Effect of rapid maxillary expansion on the dimension of the nasal cavity and on facial morphology assessed by acoustic rhinometry and rhinomanometry

OBJECTIVE: To assess the effects of rapid maxillary expansion on facial morphology and on nasal cavity dimensions of mouth breathing children by acoustic rhinometry and computed rhinomanometry. METHODS: Cohort; 29 mouth breathing children with posterior crossbite were evaluated. Orthodontic and otorhinolaryngologic documentation were performed at three different times, i.e., before expansion, immediately after and 90 days following expansion. RESULTS: The expansion was accompanied by an increase of the maxillary and nasal bone transversal width. However, there were no significant differences in relation to mucosal area of the nose. Acoustic rhinometry showed no difference in the minimal cross-sectional area at the level of the valve and inferior turbinate between the periods analyzed, although rhinomanometry showed a statistically significant reduction in nasal resistance right after expansion, but were similar to pre-treatment values 90 days after expansion. CONCLUSION: The maxillary expansion increased the maxilla and nasal bony area, but was inefficient to increase the nasal mucosal area, and may lessen the nasal resistance, although there was no difference in nasal geometry. Significance: Nasal bony expansion is followed by a mucosal compensation.

Anatomical and radiographic appearance of the capuchin monkey thoracic cavity (Cebus apella)

The capuchin monkey is widespread both north and south of the Legal Amazon and in the Brazilian cerrado. Ten clinically healthy capuchin monkeys were submitted to an anatomical and radiographic study of their thoracic cavities. The radiographic evaluation allowed the description of biometric values associated with the cardiac silhouette and thoracic structures. Application of the VHS (vertebral heart size) method showed positive correlation (P<0.05) with depth of the thoracic cavity, as well as between the body length of vertebrae T 3, T 4, T 5 and T 6 and the cardiac length and width. The lung fields showed a diffuse interstitial pattern, more visible in the caudal lung lobes and a bronchial pattern in the middle and cranial lung lobes. The radiographic examination allowed preliminary inferences to be made concerning the syntopy of the thoracic structures and modifiication of the pulmonary patterns and cardiac anatomy for the capuchin monkey.

Vascular leiomyoma in the oral cavity

The aim of this study was to examine a case report of vascular leiomyoma located in the oral mucosa of the oral cavity. Vascular leiomyoma is a benign tumor arising from smooth muscle. One factor that makes vascular leiomyomas in the oral cavity rare is that there is little smooth muscle in the mouth. The most common histological subtype in the oral cavity is the vascular subtype. The greatest difficulty in histological diagnosis of this entity is the similarity in morphology with other malignancies, particularly of neural or fibroblastic lineage. Wide surgical resection is the only treatment reported in the literature with good results. The recurrence rate is very low if complete resection is achieved. The study of rare or unusual lesions is very important for the clinical diagnosis of vascular leiomyoma

Gross morphology of rhea oropharyngeal cavity

The rhea (Rhea americana americana) is an american bird belonging to Ratite's family. Studies related to its morphology are still scarce. This study aims to describe the macroscopic structures of the oropharyngeal cavity. Five heads (2 to 6 months old) formalin preserved were anatomically dissected to expose the oropharynx. The oropharynx of the rhea was "bell-shaped" composed by the maxillary and mandibular rhamphotheca. The roof and floor presented two distinct regions different in colour of the mucosa. The rostral region was pale pink contrasting to grey coloured caudal region. The median longitudinal ridge extended rostrally from the apex of the choana to the tip of the beak in the roof and it is clearly more prominent and rigid than the homolog in the floor that appeared thin and stretched merely along the rostral portion of the regio interramalis. The floor was formed by the interramal region, (regio interramalis) tongue and laryngeal mound containing glove-shaped glottis. This study confirmed the basic morphology of the oropharinx of the rhea. However, important morphological information not previously described is highlighted and contradictory information present in the literature is clarified.

