A dehydrated space-weathered skin cloaking the hydrated interior of Ryugu

Without a protective atmosphere, space-exposed surfaces of airless Solar System bodies gradually experience an alteration in composition, structure and optical properties through a collective process called space weathering. The return of samples from near-Earth asteroid (162173) Ryugu by Hayabusa2 provides the first opportunity for laboratory study of space-weathering signatures on the most abundant type of inner solar system body: a C-type asteroid, composed of materials largely unchanged since the formation of the Solar System. Weathered Ryugu grains show areas of surface amorphization and partial melting of phyllosilicates, in which reduction from Fe³⁺ to Fe²⁺ and dehydration developed. Space weathering probably contributed to dehydration by dehydroxylation of Ryugu surface phyllosilicates that had already lost interlayer water molecules and to weakening of the 2.7 µm hydroxyl (-OH) band in reflectance spectra. For C-type asteroids in general, this indicates that a weak 2.7 µm band can signify space-weathering-induced surface dehydration, rather than bulk volatile loss.

Room temperature facile synthesis of olivine-Co2SiO4 nanoparticles utilizing a mechanochemical method

Co₂SiO₄ is a ceramic pigment and promising battery material of significant technological interest, as well as a model end-member of one of the most important mineral families in the Earth's crust and upper mantle. All previously developed methods for synthesis of Co₂SiO₄ require high-temperature processing, which promotes grain growth, while the nanocrystalline form is required for some important technological applications. Here, we report a successful method for synthesizing nanocrystalline Co₂SiO₄via a simple and inexpensive high-energy ball milling mechanochemical process. Products of the synthesis were characterized by a combination of XRD and TEM, and their crystal structures and elemental compositions are reported.

Impact pressure induces synthesis of nanocrystalline olivine Co₂SiO₄.

Combined Focused Ion Beam-Ultramicrotomy Method for TEM Specimen Preparation of Porous Fine-Grained Materials

A new transmission electron microscopy (TEM) specimen preparation method that utilizes a combination of focused ion beam (FIB) methods and ultramicrotomy is demonstrated. This combined method retains the benefit of site-specific sampling by FIB but eliminates ion beam-induced damage except at specimen edges and allows recovery of many consecutive sections. It is best applied to porous and/or fine-grained materials that are amenable to ultramicrotomy but are located in bulk samples that are not. The method is ideal for unique samples from which every specimen is precious, and we demonstrate its utility on fine-grained material from the one-of-a-kind Paris meteorite. Compared with a specimen prepared by conventional FIB methods, the final sections are uniformly thin and free from re-deposition and curtaining artifacts common in FIB specimens prepared from porous, heterogeneous samples.

Untangling the formation and liberation of water in the lunar regolith

The source of water (H2O) and hydroxyl radicals (OH), identified on the lunar surface, represents a fundamental, unsolved puzzle. The interaction of solar-wind protons with silicates and oxides has been proposed as a key mechanism, but laboratory experiments yield conflicting results that suggest that proton implantation alone is insufficient to generate and liberate water. Here, we demonstrate in laboratory simulation experiments combined with imaging studies that water can be efficiently generated and released through rapid energetic heating like micrometeorite impacts into anhydrous silicates implanted with solar-wind protons. These synergistic effects of solar-wind protons and micrometeorites liberate water at mineral temperatures from 10 to 300 K via vesicles, thus providing evidence of a key mechanism to synthesize water in silicates and advancing our understanding on the origin of water as detected on the Moon and other airless bodies in our solar system such as Mercury and asteroids.

Multiple generations of grain aggregation in different environments preceded solar system body formation

The solar system formed from interstellar dust and gas in a molecular cloud. Astronomical observations show that typical interstellar dust consists of amorphous (a-) silicate and organic carbon. Bona fide physical samples for laboratory studies would yield unprecedented insight about solar system formation, but they were largely destroyed. The most likely repositories of surviving presolar dust are the least altered extraterrestrial materials, interplanetary dust particles (IDPs) with probable cometary origins. Cometary IDPs contain abundant submicron a-silicate grains called GEMS (glass with embedded metal and sulfides), believed to be carbon-free. Some have detectable isotopically anomalous a-silicate components from other stars, proving they are preserved dust inherited from the interstellar medium. However, it is debated whether the majority of GEMS predate the solar system or formed in the solar nebula by condensation of high-temperature (>1,300 K) gas. Here, we map IDP compositions with single nanometer-scale resolution and find that GEMS contain organic carbon. Mapping reveals two generations of grain aggregation, the key process in growth from dust grains to planetesimals, mediated by carbon. GEMS grains, some with a-silicate subgrains mantled by organic carbon, comprise the earliest generation of aggregates. These aggregates (and other grains) are encapsulated in lower-density organic carbon matrix, indicating a second generation of aggregation. Since this organic carbon thermally decomposes above ∼450 K, GEMS cannot have accreted in the hot solar nebula, and formed, instead, in the cold presolar molecular cloud and/or outer protoplanetary disk. We suggest that GEMS are consistent with surviving interstellar dust, condensed in situ, and cycled through multiple molecular clouds.

