A new species of Alternaria causing leaf spots on the rubber tree (Hevea brasiliensis) in Yunnan, China, was isolated, examined, and illustrated. Morphologically, it belongs to the section Porri of Alternaria, which produces relatively large conidia and a simple or branched, filamentous long beak. It is, however, characterized by conidiophores gradually enlarging near the apex into a clavate conidiogenous cell and long ellipsoid to obclavate, smooth-walled conidia with a long filamentous beak. Molecular phylogenetic analyses based on ITS rDNA, GAPDH, and TEF1-alpha sequences demonstrate that the phytopathogen falls in the clade of the section Porri, being most closely related to A. sidae, A. sennae, A. deseriticola, A. cyamopsidis, A. rostellata, A. nitrimali, A. crassa, and A. thunbergiae.
Acanthaceae ; Accidental Falls ; Alternaria ; Animals ; Ascomycota ; Beak ; China ; Classification ; DNA, Ribosomal ; Hevea ; Rubber ; Spores, Fungal

PURPOSE: The spontaneous extensor pollicis longus (EPL) tendon rupture is a well-documented complication of non-displaced or minimally displaced distal radius fracture. Authors analyzed the radiographs of patients treated for closed EPL rupture after distal radius fracture. MATERIALS AND METHODS: Twenty-eight patients (21 females, 7 males; average age of 58 years) with tendon transfer for spontaneous rupture of EPL after distal radius fracture were included. Wrist radiographs were taken at the first visit with EPL rupture. On the lateral view, posterior cortical displacement, distance from highest point in Lister's tubercle to fracture line, and height of the Lister's tubercle were measured. The distance from the lunate facet to the fracture line was measured on anteroposterior view. Radiologic change at the time of EPL rupture around the Lister's tubercle was evaluated by comparing it with the contra lateral wrist radiograph. Radial beak fracture pattern was also identified. RESULTS: The interval between the injury and the spontaneous EPL rupture varied from 2 to 20 weeks, with an average of 6.7 weeks. There were 25 cases of non-displacement, 3 cases of mean 2.0 mm cortical displacement. The average distance from the lunate facet to the fracture line was 9.1 mm (3-12.1 mm), from the highest point in Lister's tubercle to the fracture line was 3.0 mm toward proximal radius (1.7-4.9 mm). The average height of the Lister's tubercle was 3.4 mm in the injured wrist and 3.1 mm in the opposite wrist. Radial beak fracture pattern was shown at 11 cases. CONCLUSION: All cases presented no or minimal displaced fracture, and the fracture line was in the vicinity of the Lister's tubercle. Those kinds of fractures can highlight the possibility of spontaneous EPL rupture, depites its rarity.
Animals ; Beak ; Female ; Humans ; Male ; Radius Fractures* ; Radius* ; Rupture* ; Rupture, Spontaneous ; Tendon Transfer ; Tendons ; Wrist

