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Volumetric Approach to Midfacial Rejuvenation
Published in Neil S. Sadick, Illustrated Manual of Injectable Fillers, 2020
Robert A. Glasgold, Justin C. Cohen, Mark J. Glasgold, Sachin M. Shridharani, Jason D. Meier
For the purposes of this chapter, the midface is defined as extending from the lower eyelid (superior most aspect) to the oral commissure (inferior most aspect). Midfacial aging is primarily a function of volume loss. A youthful midface has a single convexity spanning from the lower eyelid to nasolabial fold (NLF), without a demarcation between the lower eyelid and cheek. As one ages, a generalized deflation and descent of the midface occurs, with more focal volume loss along the inferior orbital rim and anterior cheek (Figure 7.1a and b). These changes transform the youthful highlights of the midface convexity to a shadow-filled double concavity. Midfacial rejuvenation requires restoration of volume to remove or minimize the shadows of senescence and restore the vibrant highlights of youth (Figure 7.2a and b) (1). The potential options for adding midfacial volume have been greatly enhanced by the advances of injectable fillers.
Spinal Cord and Reflexes
Published in Nassir H. Sabah, Neuromuscular Fundamentals, 2020
The gray matter of the spinal cord is surrounded by massive ascending and descending fiber tracts (Figure 11.3). The right-half of the figure shows the main tracts through the spinal cord that are involved in motor function, which will be referred to later (Section 12.2.5). The left half of the figure shows the main ascending tracts, that is, the tracts that carry signals to the brain. The ascending and descending tracts course through the spinal cord as three major longitudinal funiculi referred to as the anterior, or ventral, funiculus, the lateral funiculus and the posterior, or dorsal, funiculus. Just anterior to the layer X is the ventral white commissure, which is a fiber tract that connects the two halves of the spinal cord (Figure 11.3).
Perioral Region
Published in Ali Pirayesh, Dario Bertossi, Izolda Heydenrych, Aesthetic Facial Anatomy Essentials for Injections, 2020
Krishan Mohan Kapoor, Philippe Kestemont, Jay Galvez, André Braz, John J. Martin, Dario Bertossi
The upper lip extends from the subnasale/subnasal point at the nasal base (cranially), to the nasolabial folds (bilaterally), to the lower edge of the vermilion border (caudally). The lower lip extends from its free vermilion edge (cranially), the oral commissures (laterally), and the labiomental crease (inferiorly). At the vermilion-cutaneous junction, a thin, pale line termed “white roll” highlights the color difference between the vermilion and the skin. In the upper central region, the white roll forms a V which, together with paramedian vermilion prominences, forms the Cupid's bow. Two vertical tissue columns (the philtral columns) form a midline depression (philtrum), which extends from lip border to the columella above (Figure 8.1). The labiomental crease passes horizontally in an inverted U shape across the lower lip, separating it from the chin.
Factors influencing the clinical efficacy of high-intensity focused ultrasound in the treatment of non-neoplastic epithelial disorders of the vulva: a retrospective observational study
Published in International Journal of Hyperthermia, 2021
Tongfu Feng, Liming Wang, Daojing Zhu, Ying Wu, Juan Xie, Lin Fang, Xin Du
From January 2014 to June 2018, 186 patients with NNEDV, confirmed by pathological biopsy and treated with HIFU, were selected. Among them, 51 patients were diagnosed with lichen sclerosis of the vulva (LSV), 106 patients with lichen simplex chronicus (LSC), and 29 patients with lichen planus (LP). The mean age of these patients was 45.6 ± 11.0 years, and the median disease course was 5.7 ± 3.2 years. The anterior commissure of the labia and labia fourchette served as the top and bottom vertices and the medial margins of the left and right labia majora as the boundaries. The area between the boundaries was designated as the central region and the area outside the boundaries as the peripheral region (Figure 1). The patients were divided into three groups according to the location of the lesions: central, peripheral, and mixed, with 15, 114, and 57 patients, respectively, in each group. In addition, patients were divided into two groups according to their depression and/or anxiety levels: 159 patients in the no or mild symptom group and 27 patients in the moderate or severe symptoms group. Patients with depression and anxiety were evaluated using the self-rating depression scale and self-rating anxiety scale when they received treatment. After evaluation, the patients were subsequently diagnosed and received intervention by a psychologist.
Seizure and cognitive outcomes of posterior quadrantic disconnection: a series of 12 pediatric patients
Published in British Journal of Neurosurgery, 2020
Yao Wang, Chao Zhang, Xiu Wang, Lin Sang, Feng Zhou, Jian-Guo Zhang, Wen-Han Hu, Kai Zhang
After this procedure, the fibres mentioned in 1)–3) above were disconnected with remaining fibres as follows: 5) hippocampal efferent fibres; 6) projection fibres from the amygdala; 7) fibres through the anterior commissure between the anterior temporal lobe and limbic cortex; and 8) projection fibres from the insula to the basal ganglia, thalamus, hypothalamus and brain stem.(3) Stage III: Mesial temporal resection: After the opening of the temporal horn, the amygdala was revealed in the anteromedial part. The amygdala was removed along with resection of the subdural uncinate gyrus. The superior boundary of the amygdala resection was located at the top of the temporal horn of the lateral ventricle. The hippocampus was exposed and resected along the temporal horn and choroid fissure.
Regional callosal integrity and bilaterality of limb weakness in amyotrophic lateral sclerosis
Published in Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 2020
Sicong Tu, Chenyu Wang, Ricarda A.L. Menke, Kevin Talbot, Michael Barnett, Matthew C. Kiernan, Martin R. Turner
The underlying pathological process associated with laterality of limb weakness and subsequent spread in ALS remains unclear, but may involve abnormality in transcallosal inhibitory control (16). Degeneration affects excitatory callosal pyramidal neurons whose primary targets are inhibitory interneurons in the contralateral hemisphere (32) via a corticofugal transsynaptic glutamate excitotoxic process (33,34). The current findings of a clinical association between reduced corpus callosum integrity and unilateral limb weakness suggests obstruction of the primary interhemispheric commissure of the brain may influence spread of symptoms. There are of course smaller subcortical commissures, which may explain a progressive involvement of deep gray matter structures with disease progression in ALS (35,36). They have been shown to play a fundamental role in the functional reconfiguration of the brain when interhemispheric transfer is compromised, such as following callosotomy and congenital agenesis of the corpus callosum (29). Our findings would then suggest involvement of extra-motor callosal fibers, as the primary motor connected posterior midbody is selectively impacted across all ALS patients, irrespective of the bilaterality, or not, of limb weakness.