Alar Research Articles

Multi-plane hyaluronic acid injection for rhinoplasty

To investigate the effect of multi-plane Hyaluronic acid (HA) injection for rhinoplasty. The HA was injected below or above the periosteum at the nasal bone, above the perichondrium at the cartilage portion of nose, and between the great alar cartilage at the nasal tip. The HA volume was 1-1.5 ml, according to the nose form and aesthetic assessment. Over-injection was not permitted. Touch-up injection could be performed one week after the first injection if need. From Jan. 2010 to Jan. 2012, 60 cases underwent rhinoplasty with HA injection. The patients were followed up for 10-13 months with satisfactory result. The effect lasted about 9 months with the longest period as 12 months and the shortest period as 6 months. Good results can be achieved with multi-plane HA injection for rhinoplasty.

Elongating Asian nose with autologous septal cartilage

Objective To employ autologous septal cartilage grafting as a new method of elongating the nose and adjusting the nasolabial angle in order to correct the deformities of short nose and bulbous tip.Methods A set of techniques,including,yet not limited to,releasing and sculpturing of the alar cartilages,harvesting of septal cartilages and carving them into L shape and cap-like shape for transplant,moulding the soft tissue envelop with buried through and through sutures etc.were used to lengthen the nose and modify the tip.Results From 2004 to now,the new technique had been applied to 345 patients with short nose and bulbous tip.Follow-up ranged from 6- 48 months,satisfactory outcomes were obtained.Conclusions The new technique adopted by the author in which autologous septal cartilages are settled to the anterior angle of the nasal septum and between the domes of alar cartilages has been proved to be a viable and reliable way to lengthen the nose.Further advantages of this technique include the easiness of harvesting grafts,minimal injury,rare complications of infection and rejection etc. Key words: Short nose; Nasal elongation; Autologous septal cartilage graft; Comprehensive rhinoplasty

Effect of four line tension relaxing for nasal deviation rectification under endoscope

To explore the effect of four line tension relaxing septorhinoplasty for nasal deviation complicated with the deformity of nasal septal cartilage under endoscope. Seventeen patients with nasal septum deviation from December 2009 to April 2011 were included in this study. The patients were divided into different groups depending on different deformity of quadrangular cartilage. Different surgical methods were used according to different deviation of nasal septum. First, a C-shape or L-shape incision was made on one side of the nasal septum under endoscope, then the nasal septal cartilage was separated from the angle formed by two greater alar cartilages, perpendicular plate of the ethmoid bone, the junction of vomer and maxilla at the nasal crest, and the upper lateral cartilage, this procedure was applied to correct deviation of nasal septum and nasal pyramid by decompression, which was named four lines tension relaxing correction. Seventeen patients with nasal septal deviation obtained satisfied curative effect. Nasal deviation and deviation of nasal septum were all corrected, patients got better appearance and good nasal ventilation, no complication was observed. Nasal deviation complicated with the deformity of nasal septal cartilage could be completely corrected by only one septorhinoplasty operation--four lines tension relaxing correction.

Anatomical features of nasolabial fold

Objective To investigate the anatomic characteristics of the nasolabial fold and to give an accurate description and definition of it in order to to provide theoretical basis for plastic, cosmetic and maxillofacial surgery. Methods Ten (20 sides) adult fresh bodies with vascular perfusion of formalin fixed after morphological observation under a 10 × magnifying len. Results Nasolabial fold was a border between fat-rich zone and non-fat zone in the midfacial region. The nasolabial fold derived from nasal alar skin point in the transverse portion of nasalis, and ended at the outer skin point of zygomaticus major muscle in the mouth. From the anatomy point of view, the nasolabial fold was divided into three segments: the upper, the middle and the under. The upper segment ( Ⅰ ) was the transverse portion of nasalis, (20. 38± 0. 74) mm in length; the middle section ( Ⅱ ): levator labii superioris,(17.13 ± 0.57) mm in length; the under segment (Ⅲ ): modiolus, (20. 81 ±0. 70) mm in length. The nasolabial fold was a connecting region where seven mimetic muscles inserted into the skin point. Superficial musculoapneurotic system (SMAS) and the nasolabial fold were composed of seven mimetic muscles belonging to the same layer. Conclusions The nasolabial fold is a region where the seven mimetic muscles insert into the skin point for connection, and regardless of age, it is an eternal existence. The nasolabial fold is different from the nasolabial wrinkle formed with facial aging and the nasolabial ridges formed by facial mimetic muscles changes. Key words: Nasolabial fold; Microdissection; Mimetic muscles

