Access to the frontal sinus and zygomatico frontal suture through the supratarsal fold

Precise repositioning of a fractured zygoma is difficult. The traditional approach is through an eyebrow incision, but it can produce a scar that causes aesthetic and psychological problems for the patient. We describe the supratarsal fold approach to expose the frontozygomatic suture and to reduce small displacements of frontal sinus anterior wall; it gives good access and excellent aesthetic results. (C) 2007 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Immunohistochemical, tomographic and histological study on onlay iliac grafts remodeling

The information concerning the molecular events taking place in onlay bone grafts are still incipient. The objective of the present study is to correlate the effects of perforation of resident bone bed on (1) the timing of onlay autogenous graft revascularization; (2) the maintenance of volume/density of the graft (assessed through tomography); and (3) the occurrence of bone remodeling proteins (using immunohistochemistry technique) delivered in the graft. Thirty-six New Zealand White rabbits were subjected to iliac crest onlay bone grafting on both sides of the mandible. The bone bed was drill-perforated on one side aiming at accelerating revascularization, whereas on the other side it was kept intact. After grafts fixation and flaps suture all animals were submitted to tomography on both mandible sites. Six animals were sacrificed, respectively, at 3, 5, 7, 10, 20 and 60 days after surgery. A second tomography was taken just before sacrifice. Histological slides were prepared from each grafted site for both immunohistochemistry analysis [osteopontin, osteocalcin, type I collagen and vascular endothelial growth factor (VEGF) anti-bodies] and histometric analysis. The values on bone volume measured on tomography showed no statistic significance (P >= 0.05) between perforated and intact sites. Grafts placed on perforated beds showed higher bone density values compared with non-perforated ones at 3 days (P <= 0.05). This correlation was inverted at 60 days postoperatively. The findings from VEGF labeling revealed a tendency for earlier revascularization in the perforated group. The early revascularization of bone grafts accelerated the bone remodeling process (osteocalcin, type I collagen and osteopontin) that led to an increased bone deposition at 10 days. The extended osteoblast differentiation process at intermediate stages in the perforated group cooperated for a denser bone at 60 days.

Upper-mantle seismic structure beneath SE and Central Brazil from P- and S-wave regional traveltime tomography

We present models for the upper-mantle velocity structure beneath SE and Central Brazil using independent tomographic inversions of P- and S-wave relative arrival-time residuals (including core phases) from teleseismic earthquakes. The events were recorded by a total of 92 stations deployed through different projects, institutions and time periods during the years 1992-2004. Our results show correlations with the main tectonic structures and reveal new anomalies not yet observed in previous works. All interpretations are based on robust anomalies, which appear in the different inversions for P-and S-waves. The resolution is variable through our study volume and has been analyzed through different theoretical test inversions. High-velocity anomalies are observed in the western portion of the Sao Francisco Craton, supporting the hypothesis that this Craton was part of a major Neoproterozoic plate (San Franciscan Plate). Low-velocity anomalies beneath the Tocantins Province (mainly fold belts between the Amazon and Sao Francisco Cratons) are interpreted as due to lithospheric thinning, which is consistent with the good correlation between intraplate seismicity and low-velocity anomalies in this region. Our results show that the basement of the Parana Basin is formed by several blocks, separated by suture zones, according to model of Milani & Ramos. The slab of the Nazca Plate can be observed as a high-velocity anomaly beneath the Parana Basin, between the depths of 700 and 1200 km. Further, we confirm the low-velocity anomaly in the NE area of the Parana Basin which has been interpreted by VanDecar et al. as a fossil conduct of the Tristan da Cunha Plume related to the Parana flood basalt eruptions during the opening of the South Atlantic.

Deep crustal structure of the Parana Basin from receiver functions and Rayleigh-wave dispersion: Evidence for a fragmented cratonic root

The deep crustal structure of the Parana Basin of southern Brazil is investigated by analyzing P- and PP-wave receiver functions at 17 Brazilian Lithosphere Seismic Project stations within the basin. The study area can be described as a typical Paleozoic intracratonic basin that hosts one of the largest Large Igneous Province of the world and makes a unique setting for investigating models of basin subsidence and their interaction with mantle plumes. Our study consists of (1) an analysis of the Moho interaction phases in the receiver functions to obtain the thickness and bulk Vp/Vs ratio of the basin`s underlying crust and (2) a joint inversion with Rayleigh-wave dispersion velocities from an independent tomographic study to delineate the detailed S-wave velocity variation with depth. The results of our analysis reveal that Moho depths and bulk Vp/Vs ratios (including sediments) vary between 41 and 48 km and between 1.70 and 1.76, respectively, with the largest values roughly coinciding with the basin`s axis, and that S-wave velocities in the lower crust are generally below 3.8 km/s. Select sites within the basin, however, show lower crustal S-wave velocities slightly above 3.9 km/s suggestive of underplated mafic material. We show that these observations are consistent with a fragmented cratonic root under the Parana basin that defined a zone of weakness for the initial Paleozoic subsidence of the basin and which allowed localized mafic underplating of the crust along the suture zones by Cenozoic magmatism.

