Effects of birch encroachment, water table and vegetation on methane emissions from peatland microforms in a rewetted bog.

This study investigated the influence of vegetation and microforms on methane (CH4) balances of a rewetted bog in north-west Germany. The two study sites are in close proximity on the same former peat extraction area, one dominated by Sphagnum-mosses and the other one by a dense Betula pubescens stand with a high Eriophorum vaginatum cover. The contribution of microforms (hummocks/hollows) to CH4 emissions and the effect of Betula encroachment has been studied. Transparent and opaque chambers were used to measure CH4 fluxes every 3-4 weeks during daytime for one year. For the estimation of annual balances, three methods were compared and the method using water level and soil temperature as explanatory variables was selected. Fluxes were scaled to the site level. The annual emissions per site are and 7.1 ± 1.5 g CH4-C m-2 year-1 at the treed site and 36.1 ± 3.5 g CH4-C m-2 year-1 at the open site, mainly controlled by higher water levels. Highest annual emissions originated from hollows at the open site, but in the vegetation period, hummock emissions tend to be higher. At the tree site, emission differences between the microforms were less pronounced. There were no differences between fluxes from transparent and opaque chambers.

Muscle Flap Reconstruction Based on Muscle Tension Line Groups to Repair the Philtrum of Patients With Microform Cleft Lip or Secondary Cleft Lip.

ABSTRACT: The muscle flap reconstruction technique was developed based on the concept of muscle tension line groups, which elucidates how nasolabial muscle tension helps maintain the shape of the philtrum. To investigate the operative effect, we reviewed 43 patients with microform cleft lip and 102 patients with secondary cleft lip treated with muscle flap reconstruction between January 2018 and June 2020. The patients were scanned using the digital three-dimensional stereophotogrammetry face system pre- and post-operatively, and comparative analysis of three-dimensional (3D) images was used to highlight variations of the philtrum. Visual analog scales were used to assess surgical outcomes. More than 6 months after the surgery, comparative 3D images of 37 patients (86.04%) with microform cleft lip and 86 patients (84.31%) with secondary cleft lip showed visible improvement in the prominence of the affected column. In addition, visual analog scale scores showed that 38 microform cleft lip patients (88.37%) and 89 secondary cleft lip patients (87.25%) had a good appearance. The postoperative prominence of the philtral column in both groups improved significantly compared to before surgery (P < 0.001 and P < 0.001, respectively). There was no significant difference in scores for philtrum prominence pre- and post-operatively between the 2 groups (P > 0.05). Muscle flap reconstruction is an effective means to create the 3D configuration of the philtrum. The biomechanical properties of muscles play a vital role in the morphological maintenance of the philtrum.

Multiple Structural Microform Defects Suggest Role of Modifier Genes.

ABSTRACT: One of the biggest challenges in clinical genetics is establishing associations between specific germline mutations and the resulting spectrum of phenotypes. The careful characterization of clinical presentations continues to be a tool for establishing these genotype phenotype correlations. The authors intend, by presenting a case study, proposing that the concomitant occurrence of a combinations of mild structural anomalies in the same individual may be due to changes in genes that can be linked by related pathways. A new born with cleft lip and palate was referred at the Cleft Lip and Palate Center. The anamnese was performed and collected data of familiar history, parental consanguinity, and information about pregnancy period. The careful characterization of clinical presentations and the genetic pathways was studied. It is possible that there is no single mutation that can be clearly identified as the etiology of the combination of the defects displayed in the present case.

Long-Term Outcomes of the Minimal Skin Incision Technique for Correcting Severe Microform and Minor-Form Cleft Lip With Philtrum Reconstruction Through the Intraoral Incision.

BACKGROUND: Because the traditional technique is known to cause visible scarring, it is challenging to yield optimal outcomes while treating a severe type of microform and minor-form cleft lip. The authors present a new refined technique with minimal skin incision and philtrum formation through an intraoral incision. METHODS: The surgical technique involves single Z-plasty or double or triple unilimb Z-plasty to restore an elevated cupid's bow peak and overlapping of an orbicularis oris muscle flap to create the philtrum through an intraoral incision. Cleft lip nasal deformity was corrected with reverse-U incision and V-Y plasty. RESULTS: Eighteen patients were operated between September 2008 and June 2017. Patient age at the time of surgery ranged from 3 to 12 months. The duration of follow-up ranged from 12 months to 7 years (mean, 36 months). The elevated cupid's bow was corrected by performing single Z-plasty in 6 patients, double unilimb Z-plasty in 7 patients, and triple unilimb Z-plasty in 5 patients. In all cases, the notch or elevated cupid's bow was corrected, the surgical scar was minimal, and philtrum reconstruction was satisfactory. Minor scar revision was performed in 4 patients. Cleft lip nasal deformity was corrected in fifteen patients. CONCLUSIONS: The technique adopted here causes minimal scarring, facilitates the formation of an anatomical philtrum, preserves the continuity and function of the muscle, and presents sufficient elevation of the philtral column.

