Lateral Cleft Research Articles

A new feather mite species of the genus Temnalges (Acariformes: Psoroptoididae) from coots, Fulica spp. (Gruiformes: Rallidae)

A new feather mite species, Temnalges fulicae sp. n. (Psoroptoididae: Pandalurinae), is described from two species of coots, Fulica americana Gmelin, 1789 (type host), in Canada, and F. atra Linnaeus, 1758, in Denmark. The new species is close to other species of the genus associated with rails (Rallidae), especially to T. megalonyx Gaud, 1968, in having a long spur-like process on tibia III in males, and the prodorsal and hysteronotal shields separated by a wide area of striated tegument in females. Males of Temnalges fulicae are most clearly distinguished from T. megalonyx in having the opisthosoma rounded and without terminal and lateral clefts, and the adanal shields narrow and short. In females, the prodorsal shield has a convex posterior margin, the hysteronotal shield is roughly rectangular, and setae 4a extend to the bases of setae ps3. Additionally, we provide a world checklist and a key to Temnalges species.

Structural basis for triacylglyceride extraction from mycobacterial inner membrane by MFS transporter Rv1410

Mycobacterium tuberculosis is protected from antibiotic therapy by a multi-layered hydrophobic cell envelope. Major facilitator superfamily (MFS) transporter Rv1410 and the periplasmic lipoprotein LprG are involved in transport of triacylglycerides (TAGs) that seal the mycomembrane. Here, we report a 2.7 Å structure of a mycobacterial Rv1410 homologue, which adopts an outward-facing conformation and exhibits unusual transmembrane helix 11 and 12 extensions that protrude ~20 Å into the periplasm. A small, very hydrophobic cavity suitable for lipid transport is constricted by a functionally important ion-lock likely involved in proton coupling. Combining mutational analyses and MD simulations, we propose that TAGs are extracted from the core of the inner membrane into the central cavity via lateral clefts present in the inward-facing conformation. The functional role of the periplasmic helix extensions is to channel the extracted TAG into the lipid binding pocket of LprG.

Unilateral cleft lip anatomy combined with nasal deformities for clinical application in rhinoplasty at Cho Ray Hospital

Nasal deformity in unilateral cleft lip patients has many different clinical forms, causing severe disproportion on both sides of the nose. The treatment of rhinoplasty in these cases is very complex and always a challenge for the surgeon. This study aims to investigate the characteristics of nasal deformities in unilateral cleft lip patients, thereby helping clinical surgeons better prepare for rhinoplasty in these patients. A retrospective method describes a series of cases performed on 89 unilateral cleft lip patients who had lip surgery but still deformed the nose and came for examination and treatment at the Department of Plastic Surgery, Cho Ray Hospital, from December 2013 until October 2022. The study results showed that, 64/89 patients were female (71.9%), only 25 male patients (28.1%), the lowest age was 16 and the highest was 64 years old. 44 patients had a lateral cleft lip on the left side (49.44%) and 45 patients on the right side (50.56%), 100% of the patients had features of nasal deformities: the nasal tip is horizontal, lower and longer than the normal side, nasal base defect, deviated nasal columella, deviated nasal tip, and the nostrils are wide and flat.

Pilot study of factors contributing to canine impaction after secondary alveolar bone grafting in unilateral cleft lip and palate patients

Alveolar bone grafting (ABG) is broadly performed for cleft lip and palate patients. The rate of canine impaction post-ABG is much higher than the prevalence of canine impaction in non-cleft patients. This pilot study was designed to investigate factors involved in canine eruption failure after ABG and to predict the possibility of canine impaction in unilateral cleft lip and palate (UCLP) patients. This retrospective observational study examined 45 patients with UCLP (mean age 7.9 years) classified into an impacted group (n = 9) and a spontaneously erupted group (n = 36). From 3D images, we measured lateral incisor presence or absence, lateral incisor position on the cleft side, canine position, movement change, cleft volume, and canine and first premolar overlap-area. Multivariate logistic regression analysis using independent variables indicated significant differences in results, selecting highly relevant items. Multivariate analysis indicated a significant association between the overlap-area between the canine and the first premolar at pre-ABG (p = 0.038) and the distance between the cleft side cusp tips of canine and the lateral cleft margin of pre-ABG (p = 0.005). Results suggest that canine impaction is predictable at an early stage in pre-ABG and show the possibility of comprehensive diagnosis of canine impaction using computed tomography.