Tuning Nonlinear Mechanical Mode Coupling in GaAs Nanowires Using Cross-Section Morphology Control

We investigate the nonlinear mechanical properties of GaAs nanowires with anisotropic cross-section. Fundamental and second order flexural modes are studied using laser interferometry with good agreement found between experiment and theory describing the nonlinear response under mechanical excitation. In particular, we demonstrate that the sign of the nonlinear coupling between orthogonal modes is dependent on the cross-section aspect ratio. The findings are of interest for applications such as amplitude to frequency conversion and vectorial force sensing.

Linearly polarized emission from an embedded quantum dot using nanowire morphology control

GaAs nanowires with elongated cross sections are formed using a catalyst-free growth technique. This is achieved by patterning elongated nanoscale openings within a silicon dioxide growth mask on a (111)B GaAs substrate. It is observed that MOVPE-grown vertical nanowires with cross section elongated in the [21̅1̅] and [1̅12] directions remain faithful to the geometry of the openings. An InGaAs quantum dot with weak radial confinement is realized within each nanowire by briefly introducing indium into the reactor during nanowire growth. Photoluminescence emission from an embedded nanowire quantum dot is strongly linearly polarized (typically >90%) with the polarization direction coincident with the axis of elongation. Linearly polarized PL emission is a result of embedding the quantum dot in an anisotropic nanowire structure that supports a single strongly confined, linearly polarized optical mode. This research provides a route to the bottom-up growth of linearly polarized single photon sources of interest for quantum information applications.

Chemically anomalous, preaccretionally irradiated grains in interplanetary dust from comets

Nonstoichiometric grains with depletions of magnesium and silicon (relative to oxygen) and inclusions of iron-nickel metal and iron-rich sulfides have been identified in interplanetary dust particles from comets. These chemical anomalies accumulate in grains exposed to ionizing radiation. The grains, known as GEMS (glass with embedded metal and sulfides), were irradiated before the accretion of comets, and their inferred exposure ages, submicrometer sizes, and "amorphous" silicate structures are consistent with those of interstellar silicate grains. The measured compositional trends suggest that chemical (as well as isotopic) anomalies can be used to identify presolar interstellar components in primitive meteoritic materials.

Role of transfusion in stem cell transplantation: a freedom-from-transfusion (FFT), cost and survival analysis

BACKGROUND

Transfusion of blood products is often necessary for patients undergoing stem cell transplantation (SCT). The need for red cell and platelet transfusion may vary significantly depending on the type of transplantation and underlying disease.

METHODS

In an attempt to evaluate the need and volume of transfusions in patients undergoing SCT at University of Kansas Medical Center, the authors retrospectively evaluated the transfusion data of all patients who received SCT between 2000 and 2005.

RESULTS

A total of 138 (90%) out of 154 patients undergoing autologous SCT and 24 (43%) out of 56 patients with allogeneic SCT exhibited total hematopoietic engraftment and freedom from transfusion (FFT). Time to achieve FFT (median; range) for RBC units for autologous SCT (12; 0-183) was significantly shorter compared with allogeneic SCT (16.5; 0-373). Number of RBC units (median; range) transfused were significantly less in patients undergoing autologous SCT (4; 0-26) compared to patients undergoing allogeneic SCT (6.5; 0-54). The median cost of transfusion was significantly higher in patients undergoing allogeneic SCT (red cell: $2,015; platelet: $4,480) compared to patients undergoing autologous SCT (red cell: $1,240; platelet: $2,520). The authors recognize that this was a retrospective single-center study and practice guidelines may vary from center to center.

CONCLUSION

Authors conclude that transfusion of blood products is an expensive but integral part of SCT, more so for allogeneic SCT than for patients undergoing autologous SCT. Total FFT is a desirable long-term goal of successful marrow transplantation.