PURPOSE: Reconstruction of sideburn and frontal hairline alopecia after burn injuries is one of the challenging tasks in reconstructive surgery. We report on the successful experiences to reconstruct the sideburn and frontal hairline alopecia with various scalp flaps such as Beak scalp flap, scalp rotation flap, scalp transposition flap and scalp expansion operation. METHODS: We experienced the patients who had postburn scalp alopecia after severe facial burn injuries. Among them we selected 8 patients of postburn sideburn and frontal hairline loss and reconstructed with variable scalp flaps. The types of scalp flaps for reconstruction were the Beak scalp flap which is made of the extended postauricular scalp flap combined with the central scalp rotation flap, scalp rotational flap, scalp transposition flap, and scalp expansion operations. We studied the indication of the transferred various scalp flaps for each case considering the size and shape of hair loss lesion, complications, problems of donor site, appearance of reconstructed frontal hairline and sideburns through follow survey. The follow-up periods were 3 months to 2 years. RESULTS: We experienced 8 patients of postburn sideburn and frontal hairline alopecia. Patients' age ranged from 13 to 16 years. male to female ratio was 2:6. Reconstruction methods were 1 case of Beak scalp flap, 1 case of scalp rotation flap, 1 case of scalp transposition flap and 5 cases of scalp expansions. All transferred scalp flaps were completely survived. As complications, 1 case hematoma, 1 case partial edge extrusion of expander, 1 case of persistent headache in scalp expansion operation were noted. There were no remarkable problems in scalp donor site. After 3 months to 2 years follow up, satisfactory results were obtained in all patients. Illustrated Case: The 31-years-old female patient had loss of right frontal hairline, sideburn caused by flame burn. With aid of 3D computerized graphic design, the extended posterior auricular scalp flap with the central frontal scalp rotation flap, which is called as the Beak scalp flap, is a newly designed scalp flap for correction of her frontal hairline and sideburn alopecia. The size of the central frontal scalp rotation flap was 12x11 cm, and the size of the extended postauricular scalp flap was 7x1.5 cm. This flap is elevated simultaneously and could cover the sideburn and frontal hairline alopecia in a single procedure. At postoperatively, the transferred the Beak scalp flap was survived completely. The 9 months follow-up after operation, well reconstructed her right sideburn and frontal hairline was shown. CONCLUSION: For reconstruction of postburn sideburn and frontal hairline alopecia, the scalp flaps transfer should be precisely design in accordance with size, location of hair loss, direction of hair, and also it is emphasized to minimize postoperative scalp donor scars. We had successful reconstruction of postburn sideburn and frontal hairline alopecia by the Beak scalp flap, as a newly designed the composite scalp flap, which is made of the extended postauricular scalp flap combined with the central frontal scalp rotation flap, this flap can be used for reconstruction of loss of sideburn and frontal hairline in a single stage procedure. And also we have used scalp rotation flap, scalp transposition flap, and scalp expansion operations for this purpose. We present these method's reliability and validity.
Alopecia* ; Animals ; Beak ; Burns ; Cicatrix ; Female ; Follow-Up Studies ; Hair ; Headache ; Hematoma ; Humans ; Male ; Reproducibility of Results ; Scalp* ; Tissue Donors

OBJECTIVES: Draf IIb approach provides wide, unilateral access to the frontal sinus. This approach can be extended without destruction of the contralateral frontal sinus drainage pathway, performed during Draf III (modified Lothrop) procedure. There is limited data in the literature regarding the use of modified Draf IIb procedures. METHODS: Patients treated with extended Draf IIb procedures in a single center were retrospectively assessed. RESULTS: Ten patients were identified, including 2 cases of osteoma, 1 inverted papilloma, 1 carcinoma, 5 mucoceles, and 1 chronic rhinosinusitis patient. Six patients had undergone prior surgery, including external procedures in 3 cases. Modifications of Draf IIb were classified as the following: removal of the anterosuperior nasal septum adjacent to the nasal beak, removal of the intersinus septum, and a combination of the above-mentioned methods (upper nasal septum and intersinus septum removal). There were 3 patients operated on with type 1 modification, one patient with type 2 modification, and 6 patients with type 3 modification. There were no perioperative complications. CONCLUSION: In selected cases, extended Draf IIb procedures are safe and effective in the treatment of frontal sinus disease.
Animals ; Beak ; Drainage ; Endoscopy ; Frontal Sinus* ; Humans ; Mucocele ; Nasal Septum ; Osteoma ; Papilloma, Inverted ; Pathology* ; Retrospective Studies

