Flap vs. ""flapless"" surgical approach at immediate implants: a histomorphometric study in dogs

Aim To compare the remodeling of the alveolar process at implants installed immediately into extraction sockets by applying a flap or a ""flapless"" surgical approach in a dog model. Material and methods Implants were installed immediately into the distal alveoli of the second mandibular premolars of six Labrador dogs. In one side of the mandible, a full-thickness mucoperiosteal flap was elevated (control site), while contra-laterally, the mucosa was gently dislocated, but not elevated (test site) to disclose the alveolar crest. After 4 months of healing, the animals were sacrificed, ground sections were obtained and a histomorphometric analysis was performed. Results After 4 months of healing, all implants were integrated (n=6). Both at the test and at the control sites, bone resorption occurred with similar outcomes. The buccal bony crest resorption was 1.7 and 1.5 mm at the control and the test sites, respectively. Conclusions ""Flapless"" implant placement into extraction sockets did not result in the prevention of alveolar bone resorption and did not affect the dimensional changes of the alveolar process following tooth extraction when compared with the usual placement of implants raising mucoperiosteal flaps. To cite this article:Caneva M, Botticelli D, Salata LA, Souza SLS, Bressan E, Lang NP. Flap vs. ""flapless"" surgical approach at immediate implants: a histomorphometric study in dogs.Clin. Oral Impl. Res. 21, 2010; 1314-1319.doi: 10.1111/j.1600-0501.2009.01959.x.

Immediate conservative breast surgery reconstruction with perforator flaps: New challenges in the era of partial mastectomy reconstruction?

Introduction: Although the use of local flaps in conservative breast surgery (CBS) reconstruction is a reliable technique, little information has been available regarding outcome following the use of perforator flaps. The purpose of this study is to analyze the feasibility, surgical planning and outcome following CBS reconstruction with intercostal artery perforator (ICAP) flap. Patients/methods: Thirteen patients underwent CBS reconstructions with an ICAP flap. These flaps were raised from adjacent tissue located on the lateral and thoracic region and based on perforators originating from the costal and muscular segment of the intercostal vessels. The technique was indicated in patients with small/moderate volume breasts. Results: Mean time of follow-up was 32 months. Flap complications were evaluated and information on patient satisfaction were collected. 61.5 percent had tumors located in the lower-outer quadrants and 69.2 percent had tumors measuring 2 cm or less (T1). Complications occurred in 3 patients (23%), including wound dehiscence in 2 patients and fat necrosis in one. All cases were treated by conservative approach with a good result. No flap loss or wound infection were reported. 90 percent were either satisfied or very satisfied with their result. Conclusion: The ICAP flap is a reliable technique for immediate CBS reconstruction. The technique is advantageous because it does not require the use of muscle transfer, with minimum donor site morbidity. Success depends on patient selection, coordinated planning with the oncological surgeon and careful intra-operative management. (C) 2011 Elsevier Ltd. All rights reserved.

Right coronary artery fistula to the coronary sinus and right atrium associated with giant right coronary enlargement detected by transthoracic echocardiography

We present the case of a 54-year-old female with a previous history of lung fibrosis secondary to methotrexate used for rheumatoid arthritis who was referred to cardiology evaluation due to precordial pain. Echocardiography showed biatrial enlargement with an enlarged coronary sinus and tubular image posterior to the heart. On the coronary angiogram, the right coronary artery was enlarged, and a distal fistula was identified. The patient underwent a contrast enhanced cardiac computed tomography which demonstrated an aneurysmatic right coronary artery with a distal fistula to the right atrium and coronary sinus. As the chest pain did not recur and there was a high risk of the intervention to correct coronary fistula, the patient remained on conservative treatment.