Multiple-slice spiral CT evaluation of occipital condyle fractures

Objective To explore the MSCT findings of occipital condyle fracture (OCF) and improve its diagnostic accuracy. Methods Nineteen patients with OCF, selected from 110 patients suffering high energy injuries at the craniocervical junction, were enrolled into the study. The MSCT appearances of OCFs were retrospectively analyzed by two experienced radiologists. OCF had four types: type Ⅰ was a comminuted fracture, type Ⅱ was a extension of basilar skull fracture, type Ⅲ was an avulsion fracture at the attachment site of alar ligament on occipital condyle, type Ⅳ was a fracture of mixed pattern consisting of two or more above fracture types. Results In 19 patients, the left, right and bilateral OCFs were seen in 7,11 cases, and 1 case, respectively. Type Ⅰ was found in one case, which was a comminution of the left occipital condyle. Type Ⅱ was found in 5 cases, which involved the middle and posterior parts of occipital condyles with 2 on the left and 3 on the right, Type Ⅲ was found in 12 cases which showed various degree of fragment displacement with 3 occuring on the left, 8 on the right, 1 involving bilateral sides, 6 involving articular surfaces and 7 accompaning by enlargment of alar ligaments. Type Ⅳ was found in one case, with coexistence of Type Ⅱ and type Ⅲ. In addition, OCFs were accompanied by head and (or) cervical spine injuries in 14 cases, which included cranial fracture in 8 cases, epidural hematoma in 4 cases, subarachnoid hemorrhage in one case, cerebral contusion and laceration in one case, subfalcial hernia in one case, cervical spine fracture and dislocation in 9 cases, and so on. Conclusion OCFs can be accurately diagnosed by MSCT, which is important for selection of treatment protocols. Key words: Occipital bone; Fracture,bone; Tomography,X-ray computed

Correction of nasal deformities in unilateral cleft lip

Objective To analyze the mechanism of nasal deformity by reviewing the possible pathogenesis and nasal anatomy and to find the effective and reliable operative methods to correct nasal deformities in unilateral cleft lip.Methods 57 patients (37 males,20 females,and range in age from 12 to 25 years,with mean of 18.6 years) with nasal deformities in unilateral cleft lip were available for this study.The nasal deformities were treated with the following surgical procedures according to the different locations and degree Of nasal deformities.The eompositive techniques included:alveolar bone grafting was taken to correct the collapse the nasaI base;a cortical plate was inserted between the two medial crura of the alar cartilage.According to the nasal contours of non-cleft side,the alar cartilage was resected and suspended to its normal and symmetrical position.The alar cartilaginous ring was reconstruction,which maintained the nostril shape 3 month postoperatively.Results A total of 57 cases were treated by the method above,and were ranged with score by operators and patients.93% of cases were evaluated as satisfaction after operation.The follow-up for 3 to 24 months showed that 52 cases had achieved satisfactory effects,5 cases showed the trend to relapse.Conclusion The cause of nasal deformities in unilateral cleft lip is complex.The study has achieved a significant improvement by synthetical correction of deformities of maxilla,cartilage and soft tissues, and the restoration of nasal-labial muscles.The rigid suspending is more important to maintain the nostril contour and avoid relapse. Key words: Unilateral cleft lip; Nasal deformity; Rhinoplasty

Three-dimensional image reconstruction and anthropometry of nasal cartilages in Chinese