Tailored Microform Cleft Lip Repair: Personalizing Small Incisions, Orbicularis Reconstruction, and Rhinoplasty.

BACKGROUND: In the last decade, many surgeons have reported their perspectives on microform cleft lip repair, including techniques for incision placement and size, philtral reconstruction, and nasal base reconstruction. This interest demonstrates continued controversy in the repair of microform cleft lip. METHODS: This is a retrospective cohort of patients from 2010 to 2016. The authors included patients with microform cleft lip repaired by our described technique who had both preoperative photographs, as well as photographs taken at >1-year follow-up. Patient outcomes were assessed through anthropometric measurements and also subjectively by 3 senior residents of plastic surgery. RESULTS: The inclusion criteria yielded 36 microform cleft lip patients. Most patients were satisfied with their results. Regarding subjective assessment, the scar appearance and symmetry was fairly good. Objective measurements indicated excellent symmetry, with the cleft side achieving 92.58% of the height and measurements of the non-cleft side. CONCLUSIONS: Our method of combining labial muscle reconstruction through a personalized, small incision effectively corrects microform cleft lip deformity with minimal scar burden.

Correction of Minor-Form and Microform Cleft Lip Using Modified Muscle Overlapping with a Minimal Skin Incision

BACKGROUND: In treating minor-form or microform cleft lip, obtaining an optimal result is a challenge because of the visible scarring caused by traditional surgery. We present a refined method using muscle overlapping with a minimal skin incision in patients younger than 3 years, a group characterized by thin muscle. METHODS: The surgical technique involves restoration of the notched vermillion using Z-plasty, formation of the philtral column using overlapping of an orbicularis oris muscle flap through an intraoral incision, and correction of the cleft lip nasal deformity using a reverse-U incision and V-Y plasty. A single radiologist evaluated ultrasonographic images of the upper lip. RESULTS: Sixty patients were treated between September 2008 and June 2014. The age at the time of operation ranged from 6 to 36 months (mean, 26 months). The follow-up period ranged from 8 to 38 months (mean, 20 months) in minor-form cases and from 14 to 64 months (mean, 37 months) in microform cases. A notched cupid's bow was corrected in 10 minor-form cases and 50 microform cases. Ultrasonographic images were obtained from 3 patients with minor-form cleft lip and 9 patients with microform cleft lip 12 months after surgery. The average muscle thickness was 4.5 mm on the affected side and 4.1 mm on the unaffected side. CONCLUSIONS: The advantages of the proposed procedure include the creation of an anatomically natural philtrum with minimal scarring. This method also preserves the continuity and function of the muscle and provides sufficient augmentation of the philtral column and nostril sill.

Assessing nest-building behavior of mice using a 3D depth camera.

We developed a novel method to evaluate the nest-building behavior of mice using an inexpensive depth camera. The depth camera clearly captured nest-building behavior. Using three-dimensional information from the depth camera, we obtained objective features for assessing nest-building behavior, including "volume," "radius," and "mean height". The "volume" represents the change in volume of the nesting material, a pressed cotton square that a mouse shreds and untangles in order to build its nest. During the nest-building process, the total volume of cotton fragments is increased. The "radius" refers to the radius of the circle enclosing the fragments of cotton. It describes the extent of nesting material dispersion. The "radius" averaged approximately 60mm when a nest was built. The "mean height" represents the change in the mean height of objects. If the nest walls were high, the "mean height" was also high. These features provided us with useful information for assessment of nest-building behavior, similar to conventional methods for the assessment of nest building. However, using the novel method, we found that JF1 mice built nests with higher walls than B6 mice, and B6 mice built nests faster than JF1 mice. Thus, our novel method can evaluate the differences in nest-building behavior that cannot be detected or quantified by conventional methods. In future studies, we will evaluate nest-building behaviors of genetically modified, as well as several inbred, strains of mice, with several nesting materials.