Carpenter Syndrome: Extended RAB23 Mutation Spectrum and Analysis of Nonsense-mediated mRNA Decay

Carpenter syndrome, a rare autosomal recessive disorder characterized by a combination of craniosynostosis, polysyndactyly, obesity, and other congenital malformations, is caused by mutations in RAB23, encoding a member of the Rab-family of small GTPases. In 15 out of 16 families previously reported, the disease was caused by homozygosity for truncating mutations, and currently only a single missense mutation has been identified in a compound heterozygote. Here, we describe a further 8 independent families comprising 10 affected individuals with Carpenter syndrome, who were positive for mutations in RAB23. We report the first homozygous missense mutation and in-frame deletion, highlighting key residues for RAB23 function, as well as the first splice-site mutation. Multi-suture craniosynostosis and polysyndactyly have been present in all patients described to date, and abnormal external genitalia have been universal in boys. High birth weight was not evident in the current group of patients, but further evidence for laterality defects is reported. No genotype-phenotype correlations are apparent. We provide experimental evidence that transcripts encoding truncating mutations are subject to nonsense-mediated decay, and that this plays an important role in the pathogenesis of many RAB23 mutations. These observations refine the phenotypic spectrum of Carpenter syndrome and offer new insights into molecular pathogenesis. (C) 2011 Wiley-Liss, Inc.

POLYGLYCOLIC ACID TUBE ASSOCIATED WITH GM1 IN REGENERATION OF PERIPHERAL NERVES

Introduction: Nerve allografting is regarded as a treatment of choice in large neural tissue losses preventing repair by primary anastomosis. In these cases, a synthetic polyglycolic acid tube is an alternative for nerve grafting. On the other hand, several studies have emphasized the importance of neurotrophic factors on neural regeneration, including substances with potential to optimize neural regeneration, especially the GM1, an neurotrophic enhancer factor. Objective: to compare, in rats, the neural regeneration degree using histological analysis, regenerated myelinized axons count, and functional analysis with the use of neurotube and GM1. Methods: This assessment was performed by interposing allograft (group A), polyglycolic acid tube (group B) and polyglycolic acid tube associated to GM1 (group C) on 5-mm sciatic nerve defects. Results: Neuroma formation was found only on group A. Groups A and C showed similar histological patterns, except for the regenerated axons on group C, which were shown to be better organized and myelinized than in group A. Conclusion: on functional recovery, no statistically significant difference was found for the three groups, despite of qualitative and quantitative histological differences found.

HISTOLOGIC EVALUATION OF END-TO-SIDE NEURORRHAPHY. EXPERIMENTAL STUDY IN RATS

Objective: The aim of this study was to histologically compare the axonal sprouting after end-to-side neurorrhaphy with or without epineurotomy. Methods: twenty male Wistar rats were used, divided into two groups of 10 rats each. A 1.0cm segment of the tibial nerve E was dried and sutured on the opposite side, where it was sutured into the sciatic nerve D. In Group I, the suture was made directly in the epineurium and in Group II, epineurotomy was performed. After 4 weeks, histological evaluation was carried out of the transposed segment and the sciatic nerve distal to the suture. Results: the results showed a small number of remyelinated fibers, varying from 7 to 51 fibers in Group I and from 10 to 91 fibers in Group II. The Mann-Whitney U test was used, with p=0.311, showing there is no statistically significant difference between the two groups. There was no positive relation between the number of remyelinated fibers in the graft and in the suture site distal to the sciatic lesion. Conclusion: lateral-ending neurorrhaphy, with or without epineural window, does not promote efficient remyelinization. Level of Evidence: Level II, prospective comparative study.

Single-use Trocar Is it Possible to Reprocess it After the First Use?