Objective To conduct a morphologic and anatomic study on nasal cartilages (including nasal alar cartilage, nasal septal cartilage and upper lateral cartilage) in Chinese, and to compare measured parameters with the other races. Methods 20 adult embalmed cadavers were dissected, 40 nasal alar cartilages, 20 nasal septal cartilages and 40 upper lateral cartilages were collected and scanned by CT, and three-dimensional images were reconstructed. As Zelnik' and Ofodile's work, the data of the images were collected. Results The distances from the nostril rim to the caudal boarder of the lateral crus in the series were (4. 54 ±0. 59) mm anteriorly, (5. 54±0. 69) mm in the middle, and (10. 45± 1. 15) mm posteriorly. The length of the lateral crus was (18. 51 ±1. 63) mm, the width was (7. 99±1. 66) mm, and the thickness was (0. 49±1. 28) mm. Conclusion The Caucasian nasal cartilages are the biggest in all races, and the other's were approximately same. Key words: Nasal cartilages; Anatomy; Three-dimensional image reconstruction measurement

Clinical application of ear cartilage in augmentation rhinoplasty

Objective To investigate the superiority of augmentation rhinoplasty by using ear cartilage.Methods We excised ear cartilage from patient's unilateral ear.106 cases were performed through suitable ear cartilage that was carved to some shape and then transplanted to nasal tip and columella,and two alar cartilages were sutured and implant was used for rhinoplasty.Results All cases were followed up for one year after operation without implant slipping and malposition of implant,with better figure after enhancing and lengthening nasal tip.Conclusions This method of augmentation rhinoplasty using ear cartilage can avoid complications such as slipping,malposition and exposure of implant.Therefore,it is deserved to recommend clinical application. Key words: Ear; Cartilage; Augmentation rhinoplasty; Nasal tip

A 3D soft-tissue study of the human external nose region from childhood to old age

The external nose is one of the body structures that continue to modify and enlarge throughout life, well beyond the attainment of skeletal maturity. The objective of the current study was to measure: 1. normal sex-related dimensions of external nose (linear distances, ratios, angles, volume and surface area); and 2. growth changes between childhood and old age. The 3D coordinates of several soft-tissue landmarks on the external nose were obtained by a non-invasive, computerized digitizer in 519 male and 340 female healthy subjects aged 4-73 years. The subjects were divided into 11 non overlapping age groups. From the landmarks, nasal volume and external surface area; nasal and alar base widths, nasal height, nasal bridge length, philtrum length, nasal tip protrusion, right and left nostril lengths, superior and inferior nostril widths; nasal tip protrusion-to-nasal height, and nasal width-to-nasal height ratios; nasal convexity, alar slope, and nasal tip angles were calculated, and averaged for age and sex. Comparisons were performed by factorial analysis of variance. On average, men had larger nasal external volume and area, linear distances and nasal width-to-height ratio than women (p < 0.01); no sex differences were found for the angles and the nasal tip protrusion-to-nasal height ratio. Age significantly influenced all analyzed measurements (p < 0.001): nasal volume, area, linear distances increased from childhood to old age, while the nasal tip angle decreased as a function of age. No consistent age-related patterns were found for the ratios and the nasal convexity and alar slope angles. Men and women had different age-related patterns, with significant sex by age interactions (p < 0.001). Overall, in most occasions male increments in nasal dimensions were larger than female ones. Data collected in the present investigation could serve as a data base for the quantitative description of human nasal morphology during normal growth, development and aging. Forensic applications (evaluations of traumas, craniofacial alterations, teratogenic-induced conditions, facial reconstruction, aging of living and dead persons, personal identification) may also benefit from ageand sexbased data banks.