Direct removal of beak-type ossification of posterior longitudinal ligament at thoracic spine (T-OPLL) is a challenging surgical technique due to the potential risk of neural injury. Slipping off the cutting surface of a high-speed drill may result in entrapment in neural structures, leading to serious complications. Removal of T-OPLL with an ultrasonic osteotome, utilizing back and forth micro-motion of a blade rather than rotatory-motion of drill, may reduce such complications. We have applied the ultrasonic osteotome for posterior circumferential decompression of T-OPLL for three consecutive patients with beak-type OPLL and have described the surgical techniques and patient outcomes. The preoperative chief complaint was gait disturbance in all patients. Japanese orthopedic association scores (JOA) was used for functional assessment. Scores measured 2/11, 5/11, 2/11, and 4/11 for each patient. The ventral T-OPLL mass was exposed after posterior midline approach, laminotomy and transeversectomy. The T-OPLL mass was directly removed with an ultrasonic osteotome and instrumented segmental fixation was performed. The surgeries were uneventful. Detailed surgical techniques were presented. Gait disturbance was improved in all patients. Dural tear occurred in one patient without squeal. Postoperative JOA was 6/11, 10/11, 8/11, and 8/11 (recovery rate; 44%, 83%, 67%, and 43%) respectively at 18, 18, 10, and 1 months postoperative. T-OPLL was completely removed in all patients as confirmed with computed tomography scan. We hope that surgical difficulties in direct removal of T-OPLL might be reduced by utilizing ultrasonic osteotome.
Animals ; Asian Continental Ancestry Group ; Beak ; Decompression ; Gait ; Hope ; Humans ; Laminectomy ; Orthopedics ; Ossification of Posterior Longitudinal Ligament* ; Spine* ; Tears ; Ultrasonics* ; Ultrasonography

BACKGROUND AND OBJECTIVES: Endoscopic management of frontal sinus disease remains a difficult task. In order to minimize the risk of intracranial complication, easily identifiable landmarks and measurements should be required. This study aims to identify standard distances from the columella to the anterior and posterior borders of the frontal sinus ostium in Korean men and women. SUBJECTS AND METHOD: We obtained the sagittal images taken from 30 men and 30 women. Measurements from the columella to the nasofrontal beak (NFB) and anterior skull base (ASB) were made. Also, the angle between the lines of the columella to the ASB and hard palate was measured. RESULTS: The mean distance from the columella to the NFB was 55.3+/-3.9 mm in men and 52.1+/-4.7 mm in women (p<0.01). The mean distance from the columella to the ASB was 62.1+/-4.5 mm in men and 59.0+/-4.7 mm in women (p<0.01). The mean angle between the lines of the columella to the ASB and hard palate was 71.8+/-4.5degrees in men and 70.7+/-4.6degrees in women (p>0.05). CONCLUSION: This study suggests sinus surgeons to stay a distance from the columella of less than 57.6 mm in men and 54.3 mm in women to minimize skull base injury.
Animals ; Beak ; Endoscopy ; Female ; Frontal Sinus* ; Humans ; Male ; Palate, Hard ; Skull Base

PURPOSE: We attempted to determine the differences in frequency, as well as clinical, radiologic characteristics of atypical femoral fracture between groups of patients who have taken bisphosphonate and those who have not by conduct of a retrospective analysis of patients with low energy subtrochanteric and shaft fractures of the femur. MATERIALS AND METHODS: We conducted a retrospective study of 44 cases of 41 female patients over 60 years old who underwent surgery due to femoral shaft/subtrochanteric fractures from August 2001 to October 2011. The patients were divided into two groups: Group A, 22 cases in 19 patients with a history of bisphosphonate treatment; Group B, 22 cases in 22 patients without a history of bisphosphonate treatment as a control group. We assessed the duration of bisphosphonate treatment, presence of prodromal symptoms, and radiological results, and compared age, BMD results, union period, and nonunion rate between the two groups. RESULTS: Mean medication period was 56.8 months(12-132 months) and prodromal symptoms were observed in one case. Lateral cortical thickening and transverse fracture with a medial cortical bone beak were observed in all patients of Group A, and contralateral cortical hypertrophy of the femur was noted in 15 patients(17 cases) (77.3%). Mean age was 73.2 years in Group A and 78.2 years in Group B, which showed significant difference (P=0.021), while no difference was observed in BMD, union period, and nonunion rate. CONCLUSION: An atypical femoral fracture can occur in the subtrochanteric or shaft of the femur. The typical radiological characteristics of this fracture are lateral cortical thickening and transverse fracture with a medial cortical bone beak and contralateral abnormality of cortical bone. Findings of this study suggest that medical practitioners should be careful of atypical fractures with osteoporosis patients who use prolonged bisphosphonate.
Animals ; Beak ; Female ; Femoral Fractures ; Femur ; Humans ; Hypertrophy ; Osteoporosis ; Prodromal Symptoms ; Retrospective Studies

