• Title/Summary/Keyword: Midline

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The Difference of Success Rate between the Midline Approach and the Paramedian Approach of Spinal Anesthesia in each of Flexed Patients and Straightened Patients (한국 성인에서 정중접근법과 측면접근법에 의한 요부 척추천자시 전굴 자세에 따른 성공률의 비교)

  • Cho, Myung-Hyun;Lee, Jong-Sun
    • The Korean Journal of Pain
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    • v.9 no.1
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    • pp.126-129
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    • 1996
  • Background: Advantages of paramedian approach over midline approach include less tissue trauma and less dependence on patient's ability to assume a fetal position. When midline approach fails in patients who are difficult to take a position with lumbar spine flexed, paramedian approach to interlaminar space may succeed. Methods: Success rates of spinal anesthesia were measured for 47 flexed patients by midline approach, 48 flexed patients by paramedian approach, 23 straightened patients receiving spinal anesthesia by midline approach, and 23 straightened patients by paramedian approach. Results: Success rates in flexed patients were 100% by midline approach and 100% by paramedian approach. Success rates for straightened patients were 13.0% by midline approach and 78.3% by paramedian approach. For straightened patients there were no correlations between success fate and age, weight, Ponderal Index but there were correlations between height and midline approach of spinal anesthesia. Conclusion: Pertaining to adult Koreans, success rates of spinal anesthesia for strainghtened patients were less than those for flexed patients. Success rate of paramedian approach of spinal anesthesia among strainghtened patients were better than those of midline approach.

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Perception of discrepancy in the upper midline position in conjunction with the gingival display according to various occupations in Iran

  • Hooman Zarif Najafi;Taraneh Estedlal;Maryam Saki;Maryam Azadi
    • The korean journal of orthodontics
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    • v.53 no.3
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    • pp.163-174
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    • 2023
  • Objective: This study evaluated the influence of various gingival displays on the esthetic perception in the presence of upper dental midline discrepancy. Methods: A smiling image of a male subject was altered digitally to produce five image series: normal smile (series A), decreased tooth show (series B), increased gingival show (series C), maxillary cant (series D), and asymmetric upper lip elevation (series E). In each image series, the midline was deviated to the right and left incrementally. A total of 210 raters (four professional groups and laypersons, n = 42 in each group) determined the midline deviation threshold and the attractiveness of midline position in each series. Results: The right and left thresholds were statistically similar for the symmetrical series (A, B, and C), while for series D, the right threshold was significantly lower. In most rater groups, the mean threshold order was: B > A > E > C > D. In all the series, the raters selected the coincident midline as the most attractive series except for series D, for which 1-2-mm deviations to the left were selected as the most attractive by almost all the groups. Conclusions: It is crucial to establish the coincident midline position in a symmetrical smile, especially when a gummy smile exists. In the asymmetrical gingival show, a coincident midline might not be the most esthetic midline position.

Relationship between Mandibular Midline Shift and First Moral Relation, and Their Effects on the Mandibular Height and the Occlusal Plane Angle (하악정중선의 편위와 제 1대구치 교합관계가 하악골의 높이 및 교합면 경사에 미치는 영향)

  • Han, Kyung-Soo;Kim, Chang-Hyun
    • Journal of Oral Medicine and Pain
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    • v.25 no.2
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    • pp.205-214
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    • 2000
  • This study was performed to investigate the relationship between mandibular midline shift and anteroposterior first molar occlusal relation, and their effects on the mandibular height and the occlusal plane angle. For this study, 49 patients with temporomandibular disorders were selected. They did not show facial asymmetry and their facial midline coincide with maxillary dental midline. Upper and lower mandibular impression were taken and the casts were fabricated. Amount and direction of the mandibular midline shift and the anteroposterior shift between the two occluding first molars were measured on the casts. Several items related to height such as mandibular height from top of the articular surface of the condyle to curve changing point between antegonial notch and mandibular angle, condylar height which was the vertical distance from the articular surface to retroepicondyle of the condyle, and sigmoid height from the deepest point of sigmoid notch to the curve changing point and the occlusal plane angle were also measured on the panoramic and on the transcranial radiographs. Correlation between midline shift and anteroposterior first molar relation and comparison between right and left mandibular height by the midline shift and the first molar relation were analysed by SPSS windows program. The results of this study were as follows : 1. Mean amount of midline shift in the subjects with midline shift were 2.0mm for both side, respectively. The first molar relation of the ipsilateral side of midline shift showed Angle class II tendency and the contralateral side showed Angle class III tendency, which meant drift of the dentition to the side of the midline shift. 2. The occlusal plane angle on the panoramic radiograph were $13.0^{\circ}$ in right, and $12.5^{\circ}$ in left side, and their were no correlation between occlusal plane angle and mandibular midline shift and the first molar occlusal relation. 3. Angle's classification for both sides of the first molar relation were same in about half of all the subjects. Amount of deviation from class I first molar relation, however, were decreased in the contralateral side of observed side. 4. Mandibular height of the ipsilateral side to which mandibular midline shift showed tendency of lower than that of the contralateral side, and there was a tendency that the height was higher in class III subjects, then class II subjects, and lower in class I subjects. However, condylar height did not show any difference in the subjects with midline shift and also show no difference by the first molar occlusal relation.

