• Archives of Plastic Surgery
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• v.32 no.2
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• pp.219-226
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• 2005

Muller's muscle-levator aponeurosis advancement procedure was performed to correct mild to moderate congenital blepharoptosis with moderate to good levator function and to correct severe aquired blepharoptosis with poor levator function. Through the blepharoplasty incision, the upper half of the tarsal plate was exposed and the orbital septum was opened to show the levator aponeurosis. The Muller's muscle was dissected from the superior margin of the tarsal plate and from the posteriorly located conjunctiva with sharp scissors. The Muller's muscle and levator aponeurosis were advanced on the anterior surface of the tarsal plate as a composite flap and fixed approximately 3 to 4 mm inferior to the upper edge of the tarsal plate with three horizontal 6-0 nylon mattress sutures. The amount of advancement of the composite flap was controlled by the location of the upper eyelid margin 2 mm below the upper limbus in primary gaze after the first suture in the middle portion of the flap. The excess flap was trimmed off with scissors, but trimming was usually not necessary in cases of mild to moderate ptosis. Nine cases underwent this Muller's muscle-levator aponeurosis advancement procedure from September 2003 to September 2004. Five cases were congenital blepharoptosis with 2-4 mm ptosis and more than 5 mm of levator function, but three of the four acquired ptosis cases had more than 4 mm ptosis with poor levator function. The age of the patients ranged from 7 to 81 years. In operative results, all patients except one traumatic case were within 1 mm of the desired eyelid height in primary gaze. This procedure can provide not only tightening of the Muller's muscle but also advancement and firm fixation of the levator aponeurosis to the tarsal plate, yielding predictable results.

• Journal of fish pathology
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• v.11 no.1
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• pp.77-81
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• 1998

By standardized method, Bacillus subtilis BGA, Bacillus cereus var. mycoides ATCC 11778, and Micrococcus luteus ATCC 9341 were seeded on the muller hinton agar (Difco) plate, and pH was adjusted to 6.0, 7.2, and 8.0. Five agar plates, B. subtilis (pH 6.0), B. cereus (pH 6.0), B. subtilis (pH 7.2), B. subtilis (pH 8.0), and M. luteus (pH 8.0), were employed as test plates of modified EEC 4-plate method. Oxytetracycline (OTC) with a diet was orally administered to flounder, Paralichthys olivaceus, at 100 mg/kg once a day. After oral administration, modified EEC 4-plate method by the three screening test using muscle-direct, extraction-disk and direct-disk methods was conducted for 3 fish at 1, 3, 5, 10, 15, 20, 25 and 30 days. Muscle-direct treatment of B. subtilis (pH 6.0) was found to be dubious positive (${\pm}$) at the 1st day after the administration; thereafter, it was found to be negative to the last day of the experiment. Extraction-disk and direct-disk treatment of B. subtilis (pH 6.0) were found to be negative from the 1st day to the last day after the administration. B. subtilis (pH 7.2), B. subtilis (pH 8.0), and M. luteus (pH 8.0) by the three screening tests, were found to be negative all the way after the administration. On the other hand, B. cereus (pH 6.0) by the three screening tests was clearly found to be positive for the first 15 days after the administration, and then muscle-direct and direct-disk treatment of B. cereus (pH 6.0) were found to be dubious positive at 20th days after the administration. However extraction-disk treatment of B. cereus (pH 6.0) was clearly found to be negative at the same stage; thereafter, the three screening tests of B. cereus (pH 6.0) were found negative to the last of the experiment. These findings showed that to have equal sensitivity to those determination for the residual detection of OTC, and also confirmed that B. cereus was effective test organism for the monitoring of OTC.