Constraints on the formation age of cometary material from the NASA Stardust mission

We measured the 26Al-26Mg isotope systematics of a approximately 5-micrometer refractory particle, Coki, returned from comet 81P/Wild 2 in order to relate the time scales of formation of cometary inclusions to their meteoritic counterparts. The data show no evidence of radiogenic 26Mg and define an upper limit to the abundance of 26Al at the time of particle formation: 26Al/27Al < 1 x 10(-5). The absence of 26Al indicates that Coki formed >1.7 million years after the oldest solids in the solar system, calcium- and aluminum-rich inclusions (CAIs). The data suggest that high-temperature inner solar system material formed, was subsequently transferred to the Kuiper Belt, and was incorporated into comets several million years after CAI formation.

Comparison of comet 81P/Wild 2 dust with interplanetary dust from comets

The Stardust mission returned the first sample of a known outer solar system body, comet 81P/Wild 2, to Earth. The sample was expected to resemble chondritic porous interplanetary dust particles because many, and possibly all, such particles are derived from comets. Here, we report that the most abundant and most recognizable silicate materials in chondritic porous interplanetary dust particles appear to be absent from the returned sample, indicating that indigenous outer nebula material is probably rare in 81P/Wild 2. Instead, the sample resembles chondritic meteorites from the asteroid belt, composed mostly of inner solar nebula materials. This surprising finding emphasizes the petrogenetic continuum between comets and asteroids and elevates the astrophysical importance of stratospheric chondritic porous interplanetary dust particles as a precious source of the most cosmically primitive astromaterials.

Microcalcifications of the breast: size matters! A mammographic-histologic correlation study

Core needle biopsies (CNBs) of the breast are highly sensitive techniques for sampling of mammographic calcifications. Currently, there is no standardized protocol for evaluating such samples. This study was undertaken to attempt to standardize the procedure of correlating histologic findings with mammographically detectable calcification. 113 CNBs with mammographic evidence of calcification were first reviewed and histologically categorized into 2 main groups based on the presence or absence of microcalcifications. Biopsies with microcalcifications were divided into < 100 microm and > or = 100 microm subgroups based on microcalcifications largest diameter either in aggregate or in isolation. Tissue blocks from discrepant biopsies (negative and < 100 microm microcalcifications) were radiographed. Deeper sectioning into the blocks was performed for discrepant biopsies. 102 of 113 CNBs (90.2%) had microcalcifications on primary review; 11 were negative and 21 had microcalcifications (< 100 microm) considered below the limit of mammographic detectability. Following tissue block radiology and deeper sectioning, large microcalcifications > or = 100 microm were identified in 12 discrepant biopsies (1 negative and 11 < 100 microm). Without careful evaluation 10 discrepant biopsies would have been erroneously reported as "false" positive and one as "false" negative for microcalcifications. In conclusion, tissue block radiography and deeper sectioning is required to assess microcalcifications in all discrepant cases. We recommend a systematic approach to standardize reporting of microcalcifications in CNBs. Pathologists should routinely report the size of microcalcifications in their reports and correlate their findings with the tissue block radiologic findings. Discrepant "false-positive with < 100 microm microcalcifications" biopsies should be considered non-diagnostic and should be handled the same way as "negative" biopsies.

Elemental compositions of comet 81P/Wild 2 samples collected by Stardust

We measured the elemental compositions of material from 23 particles in aerogel and from residue in seven craters in aluminum foil that was collected during passage of the Stardust spacecraft through the coma of comet 81P/Wild 2. These particles are chemically heterogeneous at the largest size scale analyzed ( approximately 180 ng). The mean elemental composition of this Wild 2 material is consistent with the CI meteorite composition, which is thought to represent the bulk composition of the solar system, for the elements Mg, Si, Mn, Fe, and Ni to 35%, and for Ca and Ti to 60%. The elements Cu, Zn, and Ga appear enriched in this Wild 2 material, which suggests that the CI meteorites may not represent the solar system composition for these moderately volatile minor elements.

Mineralogy and petrology of comet 81P/Wild 2 nucleus samples

The bulk of the comet 81P/Wild 2 (hereafter Wild 2) samples returned to Earth by the Stardust spacecraft appear to be weakly constructed mixtures of nanometer-scale grains, with occasional much larger (over 1 micrometer) ferromagnesian silicates, Fe-Ni sulfides, Fe-Ni metal, and accessory phases. The very wide range of olivine and low-Ca pyroxene compositions in comet Wild 2 requires a wide range of formation conditions, probably reflecting very different formation locations in the protoplanetary disk. The restricted compositional ranges of Fe-Ni sulfides, the wide range for silicates, and the absence of hydrous phases indicate that comet Wild 2 experienced little or no aqueous alteration. Less abundant Wild 2 materials include a refractory particle, whose presence appears to require radial transport in the early protoplanetary disk.

