Postnatal development of Eustachian tube: a computer-aided 3-D reconstruction and measurement study

To ascertain the relationship among 2,5-hexanedione (2,5-HD) concentrations in nerve, serum and urine, rats were injected subcutaneously with 2.6 mmol/kg 2,5-HD alone, or together with 2.6 or 13.0 mmol/kg of methyl ethyl ketone, acetone and toluene. 2,5-HD concentrations in sciatic nerve (NC), serum (SC) and urine (UC) were determined, and the linear regression between each two of NC, SC, and UC were calculated. There was good correlation between NC and SC, SC and UC in the 2,5-HD alone group, and good correlation between NC and SC in the co-treated groups. Co-treatment solvent had little effect on the relationship between SC and NC. 13.0 mmol/kg co-treated solvent tended to decrease the regression coefficients compared with 2.6 mmol/kg co-treated solvent. These results show that SC can be used in estimating NC in the 2,5-HD alone or co-treated groups, and UC can be used in estimating SC in the 2,5-HD alone group.     

Cross-sectional area measurement of soft tissue. A new casting method

A new replica moulding technique for determining cross-sectional area has been developed. The accuracy of this technique has been investigated. Comparisons have been made with the area micrometer and the laser micrometer to establish the relative accuracy of each technique. The replica technique systematically underestimated the cross-sectional area by 6.2%. However, when this shrinkage artefact was corrected for, the residual error was +/- 1.8%. Relative to the corrected replica method, it was calculated that the area micrometer underestimated cross-sectional area by 16.2 +/- 6.9% (SD) and that the assumption of a convex cross-section would have caused the laser micrometer to overestimate cross-sectional area by an average of 2.3 +/- 1.5% (SD) for tendon, 4.7 +/- 2.5% for 'round' ligament specimens and 19.1 +/- 6.4% for cruciate ligament bundles with obvious concavities in their cross-sections. The moulding method was thought to be particularly useful for soft tissue specimens with irregular cross-sections.     

Intracranial facial nerve neurinoma: surgical strategy of tumor removal and functional reconstruction

The effects of a new forskolin derivative, (13R)-spiroforskolin, on the ventricular cAMP-activated chloride current (I(Cl(cAMP))) and the atrial L-type calcium current (I(Ca,L)) were measured by means of whole-cell recording from isolated guinea-pig cardiac myocytes at 30 degrees C and 20-22 degrees C, respectively. In contrast to forskolin, the derivative contains a tetrahydrofuran rather than a tetrahydropyran moiety. (13R)-spiroforskolin activated I(Cl(CAMP)) in 58% of the ventricular myocytes studied. The concentration required for the half maximal effect (EC50 value) amounted to 9.6x10(-11) M and was lower than the EC50 value for forskolin (2.4x10(-8) M). (13R)-spiroforskolin evoked a smaller maximal I(Cl(cAMP)) amplitude than forskolin. The rundown of the (13R)-spiroforskolin-activated I(Cl(cAMP)) was faster than that of the forskolin-induced current. Neither forskolin nor (13R)-spiroforskolin in maximally effective concentrations increased I(Cl(cAMP)) in cells containing high concentrations of cAMP. Furthermore, as an activator of atrial I(Ca,L) (13R)-spiroforskolin displayed a smaller activation and a lower EC50 value (5.8x10(-10) M) than forskolin (EC50 value: 3.7x10(-7) M). The effect of (13R)-spiroforskolin was observed in only 30% of the atrial cells studied. None of the drugs exerted a stimulatory effect in atrial cells containing a high [cAMP]. The washout of the drug effect was significantly faster in (13R)-spiroforskolin- than in forskolin-treated atrial myocytes. We conclude that (13R)-spiroforskolin as a forskolin derivative displays unique characteristics. It is a more potent but less efficacious activator of cardiac ionic conductances than the parent compound. The results suggest that (13R)-spiroforskolin, like forskolin, most probably exerts its effects via stimulation of the adenylyl cyclase.     

