.05). Defensive players exhibit greater eccentric torque of knee extensor muscles compared to midfield players. It can be concluded that the analyzed soccer players did not present bilateral asymmetries in flexor/extensor knee muscles neither in inverter/eversion ankle muscles.

Resumo As assimetrias bilaterais e os desequilíbrios musculares estão associados com o risco aumentado para lesões nos membros inferiores e ainda parecem implicar o desempenho dos atletas. Assim, este estudo objetivou analisar a assimetria bilateral de jogadores de futebol da categoria sub 20 (pico de torque e razão convencional e funcional dos extensores/flexores do joelho e inversores/eversores do tornozelo), além de comparar tais variáveis entre jogadores defensores, meias e atacantes. Participaram deste estudo 22 atletas da categoria sub 20, que foram submetidos a um teste isocinético com cinco repetições máximas a 180º/s para o joelho e 120º/s para o tornozelo, ambos com ações concêntricas e excêntricas. Utilizou-se o teste t para dados dependentes para comparar os valores de torque entre os membros dominante e não-dominante e ANOVA one way para comparar as variáveis neuromusculares entre jogadores de diferentes posições, ambos a p < 0,05. Não foram observadas diferenças significativas em nenhuma variável neuromuscular (pico de torque e razão funcional e convencional) entre os lados dominante e não-dominante (p > 0,05). Foi verificado que os jogadores defensores apresentavam valores de torque excêntrico nos extensores do joelho, superiores aos meias (p < 0,05). Os jogadores que atuam na defesa apresentam maior torque excêntrico nos extensores do joelho, quando comparados aos jogadores de meio-campo. Pode-se concluir que os jogadores analisados não apresentaram assimetrias bilaterais nos músculos flexores/extensores do joelho, bem como nos inversores/eversores do tornozelo.

Effectiveness of Helmet Cranial Remodeling in Older Infants with Positional Plagiocephaly

BACKGROUND: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (> or =18 months). METHODS: We conducted a retrospective study of 27 infants with positional plagiocephaly without synostosis, who were started from 2008 to 2012. Every child underwent a computerized tomography (CT) before starting helmet therapy to exclude synostosis of the cranial sutures and had CT performed once again after satisfactory completion of therapy. Anthropometric measurements were taken on using spreading calipers in every child. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy. RESULTS: The discrepancy of CVA and CVAI of all the patients significantly decreased after cranial molding helmet treatment in older infants (> or =18 months) 7.6 mm from 15.6 mm to 8 mm and 4.51% from 9.42% to 4.91%. Six patients had confirmed successful outcome, and all subjects were good compliance patients. The treatment lasted an average of 16.4 months, was well tolerated, and had no complication. Additionally, the rate of the successful treatment (final CVA < or =5 mm) significantly decreased when the wearing time per was shorter. CONCLUSION: This study showed that treatment by cranial remodeling orthosis was effective if the patient could wear the helmet longer and treatment duration was somewhat longer than in younger patients, well tolerated in older infants and had no morbidity. This therapeutic option is available and indicated in these older infants before other cranial remodeling surgery.

Effectiveness of Helmet Cranial Remodeling in Older Infants with Positional Plagiocephaly

BACKGROUND: Management of positional plagiocephaly by wearing a cranial molding helmet has become a matter of growing medical interest. Some research studies reported that starting helmet therapy early (age 5 to 6 months) is important and leads to a significantly better outcome in a shorter treatment time. The aim of the present study was to evaluate the effectiveness of cranial remodeling treatment with wearing helmet for older infants (> or =18 months). METHODS: We conducted a retrospective study of 27 infants with positional plagiocephaly without synostosis, who were started from 2008 to 2012. Every child underwent a computerized tomography (CT) before starting helmet therapy to exclude synostosis of the cranial sutures and had CT performed once again after satisfactory completion of therapy. Anthropometric measurements were taken on using spreading calipers in every child. The treatment effect was compared using cranial vault asymmetry (CVA) and the cranial vault asymmetry index (CVAI), which were obtained from diagonal measurements before and after therapy. RESULTS: The discrepancy of CVA and CVAI of all the patients significantly decreased after cranial molding helmet treatment in older infants (> or =18 months) 7.6 mm from 15.6 mm to 8 mm and 4.51% from 9.42% to 4.91%. Six patients had confirmed successful outcome, and all subjects were good compliance patients. The treatment lasted an average of 16.4 months, was well tolerated, and had no complication. Additionally, the rate of the successful treatment (final CVA < or =5 mm) significantly decreased when the wearing time per was shorter. CONCLUSION: This study showed that treatment by cranial remodeling orthosis was effective if the patient could wear the helmet longer and treatment duration was somewhat longer than in younger patients, well tolerated in older infants and had no morbidity. This therapeutic option is available and indicated in these older infants before other cranial remodeling surgery.