Repair of Unilateral Incomplete Lesser Form Cleft Lip

Analysis of Procedures for Correction of Microform Cleft Lip through Strategic Approaches

BACKGROUND: Even though degrees of deformation of microform cleft lip are not high, it has to be corrected with various procedures upon conditions and areas since it has various expressions. Many studies have focused on the classifications and procedures, but there are only a few studies on how much these procedures are performed in the actual field. This study aims to analyze the utilization of various procedures upon major correction points. METHODS: A total of 52 patients who had been corrected by one surgeon from 1995 to 2011 were enrolled as subjects. Based on the medical records, it was checked whether the incision was made or not along with the correction procedures for alar base and philtral column, Cupid's bow, and vermillion free margin. RESULTS: In case of an incision, full incision (42 times) was conducted most frequently. For alar base and philtral column, muscle re-approximation (25 times) was performed most frequently. However, recently, it was shown that excision on only the affected area and correction with dermis were more likely to be used. For Cupid's bow and vermilion free margin, elliptical excision on the only affected area followed by re-approximation was performed most frequently for 46 times (Cupid's bow) and 44 times (vermilion free margin), respectively. CONCLUSION: For the correction of microform cleft lip, less invasive procedures are preferred. However, in the actual field, if needed, aggressive procedures consisting of incisions have been conducted to correction. These trends are somewhat changed to utilization of a simple procedure, such as excision on the modified area, followed by a re-approximation rather than complicated procedures using the muscle.

Assinatura e certificação digital: sua aplicação na Odontologia / Digital signature and certification: application in Dentistry

A digitalização de documentos odontológicos com a assinatura digital e correspondente certificação é assegurada pela criptografia de arquivos, preservando-se o sigilo e a autoria da informação apresentada em prontuários. Os contratos, registros de tratamento e demais documentos que devem ser mantidos por longos prazos são substituídos por cópias certificadas, eliminando a necessidade de espaço físico e outras precauções necessárias para a conservação do material nos consultórios. Profissionais da área da saúde e, particularmente, o Cirurgião Dentista devem conhecer as possibilidades de emprego de técnicas, envolvendo o reconhecimento de arquivos, imagens e documentos digitalizados

Correction of Upper Lip Depression Using Conchal Cartilage Graft in Unilateral Cleft Lip Deformity

PURPOSE: To correct the upper lip depression after the correction of unilateral cleft lip, autologous grafts such as bone, dermal, fascial grafts and fat injections or alloplastic implants are used. Transplanted bones, dermis and fascia have a tendency to be absorbed and have donor morbidity. Fat injections are absorbed inconsistently and alloplastic implants have problems such as foreign body reactions, protrusions and infections. Authors corrected the upper lip depression using conchal cartilage graft in unilateral cleft lip deformity and the results was analysed with photos. METHODS: 26-unilateral cleft lip and 2-microform cleft lip cases, totally 28 cases were performed. Their mean age was 21.89 years. The male and female cases were 12 and 16, respectivley. Under anesthesia (general: 18 cases and local: 10 cases), cavum conchae (n=8), cymba conchae (n=16) and whole conchae (n=4) were harvested. Transversely cut the margin of the obtained cartilage, we cut out the most bent portion and put a partial-thickness incision on concave surface in cases of excessive convexity. Then, we performed the onlay graft of the conchal cartilage via scar revision site in unilateral cleft lip and via the reconstruction site of the cupid bow in microform cleft lip. The augmentation of the upper lip was evaluated with photos. Adapting the baseline connecting between the both cheilions as a horizontal standard line, we measured the highest point among the tangents between the upper lip and nose (point a), the lowest point (point c), the middle point between a and c (point b) and the vertical line from the alare (point d) to the horizontal standard line. To assess the postoperative symmetry, we compared cleft side upper lip contour index (%) A,B,C,D=(a,b,c,d)-ch x 100/(ch-ch) and non-cleft side upper lip contour index (%) A',B',C',D'= (a',b',c',d')-ch x 100 / (ch-ch).h) RESULTS: After the surgery, no complication was found except in one case which double layers graft performed in the cleft lip deformity, the lateral portion was protruded. The upper lip contour index, the difference of A and A' were-0.83%, and thus the mild depression was persisted. Difference of B and B', C and C', D and D' were 0.83%, 1.07%, 0.90%. There were statistically significant difference, and thus the depression of upper lip were improved generally. CONCLUSION: Authors performed the onlay graft of the conchal cartilage in unilateral cleft lip deformity and found that the depression of the upper lip was well corrected except the uppermost part when photogrammetrically analyzed.

Ultrastructural Characteristics of the Orbicularis Oris Muscle in the Microform Cleft Lip

RecentIy, increasing emphasis has been placed on the histochemical and ultrastructural characteristics of the muscle in the cleft lip. Schendelet al and Cho et al demonstrated a non-neurogenic muscle atrophy and mitochondrial myopathy, and Raposio examined an increased inflammatory reaction, but no mitochondrial abnormalities of the cleft lip muscle. However, no study has focused on the ultrastructure of the microform cleft lip muscle. Eleven muscle specimens were obtained from the microform cleft lip patients at the time of primary repair from Jun.1997 to Aug.1998 and they were submitted to histologic and histochemical examinations as well as electron microscopy. A non-neurogenic muscle atrophy was seen on HE stain. Modified Gomori trichrome stain revealed red granularity of the muscle fibers, suggesting an increase in mitochondrial activity, however, no ragged-red fibers, a typical sign of mitochondrial myopathy, was found. Electron microscopy revealed atrophy, disarray, and focal loss of myofibrils, dilated sarcoplasmic reticulum with glycogen deposit, and interstitial fibrosis. However, the mitochondrial morphology was well preserved with an increase of the number of the mitochondria which might be secondary change to muscle degeneration. In conclusion, ultrastructural characteristics of the orbicularis oris muscle in the microform cleft lip is non-neurogenic muscle atrophy without mitochondrial myopathy which is controversial in the complete cleft lip.