Anomalous relationship of the facial nerve and the retromandibular vein: a case report

A 72-year-old man suffering from non-Hodgkin's lymphoma is described. After failing to respond to chlorambucil-prednisone regimen for three months, he was treated by splenic irradiation (total dose 500 cGY) in 10 consecutive daily doses. Two days after the last irradiation, the patient developed acute tumor lysis syndrome (TLS) with extreme blood levels of uric acid (33.7 mg/dl), phosphorus (13.7 mg/dl), potassium (6.08 mEq/l), and calcium (6.8 mg/dl). It should be remembered that the acute TLS, which usually occurs following chemotherapy, can also be radiation-induced.     

Neurinoma of the facial nerve mimicking a parotid tumour. A case report

A case of a facial neurinoma localized in the right parotid gland is presented. Neurinomas derived from the facial nerve are very rare especially when extracranially located. Despite imaging and other investigations, extirpation of the tumour and histopathological examination are the only way to establish the diagnosis. Neurinomas are encapsulated and can be dissected without interruption of nerve branches.     

Aesthetic facial reconstruction: blending human perception and the facial subunit theory

Facial reconstructive surgical results play a key role in how an individual accepts themselves and how society accepts the individual. Surgeons must strive to create the most aesthetic results, which includes reestablishing the expected contours, highlights, and landmarks. By understanding the subunits theory, plastic surgical nurses can provide patients with knowledgeable preoperative teaching, and can better anticipate the scope and necessary equipment for each reconstruction.     

Abnormal branching of facial nerve with ossicular anomalies: report of two cases

Two cases with almost identical anomalies of the facial nerve and ossicles were reported. The two girls, ages 9 and 14 years, with unilateral hearing loss underwent exploratory tympanotomy. A huge suprameatal spine and tumor-like swelling of the facial nerve at the tympanic portion as well as its abnormal branching at the pyramidal bend were noted; one of the branches of the facial nerve appeared on the surface of the temporal bone running through the tympanomastoid suture. The distal parts of the long process and lenticular process of incus were missing as if they were eroded by the swollen facial nerve, and the superstructure of the stapes also was absent. No anomaly was seen in any other part of their ears or bodies. This specific type of anomaly is considered rare and important in that surgeons may misdiagnose the swollen facial nerve as a tumor, resulting in facial nerve paralysis due to injury or unnecessary biopsy.     

Compression of the ulnar nerve in Guyon's canal by a traumatic aneurysm. A case report

A patient developed after an occupational trauma with fall on the ulnar edge of his right hand pain and swelling in the ulnar area with reduced sensation in the fourth and fifth finger. After examination performed by a neurologist, ulnar nerve-entrapment was diagnosed and operative treatment was indicated. The release of the ulnar tunnel showed a traumatic aneurysma of the ulnar artery compressing the superficial branch of the ulnar nerve. The tumor was removed and end-to-end anastomosis ensued. Four weeks after surgery, examination showed complete recovery. Various reasons of ulnar tunnel syndrome are discussed.     

Intraoperative measurement of choline acetyltransferase activity to evaluate the functional status of donor nerve during reinnervated free muscle transfer: a preliminary report

Intraoperative choline acetyltransferase activity measurements were used to evaluate the functional status of donor nerves during reinnervated free muscle transfer. This technique was applied to 3 cases. One was a lower-type brachial plexus injury in combination with radial nerve injury; the other 2 were Volkmann's ischemic contractures. Gracilis muscle was transferred for reconstruction of wrist extension in all cases. The donor nerves included 1 anterior interosseous nerve and 2 posterior interosseous nerves. A fascicle with choline acetyltransferase activity above 2,000 cpm was considered to be reliable as a motor fascicle. Reinnervation of transferred muscle was confirmed by electromyographic examination within the first 3.3 months (range, 2.5 to 4 months) after surgery and all muscles obtained useful recovery. This technique can directly and quantitatively verify the functional quality of the donor motor fascicle when the quality of the donor nerve is in doubt.     