EEG A1, A2, and Percent Asymmetry Indices in Major Depressive Disorder; The Importance of Symptom Severity of Depression and Anxiety / 신경정신의학

OBJECTIVES: In this study we investigated characteristics of asymmetry pattern of EEG in patients with major depressive disorder according to the severity of depression and anxiety symptoms, employing A1, A2, and Percent (PCT) asymmetry indices. METHODS: Subjects involved in this study were 11 healthy controls and 11 patients with major depressive disorder who have taken no medicines for four weeks just before the study. These subjects were selected so that the two groups can have no difference in gender and age. Beck Depression Inventory (BDI), 17-item Hamilton Depression Rating Scale (HDRS), Zung's Self-Rating Depression Scale (SDS) and Spielberger's State-Trait Anxiety Inventory (STAI) were used to evaluate depression and anxiety symptoms, respectively. Resting EEG was recorded from F3, F4, C3, C4, T7, T8, O1 and O2 electrode sites. RESULTS: The temporal region showed a difference in A1, A2, and PCT asymmetry indices between the depression group and the control group. Frontal (F3, F4) and temporal (T7, T8) regions showed correlation between STAI-T score and A1, A2, and PCT asymmetry indices. CONCLUSION: The results of this study showed that EEG A1, A2, and PCT asymmetry indices can be used as useful indices for depression. Also, it was found that trait anxiety had influence on A1, A2, and PCT asymmetry indices.

The Predictive Value of FDG-PET for Lateralizing Wada Memory Dominance and Epileptic Focus in Patients with Temporal Lobe Epilepsy

Backgroud : To examine the predictability of regional cerebral glucose metabolism in determining Wada memory dominance and lateralizing epileptic focus. METHODS: 1 8 F-fluorodeoxyglucose positron emission tomography (FDG-PET) and Wada test were performed in 18 patients with temporal lobe epilepsy (TLE). Regions of interest were determined in mesial, polar, anterior-lateral, mid-lateral, and posterior-lateral regions of the temporal lobe. The asymmetry indices of FDG-PET (PET-AI) were calculated in each ROI of temporal lobe, and those of Wada memory test (Wada-AI) were obtained as well. RESULTS: Pearson correlation coefficient showed Wada-AI was significantly correlated with PET-AI in mesial (r=0.67, p=0.001), polar (r=0.55, p=0.010), anterior-lateral (0.55, p=0.009) and mid-lateral (r=0.51, p=0.016) temporal regions. However, after simple linear regression analysis, PET-AI of mesial temporal region alone was significantly correlated with Wada-AI (p=0.008). In localizing epileptic focus, Wada-AI could correctly lateralize the seizure focus in 90% of the left TLE and 75% of the right TLE patients. No false lateralization by Wada-AI was observed except two patients showing prolonged confusion after amobarbital injection who were not included in this study. The PET-AI of the mesial temporal region showed the highest sensitivity of seizure lateralization (100% of left TLE and 87.5% of right RLE). CONCLUSIONS: Although FDG-PET hypometabolism is observed both at mesial and lateral regions of the temporal lobe in mesial TLE, mesial temporal region appeared to be a dominant and leading area for lateralizing Wada memory dominance and epileptic focus.

Predictive Values of Four Wada Memory Asymmetry Indices in Postsurgical Memory Outcome

BACKGROUND: The interpretation of Wada memory test is various in different epilepsy centers. Four types of Wada memory score (WMS) were defined by four different criteria to determine the best WMS in predicting postsurgical memory outcome. METHODS: Twenty temporal lobe epilepsy patients underwent Wada test before surgery and pre- and post-operative neuropsychological tests. WMS was obtained by four ways; including 1) total stimulating items, 2) items presented between one and two minutes after amobarbital injection, 3) items presented before ipsilateral EEG slowing decreased to 50%, 4) items presented until EEG slowing disappeared. Wada memory asymmetry index (WAI) was determined by [(WMS of normal side ? WMS of epileptic side)/their mean]. Logical and visual memory tests were performed before and after operation. Neuropsychological asymmetry index (NPAI) was defined as [(postsurgical score ? Presurgical score)/their mean]. Spearman correlation coefficients were obtained between WAIs and NPAIs. RESULTS: WAIs obtained by method 2) and 3) showed relatively good correlation with NPAIs. Visual memory outcome was correlated with WMS better than logical memory both in non-dominant and dominant hemisphere epilepsy groups. The lateralizing value of memory dominance in non-dominant hemisphere epilepsy group was greater than that of dominant group. CONCLUSIONS: Early presented stimuli during Wada test had a better predictive value of postoperative memory outcome.