The septum in rhinoplasty

Recognition and correction of septal abnormalities in rhinoplastic surgery has been a constant evolution aided by the development of an in depth anatomic understanding of the nose and the refinement of techniques based on the pertinent anatomy. Whether the deformity presents a functional, aesthetic, or combined problem, the authors prefer a single stage technique that separates the structural components of the nose, isolating the deformities present, and then reconstructing the components to effect a desirable result in terms of airway and appearance. Although no two nasal surgeries are identical, there are characteristic deformities that are noted to be generally more problematic. We briefly review normal septal anatomy as it pertains to the septorhinoplasty operation and then discuss our approach to specific septal variations that we have found to have a significant impact with regard to achieving satisfactory functional and aesthetic results.     

The first polar body does not predict accurately the location of the metaphase II meiotic spindle in mammalian oocytes

OBJECTIVE: To evaluate how well polar body location predicts spindle localization and to examine spindle morphology. DESIGN: Randomized, controlled animal study. SETTING: University-affiliated research laboratory. ANIMAL(S): Mature, female golden hamsters. INTERVENTION(S): After superovulation with pregnant mare serum gonadotropin and hCG, metaphase II oocytes were obtained and imaged under digital polarization microscopy. MAIN OUTCOME MEASURE(S): Identify the meiotic spindle in living, unfixed hamster oocytes and determine spindle location relative to the polar body. RESULT(S): Spindles were imaged in 30 oocytes and only in 5 of them could the polar body predict the spindle localization. In the remaining oocytes, the spindles presented a random distribution within the cytoplasm. CONCLUSION(S): These data show that the polar body location is not an accurate predictor for meiotic spindle location in mammalian oocytes.     

Development of a mathematical model for predicting concentrations of small asbestos fibers

The standard method of asbestos sample analysis by phase-contrast microscopy excludes fibers which are below the resolution limits of the light microscope. Electron microscopic studies revealed that fibers in these small size ranges comprise the majority of fibers in asbestos dust. This research was conducted to determine if the development of a mathematical model for predicting concentrations of small fibers (less than 5 microns length) based on phase-contrast concentrations was feasible. The model presented in this paper was evaluated for its practical utility and was determined to be of minimal value; however, it was felt that the development of a reasonably accurate model can be arrived at through continued research.     

Digital, labial, and velopharyngeal reaction times in normal speakers

The relationship between inherent speed limitations of the velopharyngeal mechanism and the observed phenomenon of assimilation nasality was investigated by studying the reaction times of 10 normal adults performing three movements: (1) lip closing, (2) velopharyngeal closing, and (3) pressing a response key with a finger. The first two movements were monitored using a photodetector system. Across nearly 300 responses for each of the motor responses, the average reaction times, in milliseconds, were 194 for the digital, 203 for the labial, and 206 for the velopharyngeal movements. An analysis of variance revealed no consistent differences among these responses. The significance of these data is discussed with respect to speech motor control and clinical evaluation of patients with velopharyngeal impairments.     

Clinical Assessment of Gestational Age

There is disagreement among authors as to what criteria are most reliable in assessing postnatal fetal age. A comparison–for objectivity, accuracy, and frequency of use– of specific criteria was made using three independent examiners at different educational levels: a second-year medical student, a perinatal nurse practitioner, and a pediatrics resident. It was shown that trained examiners develop favorite criteria which differ among examiners and thus sacrifice accuracy; however, accurate assessment of fetal age can be accomplished by an examiner with minimum clinical knowledge.     

Working With Parents Through a Devastating Experience-The Birth of a Mongoloid Child

The author believes that professional advice given the parents of a mongoloid infant determines their initial decision on institutionalization. Multidisciplinary counseling by the health team can help parents decide on a course of action that will prove satisfactory in the long run. Consultation should include health t e r n efforts to help parents work through the mourning process and presentation of a) an objective, comprehensive view of the child's condition, b) information on integrating a mongoloid into the family unit, and c) outside resources available to the parents. Deliberation with the parents to help them reach their own decision is essential.