Prevalence of cystic metastases in a consecutive cohort of surgically removed branchial cleft cysts

Background Solitary cystic lesion of the neck may often be the only initial presenting symptom for branchial cleft cysts and cystic metastases. Aims/objectives To analyse the malignancy rate detected in patients undergoing surgical treatment for lateral branchial cleft cyst. Material and methods The records of all patients with surgical procedure code ENB40 (Excision of lateral branchial cleft cyst- or fistula) between 2003 and 2019 were reviewed. After excluding 150 patients, 436 patients were included for final analysis. Re-evaluation of the cytology including HPV-analysis was performed in those who had a malignant cyst. Results Cystic metastases were demonstrated histologically after surgical excision in 13 patients (3%). In patients over 18 years of age, the prevalence of cystic metastasis regardless of the primary tumour type was 3.3%. Conclusion and significance When the investigation protocol for solitary cystic lesions of the neck is followed, the negative predictive value for malignancy is 97%. All adult patients with a cytologic verified diagnosis of branchial cyst should be examined with HPV-analysis of the cystic sample before excision of the cyst. Failure of predicting a malignancy is often associated with cytology of poor cellularity which may be improved by more frequent use of ultrasound guided fine-needle aspiration cytology (FNAC).

Presentation and Management of Atypical Orofacial Clefts: A Single-Institution Experience for 13 Year Period.

This study reviews the craniofacial clefts that presented at a Nigerian tertiary health facility, highlighting our experience with the pattern of presentation and surgical care of these patients. A retrospective review of the smile train database and medical records of all individuals who had been diagnosed with any of the Tessier craniofacial clefts and managed between 1st January 2007 and 31st December 2020 was done. The data were presented as numbers and percentages of cases. The cleft clinic of a tertiary health facility and a major cleft referral center in South-West Nigeria. Forty-five patients with craniofacial clefts were managed over the study period. 15.6% had associated syndromes, 2.2% had a family history of similar craniofacial cleft and 11% had a history of a possible teratogen. There were 21 (46.7%) middle clefts, 14(31.1%) lateral clefts and 10(22.2%) oblique clefts. The most common type of cleft was Tessier 0 while the Tessier 6 was the least common type. The median age at surgery was 10 months for male and 5months for female subjects, 15.3% complication rate was found in this study. Four patients had revision surgeries to correct residual deformities in this study. The diverse presentations and occurrence of the rare craniofacial clefts present complex aesthetic and functional problems that require individualized often multidisciplinary care. The execution of a properly planned treatment will reduce complications and the need for revision surgeries.

Mitral valve cleft gapping mechanism in functional mitral regurgitation: An in-vitro study

Background and aimGapping formation of the mitral valve cleft is unknown. The objective of this study was to quantify the geometry of mitral valve cleft coaptation in the asymmetric and symmetric papillary muscles (PMs) positions in a dilated annulus in order to reveal mitral valve gapping mechanism. MethodsNine fresh porcine mitral valves with the posterior leaflet clefts were sutured onto a saddle-shaped dilated annulus in an in-vitro experiment to simulate mitral valve closure at hydrostatic pressure. PMs were adjusted to the normal position, and subsequently to positions of asymmetric and symmetric PM displacement. Sonomicrometry was used to measure positions of the lateral and medial clefts. ResultsPM displacement tethered the leaflets. Both the opening angle and contact angle of the lateral cleft, but not of the medial cleft, increased in the asymmetric PM displacement. Neither the opening angle nor contact angle of both clefts increased in the symmetric PM displacement. ConclusionsDisplacement of the postero-medial PM moves the posterior leaflet medially and impairs coaptation of the lateral cleft, but not medial cleft, which suggest that the medial cleft displacement in the asymmetric PM position is another mechanism of gap formation in addition to leaflet tenting due to apical leaflet displacement. Symmetric PM displacement cause leaflet tenting, but doesn’t impair the leaflet cleft coaptation, which suggest that the asymmetric PM position is even worse than the symmetric PM position.

