Submental perforator flap: Location and number of submental perforating vessels

The sites and numbers of submental perforator vessels were examined using a Doppler probe in 21 volunteers. The subcutaneous vascular network from each perforator was studied in three cases of dissection of upper-neck lymph nodes among the volunteers. A perforator from the submental vessels was noted in all 21 volunteers: a single perforator in 13 cases, and double perforators in eight. The main perforator, which had some subdermal branches, was located 31.8 (8.3) mm in front of the facial artery that was palpated at the mandible. Five patients who presented with skin defects on the cheek and the chin had the submental perforator flap reconstructed, excluding the platysma muscle. All flaps covered the wounds. The submental perforator flap was useful for reconstructing skin defects on the cheek and the chin, because the site of the submental perforator was stable and raising the flap was easy, and the colour and texture matches were acceptable.     

Perceived color shift of ceramics according to the change of illuminating light with spectroradiometer

PURPOSE

Perceived color of ceramics changes by the spectral power distribution of ambient light. This study aimed to quantify the amount of shifts in color and color coordinates of clinically simulated seven all-ceramics due to the switch of three ambient light sources using a human vision simulating spectroradiometer.

MATERIALS AND METHODS

CIE color coordinates, such as L*, a* and b*,of ceramic specimens were measured under three light sources, which simulate the CIE standard illuminant D65 (daylight), A (incandescent lamp), and F9 (fluorescent lamp). Shifts in color and color coordinate by the switch of lights were determined. Influence of the switched light (D65 to A, or D65 to F9), shade of veneer ceramics (A2 or A3), and brand of ceramics on the shifts was analyzed by a three-way ANOVA.

RESULTS

Shifts in color and color coordinates were influenced by three factors (P<.05). Color shifts by the switch to A were in the range of 5.9 to 7.7 ΔE*_abunits, and those by the switch to F9 were 7.7 to 10.2; all of which were unacceptable (ΔE*_ab > 5.5). When switched to A, CIE a* increased (Δa*: 5.6 to 7.6), however, CIE b* increased (Δb*: 4.9 to 7.8) when switched to F9.

CONCLUSION

Clinically simulated ceramics demonstrated clinically unacceptable color shifts according to the switches in ambient lights based on spectroradiometric readings. Therefore, shade matching and compatibility evaluation should be performed considering ambient lighting conditions and should be done under most relevant lighting condition.     

Muscle architecture adaptations to knee extensor eccentric training: Rectus femoris vs. vastus lateralis

Introduction: Changes in muscle architecture induced by eccentric knee extensor training remain unclear, as well the adaptive responses of synergistic knee extensor muscles with different geometrical designs. Methods: Ultrasonography images were taken from rectus femoris (RF) and vastus lateralis (VL) of 20 male volunteers before and after a non‐training control period of 4 weeks, and additional evaluations were performed after 4, 8, and 12 weeks of isokinetic eccentric training. Results: RF and VL had significant changes in muscle architecture within the first 4 training weeks, and the adaptive response throughout the intervention was similar. Muscle thickness increased by around 7–10%, fascicle length increased 17–19%, and pennation angle was unchanged. Conclusions: Increased muscle thickness due to eccentric training was related to increased fascicle length and not to pennation angle changes. Although RF and VL have a different fascicular geometry, they had similar morphological adaptations to eccentric training. Muscle Nerve 48 : 498–506, 2013     

Sternocleidomastoid ultrasonography data for muscular torticollis in infants

Introduction: This study was performed to obtain normative ultrasonographic data of the sternocleidomastoid (SCM) muscle in infants and to describe an ultrasound method for evaluating muscular torticollis. Methods: The thickness and cross‐sectional area (CSA) of the sternal and clavicular heads of the SCM in 84 subjects were analyzed retrospectively. The diagnostic performance of ultrasonography (US) was estimated using receiver‐operating characteristic analysis. Results: Muscle thickness increased with age until 10 months. There were no significant differences in thickness or CSA between the right and left sides (P > 0.05) in normal subjects. A ratio of the thickness of the affected side to the unaffected side for the sternal head of the SCM muscle of >1.19 showed a diagnostic sensitivity of 97.9% and specificity of 96.4%. Conclusions: Distinguishing the heads of the SCM muscle and comparing the thickness of the same head on both sides using US may be helpful for evaluating torticollis in infants. Muscle Nerve 000: 000–000, 2013     

Increased nerve vascularization detected by color doppler sonography in patients with ulnar neuropathy at the elbow indicates axonal damage

Introduction: The aim of this study was to establish the prevalence of increased intraneural vascularization detected by ultrasonography (IVUS) in patients with ulnar neuropathy at the elbow (UNE) and to determine its relationship to clinical, ultrasonographic, and electrodiagnostic findings. Methods: High‐resolution ultrasonography and color Doppler imaging were performed in 137 patients with confirmed UNE, 24 patient controls, and 70 healthy controls (HCs). Results: IVUS was found in 21 (15%) of 137 patients with UNE, in 1 (4%) of 24 patient controls, and in 0 of 70 HCs (P = 0.001). Patients with IVUS were more likely to have severe weakness (P = 0.01), severe atrophy of ulnar‐innervated muscles (P = 0.008), axonal damage (P = 0.001), and more pronounced nerve enlargement (P = 0.03) than those without IVUS. Conclusions: IVUS in the ulnar nerve can be detected in patients with UNE and is associated with nerve enlargement and clinical and electrodiagnostic severity. In addition, IVUS is associated with axonal damage. Muscle Nerve, 2013     

