Entire Lip Research Articles

Geometry, specification, and drilling performance of a plane rake faced drill point design

A study of a modified drill point design with plane rake faces is presented. The critical geometries that uniquely define the drill point design are analysed based on the international standard. The study shows that the modified drill design yields positive normal rake angle on the entire lips and point relieving in the chisel edge region. An experimental study of drilling a high tensile steel using 7–13 mm high-speed steel (HSS) drills with titanium nitride (TiN) coatings has been carried out to assess the new drill point design. It shows that the modified plane rake faced (PRF) drills can reduce the thrust force by as much as 46.9 per cent with an average of 23.8 per cent, as compared to the conventional twist drills under the corresponding cutting conditions, while the reduction in torque is also significant with the maximum of 24.9 per cent. These drilling performance improvements are comparable to those from using the multi-facet drills that were claimed as one of the most heartening drill developments in several decades for drilling force reduction, while the PRF drills can be easily sharpened using the conventional twist drill grinders. The drill-life tests amply demonstrate the superiority of the PRF drills over the conventional twist drills.

One-stage reconstruction of the entire upper lip and the columella with a modified bilateral nasolabial flap

The functional and cosmetic reconstruction of the upper lip after a subtotal defect is a highly demanding challenge, especially when the columella is involved. In the majority of cases, the surgical techniques described in the literature are suitable only for restoring the function and appearance of the upper lip but not for reconstructing adjacent areas. In this article, we present the case of an 85-year-old female patient with an extensive, aggressive and highly invasive basal cell carcinoma of the upper lip and the columella. We describe a modification of the nasolabial flap technique using cheek tissue for the reconstruction of the defect. The modified flap is used for both the full-thickness reconstruction of the subtotal upper-lip defect and the restoration of the function and appearance of the columella. This technique allows excellent cosmetic and functional results to be obtained in a single-stage procedure.

A study of high-performance plane rake faced twist drills.: Part I: Geometrical analysis and experimental investigation

A study of a modified drill point design with plane rake faces for drilling high-tensile steels is presented. A geometrical analysis has shown that the modified drill point design yields positive normal rake angle on the entire lips and point relieving in the vicinity of the chisel edge. This drill geometry can be expected to reduce the cutting forces and torque, and hence reduce the possible drill breakages when drilling high-tensile steels. An experimental study of drilling an ASSAB 4340 high-tensile steel with 7–13 mm titanium nitride (TiN) coated high-speed steel (HSS) drills has shown that the modified drills can reduce the thrust force by as much as 46.9%, as compared to the conventional twist drills under the corresponding cutting conditions, while the average reduction of torque is 13.2%. Drill-life tests have also been carried out and confirmed the superiority of the modified drills over the conventional twist drills. In some cases, the conventional drills were broken inside the workpiece, while the modified drills performed very well under the same cutting conditions. To mathematically predict the drilling performance and optimise the drilling process using the plane rake faced drills, predictive models for the cutting forces, torque and power will be developed in the second part of this investigation.

Wild orchids of the prairies and Great Plains region of North America

Wild orchids of the prairies and Great Plains region of North America

Persistent Non-Tender Swelling of the Upper Lip

A 27-year-old man presented with a 5-month history of persistent swelling of the upper lip (figure 1). Over this period the intensity of swelling changed spontaneously without a noticeable external cause. Clinical examination revealed a smooth, pasty swelling of the entire upper lip with a slight redness of the skin. The patient reported no subjective symptoms. No further lesions were revealed by complete clinical examination of the rest of the head and neck region. Neurologic examination, particularly of the facial nerve, was unrevealing. The patient's medical and surgical histories were non-contributory. A diagnostic biopsy was performed.

Actinic cheilitis: histologic study of the entire vermilion and comparison with previous biopsy

Actinic cheilitis (AC), is the very superficial, incipient form of actinically induced squamous cell carcinoma of the lower lip. Few studies of actinic cheilitis analyzed the entire lip vermilion searching for microscopic areas of progressing carcinoma. Twenty patients with biopsy proved actinic cheilitis presenting with diffuse clinical changes were submitted to vermilionectomy of lower lip. Surgical specimens were sectioned every 3 mm, studied histopathologically and findings were compared with the biopsy. Histological findings were classified as 'AC', carcinoma in situ (CIS), superficially invasive squamous cell carcinoma (SISCC), and invasive squamous cell carcinoma (ISCC). Comparison between biopsies and most severe changes on vermilionectomies revealed coincidental changes in 10 cases (50%), more severe changes on biopsy occurred in two cases (10%) and in eight cases (40%) the changes on vermilionectomy were more severe. SISCC was diagnosed in nine cases (45%): of these, two had been detected on biopsy, six had shown a milder aspect on biopsy, and in one biopsy had shown ISCC. Foci of discontinuous areas of SISCC were detected in four cases (20%). These findings suggest that cases of AC presenting with poorly demarcated lesions may bear severe histopathological changes irregularly distributed along the vermilion.