Seismites as a tool in the palaeoenvironmental reconstruction of fluvial deposits: The Cambrian Guarda Velha Formation, southern Brazil

Soft-sediment deformation (SSD) is widely described in the literature, but there is no clear consensus regarding its origin and significance. Existing models for SSD in fluvial sediments do not clearly demonstrate a relationship between the structures, preserved facies expression, and larger-scale depositional architecture. In this study several types of SSD structures are recorded in Cambrian fluvial deposits and these occur interbedded with undeformed strata throughout the entire stratigraphic interval. The random distribution of these features in relation to primary facies types and fluvial forms indicates that they have neither a direct nor indirect relationship with any depositional processes or bedform type. We propose that the relationship of SSD at the bed-set-scale to larger-scale depositional architecture, combined with tectono-stratigraphic analysis allows the determination of both short-term fluvial hydraulic conditions in ancient stream systems, such as the nature of the flow regime responsible for depositing ancient fluvial stream successions, and the long-term subsidence rates, in the form of mean recurrence interval of the seismic events responsible for triggering the generation of SSD in tectonically active basins. (c) 2012 Elsevier B.V. All rights reserved.

Revision of the genus Spinosipella (Bivalvia : Verticordiidae), with descriptions of two new species from Brazil

A revision of the deep-water verticordiid genus Spinosipella is provided, based on conchological and anatomical characters. The genus is considered distinct from Verticordia (of which it was considered a subgenus) based on the strong ribs, prickly surface, reduction of lunula, relative large size, weakly spiral valve shape, and other characters. The following species are considered in the genus: (1) Spinosipella agnes new species, ranging from Florida, USA, to Rio de Janeiro, Brazil, and also including the Porcupine Abyssal Plain in the North Atlantic; (2) S. tinga new species, occurring from Rio de Janeiro to Rio Grande do Sul, Brazil; (3) S. acuticostata (Philippi, 1844), a Pliocene fossil from southern Italy; (4) S. deshayesiana (Fischer, 1862), from south and central Indo-Pacific (S. ericia Hedley, 1911, the type species of the genus, was revealed to be a new synonym of S. deshayesiana); and (5) S. costeminens (Poutiers, 1981), from the tropical west Pacific. The five species differ mainly in conchological details of the number and size of ribs, of the prickly sculpture, shape of the shell, of the hinge and the degree of convexity. Anatomical description is also provided for the two Pacific species, which differ among themselves mainly by the size of the pair of renal folds. From the standpoint of anatomical characters, the more significant are: the wide lithodesma; the elongation of the auricles, crossing the roof of pallial cavity; a tall digital fold in posterior region of supraseptal chamber; the low but wide palps; the muscular, gizzard-like stomach; the complete separation of both constituents of the hermaphroditic gonad (a ventro-posterior testicle and a centro-dorsal ovary), and a complete fusion of the visceral ganglia.

Paleoenvironmental reconstruction of a Late Quaternary lagoon system in southern Brazil (Jaguaruna region, Santa Catarina state) based on multi-proxy analysis

This paper provides a paleoenvironmental reconstruction of a Late Quaternary lagoon system in the Jaguaruna region of Santa Catarina state, southern Brazil. Integrated results of bulk sedimentary organic matter characterization (delta C-13, delta N-15 and C/N), microfossil (pollen and diatom) and grain-size analysis from three shallow cores (similar to 2.5m depth) allowed us to propose an evolving paleogeographic scenario in this coastal region for the last ca. 5500 cal a BP. The lagoonal system in this area was more extensive during the mid-Holocene than today, with a gradual and continuous lagoon-sea disconnection until the present. We add to the debate regarding relative sea-level (RSL) variations for the Brazilian coast during the Holocene and discuss the importance of sedimentary dynamics for interpreting changes in coastal ecosystems. The multi-proxy analysis suggests that changes in coastal ecosystems could be directly related to local sedimentary processes, which are not necessarily linked to RSL fluctuations and/or to climatic variations. Copyright (c) 2011 John Wiley & Sons, Ltd.

Late evaluation of the relationship between morphological and functional renal changes and hypertension after non-operative treatment of high-grade renal injuries