Development of a schwannoma within a facial nerve neurofibroma: a case report and literature review

We report the presence of a schwannoma within a neurofibroma of the intratemporal facial nerve. This neurofibroma recurred 39 years after its first excision in the parotid gland. Although some believe that schwannomas and neurofibromas represent the same entity, these tumors present distinctive histopathologic and clinical characteristics, which are discussed. The extreme rarity of a schwannoma developing within a neurofibroma is underlined. This is the first report of such an association occurring within a cranial nerve.     

Measurement of resuspended aerosol in the Chernobyl area. I. Discussion of instrumentation and estimation of measurement uncertainty

Results of measurements of the resuspended radioactive aerosols in the Chernobyl area are presented which were obtained soon after the Chernobyl reactor accident and in a European project in 1992-1993. The measurements were carried out with the intention of obtaining a data base for dose assessment of resuspended radioactive particles. Potential significant dose contributions may result from inhalation and secondary contamination due to resuspended radionuclides. In this first article of a series of three papers, the instrumentation and the measurement uncertainties are discussed. An effort was made to sample quantitatively giant aerosol particles (particles larger than 10 microns aerodynamic diameter) as well. The comparison of the samplers shows, in general, an agreement of concentration measurements of 137Cs and 7Be within a factor of two. One sampler was identified with larger discrepancies and needs additional investigation of its sampling characteristics; for another device, the recalibration of the analysing system is recommended. Ordinary integrating samplers have a loss of about 30% in 137Cs activity compared to an isokinetic sampler collecting giant particles as well. The mean ratio of 137Cs activity concentration between an instrument sampling only particles larger than 10 microns and an ordinary integrating sampler is 0.39 +/- 0.15 during anthropogenic-enhanced resuspension. These findings demonstrate the significant contribution of giant particles to resuspended airborne radioactivity. The results of this study concerning integral measurements during wind-driven resuspension proved to be in good agreement with previously published data on resuspension.     

Cross-sectional studies of personality in a national sample: I. Development and validation of survey measures.

Developed and validated 3 personality scales that were included in the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study conducted by J. Cornoni-Huntley et al (1983). Items to measure neuroticism were selected rationally from a general well-being schedule developed by A. J. Dupuy (1978) and items to measure extraversion and openness to experience were selected by multiple regression from a personality inventory developed by the present authors (see record 1984-00201-001). In a sample of 654 20–96 yr old men and women from the Augmented Baltimore Longitudinal Study of Aging, all 3 short scales showed clear evidence of convergent and discriminant validity against full scales in self-reports, and against peer and spouse ratings. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rehabilitation of the paralysed face: results of facial nerve surgery

The case notes of 34 patients undergoing rehabilitative facial nerve surgery between 1978 and 1994 were retrospectively examined. Thirteen patients underwent facio-hypoglossal transposition with six achieving a facial nerve grade of IV (House-Brackmann scale) at 24 months post-surgery. Twelve patients underwent cable grafting of the facial nerve defect. Of these, 10 achieved a grade III result at 24 months. Nine patients underwent end to end anastomosis of the facial nerve, seven achieving a grade III result at 24 months after the repair. Re-routing of the facial nerve and the use of tissue glue to effect the anastomosis did not have an adverse effect on the outcome. Comparison of rerouted end to end anastomosis with non-re-routed cable grafting showed no difference. Patients presenting pre-operatively with facial weakness and those in whom nerve repair surgery was delayed for more than six months were less likely to have a good result.     

Rerouting of the intratemporal facial nerve: an analysis of the literature

Anterior rerouting of the intratemporal facial nerve in the infratemporal fossa approach is employed to access to the jugular bulb, hypotympanum, and lateral skull base, whereas posterior rerouting of the facial nerve, as employed in the transcochlear craniotomy, is most frequently used for surgery of the posterior fossa, cerebellopontine angle, prepontine region, and petrous apex. Facial nerve rerouting may lead to facial paresis or paralysis. This review of the literature is intended to define the physiologic "cost" of these procedures, so that the neurotologic surgeon can determine if the morbidity incurred in these techniques is worth the resultant exposure. Inconsistencies in reporting facial function places into question the validity of some of the cumulative data reported. Postoperatively, grades I-II facial nerve function was seen in 91% of patients undergoing short anterior rerouting, 74% of patients undergoing long anterior rerouting, and 26% of patients undergoing posterior complete rerouting. Although facial nerve rerouting allows unhindered exposure to previously inaccessible regions, it is achieved at the cost of facial nerve function. Facial nerve dysfunction increases with the length of facial nerve rerouted.     