Inheritance of calyx shape in the genus Origanum (Lamiaceae)

AbstractFive different traits responsible for calyx shape within the genus Origanum were found to be determined by five independent genes. The five traits are bell‐shaped vs. tubular‐shaped calyx, angular vs. round teeth on the upper lip, entire vs. denticulate upper lip, fully developed vs. reduced lower lip and entire vs. denticulate lower lip. The simple Mendelian inheritance of most traits for calyx shape could be used to identify hybrids between Origanum species arising from open‐pollinated plants and so avoid tedious artificial pollination resulting from small flower sizes in Origanum. Such hybrids are interesting base material for character transfer (e.g. winter hardiness or seed size) between economically important species.

Aesthetic reconstruction for large upper lip defects in men.

Although many techniques use hair-bearing flaps to repair large upper lip defects in men, few preserve orbicularis sphincter function. Available techniques can also result in an unnatural appearance, because the entire upper lip is covered by a dense region of hair. We have developed a new technique and successfully repaired a large defect in the upper lip of three men. This technique uses flaps pedicled by angular vessels and includes the orbicularis oris muscle. A good outcome can be obtained both functionally and cosmetically when used in men with defects involving more than one-half of the upper lip.

A Synopsis of the Genus Cribbia Senghas (Orchidaceae), with Two New Species from Sao Tome

Summary. Two new species of epiphytic orchid, Cribbia thomensis and C. pendula, both apparently endemic to the island of Sito Tom6, are described here for the first time. A synopsis of Cribbia Senghas is provided. Four species are now recognised, and a key to them is provided. The genus Rangaeris (Schltr.) Summerh. was established by Summerhayes (1936) as a segregate of Aerangis to which a number of the species had been previously referred. Summerhayes (1948) revised the genus recognising six species in two sections, the typical one with five species, and sect. Biglandulosa with a single species R. brachyceras (Summerh.) Summerh. He commented at the time that this latter section possibly warranted recognition at generic rank and Senghas (1985, 1986) obliged, calling it Cribbia. Cribbia Senghas has until recently been considered monotypic. However, examination of collections from Cameroon has led to the description of a second species, C. confusa (Cribb 1996). Two further collections from Sao Tome by A. Brune are also attributable to the genus because of their habit, column structure and pollinarium features but neither can be ascribed to any known species. Each has an entire ecallose lip, cylindrical spur, 3-lobed non-papillate rostellum and 2 globose porate pollinia, each attached by a linear-oblanceolate stipe to an oblongelliptic viscidium. They are described here as new species.

Brachytherapy for lower lip epidermoid cancer: Tumoral and treatment factors influencing recurrences and complications

Abstract From 1972 to 1991, 237 patients with squamous cell carcinoma of the lower lip were treated by exclusive LDR brachytherapy ( 192 Ir). There were 158 T1, 61 T2, 17 T3 and 1 T4 with 231 N0, 3 N1 and 3 N2 patients. The actuarial values at 5 years for local and regional controls, overall and specific survivals were 95%, 91%, 74% and 91%. Salvage treatment increased local control up to 99% and regional control to 94%. No heterolabial recurrence has been observed since the entire lip is treated, even for small tumors. The regional control depends closely on the thickness of the labial tumor (≥ 1 cm, p p = 0.015). Late complications are not related to tumoral thickness but to the treated thickness (> 1.4 cm, p = 0.018) and particularly to the thickness of normal tissue included in the 85% isodose (treated thickness - tumoral thickness > 0.4 cm, p = 0.025). The use of a leaded protection and low linear radioactivity wires ( 2 /cm) especially for large target volumes is required to lessen late complications. Based on this review, we advocate exclusive brachytherapy for small and intermediate tumors, with elective bilateral submaxillary and submental dissection for thick, high grade or commissure tumors. Simple recommendations are made to assure quality of the brachytherapy treatment.

Brachytherapy for lower lip epidermoid cancer: tumoral and treatment factors influencing recurrences and complications

From 1972 to 1991, 237 patients with squamous cell carcinoma of the lower lip were treated by exclusive LDR brachytherapy ( 192Ir). There were 158 T1, 61 T2, 17 T3 and 1 T4 with 231 N0, 3 N1 and 3 N2 patients. The actuarial values at 5 years for local and regional controls, overall and specific survivals were 95%, 91%, 74% and 91%. Salvage treatment increased local control up to 99% and regional control to 94%. No heterolabial recurrence has been observed since the entire lip is treated, even for small tumors. The regional control depends closely on the thickness of the labial tumor (≥ 1 cm, p < 0.0001). The healing of treatment-induced mucositis is sometimes delayed for thick tumors (≥ 1 cm, p = 0.015). Late complications are not related to tumoral thickness but to the treated thickness (> 1.4 cm, p = 0.018) and particularly to the thickness of normal tissue included in the 85% isodose (treated thickness - tumoral thickness > 0.4 cm, p = 0.025). The use of a leaded protection and low linear radioactivity wires (<2 mCi/cm, <8.6 μGy/h · m 2/cm) especially for large target volumes is required to lessen late complications. Based on this review, we advocate exclusive brachytherapy for small and intermediate tumors, with elective bilateral submaxillary and submental dissection for thick, high grade or commissure tumors. Simple recommendations are made to assure quality of the brachytherapy treatment.