The seaweed flora of Admiralty Bay, King George Island, Antarctic

Admiralty Bay is located on the western side of King George Island. Although several research teams of different nationalities have carried out surveys in the region for decades, there are only two publications dealing with the seaweed flora of the bay. Here, we report on a taxonomic survey of the seaweeds we collected during the 25th Brazilian Antarctic Expedition (December 2006/November 2007). We discovered 42 species (21 Rhodophyta, 14 Phaeophyceae, and 7 Chlorophyta), corresponding to an increase of about 31% in the seaweed biodiversity hitherto known for the region. Considering that the Antarctic Peninsula, adjacent to King George Island seems to be one of the most rapidly warming spots on the planet, this kind of survey may provide a valuable tool for detecting eventual changes in seaweed biodiversity.

Differential expression of cytokines, chemokines and chemokine receptors in patients with coronary artery disease

Monocytes/macrophages and lymphocytes have a key role in the pathogenesis of atherosclerosis through the production of inflammatory and anti-inflammatory cytokines. We evaluated mRNA expression and protein production of CCL2, CXCL8, CXCL9, CXCL10, IFN-gamma and IL-10 in vitro as well as the expression of the CCR2 and CXCR3 receptors in peripheral blood mononuclear cells (PBMCs) of patients with coronary artery disease (CAD) and healthy controls in the presence or absence of oxidized LDL (oxLDL). Patients with CAD showed higher constitutive expression of CCL2, CXCL8, CXCL9, CXCL10 and IFN-gamma mRNA and, after stimulation with oxLDL, higher expression of CCL2 and CXCL8 mRNA than the control group. We also detected higher levels of CCL2 and CXCL8 in supernatants of oxLDL-stimulated PBMCs from CAD patients than in corresponding supernatants from controls. Patients with CAD had a higher percentage of constitutive CCR2(+) and CXCR3(+) cells after stimulation with oxLDL. Among CAD patients, the main differences between the stable (SA) and unstable angina (UA) groups were lower IL-10 mRNA production in the latter group. Altogether, our data suggest that PBMCs from CAD patients are able to produce higher concentrations of chemokines and cytokines involved in the regulation of monocyte and lymphocyte migration and retention in atherosclerotic lesions. (C) 2008 Elsevier Ireland Ltd. All rights reserved.

Modified abbreviated transcavernous approach to basilar artery aneurysms-Case report

Background: Endovascular procedures and direct surgical clipping, are the main therapeutic modalities for managing of BAAs. Furthermore, giant or wide-necked aneurysms and those that involve the PCA or perforators at its neck usually are not embolized. Case Description: A 55-year-old man presented to the emergency room complaining Of Sudden and intense headache. Neurological examination evidenced meningismus. Computed tomography disclosed a subarachnoid hemorrhage (Fisher grade III). Arteriograms revealed BAA, whose neck was partially obseured by the PCP. A standard pterional craniotomy was performed, followed. by extensive drilling of the greater sphenoid wing. The neck was partially hidden by the PCP, and no proximal control was obtained without drilling the PCP and opening the CS (modified TcA). Drilling of the PCP was begun by cutting the overlying dura and extended caudally as much as possible. Next. opening, of the roof of the CS was performed by incising the dura in the oculomotor trigone medical and parallel 10 the oculomotor nerve and lateral to ICA: the incision progressed posteriorly toward the dorsum sellae. Further resection of the dorsum sellac and clivus was carried out. After performing these steps, proximal control was obtained, aneurysm was deflated, perforators were saved. and aneurysm was clipped. Conclusions: This study has demonstrated the clinical Usefulness of and abbreviated form of the TcA, which led the ""modified TcA."" in approaching complex low-lying, BAA. It provides additional surgical room by removing the PCP and partially, opening the CS, which permits further bone removal and improves exposure. (C) 2009 Elsevier Inc. All rights reserved.