The aim of this study was to verify and describe the presence of microorganisms in the single-use trocar after its use in surgical procedures, and after this device was submitted to cleaning, conditioning, and sterilization by physicochemical processes (formaldehyde, ethylene oxide, and hydrogen peroxide plasma). Twenty-eight trocars of the Ethicon, Auto-suture, and Aesculap brands, were randomly selected and analyzed after laparoscopic cholecystectomy. The results have shown that cultures grown of the material collected from the trocars, immediately after its use and before its sterilization process, showed the presence of bacteria and fungi in 46.5% (13). In 53.5% (15) of the trocars, the presence of microorganisms was not detected, very likely due to niche`s scarcity. In the cultures grown of the 28 trocars after being submitted to sterilization processes, the presence of microorganisms was not verified. We can therefore conclude that although trocars possess compartments not easily accessed for cleaning, these devices can be adequately cleaned and effectively sterilized, when well manipulated, in the institution where the study was carried out by the processes of steam sterilization at low temperature and formaldehyde, ethylene oxide, and hydrogen peroxide plasma.

Craniosynostosis in Pycnodysostosis: Broadening the Spectrum of the Cranial Flat Bone Abnormalities

Pycnodysostosis is a rare autosomal recessive skeletal dysplasia caused by the absence of active cathepsin K, which is a lysosomal cysteine protease that plays a role in degrading the organic matrix of bones, acting in bone resorption and bone remodeling. The disease is primarily characterized by osteosclerosis, bone fragility, short stature, acro-osteolysis, and delayed closure of the cranial sutures. A differing feature, cranial synostosis, has occasionally been described in this disorder. We reviewed six unrelated patients with pycnodysostosis (mean age of 10 years and 4 months) in order to evaluate the presence of craniosynostosis. In addition to the typical findings of the condition, they all presented premature fusion of the corona! suture. Although none of them showed signs of cranial hypertension, one patient had had the craniosynostosis surgically corrected previously. These data suggest that the cranial sutures in pycnodysostosis can display contradictory features: wide cranial sutures, which are commonly described, and craniosynostosis. The clinical impact of this latter finding still remains to be elucidated. Further studies are necessary to address more precisely the role of cathepsin K in suture patency. (C) 2010 Wiley-Liss, Inc.

Neoproterozoic geodynamic evolution of SW-Gondwana: a southern African perspective

Our current understanding of the tectonic history of the principal Pan-African orogenic belts in southwestern Africa, reaching from the West Congo Belt in the north to the Lufilian/Zambezi, Kaoko, Damara, Gariep and finally the Saldania Belt in the south, is briefly summarized. On that basis, possible links with tectono-stratigraphic units and major structures on the eastern side of the Rio de la Plata Craton are suggested, and a revised geodynamic model for the amalgamation of SW-Gondwana is proposed. The Rio de la Plata and Kalahari Cratons are considered to have become juxtaposed already by the end of the Mesoproterozoic. Early Neoproterozoic rifting led to the fragmentation of the northwestern (in today`s coordinates) Kalahari Craton and the splitting off of several small cratonic blocks. The largest of these ex-Kalahari cratonic fragments is probably the Angola Block. Smaller fragments include the Luis Alves and Curitiba microplates in eastern Brazil, several basement inliers within the Damara Belt, and an elongate fragment off the western margin, named Arachania. The main suture between the Kalahari and the Congo-So Francisco Cratons is suspected to be hidden beneath younger cover between the West Congo Belt and the Lufilian/Zambezi Belts and probably continues westwards via the Cabo Frio Terrane into the Goias magmatic arc along the Brasilia Belt. Many of the rift grabens that separated the various former Kalahari cratonic fragments did not evolve into oceanic basins, such as the Northern Nosib Rift in the Damara Belt and the Gariep rift basin. Following latest Cryogenian/early Ediacaran closure of the Brazilides Ocean between the Rio de la Plata Craton and the westernmost fragment of the Kalahari Craton, the latter, Arachania, became the locus of a more than 1,000-km-long continental magmatic arc, the Cuchilla Dionisio-Pelotas Arc. A correspondingly long back-arc basin (Marmora Basin) on the eastern flank of that arc is recognized, remnants of which are found in the Marmora Terrane-the largest accumulation of oceanic crustal material known from any of the Pan-African orogenic belts in the region. Corresponding foredeep deposits that emerged from the late Ediacaran closure of this back-arc basin are well preserved in the southern areas, i.e. the Punta del Este Terrane, the Marmora Terrane and the Tygerberg Terrane. Further to the north, present erosion levels correspond with much deeper crustal sections and comparable deposits are not preserved anymore. Closure of the Brazilides Ocean, and in consequence of the Marmora back-arc basin, resulted from a change in the Rio de la Plata plate motion when the Iapetus Ocean opened between the latter and Laurentia towards the end of the Ediacaran. Later break-up of Gondwana and opening of the modern South Atlantic would have followed largely along the axis of the Marmora back-arc basin and not along major continental sutures.

