First-Bite Syndrome: A Rare Complication of Carotid Endarterectomy.

This report describes the rare complication of first-bite syndrome (FBS) after carotid endarterectomy (CEA). Although FBS is well known in otolaryngologic literature, it is rarely discussed in relation to vascular surgery. FBS is most commonly a postoperative pain syndrome that is thought to be the result of selective parotid gland sympathetic denervation. The resultant facial pain is centered around the parotid region and triggered by initiation of mastication. The pain is severe, but short in duration, and quite specific in pattern. We present a case of FBS after CEA with complex anatomy. The patient developed typical symptoms of ipsilateral parotid, mandibular pain during the postoperative course. Workup excluded other diagnoses. The symptoms were self-limiting but did not resolve completely. Vascular surgeons, who are universally aware of the presentation of Horner's syndrome, should also be aware of this rare complication with similar pathophysiology.

Gram-positive and Gram-negative subcellular localization using rotation forest and physicochemical-based features.

BACKGROUND: The functioning of a protein relies on its location in the cell. Therefore, predicting protein subcellular localization is an important step towards protein function prediction. Recent studies have shown that relying on Gene Ontology (GO) for feature extraction can improve the prediction performance. However, for newly sequenced proteins, the GO is not available. Therefore, for these cases, the prediction performance of GO based methods degrade significantly. RESULTS: In this study, we develop a method to effectively employ physicochemical and evolutionary-based information in the protein sequence. To do this, we propose segmentation based feature extraction method to explore potential discriminatory information based on physicochemical properties of the amino acids to tackle Gram-positive and Gram-negative subcellular localization. We explore our proposed feature extraction techniques using 10 attributes that have been experimentally selected among a wide range of physicochemical attributes. Finally by applying the Rotation Forest classification technique to our extracted features, we enhance Gram-positive and Gram-negative subcellular localization accuracies up to 3.4% better than previous studies which used GO for feature extraction. CONCLUSION: By proposing segmentation based feature extraction method to explore potential discriminatory information based on physicochemical properties of the amino acids as well as using Rotation Forest classification technique, we are able to enhance the Gram-positive and Gram-negative subcellular localization prediction accuracies, significantly.

The relationship of external and internal sidewall dimensions in the adult Caucasian nose.

OBJECTIVES/HYPOTHESES: Nasal bone length is commonly referenced in the rhinoplasty literature. It has been suggested that short nasal bone length may predispose one to a greater risk of middle vault collapse after rhinoplasty. However, there are limited data available on what constitutes the normal dimensions of these pertinent structures of the nasal sidewall. In addition, no data exist on the gender and ethnic variability of such dimensions. This article reports on measurements of nasal bones and associated structures in adult Caucasian cadavers and their relationships to the nasal sidewall. Furthermore, this study assesses the validity of using surface measurements to approximate the true dimensions of the nasal sidewall structures. METHODS: Using 37 adult cadavers, stable, external, nasal landmarks were identified and measured to approximate the dimensions of the nasal bones and upper lateral cartilages. These clinically relevant surface landmarks were then evaluated relative to the direct measurements of dissected nasal bones and upper lateral cartilages in a subgroup of 14 cadavers. RESULTS: For the subgroup, the average length Ainternal (nasal bone) was 24.57 mm; the average measured length Binternal (upper lateral cartilage) was 12.43 mm. Measurements for the subgroup obtained via external landmarks were 20.21 mm (Aexternal) and 15.67 mm (Bexternal), respectively. The relationship of the nasal bone internal length to the external measurement (A) was a ratio of 1.22:1, whereas the internal length of the upper lateral cartilage to the corresponding external measurement (B) was 0.79:1. Average external measurements for the total group were 20.43 mm for the nasal bone and 14.30 mm for the upper lateral cartilage. CONCLUSIONS: These data provide useful information to guide the surgeon in avoiding middle vault collapse postoperatively and when evaluating those patients with presurgical middle vault concerns. With less ability to support the upper lateral cartilages, short nasal bones can predispose an individual to middle vault collapse postoperatively.