Lateral canthal choristomas associated with colobomas of lateral canthus

Choristomas are congenital lesions presenting normal tissue in an abnormal location. A conjunctival dermolipoma is a congenital choristomas tumor usually localized in the temporal aspects of the bulbar conjunctiva, near the lateral canthus. It may be associated with developmental anomalies of the second branchial arch, such as Goldenhar syndrome. The association between dermolipoma and lateral canthal cleft without other congenital anomalies is uncommon. The purpose of this paper is to present a series of isolated choristomas in the lateral canthus associated with a lateral cleft. We present 3 cases of dermolipoma at the lateral canthus associated with isolated lateral cleft. The dermolipomas’ appearance ranges from a flat lesion to a large pedunculated tumor, obliterating the lateral conjunctival fornix. A partial removal of the dermolipoma was done with canthoplasty to close the lateral coloboma. Surgical management of dermolipoma with partial excision aimed at reducing visible tumor produced good cosmetic results, without complications. Microscopic examination of the tumor revealed a mass covered by stratified squamous keratinized epithelium. The mass comprised largely of mature adipose tissue interspersed with bundles of collagen. The presence of pilosebaceous units was also noted. Based on these features, a histopathological diagnosis of a dermolipoma was made. The association between dermolipoma and isolated lateral canthal cleft is much less common than the associations with other distinguishing abnormalities. In summary, these cases illustrate that dermolipomas are also a part of a wide spectrum that characterizes benign growths of the eyelids. Level of evidence: Level V, therapeutic study.

Surgical Correction of Tessier No. 7 Facial Cleft of Goldenhar Syndrome Patient: A Case Report

Goldenhar syndrome is a disease that caused by affected structures induced by the first and second bronchial arch. It is characterized by various clinical symptoms such as ocular abnormality, external auditory canal stenosis, ear tag, mandibular dysplasia, and spinal abnormality. Since the fusion of the maxillary and mandibular processes is also affected, lateral cleft at commissure of mouth appears commonly. According to Tessier s craniofacial cleft classification in 1976, lateral cleft at commissure of mouth corresponds to Tessier No. 7 classification, characterized by philtrum displacement due to non-union and improper development of muscles around the mouth. There is no definite time for the treatment of these patients with facial anomalies, but it is necessary to perform surgical correction at the appropriate time considering the functional and social aspects of the patient. Patients with Goldenhar syndrome are often accompanied by other systemic diseases. Therefore, it is advisable to perform oral and maxillofacial surgery after evaluate the systemic conditions of the patient. There are few surgical methods to correction Tessier No. 7 facial clefts, but the gold standard is not established. In this case, surgical correction of lateral cleft was performed using simple suture method based on reorientation of orbicularis oris muscle, where reorientation of zygomaticus major muscle and risorius muscle. Triangular abundant skin of mouth commissure was rotated to intraoral side and used appropriately to closure. After the operation, the patient’s symmetry of the lip was recovered, and the functional recovery of the orbicularis oris muscle was achieved.

Atypical Facial Clefts From Northcentral Nigeria, Review of 36 Cases.