Major shear zones of southern Brazil and Uruguay: escape tectonics in the eastern border of Rio de La plata and Paranapanema cratons during the Western Gondwana amalgamation

The Mantiqueira Province represents a series of supracrustal segments of the South-American counterpart formed during the Gondwana Supercontinent agglutination. In this crustal domain, the process of escape tectonics played a conspicuous role, generating important NE-N-S-trending lineaments. The oblique component of the motions of the colliding tectonic blocks defined the transpressional character of the main suture zones: Lancinha-Itariri, Cubato-Arcadia-Areal, Serrinha-Rio Palmital in the Ribeira Belt and Sierra Ballena-Major Gercino in the Dom Feliciano Belt. The process as a whole lasted for ca. 60 Ma, since the initial collision phase until the lateral escape phase predominantly marked by dextral and subordinate sinistral transpressional shear zones. In the Dom Feliciano Belt, southern Brazil and Uruguay, transpressional event at 630-600 Ma is recognized and in the Ribeira Belt, despite less coevally, the transpressional event occurred between 590 and 560 Ma in its northern-central portion and between ca. 625 and 595 Ma in its central-southern portion. The kinematics of several shear zones with simultaneous movement in opposite directions at their terminations is explained by the sinuosity of these lineaments in relation to a predominantly continuous westward compression.

Relics of eclogite facies assemblages in the Ceara Central Domain, NW Borborema Province, NE Brazil: Implications for the assembly of West Gondwana

The Borborema Province, in the NE of Brazil, is a rather complex piece in the Brazil-Africa puzzle as it represents the junction of the Dahomeyide/Pharusian, Central African, Aracuai and Brasilia fold belts located between the West-African/Sao Luis, Congo/Sao Francisco and Amazonas craton. The correlation between the Dahomeyides from W-Africa (Ghana, Benin, Togo, and Mali) and the Borborema Province involves the Medio Coreau and Central Ceara domains. The inferred continuation of the main oceanic suture zone exposed in the Dahomeyides of W Africa is buried beneath the Phanerozoic Parnaiba Basin in Brazil (northwest of the Medio Coreau domain) where some high density gravity anomalies may represent hidden remnants of an oceanic suture. In addition to this major suture a narrow, nearly continuous strip composed of mainly mafic pods containing relics of eclogite-facies assemblages associated with partially migmatized granulite-facies metapelitic gneisses has been found further east in the NW Borborema Province. These high pressure mafic rocks, interpreted as retrograded eclogites, are located between the Transbrasiliano Lineament and the Santa Quiteria continental arc and comprise primitive to evolved arc-related rocks with either arc- or MORB-type imprints that can indicate either deep subduction of oceanic lithosphere or roots of continental and oceanic magmatic arcs. Average peak P-T conditions under eclogite-facies metamorphism (T=770 degrees C and P = 17.3 kbar) were estimated using garnet-clinopyroxene thermometry and Jd content in clinopyroxene. Transition to granulite-facies conditions, as well as later widespread re-equilibration under amphibolite facies, were registered both in the basic and the metapelitic rocks and suggest a clockwise P-T path characterized by an increase in temperature followed by strong decompression. A phenomenon possibly related to the exhumation of a highly thickened crust associated with the suturing of the Medio Coreau and Central Ceara domains, two distinct crustal blocks separated by the Transbrasiliano Lineament. (C) 2009 International Association for Gondwana Research. Published by Elsevier B.V. All rights reserved.

The basement of the Punta del Este Terrane (Uruguay): an African Mesoproterozoic fragment at the eastern border of the South American Rio de La Plata craton

The Punta del Este Terrane (eastern Uruguay) lies in a complex Neoproterozoic (Brasiliano/Pan-African) orogenic zone considered to contain a suture between South American terranes to the west of Major Gercino-Sierra Ballena Suture Zone and eastern African affinities terranes. Zircon cores from Punta del Este Terrane basement orthogneisses have U-Pb ages of ca. 1,000 Ma, which indicate an lineage with the Namaqua Belt in Southwestern Africa. U-Pb zircon ages also provide the following information on the Punta del Este terrane: the orthogneisses containing the ca. 1,000 Ma inheritance formed at ca. 750 Ma; in contrast to the related terranes now in Africa, reworking of the Punta del Este Terrane during Brasiliano/Pan-African orogenesis was very intense, reaching granulite facies at ca. 640 Ma. The termination of the Brasiliano/Pan-African orogeny is marked by formation of acid volcanic and volcanoclastic rocks at ca. 570 Ma (Sierra de Aguirre Formation), formation of late sedimentary basins (San Carlos Formation) and then intrusion at ca. 535 Ma of post-tectonic granitoids (Santa Teresa and Jos, Ignacio batholiths). The Punta del Este Terrane and unrelated western terranes represented by the Dom Feliciano Belt and the Rio de La Plata Craton were in their present positions by ca. 535 Ma.