Objective: To evaluate the anatomical and functional renal alterations and the association with post-traumatic arterial hypertension. Methods: The studied population included patients who sustained high grades renal injury (grades III to V) successfully non-operative management after staging by computed tomography over a 16-year period. Beyond the review of medical records, these patients were invited to the following protocol: clinical and laboratory evaluation, abdominal computed tomography, magnetic resonance angiography, DMSA renal scintigraphy, and ambulatory blood pressure monitoring. The hypertensive patients also were submitted to dynamic renal scintigraphy (Tc-99m EC), using captopril stimulation to verify renal vascular etiology. Results: Of the 31 patients, there were thirteen grade III, sixteen grade IV (nine lacerations, and seven vascular lesions), and two grade V injuries. All the patients were asymptomatic and an average follow up post-injury of 6.4 years. None had abnormal BUN or seric creatinine. The percentage of renal volume reduction correlates with the severity as defined by OIS. There was no evidence of renal artery stenosis in Magnetic Resonance angiography (MRA). DMSA scanning demonstrated a decline in percentage of total renal function corresponding to injury severity (42.2 +/- 5.5% for grade III, 35.3 +/- 12.8% for grade IV, 13.5 +/- 19.1 for grade V). Six patients (19.4%) had severe compromised function (< 30%). There was statistically significant difference in the decrease in renal function between parenchymal and vascular causes for grade IV injuries (p < 0.001). The 24-hour ambulatory blood pressure monitoring detected nine patients (29%) with post-traumatic hypertension. All the patients were male, mean 35.6 years, 77.8 % had a familial history of arterial hypertension, 66.7% had grade III renal injury, and average post-injury time was 7.8 years. Seven patients had negative captopril renography. Conclusions: Late results of renal function after conservative treatment of high grades renal injuries are favorable, except for patients with grades IV with vascular injuries and grade V renal injuries. Moreover, arterial hypertension does not correlate with the grade of renal injury or reduction of renal function.

The density of metastatic lymph node as prognostic factor in squamous cell carcinoma of the tongue and floor of the mouth

The presence of metastatic lymph nodes is a relevant prognostic factor in oral cancer. Objective: This paper aims to assess metastatic lymph node density (pN+) in patients with tongue and floor-of-mouth squamous cell carcinoma (SCC) and the association of this parameter with disease-free survival (DFS). Materials and Methods: A group of 182 patients seen between 1985 and 2007 was included, 169 of which were males. Five were on stage I, 35 on stage II, 56 on stage III, and 85 on stage IV. Median values were considered in lymph node density assessment, and the Kaplan-Meier curve was used to evaluate DFS; survival differences within the group were elicited through the log-rank test. Results: An average 3.2 metastatic lymph nodes were excised from the patients in the group. Density ranged from 0.009 to 0.4, with a mean value of 0.09. Five-year DFS rates were of 44% and 28% for the groups with lymph node densities below and above the median respectively (p = 0.006). Two-year local/regional control was achieved for 71% and 49% for the patients below and above the median density respectively (p = 0.01). In terms of pN staging, local/regional control was achieved in 70% and 54% of pN1 and pN2 patients respectively, albeit without statistical significance (0.20%). Conclusion: Lymph node density may be used as a prognostic indicator for tongue and floor-ofmouth SCC.

Pollen morphology of the genus Eremanthus Less. (Vernonieae, Asteraceae)

(Pollen morphology of the genus Eremanthus Less. (Vernonieae, Asteraceae)). In order to evaluate the significance of the pollen morphology for generic and infrageneric taxonomy of the genus Eremanthus (Vernonieae, Asteraceae), and to provide additional data for its phylogenetic reconstruction, the pollen of 20 of the 23 species of the genus was examined using light and scanning electron microscopy. Acetolysed pollen grains were measured, described, and illustrated using light microscopy, while non-acetolysed pollen grains were analyzed using scanning electron microscopy. Pollen grains of these species are isopolar, oblate-spheroidal in most of the species, more rarely prolate spheroidal or suboblate, subtriangular amb, tricolporate and subechinolophate. The variation among quantitative characters does not correlate with the macromorphological subdivision of the genus or with the generic or specific limits.

Submental Endotracheal Intubation: A Valuable Resource for the Management of Panfacial Fractures

Modern techniques for surgical treatment of midfacial and panfacial fractures in maxillofacial trauma lead to special problems for airway management. Usually, in perioperative management of panfacial fractures, the surgeon needs to control the dental occlusion and nasal pyramid assessment. For these reasons, oral and nasal endotracheal intubations are contraindicated for the management of panfacial fractures. Tracheotomy is considered by many as the preferred route for airway management in patients with severe maxillofacial fractures, but there are often perioperative and postoperative complications concerning this technique. The submental route for endotracheal intubation has been proposed as an alternative to tracheotomy in the surgical management of patients with panfacial fractures, besides it is accompanied by low morbidity. Thus, this paper aimed to describe the submental endotracheal intubation technique in a patient experiencing panfacial fracture. The subject was well treated using the submental endotracheal intubation to get good reconstruction of the fractures because the authors obtained free access of all facial fractures.