This study aims to present the pattern and management of atypical facial clefts from a Nigerian population. This is a retrospective study of patients seen during series of surgical outreach programs in North Central Nigeria, between 2011 and 2017. All cases of atypical facial clefts encountered were evaluated for the pattern of presentation using Tessier classification system. All of them were surgically repaired and outcome was determined using a Likert scale. Data were presented using descriptive statistics. Outreach programs in North Central Nigeria by Cleft & Facial Deformity Foundation. Thirty-six patients, 19 (52.8%) males and 17 (47.2%) females, were studied. The age range was 1 week to 34 years, with mean (standard deviation) of 11.2 (11.8) years. Fifty-eight cleft cases were recorded, with Tessier 1 being the commonest (n = 14; 24.1%) cleft type. There were 35 (60.3%) cases of middle cleft, 14 (24.2%) cases of oblique cleft, and 9 (15.5%) cases of lateral cleft. Typical cleft lip and palate coexisted with atypical facial cleft in 2 (5.6%) patients. Cleft was found to be median in 12 (33.3%) patients and right sided in 9 (25%) patients. Majority (n = 24, 66.7%) of the cases were repaired by simple excision plus direct closure with successful outcome. Numerical classification by Paul Tessier has reduced the inconsistencies of nomenclature among practitioners. Majority of atypical facial clefts could be treated by simple techniques with satisfactory outcomes. However, the more complex cases will require multistaged surgical approach.

Phenotypic spectrum of Tessier facial cleft number 5

IntroductionCraniofacial clefts belong to the most disfiguring and rare congenital malformations of the face and among these, orbito-facial clefts constitute approximately 0.22 % of the cases with Tessier cleft number 5 being the least common. Our aim was to define the phenotypic spectrum for this subgroup to improve clinical management. MethodsOur study group consisted of four patients which were treated at two different cleft centers. Retrospective chart review and anatomical analysis were conducted for each patient based on clinical evaluation and imaging studies. Morphological anomalies including soft tissue, bone and oral components were recorded. ResultsBased on our analysis and literature review, we could define two subtypes of Tessier facial cleft number 5. (1) Medial clefts are the more severe subtype, creating a significant soft tissue and bone defect that runs vertically, through the eyelid, infraorbital rim, maxillary sinus and cheek. They have the poorer esthetic and functional prognosis, due to orbital dystopia and absence of lower eyelid. (2) Lateral clefts are a less severe subtype characterized by the presence of a vertical furrow of the cheek running laterally to the maxillary sinus. ConclusionsWe identified two subtypes of facial cleft number 5 which require an individualized surgical management

Symptomatic Unilateral Spondylolysis Associated with Non-Spodylolytic Lateral Clefts in Adults – Guidelines for a Rare Condition

Symptomatic Unilateral Spondylolysis Associated with Non-Spodylolytic Lateral Clefts in Adults – Guidelines for a Rare Condition

Symptomatic Unilateral Spondylolysis Associated With Nonspondylolytic Lateral Clefts in Adults: Review of an Infrequently Reported Pathology

Nonspondylolytic lateral clefts of the lumbar neural arch (laminolysis and pediculolysis) are rare pathologies that usually occur consequent to repetitive stress injuries in patients with unilateral spondylolysis. These lesions are different from the usual bilateral spondylolytic defects, and their management depends upon the chronicity and the type of bony defect. We hereby discuss the verdict of current literature on underlying pathomechanics and ideal management guidelines of these rare lesions.

Structural insights into HetR-PatS interaction involved in cyanobacterial pattern formation.

The one-dimensional pattern of heterocyst in the model cyanobacterium Anabaena sp. PCC 7120 is coordinated by the transcription factor HetR and PatS peptide. Here we report the complex structures of HetR binding to DNA, and its hood domain (HetRHood) binding to a PatS-derived hexapeptide (PatS6) at 2.80 and 2.10 Å, respectively. The intertwined HetR dimer possesses a couple of novel HTH motifs, each of which consists of two canonical α-helices in the DNA-binding domain and an auxiliary α-helix from the flap domain of the neighboring subunit. Two PatS6 peptides bind to the lateral clefts of HetRHood, and trigger significant conformational changes of the flap domain, resulting in dissociation of the auxiliary α-helix and eventually release of HetR from the DNA major grove. These findings provide the structural insights into a prokaryotic example of Turing model.