Atmosphere and hydrological controls of the evapotranspiration over a floodplain forest in the Bananal Island region, Amazonia

This article discusses seasonal and interannual variations of the evapotranspiration (ET) rates in Bananal Island floodplain, Brazil. Measurements included ET and sensible heat flux using the eddy covariance method, atmospheric forcings (net radiation, Rn, vapor pressure deficit, VPD, wind speed and air temperature), soil moisture profiles, groundwater level and flood height, taken from November 2003 to December 2006. For the hydrological years (October-September) of 2003/2004, 2004/2005 and 2005/2006, the accumulated precipitation was 1692, 1471, 1914 mm and the accumulated ET was 1361, 1318 and 1317 mm, respectively. Seasonal analyses indicated that ET decreased in the dry season (average 3.7 mm day(-1)), despite the simultaneous increase in Rn, air temperature and VPD. The increase of ET in the wet season and particularly in the flood period (average 4.1 mm day(-1)) showed that the free water surface evaporation strongly influenced the energy exchange. Soil moisture, which was substantially depleted during the dry season, and adaptative vegetation mechanisms such as leaf senescence contributed to limit the dry season ET. Strong drainage within permeable sandy soils helped to explain the soil moisture depletion. These results suggest that the Bananal flooding area shows a different pattern in relation to the upland Amazon forests, being more similar to the savanna strictu senso areas in central Brazil. For example, seasonal ET variation was not in phase with Rn; the wet season ET was higher than the dry season ET; and the system stored only a tiny memory of the flooding period, being sensitive to extended drought periods.

Geochemistry of iron and manganese in soils and sediments of a mangrove system, Island of Pai Matos (Cananeia - SP, Brazil)

Five zones along a transect of 180 m were selected for study on the Island of Pai Matos (Sao Paulo, Brazil). Four of the zones are colonised by vascular plants (Spartina SP, Laguncularia LG, Avicennia AV and Rhizophora RH) and were denominated soils, and the other zone, which lacks vegetation, was denominated sediment (SD). The geochemical conditions differed significantly in soils and sediment and also at different depths. The soils were oxic (Eh > 350 mV) or suboxic (Eh: 350-100 mV) at the surface and anoxic (Eh < 100 mV) at depth, whereas in the sediment anoxic conditions prevailed at all depths, but with a lower concentration of sulphides in the pore water and pyrite in the solid fraction. Under these geochemical conditions Fe is retained in the soils, while the Mn tends to be mobilized and lost. The most abundant form of iron oxyhydroxide was lepidocrocite (mean concentration for all sites and depths, 45 +/- 19 mu mol g(-1)), followed by goethite (30 19 mu mol g(-1))and ferrihydrite (19 +/- 11 mu mol g(-1)),with significant differences among the mean concentrations. There was a significant decrease with depth in all the types of Fe oxyhydroxides measured, particularly the poorly crystalline forms. The pyrite fraction was an important component of the free Fe pool (non-silicate Fe) in all soils as well as in the sediment, especially below 20 cm depth (mean concentration for all sites and depths, 60 +/- 54 mu mol CI). Furthermore, the mean concentration of Fe-pyrite for all sites and depths was higher than that obtained for any of the three Fe oxyhydroxides measured. The Fe-AVS was a minor fraction, indicating that the high concentrations of dissolved Fe in the soils in the upper area of the transect result from the oxidation of Fe sulphides during low tide. Mossbauer spectroscopy also revealed that most of the Fe (III) was associated with silicates, in this case nontronite. The presence of crystals of pyrite associated with phyllosilicates in samples from the upper layer of the soils may indicate that pyritization of this form of Fe(III) is more rapid than usually reported for ocean bed sediments. The sequential extraction of Mn did not reveal any clearly dominant fraction, with the Mn-carbonate fraction being the most prevalent, followed by exchangeable Mn and oxides of Mn, whereas pyrite-Mn and Mn associated with crystalline Fe-oxides were present at significantly lower concentrations. The high concentration of dissolved Mn found in the soils in the lower part of the transect is consistent with the fact that the solubility is determined by the carbonate fraction. Unlike for Fe, in the soils in the higher zone, which are subject to intense drainage during low tide, there was loss of Mn, as reflected by the concentration of total Mn. (C) 2008 Elsevier B.V. All rights reserved.