Applied anatomy of rhinoplasty microsugry

Objective To provide structure and function applied anatomical of nasal sub-units for plastic and reconstruction. Methods Twelve cases fresh nose from adult head specimen,to dissect the skin,muscle fascia system, cartilage and bone,to observe and digiital measure nerve, blood vessel and ligament between cartilage. Results The thinnest skin in the point of bone and cartilage junction,the thickest parts in the nasion and the supratip breakpoint.Nose contours include of the skin,cartilage,bones and vascular muscle fascia system;Nasal subunit can be divided into nasion area,nasal dorsum area, nasal tip area,nasal ala area and nasal columella area;Nasal valve was a important anatomic part of bremh.The nasal lateral osteotomy of maxilla can change 2 mm height and width of the nasal bone;Lower lateral cartilage and upper nasal cartilage connection can be separated 6~8 mm. Curvature changes in the crura intermedium of alar cartilage Can raise nasal tip 2 mm. Extent of septal cartilage was 15 mm×20 mm,thickness was 1 mm.The mainly blood supply come from facial artery and ophthalmic artery. Vein accompanying with the same name.Lymphatic flow in the area of superficial muscle fascia. Concision Nasal bone lateral osteotomy can raise up bridge of the nose.To lengthen and highten nasal tip based on the complete strip technique of lower lateral cartilage and upper lateral,and to change angel of medial crus and middle crus of lower lateral cartilage by suture rotation.Nasal skin is rich in artery and vein,so much as four networks.Because the syndrome of nasal contraction deformation occurred more and more recently we must to avoid the vascular network injury when operation, and the anatomical level should be give more noted. Key words: Rhinoplasty; Cartilage; Contraction deformation; Digital medicine; Microsurgery

Augmentation rhinoplasty using a reverse alar cartilage flap assisted with implantation of silicon prosthesis

Objective To investigate a new method which could not only avoid the extrusion of the silicon implant, but also be benefit for the reconstruction of nasal tip and alar during nasal augmen-tation procedure. Methods Folded lower lateral cartilage flap combined with silicon implant was ap-plied for nasal dorsal augmentation and reconstruction of nasal tip and alar with its unique character at the same time. Results 12 cases were all primary healing, without infection, extrusion of implant and other complications. One month after operation, the projection of nasal tip was increased, which had better delicate and definite shape, natural appearing tip adding contour and height to nasal tip, pleas-ant definition. Conclusions Folded lower lateral cartilage flap combined with silicon implant is an ef-fective method to decrease the incidence of extrusion, when we want to have a little over-projected na-sal tip with prosthesis. It is also helpful for reconstructing the nasal tip and alar with its unique char-acter. Key words: Silicon implant; Rhinoplasty; Alar cartilage

Micro-cleft lip repair thrugh intraoral incision and combined with dermo-fat graft

Objective To explore a method of repairing microform cleft lip.Methods Reconstruet orbicularis oris muscle through intraoral incision opposite to the affected philtral ridge;Augment the depressed deformity using postauricular dermis fat graft though the canal of the upper lip;Correct the notching of the Cupid's bow through Z-plasty and dermis fat graft;Lift and fix the alar cartilage,and advance the alar base medially to reduce the cleft-site nostril.Results 8 patients were operated with this method,in which 7 patients were followed-up with satisfactory results.Conclusion It is a useful method to repair microform cleft lip using dermis fat graft through the intraoral incision. Key words: Cleft lip; Intraoral incison; Dermis fat graft

Imaging research of normal ligamentous structures in the region of craniocervical junction