Speed and accuracy of facial expression classification in avoidant personality disorder: A preliminary study.

The aim of this preliminary study was to examine whether individuals with avoidant personality disorder (APD) could be characterized by deficits in the classification of dynamically presented facial emotional expressions. Using a community sample of adults with APD (n = 17) and non-APD controls (n = 16), speed and accuracy of facial emotional expression recognition was investigated in a task that morphs facial expressions from neutral to prototypical expressions (Multi-Morph Facial Affect Recognition Task; Blair, Colledge, Murray, & Mitchell, 2001). Results indicated that individuals with APD were significantly more likely than controls to make errors when classifying fully expressed fear. However, no differences were found between groups in the speed to correctly classify facial emotional expressions. The findings are some of the first to investigate facial emotional processing in a sample of individuals with APD and point to an underlying deficit in processing social cues that may be involved in the maintenance of APD. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Aging and the perceptual organization of 3-D scenes.

In the current study, the authors investigated whether the ground dominance effect (the use of ground surface information for the perceptual organization of scenes) varied with age. In Experiment 1, a scene containing a ground, a ceiling, and 2 vertical posts was presented. The scene was either in its normal orientation or rotated to the side. In Experiment 2, a blue dot was attached to each post, with location varied from bottom to top of the posts. In Experiment 3, a scene similar to that in Experiment 1 was presented in different locations in visual field. Observers judged which of the 2 objects (posts in Experiments 1 and 3, blue dots in Experiment 2) appeared to be closer. The results indicated that both younger (mean age = 22 years) and older observers (mean age = 73 years) responded consistently with the ground dominance effect. However, the magnitude of the effect decreased for older observers. These results suggest a decreased use of ground surface information by older observers for the perceptual organization of scene layout. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Management and rehabilitation of the facial nerve in parotid surgery

The facial nerve is the single most important consideration in the surgical management of most parotid disorders. Its surgical anatomy should be well known by the head and neck surgeon. Very few conditions of the parotid gland necessitate the sacrifice of the facial nerve. When this decision is made, the benefits to be derived should be very thoughtfully measured against the tremendous cosmetic and functional sequelae that follow, and the patient should understand preoperatively to the fullest the magnitude of this decision and all its consequences. Most facial nerve deficits resulting from injury or sacrifice of the nerve can be and are best repaired by either direct anastomosis or autografting using a donor sensory nerve. Such restorations of the neuromuscular mechanism yield a physiologic result that is as close to the preinjury state as possible, and this is reflected in cosmetic and functional recoveries that are generally superior to any other of a variety of rehabilitative techniques. In all patients with a paralyzed face, extremely close attention must be given the involved eye to minimize the hazards of corneal injury.     

Trans-petrous surgery in acoustic neuroma. Value of preoperative audiovestibular and facial investigation in the risk evaluation of facial nerve function

Between 1987 and february 1994, 162 consecutive patients with acoustic neuroma were operated on by an otoneurosurgery team, using transpetrous approaches (89% translabyrinthine, 8% middle fossa and 3% retrosigmoid). The relationship between the clinical, audiometric and vestibulographic characteristics and the post-operative facial nerve function were evaluated. In acoustic neuromas with cerebello-pontine component inferior to 3 cm without central neurologic signs (ic: central controlateral auditory and/or ipsilateral vestibular pathway alteration), good post-operative facial nerve function was achieved in 80% of cases. In acoustic neuromas superior to 3 cm with alteration of the central vestibular and auditory pathways, a good result was obtained in only 30% of cases which correlated negatively with preoperative facial dysfunction. These results underline the value of preoperative facial and audiovestibular examinations in predicting the postoperative facial nerve function following surgery for acoustic neuroma.