Objective characterization of the course of the parasellar internal carotid artery using mathematical tools

Background Along the internal carotid artery (ICA), atherosclerotic plaques are often located in its cavernous sinus (parasellar) segments (pICA). Studies indicate that the incidence of pre-atherosclerotic lesions is linked with the complexity of the pICA; however, the pICA shape was never objectively characterized. Our study aims at providing objective mathematical characterizations of the pICA shape. Methods and results Three-dimensional (3D) computer models, reconstructed from contrast enhanced computed tomography (CT) data of 30 randomly selected patients (60 pICAs) were analyzed with modern visualization software and new mathematical algorithms. As objective measures for the pICA shape complexity, we provide calculations of curvature energy, torsion energy, and total complexity of 3D skeletons of the pICA lumen. We further measured the posterior knee of the so-called ""carotid siphon"" with a virtual goniometer and performed correlations between the objective mathematical calculations and the subjective angle measurements. Conclusions Firstly, our study provides mathematical characterizations of the pICA shape, which can serve as objective reference data for analyzing connections between pICA shape complexity and vascular diseases. Secondly, we provide an objective method for creating Such data. Thirdly, we evaluate the usefulness of subjective goniometric measurements of the angle of the posterior knee of the carotid siphon.

Three-dimensional description and mathematical characterization of the parasellar internal carotid artery in human infants

Inside the `cavernous sinus` or `parasellar region` the human internal carotid artery takes the shape of a siphon that is twisted and torqued in three dimensions and surrounded by a network of veins. The parasellar section of the internal carotid artery is of broad biological and medical interest, as its peculiar shape is associated with temperature regulation in the brain and correlated with the occurrence of vascular pathologies. The present study aims to provide anatomical descriptions and objective mathematical characterizations of the shape of the parasellar section of the internal carotid artery in human infants and its modifications during ontogeny. Three-dimensional (3D) computer models of the parasellar section of the internal carotid artery of infants were generated with a state-of-the-art 3D reconstruction method and analysed using both traditional morphometric methods and novel mathematical algorithms. We show that four constant, demarcated bends can be described along the infant parasellar section of the internal carotid artery, and we provide measurements of their angles. We further provide calculations of the curvature and torsion energy, and the total complexity of the 3D skeleton of the parasellar section of the internal carotid artery, and compare the complexity of this in infants and adults. Finally, we examine the relationship between shape parameters of the parasellar section of the internal carotid artery in infants, and the occurrence of intima cushions, and evaluate the reliability of subjective angle measurements for characterizing the complexity of the parasellar section of the internal carotid artery in infants. The results can serve as objective reference data for comparative studies and for medical imaging diagnostics. They also form the basis for a new hypothesis that explains the mechanisms responsible for the ontogenetic transformation in the shape of the parasellar section of the internal carotid artery.

A geochemical and lead isotopic record from a small pond in a remote equatorial island, Fernando de Noronha, Brazil

A 72 cm long core was collected from Lagoa da Viracao (LV), a small poind in the Fernando de Noronha island, northern Brazil. Sediments from the lower section of the core (20-72 cm depth) contain essentially mineral matter, while in the upper section (0-20 cm depth) mineral matter is mixed with organic matter. Lithogenic conservative elements - Si, Al, Fe, Ti, Co, Cr, Cu, Ba, Ga, Hf, Nb, Ni, Y, V, Zn, Zr and REE - exhibit remarkably constant values throughout the core, with concentrations similar to those of the bedrock. The vertical distribution of soluble elements - Ca, Mg, Na, K, P, Mn and Sr - is also homogeneous, but these elements are systematically depleted in relation to the bedrock. LOI, TOC, Br, Se, Hg and Pb, although showing nearly constant values in the lower section of the core, are significantly enriched in the upper section. The concentration profiles of Br and Se suggest that they may be accounted for by natural processes, related to the slight affinity of these elements for organic matter. On the other hand, the elevated levels of Hg and Pb in recent sediments may be explained by their long-range atmospheric transport and deposition. Furthermore, the isotopic composition of Pb clearly indicates that anthropogenic sources contributed to the Pb burden in the uppermost pond sediments.