Structural biology of presenilin 1 complexes.

The presenilin genes were first identified as the site of missense mutations causing early onset autosomal dominant familial Alzheimer's disease. Subsequent work has shown that the presenilin proteins are the catalytic subunits of a hetero-tetrameric complex containing APH1, nicastrin and PEN-2. This complex (variously termed presenilin complex or gamma-secretase complex) performs an unusual type of proteolysis in which the transmembrane domains of Type I proteins are cleaved within the hydrophobic compartment of the membrane. This review describes some of the molecular and structural biology of this unusual enzyme complex. The presenilin complex is a bilobed structure. The head domain contains the ectodomain of nicastrin. The base domain contains a central cavity with a lateral cleft that likely provides the route for access of the substrate to the catalytic cavity within the centre of the base domain. There are reciprocal allosteric interactions between various sites in the complex that affect its function. For instance, binding of Compound E, a peptidomimetic inhibitor to the PS1 N-terminus, induces significant conformational changes that reduces substrate binding at the initial substrate docking site, and thus inhibits substrate cleavage. However, there is a reciprocal allosteric interaction between these sites such that prior binding of the substrate to the initial docking site paradoxically increases the binding of the Compound E peptidomimetic inhibitor. Such reciprocal interactions are likely to form the basis of a gating mechanism that underlies access of substrate to the catalytic site. An increasingly detailed understanding of the structural biology of the presenilin complex is an essential step towards rational design of substrate- and/or cleavage site-specific modulators of presenilin complex function.

Skeleton of the Fossil SharkIsurus denticulatusfrom the Turonian (Late Cretaceous) of Germany—Ecological Coevolution with Prey of Mackerel Sharks

AnIsurus denticulatus(Glickman, 1957) shark skeleton from the late Turonian (Late Cretaceous) of Germany is described within a diverse upwelling influenced fish fauna of northern Germany, Europe. It was found in the turbiditic marly limestones at the submarine Northwestphalian Lippe Swell in the southern Proto-North Sea Basin. Compared to modern mackerel sharkIsurus oxyrinchusRafinesque, 1809, including cranial denticles, this allows a revision of the younger synonym “CretoxyrhinaGlickman, 1964”. Within the CretaceousIsurus, a loss of the lateral tooth cusps and nutritive clefts of the roots (considered as plesiomorphic character of the Lamnidae) took place from the Albian (Early Cretaceous) to the Campanian (Late Cretaceous). The tooth morphology changed during the Albian-Turonian from a tearing (I. denticulatus) to a cutting (I. mantelli) type (Coniacian-Campanian). The complete lateral cusplet and symphyseal teeth reduction inIsurusat the end of the Cretaceous seem to be a result of the coevolutionary changing feeding habits of a worldwide expanding shark. In a second evolutionary adaptation, parallel to the new radiation of marine mammals (Paleocene/early Eocene), fromIsurus, the white shark ancestors (Carcharodon) seem to originate. In another radiation fromIsurus, coevolving with appearance of dolphins and further marine mammal evolution within the Middle Miocene, a second timeIsurusdeveloped serrated teeth (I. escheri).

Anatomy research of nasolabial muscle structure in fetus with cleft lip: an iodine staining technique based on microcomputed tomography.