Closing the Clymene ocean and bending a Brasiliano belt: Evidence for the Cambrian formation of Gondwana, southeast Amazon craton

We report new paleomagnetic and geochronological data from Ediacaran rift-drift carbonates in the Paraguai belt at the southern end of the suture zone between the Amazon craton and the Sao Francisco and Rio de Plata cratons, South America. Early thrusting resulted in remagnetization ca. 528 +/- 36 Ma or later; the mean age is established by (40)Ar/(39)Ar encapsulation dating of mixed authigenic and detrital illite from remagnetized carbonates from the unmetamorphosed fold-thrust belt. This remagnetization overlaps with a 525 Ma Gondwana reference pole. Metamorphic illite from the slate belt yields (40)Ar/(39)Ar ages of 496-484 Ma, the timing of peak regional metamorphism. Oroclinal bending of the Paraguai belt was caused by a 90 degrees clockwise rotation of the east-west limb after ca. 528 Ma, probably reflecting the irregular margin of the southeast Amazon craton. The age of the Paraguai belt overlaps with that of the Pampean orogeny farther south along the western margin of the Rio de Plata craton, suggesting a coeval closure for the Clymene ocean separating the Amazon craton from the Sao Francisco and Rio de Plata cratons.

THE RIO APA CRATON IN MATO GROSSO DO SUL (BRAZIL) AND NORTHERN PARAGUAY: GEOCHRONOLOGICAL EVOLUTION, CORRELATIONS AND TECTONIC IMPLICATIONS FOR RODINIA AND GONDWANA

The Rio Apa cratonic fragment crops out in Mato Grosso do Sul State of Brazil and in northeastern Paraguay. It comprises Paleo-Mesoproterozoic medium grade metamorphic rocks, intruded by granitic rocks, and is covered by the Neoproterozoic deposits of the Corumbi and Itapocurni Groups. Eastward it is bound by the southern portion of the Paraguay belt. In this work, more than 100 isotopic determinations, including U-Pb SHRIMP zircon ages, Rb-Sr and Sm-Nd whole-rock determinations, as well as K-Ar and Ar-Ar mineral ages, were reassessed in order to obtain a complete picture of its regional geological history. The tectonic evolution of the Rio Apa Craton starts with the formation of a series of magmatic arc complexes. The oldest U-Pb SHRIMP zircon age comes from a banded gneiss collected in the northern part of the region, with an age of 1950 +/- 23 Ma. The large granitic intrusion of the Alumiador Batholith yielded a U-Pb zircon age of 1839 +/- 33 Ma, and from the southeastern part of the area two orthogneisses gave zircon U-Pb ages of 1774 +/- 26 Ma and 1721 +/- 25 Ma. These may be coeval with the Alto Terere metamorphic rocks of the northeastern corner, intruded in their turn by the Baia das Garcas granitic rocks, one of them yielding a zircon U-Pb age of 1754 +/- 49 Ma. The original magmatic protoliths of these rocks involved some crustal component, as indicated by the Sm-Nd TDm model ages, between 1.9 and 2.5 Ga. Regional Sr isotopic homogenization, associated with tectonic deformation and medium-grade metamorphism occurred at approximately 1670 Ma, as suggested by Rb-Sr whole rock reference isochrons. Finally, at 1300 Ma ago, the Ar work indicates that the Rio Apa Craton was affected by widespread regional heating, when the temperature probably exceeded 350 degrees C. Geographic distribution, age and isotopic signature of the fithotectonic units suggest the existence of a major suture separating two different tectonic domains, juxtaposed at about 1670 Ma. From that time on, the unified Rio Apa continental block behaved as one coherent and stable tectonic unit. It correlates well with the SW corner of the Amazonian Craton, where the medium-grade rocks of the Juruena-Rio Negro tectonic province, with ages between 1600 and 1780 Ma, were reworked at about 1300 Ma. Looking at the largest scale, the Rio Apa Craton is probably attached to the larger Amazonian Craton, and the actual configuration of southwestern South America is possibly due to a complex arrangement of allochthonous blocks such as the Arequipa, Antofalla and Pampia, with different sizes, that may have originated as disrupted parts of either Laurentia or Amazonia, and were trapped during later collisions of these continental masses.