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A Study of the Relationship of the Dental Midline to the Philtrum (인중과 상.하악 치아의 중심선 관계에 대한 조사연구)

  • Lee, Tae-Jung
    • Journal of Technologic Dentistry
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    • v.6 no.1
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    • pp.27-30
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    • 1984
  • This investigation was performed to study the relationship of the dental midline(an imaginary line between the centeal incisors) to the philtrum. 2,400 subjects with natural dentitions were examined. The group of the subjects was composed of 1,560 men and 840 women who had all of the upper and lower six anteriors and 0 to 4 missing teeth. Ages of the subjects ranged from 18 to 27 years. The obtained results were as follow: 1. The rates of the subjects whose philtrum and maxillary dental midline coincided was 64.92% and that of the subjects whose upper and lower dental midlines coincided was 29.17%and these rates are statistically significant, when compared respectively with those of the subjects whose philtrum and maxillary dental midline, and whose upper and lower dental midline's didn't coincide. 2. The difference between rates for the two sexes is not statistically significant. 3. Tooth missing significantly decreases the rates of the coincidence of the upper and lower dental midlines but its influence on the rates of coincidence of the dental midline to the philtrum is not significant.

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Midline enhancer activity of the short gastrulation shadow enhancer is characterized by three unusual features for cis-regulatory DNA

  • Shin, Dong-Hyeon;Hong, Joung-Woo
    • BMB Reports
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    • v.48 no.10
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    • pp.589-594
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    • 2015
  • The shadow enhancer of the short gastrulation (sog) gene directs its sequential expression in the neurogenic ectoderm and the ventral midline of the developing Drosophila embryo. Here, we characterize three unusual features of the shadow enhancer midline activity. First, the minimal regions for the two different enhancer activities exhibit high overlap within the shadow enhancer, meaning that one developmental enhancer possesses dual enhancer activities. Second, the midline enhancer activity relies on five Single-minded (Sim)-binding sites, two of which have not been found in any Sim target enhancers. Finally, two linked Dorsal (Dl)- and Zelda (Zld)-binding sites, critical for the neurogenic ectoderm enhancer activity, are also required for the midline enhancer activity. These results suggest that early activation by Dl and Zld may facilitate late activation via the noncanonical sites occupied by Sim. We discuss a model for Zld as a pioneer factor and speculate its role in midline enhancer activity.

Prediction of Midline Dose from Entrance and Exit Dose Using OSLD Measurements for Total Body Irradiation

  • Choi, Chang Heon;Park, Jong Min;Park, So-Yeon;Chun, Minsoo;Han, Ji Hye;Cho, Jin Dong;Kim, Jung-in
    • Journal of Radiation Protection and Research
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    • v.42 no.2
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    • pp.77-82
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    • 2017
  • Background: This study aims to predict the midline dose based on the entrance and exit doses from optically stimulated luminescence detector (OSLD) measurements for total body irradiation (TBI). Materials and Methods: For TBI treatment, beam data sets were measured for 6 MV and 15 MV beams. To evaluate the tissue lateral effect of various thicknesses, the midline dose and peak dose were measured using a solid water phantom (SWP) and ion chamber. The entrance and exit doses were measured using OSLDs. OSLDs were attached onto the central beam axis at the entrance and exit surfaces of the phantom. The predicted midline dose was evaluated as the sum of the entrance and exit doses by OSLD measurement. The ratio of the entrance dose to the exit dose was evaluated at various thicknesses. Results and Discussion: The ratio of the peak dose to the midline dose was 1.12 for a 30 cm thick SWP at both energies. When the patient thickness is greater than 30 cm, the 15 MV should be used to ensure dose homogeneity. The ratio of the entrance dose to the exit dose was less than 1.0 for thicknesses of less than 30 cm and 40 cm at 6 MV and 15 MV, respectively. Therefore, the predicted midline dose can be underestimated for thinner body. At 15 MV, the ratios were approximately 1.06 for a thickness of 50 cm. In cases where adult patients are treated with the 15 MV photon beam, it is possible for the predicted midline dose to be overestimated for parts of the body with a thickness of 50 cm or greater. Conclusion: The predicted midline dose and OSLD-measured midline dose depend on the phantom thickness. For in-vivo dosimetry of TBI, the measurement dose should be corrected in order to accurately predict the midline dose.