Objective To study the imaging characteristics of the ligaments in craniocervical junction (CCJ), and to optimize the examination methods and scanning sequences of the ligaments in this region. Methods Two groups of 51 healthy volunteers in each were selected to undergo CT and MRI examination respectively. The CT and MRI features of the ligaments in CCJ were assessed. Two senior imaging doctors compared the results of showing the ligaments in CCJ by several MRI sequences, including T1 WI ,T2 WI, proton density weighted imaging (PDWI), T2 * WI and short time inversion recovery (STIR) ,and proton density fat saturate (PDFSAT). Standard normal rank transformation was done according to the primary data,and then analysis of variance of repeated measurement was applied. Results CT and MRI could both demonstrate the ligaments (except the anterior atlantooccipital membrane only seen on MRI) and their adjoins in CCJ, while MRI had more advantages than CT. The display ratio of the anterior atlantooccipital membrane was 100% (51/51) by MRI. The display ratio of the apical ligament was 29.4%(15/51) by CT and 43.1% (22/51) by MRI. The posterior atlantooccipital membrane-dura complex,tectorial ligament-dura complex, transverse ligament, and alar ligament could be demonstrated clearly by CT and MRI, the display ratio was 100% respectively (51/51). The results of PDWi scored by two doctors were both 5.0, there were no significant differences between them (F = 0.000, P > 0.05), which were significantly higher than T, WI (M = 3.0), T2Wi (M = 3.0), T2 * WI (M = 1.0), STIR (M = 1.0), and PDFSAT(M = 3.0)(P < 0.01). Conclusion MRI was superior to CT in demonstrating the ligaments in CCJ. PDWI was the optimal MRI sequence. Imaging research of normal ligamentous structures in CCJ could provide valuable diagnostic and therapeutic information for evaluating the ligamentous diseases. Key words: Atlanto-occipital joint; Ligaments; Tomography, X-ray computed; Magneticresonance imaging

Bryophyte Flora of Uganda. 8. Orthotrichaceae Part 1 – Macromitrioideae

(2008). Bryophyte Flora of Uganda. 8. Orthotrichaceae Part 1 – Macromitrioideae. Journal of Bryology: Vol. 30, No. 3, pp. 201-207.

Application of Z-form plasty with a nasal mucous membrane and alar cartilage flap to repair severe secondary nasal deformity after cleft lip operation

Objective To investigate a repair method for unilateral complete cleft lip nasal deformities.Methods Based on the fullness of healthy nasal wing,Z-form plasty was designed with a nasal mucous membrane and alar cartilage flap,to prolong its curtate length of the deformed side through overlapping transposition,and then with suspension of the custom-crafted nasal wing to replace its abnormal structure,subsequently,to recover the normal anatomic structure of the nosewing,and to get the nasal deformity repaired.Results A total of 12 patients with the severe nasal deformity were treated by this method.and all had satisfactory results.Conclusion This technique is a good choice for repairing the severe secondary nasal deformity after single complete cleft lip operation. Key words: Cleft lip; Nasal deformity; Alar cartilage; Mucous membranes; Z-plasty

Determination of Daminozide in Apple Sample by Mip‐Coated Piezoelectric Quartz Sensor

A piezoelectric crystal sensor has been prepared by using a molecularly imprinted polymer as recognition element. A typical time‐response curve of the molecularly imprinted polymer (MIP)‐coated crystal to the daminozide (DM) solution has been described. Frequency shifts versus logarithm changes of DM showed good linear correlation within the concentration range of 1.0×10−9–10−6 mg ml−1 (y=11.38x+ 115.45, r=0.9872) and 1.0×10−6–10−1 mg ml−1 (y=25.22x+209.44, r=0.9938), respectively. The detection limit was 5.0×10−8 mg ml−1 (S/N=3). The obtained sensor has high sensitivity and selectivity, low cost, good reproducibility, and reusable property by combining with piezoelectric crystal and molecularly imprinted polymer.

Quartz crystal microbalance for the determination of daminozide using molecularly imprinted polymers as recognition element

As the daminozide (DM) and its metabolite have been identified to be potentially carcinogenic, rapid detection method for them is necessary for food safety. A type of piezoelectric crystal sensor has been prepared by using a molecularly imprinted polymer (MIP) as recognition element. The molecularly imprinted polymer was prepared by hot-induced precipitation polymerization, and then the polymer particles were fixed on the surface of the electrode. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) were employed to evaluate the obtained imprinted polymer particles and the MIP sensitive film coated on the electrode. The results showed that a typical time-response curve of the MIP-coated crystal to the DM solution had been given, frequency shifts versus logarithm changes of DM showed good linear correlation within the concentration range of 1.0x10(-9) to 10(-6) mg/mL (y=11.38 lg x+115.45, r=0.9872) and 1.0x10(-6) to 10(-1) mg/mL (y=25.22lgx+209.44, r=0.9938), respectively. The detection limit was 5.0x10(-8) mg/mL (S/N=3), which is lower than that of conventional methods. Further, computer simulation technology was employed to investigate the interaction between methacrylic acid and DM for elucidating the recognition mechanism. The influencing factor pH has also been investigated. The injection experiments of DM structurally related compounds indicated that the obtained sensor has high sensitivity, excellent selectivity, low cost, good reproducibility, and reusable property by combining with piezoelectric crystal and molecularly imprinted polymer.

