Goltz syndrome is a rare, X-linked dominant, multisystem disorder found almost exclusively in female patients. Although the cutaneous features predominate in most reports, characteristic abnormalities are also frequently present in the musculoskeletal system and facial region. We report a female infant born with a severe form of Goltz syndrome that included an extremely wide facial cleft, an abnormality not previously reported in a patient with this disorder. Her management demonstrates the advantages of a multidisciplinary approach to effectively care for patients with severe craniofacial abnormalities.
Objective Goltz syndrome is a rare, X-linked dominant, multisystem disorder found almost exclusively in female patients. Although the cutaneous features predominate in most reports, characteristic abnormalities are also frequently present in the musculoskeletal system and facial region. We report a female infant born with a severe form of Goltz syndrome that included an extremely wide facial cleft, an abnormality not previously reported in a patient with this disorder. Her management demonstrates the advantages of a multidisciplinary approach to effectively care for patients with severe craniofacial abnormalities.
The purpose of this study was to examine the effect of Lactosorb absorbable plates on bone healing across cranial bone defects in the rabbit skull. Two 10-mm diameter parietal skull defects were created in each of 20 rabbits, with one defect being placed on either side of the sagittal suture. In 10 rabbits, an absorbable plate was placed across both the inner and outer cortices of the left defect, and in the other 10 rabbits, an absorbable plate was placed across the outer cortex only of the left defect. The right defect always served as the control side, with no plate being placed across it. Rabbits were killed an average of 25 weeks postoperatively. Areas of reossification in the experimental and control defects of each rabbit were then measured, examined histologically, and compared. Growth across defects spanned by one plate was also compared with growth across defects spanned by two plates. Histologic and statistical analyses revealed no significant differences in reossification between the control and experimental defects in each animal and between the defects spanned by one versus two plates. This study suggests that these copolymer absorbable plates neither inhibit nor facilitate reossification across 10-mm diameter rabbit cranial defects.
One of the largest costs after erection of a boiler is the maintenance cost. Typically these costs are manageable and modest except when replacement of pressure parts is required. When replacing pressure parts in a boiler the owner should take advantage of the opportunity to evaluate the boilers history, mechanical condition and thermal performance. This evaluation is critical as it can benefit the capital replacement cost and the maintenance cost after installation. Solutions can vary from replacement with an exact duplicate, upgrade to improve mechanical reliability, or modifications to improve the thermal performance. After an initial evaluation, further studies into future operating conditions such as cycling of the boiler, fuel changes and other plant modifications can greatly change the recommended replacement. Conducting an evaluation and developing a plan upfront will help support an optimized design and ensure the optimal replacement part is designed and installed. This paper discusses options and considerations to evaluate when developing a replacement plan for pressure parts utilizing current codes and standards.
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