Combined Congenital Anterior and Posterior Midline Cleft of the Atlas Associated with Asymptomatic Lateral Atlantoaxial Subluxation

  • Park, Sun-Young;Kang, Dong-Ho;Lee, Chul-Hee;Hwang, Soo-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.44-46
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    • 2006
  • Although congenital anomalies of the atlas have been well-documented, atlas anomalies of clefts and aplasia are rare. Anterior and posterior midline clefts of the atlas have been reported separately in some series. However, combined congenital anterior and posterior midline clefts of the atlas are reported rarely. Hence, we report a very rare case of combined congenital anterior and posterior midline clefts of the atlas associated with asymptomatic lateral atlantoaxial subluxation.

Transcriptional activity of the short gastrulation primary enhancer in the ventral midline requires its early activity in the presumptive neurogenic ectoderm

  • Shin, Dong-Hyeon;Hong, Joung-Woo
    • BMB Reports
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    • v.49 no.10
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    • pp.572-577
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    • 2016
  • The short gastrulation (sog) shadow enhancer directs early and late sog expression in the neurogenic ectoderm and the ventral midline of the developing Drosophila embryo, respectively. Here, evidence is presented that the sog primary enhancer also has both activities, with the late enhancer activity dependent on the early activity. Computational analyses showed that the sog primary enhancer contains five Dorsal (Dl)-, four Zelda (Zld)-, three Bicoid (Bcd)-, and no Single-minded (Sim)-binding sites. In contrast to many ventral midline enhancers, the primary enhancer can direct lacZ expression in the ventral midline as well as in the neurogenic ectoderm without a canonical Simbinding site. Intriguingly, the impaired transcriptional synergy between Dl and either Zld or Bcd led to aberrant and abolished lacZ expression in the neurogenic ectoderm and in the ventral midline, respectively. These findings suggest that the two enhancer activities of the sog primary enhancer are functionally consolidated and geographically inseparable.

Hypothalamic Orexin-A Projections to Midline Thalamic Nuclei in the Rat

  • Lee, Hyun-S.
    • Animal cells and systems
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    • v.9 no.3
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    • pp.145-152
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    • 2005
  • A retrograde tracer, WGA-apo-HRP-gold, was injected into midline thalamic nuclei and subsequently orexin-A immunostaining was performed on the tuberal region of the hypothalamus in order to investigate orexinergic projections to the midline thalamus. Injection site was targeted within one specific region, i.e., paraventricular, centromedian, rhomboid, reuniens, or intermediodorsal nucleus, but it proved to be either one or a combination of these thalamic nuclei. The distribution of WG/orexin-double-labeled neurons exhibited a general pattern in that the majority of labeled cells were observed within the ventral portion of the lateral hypothalamus as well as the perifornical nucleus (PeF). A small number of double-labeled cells were also observed at the dorsomedial nucleus, the area dorsal to the PeF, dorsal portion of the lateral hypothalamus, and the posterior hypothalamus. These orexin-immunoreactive neurons might have wake-related influences over a variety of functions related with midline thalamic nuclei, which include autonomic control, associative cortical functions, and limbic regulation.

Identification of the 187 bp EphA7 Genomic DNA as the Dorsal Midline-Specific Enhancer of the Diencephalon and Mesencephalon

  • Kim, Yujin;Park, Eunjeong;Park, Soochul
    • Molecules and Cells
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    • v.38 no.11
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    • pp.1007-1012
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    • 2015
  • EphA7 is a key molecule in regulating the development of the dien- and mesencephalon. To get insight into the mechanism of how EphA7 gene expression is regulated during the dorsal specification of the dien- and mesencephalon, we investigated the cis-acting regulatory sequence driving EphA7 to the dorsal midline of the dien- and mesencephalon. Transgenic LacZ reporter analysis, using overlapping EphA7 BACs, was used to narrow down the dorsal midline-specific enhancer, revealing the 25.3 kb genomic region as the enhancer candidate. Strikingly, this genomic DNA was located far downstream of the EphA7 transcription start site, +302.6 kb to +327.9 kb. Further enhancer mapping, using comparative genomic analysis and transgenic methods, showed that the 187 bp genomic DNA alone, approximately 305 kb downstream of the EphA7 transcription start site, was sufficient to act as the dorsal midline-specific enhancer of EphA7. Importantly, our results indicate that the 187 bp dorsal midline-specific enhancer is critically regulated by homeobox transcription factors during the development of the dien- and mesencephalon.