Evaluating the reliability of gear pairs: Thum, H. Schmierungstechnik 1987 18, (8), 235–238, 238 (in German)

A study of a modified drill point design with plane rake faces for drilling high-tensile steels is presented. A geometrical analysis has shown that the modified drill point design yields positive normal rake angle on the entire lips and point relieving in the vicinity of the chisel edge. This drill geometry can be expected to reduce the cutting forces and torque, and hence reduce the possible drill breakages when drilling high-tensile steels. An experimental study of drilling an ASSAB 4340 high-tensile steel with 7–13 mm titanium nitride (TiN) coated high-speed steel (HSS) drills has shown that the modified drills can reduce the thrust force by as much as 46.9%, as compared to the conventional twist drills under the corresponding cutting conditions, while the average reduction of torque is 13.2%. Drill-life tests have also been carried out and confirmed the superiority of the modified drills over the conventional twist drills. In some cases, the conventional drills were broken inside the workpiece, while the modified drills performed very well under the same cutting conditions. To mathematically predict the drilling performance and optimise the drilling process using the plane rake faced drills, predictive models for the cutting forces, torque and power will be developed in the second part of this investigation.

口しん縫合創の治ゆに関する実験的研究 はんこんの引張り強さ，ハイドロキシプロリン定量，組織所見について

It is the purpose of this report to compare the wound healing process mechanically, biochemically, and histologically after straight type lip plasty with that after Z type lip plasty. Both sides of the upper lips of young rabbits, 4 weeks after birth and 450g in weight, were closed with the same number of 5-0 Nylon interrupted sutures. After rabbits were killed 3, 5, 7, 14 days and 1, 3, 6 months after the operation, the entire lip layer was excised. The tensile strength was measured with Instron tension meter, and the collagen content was determined spectrophotometically by Edward's method. Histological findings were obtained after staining with hematoxylin and eosin.The following conclusions were obtained.1. The tensile strength in both groups increased more rapidly than that of previously published reports.2. The tensiles strength after straight type lip plasty reached the tensile strength of the normal skin faster than that after Z type lip plasty.3. The increase of tensile strength in both groups was almost parallel to the increase of collagen content during one month after the operation.4. Histological examination showed that more post operative inflammation was found in Z type lip plasty group than in the straight type lip plasty group.

Reconstruction of the lower lip

A modification of the classic Gillies fan flap as used in reconstructing full thickness defects of the lower lip is described. The method is suitable for defects involving part of the width of the lip up to defects of the entire lip. It can also be used in association with a “lip-shave” when there is pre-malignant change in the vermilion generally in addition to the focus of frank squamous carcinoma.

The Grant Method in the Surgery of Epithelioma of the Lip-Reply

To the Editor —In reply to Dr. Ryfkogel's note, kindly permit me to quote from my article as formerly published inThe Journal, as follows: When half or more of the entire lip is removed, I am in the habit of perfecting and completing the operation by making an incision from each angle of the mouth backward and slightly downward half to one inch in length, down to the buccal mucous membrane, and then separating the latter from overlying tissues above, below and posteriorly to the extent of half an inch. The lip above and below is now beveled from the inner border in order to conform to natural conditions and also to make it easier to cover. The mucous membrane is now divided in the middle line and the flaps united to the skin by one continuous suture of chromicized

GASTROSTOMY FOR STRICTURE OF THE ESOPHAGUS, BY THE SBANIJEWFRANK METHOD, WITH EXHIBITION OF PATIENT.

The patient, C. F. J., age 27, male, white, entered the Grady Hospital as a private patient in my service on Jan. 28, 1896. The following history was obtained on admission: About one year ago he took one swallow of pure nitric acid by mistake, causing corrosion of the entire mouth, lips and esophagus. The mouth and lips healed about three weeks after the sloughs separated. Several months previous to admission the patient noticed an increasing difficulty in swallowing; in the last few weeks this has gotten considerably worse, and he feels now that small particles of solid food are stopped before reaching the stomach, evidently low down in the esophagus. Liquids can still be swallowed slowly and with difficulty; it takes him as much as half an hour to drink a glass of milk. At times during the past few weeks the contraction in the esophagus closes to such