Archaeological Mounds in Marajo Island in Northern Brazil: A Geological Perspective Integrating Remote Sensing and Sedimentology

Earthen mounds with archaeological artifacts have been well known in Marajo Island since the 19th century. Their documented dimensions are impressive, e.g., up to 20m high, and with areas large as 90 ha. The mounds, locally known as lesos, impose a significant. relief on the very low-lying landscape of this region, which averages 4 to 6 in above present. sea level. These features have been traditionally interpreted as artificial constructions of the Marajoara culture, designed for defense, cemetery purposes, or escape from flooding. Here, we provide sedimentological and geomorphological data that suggest an alternative origin for these structures that is more consistent with their monumental sizes. Rather than artificial, the Marajoara tesos seem to consist of natural morphological features related to late Pleistocene and Holocene fluvial, and possibly tidal-influenced, paleochannels and paleobars that became abandoned as depositional conditions changed through dine. Although utilized and modified by the Marajoara since at least 2000 years ago, these earthen mounds contain a significant non-anthropogenically modified sedimentary substratum. Therefore, the large Marajoara tesos are not entirely artificial. Ancient, Marajoara cultures took advantage of these natural, preexisting elevated surfaces to base their communities and develop their activities, locally increasing the sizes of these fluvial landforms. This alternative interpretation suggests less cumulative labor investment, in the construction of the mounds and might. have significant implications for reconstructing the organization of the Marajoara culture. (C) 2009 Wiley Periodicals, Inc.

Palaeodrainage on Marajo Island, northern Brazil, in relation to Holocene relative sea-level dynamics

A large area in northeastern Marajo Island, northern Brazil, has been characterized geomorphologically, applying information acquired from Landsat imagery. This study was combined with detailed sedimentologic analysis of continuous cores, which provided a record of depositional settings developed in this area through the Holocene. The results revealed well-preserved, meandering to anastomosed drainage networks of wide palaeochannels that were superimposed by a narrower palaeochannel system. In both cases, the sedimentary record consists of sands, heterolithic deposits and muds, locally rich in plant debris. The strata are organized into fining upward successions that reach approximately 18 m thick in the wide channels and 4 m thick in the narrow channels. Sedimentary features suggestive of a coastal location for the wider palaeochannels and reworking of sediments by tidal currents include the prevalence of well to moderately sorted, rounded to sub-rounded, fine- to medium-grained sands displaying foreset packages separated by mud couplets, suggestive of tidal cycles. The data presented herein point to a rise in relative sea level reaching the Lake Arari area during the early to late/mid Holocene. This event was followed by a relative sea level drop. Tectonics seem to have contributed to an overall lowering in relative sea level in the study area since the mid-Holocene, which does not follow the same pattern recorded in other areas along the northern Brazilian coast.

Quaternary tectonics in a passive margin: Marajo Island, northern Brazil

Marajo Island is located in a passive continental margin that evolved from rifting associated with the opening of the Equatorial South Atlantic Ocean in the Late Jurassic/Early Cretaceous period. This study, based on remote sensing integrated with sedimentology, as well as subsurface and seismographic data available from the literature, allows discussion of the significance of tectonics during the Quaternary history of marginal basins. Results show that eastern Marajo Island contains channels with evidence of tectonic control. Mapping of straight channels defined four main groups of lineaments (i.e. NNE-SSW, NE-SW, NW-SE and E-W) that parallel main normal and strike-slip fault zones recorded for the Amazon region. Additionally, sedimentological studies of late Quaternary and Holocene deposits indicate numerous ductile and brittle structures within stratigraphic horizons bounded by undeformed strata, related to seismogenic deformation during or shortly after sediment deposition. This conclusion is consistent with subsurface Bouguer mapping suggestive of eastern Marajo Island being still part of the Marajo graben system, where important fault reactivation is recorded up to the Quaternary. Together with the recognition of several phases of fault reactivation, these data suggest that faults developed in association with rift basins might remain active in passive margins, imposing important control on development of depositional systems. Copyright (C) 2007 John Wiley & Sons, Ltd.