A thorough knowledge of the anatomic structure of the orbicularis oris of the upper lip and the nasalis in fetus with cleft lip is the key for the success of cleft lip repair. To understand the anatomic structure of the muscles of nasolabial region in fetus with cleft lip, the nasolabial tissues in 4 aborted fetuses with cleft lip were soaked for 7 days with iodine solution (Lugol solution of 3.75%) and were given micro-computed tomography. After the iodine solution permeated into the soft tissues, a good contrast was showed between muscle fibers and other fibrillar connective tissues. Through the observation of the obtained images, we found that most orbicularis oris fibers gathered into bundles with clear outline and only had slight deformation and displacement on the health side of the cleft of the unilateral incomplete cleft lip; however, in the lateral cleft, the muscle fibers not only had deformation and displacement but also were immature, disorganized, and not gathered into bundles. After being restored in Digital Imaging and Communications in Medicine format, the obtained images were then transferred into Materialise's interactive medical image control system, edited, and reconstructed into three-dimensional models. The models clearly showed the spatial relationship between the muscular tissues of the nasolabial region and the nasolabial outline in fetus with cleft lip.

The structures of the CutA1 proteins from Thermus thermophilus and Pyrococcus horikoshii: characterization of metal-binding sites and metal-induced assembly.

CutA1 (copper tolerance A1) is a widespread cytoplasmic protein found in archaea, bacteria, plants and animals, including humans. In Escherichia coli it is implicated in divalent metal tolerance, while the mammalian CutA1 homologue has been proposed to mediate brain enzyme acetylcholinesterase activity and copper homeostasis. The X-ray structures of CutA1 from the thermophilic bacterium Thermus thermophilus (TtCutA1) with and without bound Na(+) at 1.7 and 1.9 Å resolution, respectively, and from the hyperthermophilic archaeon Pyrococcus horikoshii (PhCutA1) in complex with Na(+) at 1.8 Å resolution have been determined. Both are short and rigid proteins of about 12 kDa that form intertwined compact trimers in the crystal and solution. The main difference in the structures is a wide-type β-bulge on top of the TtCutA1 trimer. It affords a mechanism for lodging a single-residue insertion in the middle of β2 while preserving the interprotomer main-chain hydrogen-bonding network. The liganded forms of the proteins provide new structural information about the metal-binding sites and CutA1 assembly. The Na(+)-TtCutA1 structure unveils a dodecameric assembly with metal ions in the trimer-trimer interfaces and the lateral clefts of the trimer. For Na(+)-PhCutA1, the metal ion associated with six waters in an octahedral geometry. The structures suggest that CutA1 may contribute to regulating intracellular metal homeostasis through various binding modes.

Structural Interactions between Inhibitor and Substrate Docking Sites Give Insight into Mechanisms of Human PS1 Complexes

SummaryPresenilin-mediated endoproteolysis of transmembrane proteins plays a key role in physiological signaling and in the pathogenesis of Alzheimer disease and some cancers. Numerous inhibitors have been found via library screens, but their structural mechanisms remain unknown. We used several biophysical techniques to investigate the structure of human presenilin complexes and the effects of peptidomimetic γ-secretase inhibitors. The complexes are bilobed. The head contains nicastrin ectodomain. The membrane-embedded base has a central channel and a lateral cleft, which may represent the initial substrate docking site. Inhibitor binding induces widespread structural changes, including rotation of the head and closure of the lateral cleft. These changes block substrate access to the catalytic pocket and inhibit the enzyme. Intriguingly, peptide substrate docking has reciprocal effects on the inhibitor binding site. Similar reciprocal shifts may underlie the mechanisms of other inhibitors and of the “lateral gate” through which substrates access to the catalytic site.

Accessory maxilla with a lateral cleft lip: A rare case report

Maxillary duplication is a rare congenital anomaly that occurs in the jaw/mouth region. Duplication of jaws carrying teeth may occur either as an accessory process or, more rarely, a complete jaw. The lateral cleft lip and accessory maxilla are rare congenital abnormalities likely to occur independently but this combined manifestation of accessory jaw processes and transverse facial clefts is exceedingly rare.We report an extremely rare case of accessory maxilla carrying teeth associated with a lateral cleft lip in a 17-year-old male along with a discussion on the pathogenesis, treatment protocol and the differential diagnosis with review of literature.