Philtrum Formation in Secondary Unilateral Cleft Lip and Microform Cleft Lip Using Vertical Interdigitation of the Orbicularis Oris Muscle

For patients who have undergone cleft lip surgery, the construction of the philtrum is crucial for restoring a normal appearance of the upper lip. Thirteen patients with unilateral secondary cleft lip deformity and 12 patients with microform cleft lip were treated for the creation of a philtral column between January of 1998 and October of 2002. Fifteen patients were male and 10 patients were female with an age ranges from 6 months to 43 years old. In patients with the depressed philtral column in secondary cleft lip deformity, external approach was used. The scar on the philtral column is excised and a full-thickness incision is made down to the orbicularis oris muscle and mucosa. The medial and lateral muscle flaps are exposed and split into two leaves. The two leaves of each muscle flap are sutured together to create a vertical interdigitation. Any excess skin is not excised but rather closed with 6-0 nylon. In patients with microform cleft lip, vertical interdigitation of the orbicularis oris was performed through the intraoral incision to avoid external scarring. The follow-up period ranged from 6 months to three years, with an average of 14 months. Among the 13 patients with secondary cleft lip deformity, 10 patients were satisfied with their surgical results. Two had fair results. One patient experienced a widening of the scar and no improvement in the philtral column. A possible cause for the lack of improvement in one patient was a partial disruption of the interdigitated muscle before wound healing. On the other hand, all patients with microform cleft lip were satisfied with their surgical results. In conclusion, the advantage of this procedure includes the creation of an anatomically natural philtrum through preserving the continuity and function of the muscle, sufficient augmentation of the philtral column by the vertical interdigitation of the muscle, relief of skin tension, and no donor-site morbidity. In addition, in microform cleft lip, the external visible scar was avoidable through the intraoral incision.

Dovetail Cheiloplasty

The widely prevailing Millard's rotation-advancement flap method is characterizes with the upper lip scar on a philtral column and that it is less conspicuous than LeMesurier's or Tennison's metheds. Nowadays, straight line closure methods are employed together with the Millard's. However there are still some problems which are a straight line closure that goes against the principle of plastic surgery, a noticeable scar, tenting of the peak of Cupid's bow, a short lip tendency, and depression of the lip when the muscle contracts. In this respect, we designed two or three small trapezoid skin flaps on the cleft side and the same number of releasing incision lines on the non-cleft side and then let them interdigitate one another. We called it dovetail cheiloplasty. The muscle work was done by suturing one third of the cleft side muscle to the dissected dermis of the non-cleft side skin flap just under the philtral dimple. Our patients had a primary incomplete, a microform type cleft lip or a secondary cleft lip deformity. The result of employing this method showed an inconspicuous scar, a shorter lip, and a natural formation of the philtrum. We believe this method induces the improvement of straight line closure with respect to the quality of scars and the morphology of an upper lip.

Public Health Image Library - PHIL

Portal universal organizado pelo Centers for Disease Control and Prevention, com imagens de interesse para profissionais das ciências da saúde, cientistas, educadores, etc.

Surgical Correction of Microform Cleft Lip by Small Triangular Flap

Cleft lip is one of the most common major facial malformation. The defect of the midline tissue on the upper lip is due to failure of the contact and fusion between mesenchymal tissues of the lip. Microform cleft lip is defined as the cleft of the lip with the minor degree of the deformity on the lip and the nose. The hallmarks of the microform cleft lip are a small notching of the vermilion, a vertical congenital fibrous band extending from the vermilion to the nostril floor, and a displaced alar cartilage on the cleft side. The surgical methods of microform cleft lip include Rose-Thomson straight line closure and Millard Rotation- advancement repair. Although those methods repaired the functional impairment effectively, they failed to achieve the cosmetic improvement because of the long incision scar on the upper lip. The authors applied Tennison's small triangular flap to the microform cleft lips of the 10 patients from July 1998 to January 2001. We excised the scar on the notch of the vermilion with minimal incision using Tennison's small triangular flap and repaired the discontinuity of orbicularis oris musculture. The asymmetric nostrils were also corrected appropriately. We followed up each case with constant intervals and could get good results esthetically without shortening of the upper lip and the contracture of the scar band.