Relationship between the flow pattern and vasomotor reactivity in the ophthalmic artery,siphon and vessels within the circle of Willis in the unilateral internal carotid artery occlusion

Abstract

The aim was to study a relationship between the flow pattern in the ophthalmic artery (OA), the siphon and vessels within the circle of Willis. 27 patients, 22 males and 5 females; mean age 63 ± 15 years (SD) with unilateral occlusion of the internal carotid artery (ICA) were examined by 3-dimensional Transcranial Doppler scanner Flow signals from the OA, the siphon and intracranial vessels were registered before and after i.v. injection of 1 g acetazolamide. Pathological flow pattern was found in 18 patients in the OA on the occluded side consisting of 12 retrograde and 6 isoelectric flow directions. After acetazolamide injection retrograde systolic velocities (SV) increased significantly (p < 0.01), but anterograde velocities remained unchanged as did 3 isoelectric flow patterns, 2 turned to retrograde and one to anterograde flow direction. In the siphon lower resting anterograde mean velocities (MV) were found on both sides (p < 0.05) compared to normal subjects. Six patients had the same retrograde flow as in the OA. After acetazolamide MV in the siphon increased (p <0.01) only on the nonoccluded side. Baseline retrograde ophthalmic SVand MV in the siphon correlated (p < 0.01 and p < 0.05 respectively) with MV in the middle cerebral artery (MCA) according to linear regression analysis (x - 0.78 and 0.59 respectively). All patients, having impaired vasomotor reactivity (VMR) <11% in the anterior cerebral artery (ACA) on the occluded side, had pathological flow pattern in the OA. Patients with greatest difference (A) between MV in the ACA on the nonoccluded and occluded side had a tendency to anterograde flow (r = 0.56, p < 0.05). Pulsative index (PI) in the ACA on the occluded side was lowest in the category with retrograde flow in the OA (0.67± 0.14) and differed (p < 0.05) from normals and from the category with isoelectric and anterograde flow. Correlation of retrograde flow direction in the OA and baseline MV in the MCA and low PI in the ACA on the occluded side indicates a supplying ophthalmic collateral to the anterior brain circulation. Impaired VMR in the ACA on the occluded side in connection with pathological flow pattern in the OA may reflect an exhaustion of the ACA as a supplying vessel. [Neurol Res 1996; 18: 521-527]     

Effect of stimulation of the dorsal aspect of the cervical spinal cord on ’Iocal cerebral blood flow and EEG in the cat

Abstract

Currently there is considerable interest in electrical stimulation of the dorsal aspect of the cervical spinal cord as a potentially effective therapy for persistent vegetative patients. The authors assessed change in the local cerebral blood flow (LCBF) and electroencephalogram (EEe) in the cat following spinal cord stimulation (SCS). In 31 adult cats under isoflurane anesthesia, an electrode for SCS was introduced epidurally to the midline of the C2-C3 segment. Stimulation was performed at 25 Hz and 0.7 msec for30 min. These animals were divided into five groups by the voltage: (1) 2V (n = 7), (2) 4V (n = 7), (3) 6V (n = 7), (4) 4V with intravenous injection of muscarinic cholinergic agents - atropine sulfate (n =5), and (5) sham-operated control (n = 5) without stimulation. LCBF was measured by laser Doppler flowmetry through bilateral small burr holes at the parietal area during and 60 min after stimulation. At 2~ LCBF increased only during SCSI then returned to the pre-stimulated level, while the increase continued until the end of the experiment at 4Vand 6V. The increase in LCBF was not affected by atropine sulfate. EEe showed spike and wave or polyspikes after SCS in two animals of the 6V group, but not in the 2V and 4V groups, and moreover a moderate increase ofthe background activity at only 4V. The present data suggested that SCS at 4Vcan provide the appropriate microcirculatory enhancement with less harmful influence which continues to increase 30 min after SCSI although the exact mechanism should be elucidated continuously. Within the limitation of animal experiments, this study could provide the logical basis for determining the condition of SCS. [Neural Res 2000; 22: 386-392]     

Experience with intraoperative high frequency Doppler sonography in neurosurgical practice

Abstract

The method of blood flow velocity (BFV) evaluation by intraoperative application of the high frequency Doppler is presented. The device is used to estimate BFV changes in small caliber arteries by direct placement of the probe upon the examined vessel. BFVexaminations were performed on the site during aneurysm operations, during transsphenoidal approaches to identify the intracavernous portion of leA embedded in the tumor mass and in patients after encephalodurosynangiosis evaluated on the outpatient basis. Technical characteristics of the flowmeter used are described and examples of the BFV pictures in cerebral arteries are presented. The device allows a precise BFVevaluation in the selected vessel and detection of changes in BFV patterns particularly useful during aneurysms surgery. This method of identifying cerebral vessels may become applicable in other types of neurosurgical operations. [Neural Res 1998; 20: 655–657]