BHIVA treatment guidelines for tuberculosis (TB)/HIV infection 2005

AL Pozniak, RF Miller, MCI Lipman, AR Freedman, LP Ormerod, MA Johnson, S Collins and SB Lucas, on behalf of the BHIVA Guidelines Writing Committee Chelsea and Westminster NHS Healthcare Trust, London, UK, Centre for Sexual Health and HIV Research, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, University College London, London, UK, Royal Free Hospital, London, UK, Cardiff University School of Medicine, Cardiff, UK, Blackburn Royal Infirmary, Blackburn, Lancashire, UK, HIV i-Base, London, UK, Department of Histopathology, GKT School of Medicine, St Thomas’ Hospital, London, UK

First observation of natural circular dichroism for biomolecules in soft x-ray region studied with a polarizing undulator

We measured natural circular dichroism (CD) for biomolecules in soft x-ray region for the first time. Natural linear dichroism (LD) for K(TiO)PO4 (KTP) crystal was also measured at the K-edge energy of oxygen. Measurements of CD and LD spectra were performed at the soft x-ray undulator beamline BL23SU of SPring-8 in Japan. In this beamline, an APPLE-2 type variable undulator was installed as a light source. This undulator was operated under the phase modulation mode in which left and right circularly polarized light (LCPL and RCPL) was switched with about 0.1 Hz.As a sample for CD measurement, we used sublimated film of L-, D- and DL-phenylalanine (Phe) and L- and D-serine (Ser) (thickness ∼300 nm) and measured CD (AL–AR) spectra in the nitrogen and the oxygen K-edge region, respectively. Here, AL and AR mean the abbreviation of absorption for LCPL and RCPL, respectively. For the Phe film, we observed a negative peak at about 407 eV for the L-Phe spectra. On the contrary, a positive peak for the D-Phe spectra and no spectral feature for the DL-Phe were observed. For the Ser film, we observed positive CD peaks at around 540 eV and 548 eV at the L-Ser spectra, on the contrary, negative peaks for the D-Ser. These results are the first CD spectra for biomolecules in the soft x-ray region.We also used KTP crystal cut parallel to the plane (1,2,0) or (1,−2,0) as a sample of LD measurement and measured (AL–AR) spectra in the oxygen K-edge region and observed some peaks at about 530 eV. Since sign of these peaks were dependent on sample rotation angle in a plane perpendicular to the incident light, we concluded that these peaks are derived from linear anisotropy of crystal. Because of a weak linear polarization component of incident light, we could measure such LD spectra.

The recombinant BGH controversy in the United States: Toward a new consumption politics of food?

The history of the controversy overrecombinant bovine growth hormone (rBGH) is exploredin terms of the issue of the potential robustness ofa consumption-driven ``new'' politics of food andagriculture. It is noted that while the dominanthistorical traditions in the social sciences haveserved to discount the autonomous role that consumersand consumption play in modern societies, there hasbeen growing interest in consumption within foodstudies as well as other bodies of scholarship such aspostmodernism, social constructivism, socialcapital/social distinction, and environmentalsociology. A review of the shifting pattern ofdiscourses during the rBGH controversy shows thatconsumption-driven claims and politics played atangible, but relatively minor role. Even so, it issuggested that the rBGH experience along with paralleltrends in food politics (e.g., anti-pesticidecampaigns such as the ``Alar scare,'' agribusinessattempts to intimidate opponents through fooddisparagement laws, conditions-of-productionprovisions of the World Trade Organization agreement)could make the consumption/consumer dimension of foodpolitics more important in the future.