Several case series have suggested an association exists between atypical femoral subtrochanteric fractures and long-term use of bisphosphonates. It is thought that prolonged use of bisphosphonates may lead to adynamic, fragile bone. The radiologic features of atypical fractures include diffuse cortical thickening, transverse fracture, and beaking at the lateral subtrochanteric area. Atypical subtrochanteric femur fractures have been reported after use of alendronate, but there have been rare reports of atypical femur fractures occurring after administration of zoledronic acid. A 56-year-old female with metastatic breast cancer treated with zoledronic acid presented with pain in the right hip. X-rays showed a right subtrochanteric fracture, and she underwent operation. Four months later after having undergone an operation, the patient struggled with walking and X-ray showed delayed union of the fracture site.
Alendronate ; Animals ; Beak ; Breast ; Breast Neoplasms ; Diphosphonates ; Female ; Femoral Neck Fractures ; Femur ; Hip ; Hip Fractures ; Humans ; Imidazoles ; Middle Aged ; Walking

Pyknodysostosis is a rare autosomal recessive disorder characterized by the post natal onset of short limbs, short stature, and generalized hyperostosis along with acro-osteolysis with sclerosis of the terminal phalanges, a feature that is considered essentially pathognomonic. Other features include persistence of fontanelles, delayed closure of sutures, wormian bones, absence of frontal sinuses, and obtuse mandibular gonial angle with relative mandibular prognathism. We report a case of 17-year-old girl who presented with a chief complaint of retention of deciduous teeth. General physical examination demonstrated short stature, frontal and parietal bossing, depressed nasal bridge, beaked nose, hypoplastic midface, wrinkled skin over the finger tips, and nail abnormalities. Radiographs showed multiple impacted permanent and supernumerary teeth, hypoplastic paranasal sinuses with acro-osteolysis of terminal phalanges, and open fontanelles, and sutures along with wormian bones in the lambdoidal region.
Acro-Osteolysis ; Adolescent ; Animals ; Beak ; Craniofacial Abnormalities ; Dysostoses ; Extremities ; Fingers ; Frontal Sinus ; Humans ; Hyperostosis ; Nails, Malformed ; Nose ; Paranasal Sinuses ; Physical Examination ; Prognathism ; Pycnodysostosis ; Retention (Psychology) ; Sclerosis ; Skin ; Sutures ; Tooth, Deciduous ; Tooth, Supernumerary

OBJECTIVES: We analyzed the pneumatization pattern of the frontal recess (FR) in a Korean population. We also determined the correlation between the volume of the agger nasi cell (ANC) and the anterior-to-posterior (A-P) length of the frontal isthmus (FI) and FR. METHODS: Multiplanar paranasal sinus computed tomography (CT) images from 105 patients who underwent endoscopic sinus surgery were reviewed. The prevalence of frontal recess cells (FRCs), thickness of the frontal beak (FB), volume of the ANC, A-P length of the FI, and FR were evaluated. RESULTS: The ANC was identified in 96% of the patients and frontal cells (FCs) in 32% (FC type 1, 24.2%; type 2, 4.2%; type 3, 3.1%; and type 4, 0%). The prevalences of frontal bullar, suprabullar, supraorbital ethmoidal, and interfrontal sinus septal cells were 10%, 7.8%, 3.6%, and 6.8%, respectively. The A-P lengths of the FR and FI were 10.1+/-3.1 and 8.4+/-2.9 mm, respectively. The thickness of the FB was 7.8+/-1.8 mm and the volume of the ANC averaged 394.1+/-240.5 mm3. The thickness of the FB did not correlate with the volume of the ANC. In contrast, the A-P length of the FI and FR were positively correlated with the volume of the ANC. CONCLUSION: ANCs and FCs were found in 96% and 32% of the cases in this series. FC type 4 was not seen. What appeared to be FC4 on conventional CT was identified as FBC from reconstructed parasagittal images. A large ANC increased the A-P length of the FI and FR, regardless of the thickness of the FB.
Animals ; Beak ; Frontal Sinus ; Humans ; Prevalence ; Tomography, Spiral Computed