Prognostic significance of the number of lymph nodes in elective neck dissection for tongue and mouth floor cancers

The presence of metastatic lymph nodes is a relevant aspect in the treatment of head and neck cancer, bringing about a 50% reduction in survival. Objective: To assess the number of lymph nodes removed in the neck dissection and their relationship with the prognosis. Methods: A retrospective study involving 143 patients with tongue and mouth floor epidermoid carcinoma, which histological exam showed no lymph node metastases. Among those, 119 were males and 24 females, with mean age of 54 years. As to the primary tumor site, 65 were in the tongue and 78 in the mouth floor. T stage distribution was of four T1, 84 T2, 36 T3 and 19 T4. We carried out 176 neck dissections, unilateral in 110 cases and bilateral in 33. Of these, 78 were radical and 98 selective. The patients were broken down into three groups, according to the 33 and 66 percentiles of the number of lymph nodes resected. Results: The mean number of resected lymph nodes was 27; 24 in selective dissections and 31 in the complete ones. We did not have statistically significant differences when associated to the T and N stages. Conclusions: The larger number of lymph nodes dissected in the neck dissection identifies the group of better prognoses among pN0 cases.

Transoral Submucosal Resection of the Inferior Turbinate A Novel Approach to Functional Rhinoplasty

Background: In the presence of turbinate dysfunction, an inferior turbinectomy for persistent hypertrophy of bone and/or mucosa may be performed. We sought to explore anatomic feasibility of a transoral turbinectomy. Methods: After transoral inferior turbinectomy in 12 cadavers, average distances from the external nasal valve to inferior turbinate and from pyriform aperture to inferior turbinate were compared. Average "area of access" was calculated. Preoperative and postoperative nasal length, tip projection, and alar-base width were also compared. Results: Average distance from external nasal valve to inferior turbinate was 32.4 mm. Average distance from aperture to inferior turbinate was 2.4 mm (P < 0.0001). Average "areas of access" to nasal vault through the external nasal valve and mouth were 183.9 mm(2) and 243.6 mm(2) (P = 0.07), respectively. Conclusions: The transoral approach provides a larger "area of access" to the turbinate, a statistically significant reduction of distance to target, no postoperative changes in nasal soft tissue, and easier instrumentation.

A novel approach for the treatment of pelvic abscess: transrectal endoscopic drainage facilitated by transanal endoscopic microsurgery access

Postoperative pelvic abscesses in patients submitted to colorectal surgery are challenging. The surgical approach may be too risky, and image-guided drainage often is difficult due to the complex anatomy of the pelvis. This article describes novel access for drainage of a pelvic collection using a minimally invasive natural orifice approach. A 37 year-old man presented with sepsis due to a pelvic abscess during the second postoperative week after a Hartmann procedure due to perforated rectal cancer. Percutaneous drainage was determined by computed tomography to be unsuccessful, and another operation was considered to be hazardous. Because the pelvic fluid was very close to the rectal stump, transrectal drainage was planned. The rectal stump was opened using transanal endoscopic microsurgery (TEM) instruments. The endoscope was advanced through the TEM working channel and the rectal stump opening, accessing the abdominal cavity and pelvic collection. The pelvic collection was endoscopically drained and the local cavity washed with saline through the scope channel. A Foley catheter was placed in the rectal stump. The patient's recovery after the procedure was successful, without the need for further intervention. Transrectal endoscopic drainage may be an option for selected cases of pelvic fluid collection in patients submitted to Hartmann's procedure. The technique allows not only fluid drainage but also visualization of the local cavity, cleavage of multiloculated abscesses, and saline irrigation if necessary. The use of TEM instrumentation allows safe access to the peritoneal cavity.

Description of atmospheric conditions at the Pierre Auger Observatory using the Global Data Assimilation System (GDAS)

Atmospheric conditions at the site of a cosmic ray observatory must be known for reconstructing observed extensive air showers. The Global Data Assimilation System (GDAS) is a global atmospheric model predicated on meteorological measurements and numerical weather predictions. GDAS provides altitude-dependent profiles of the main state variables of the atmosphere like temperature, pressure, and humidity. The original data and their application to the air shower reconstruction of the Pierre Auger Observatory are described. By comparisons with radiosonde and weather station measurements obtained on-site in Malargue and averaged monthly models, the utility of the GDAS data is shown. (C) 2012 Elsevier B.V. All rights reserved.