Organics Captured from Comet 81P/Wild 2 by the Stardust Spacecraft

Organics found in comet 81P/Wild 2 samples show a heterogeneous and unequilibrated distribution in abundance and composition. Some organics are similar, but not identical, to those in interplanetary dust particles and carbonaceous meteorites. A class of aromatic-poor organic material is also present. The organics are rich in oxygen and nitrogen compared with meteoritic organics. Aromatic compounds are present, but the samples tend to be relatively poorer in aromatics than are meteorites and interplanetary dust particles. The presence of deuterium and nitrogen-15 excesses suggest that some organics have an interstellar/protostellar heritage. Although the variable extent of modification of these materials by impact capture is not yet fully constrained, a diverse suite of organic compounds is present and identifiable within the returned samples.

Impact Features on Stardust: Implications for Comet 81P/Wild 2 Dust

Particles emanating from comet 81P/Wild 2 collided with the Stardust spacecraft at 6.1 kilometers per second, producing hypervelocity impact features on the collector surfaces that were returned to Earth. The morphologies of these surprisingly diverse features were created by particles varying from dense mineral grains to loosely bound, polymineralic aggregates ranging from tens of nanometers to hundreds of micrometers in size. The cumulative size distribution of Wild 2 dust is shallower than that of comet Halley, yet steeper than that of comet Grigg-Skjellerup.

Infrared Spectroscopy of Comet 81P/Wild 2 Samples Returned by Stardust

Infrared spectra of material captured from comet 81P/Wild 2 by the Stardust spacecraft reveal indigenous aliphatic hydrocarbons similar to those in interplanetary dust particles thought to be derived from comets, but with longer chain lengths than those observed in the diffuse interstellar medium. Similarly, the Stardust samples contain abundant amorphous silicates in addition to crystalline silicates such as olivine and pyroxene. The presence of crystalline silicates in Wild 2 is consistent with mixing of solar system and interstellar matter. No hydrous silicates or carbonate minerals were detected, which suggests a lack of aqueous processing of Wild 2 dust.

Comet 81P/Wild 2 Under a Microscope

The Stardust spacecraft collected thousands of particles from comet 81P/Wild 2 and returned them to Earth for laboratory study. The preliminary examination of these samples shows that the nonvolatile portion of the comet is an unequilibrated assortment of materials that have both presolar and solar system origin. The comet contains an abundance of silicate grains that are much larger than predictions of interstellar grain models, and many of these are high-temperature minerals that appear to have formed in the inner regions of the solar nebula. Their presence in a comet proves that the formation of the solar system included mixing on the grandest scales.

Analysis of extraterrestrial particles using monochromated electron energy-loss spectroscopy

A monochromated (scanning) transmission electron microscope was used to analyze individual sub-micron grains within interplanetary dust particles (IDP). Using low-loss and core-loss electron energy-loss spectroscopy, we analyzed fluid and gas inclusions within vesiculated alumosilicate grains. It is shown that nanometer-sized vesicles contain predominantly molecular oxygen (O(2)) beside a small fraction of H(2)O. Low-loss spectra reveal the Schumann-Runge continuum peaking at 8.6 eV and absorption bands reflecting vibrational excitation states of O(2) molecules between the first (12.1 eV) and second (16.1 eV) ionization energy. The presence of oxygen gas is supported by the corresponding oxygen K-edge fine structure. The valence state of Fe in iron-oxide within the IDP was also studied. Low-loss spectra provide qualitative information about the oxidation state of iron consistent with the Fe(2+)/Fe(3+) ratio quantitatively derived from the Fe L(2,3) edge.

Mechanisms of strontium and uranium removal from high-level radioactive waste simulant solutions by the sorbent monosodium titanate

High-level waste (HLW) is a waste associated with the dissolution of spent nuclear fuel for the recovery of weapons-grade material. It is the priority problem for the U.S. Department of Energy's Environmental Management Program. Current HLW treatment processes at the Savannah River Site (Aiken, SC) include the use of monosodium titanate (MST, with a similar stoichiometry to NaTi2O5 x xH2O) to concentrate strontium (Sr) and actinides. The high affinity of MST for Sr and actinides in HLW solutions rich in Na+ is poorly understood. Mechanistic information about the nature of radionuclide uptake will provide insight about MST treatment reliability. Our study characterized the morphology of MST and the chemistry of sorbed Sr2+ and uranium [U(VI)] as uranyl ion, UO2(2+), on MST, which were added (individually) from stock solutions of Sr and 238U(VI) with spectroscopic and transmission electron microscopic techniques. The local structure of sorbed U varied with loading, but the local structure of Sr did not vary with loading. Sorbed Sr exhibited specific adsorption as partially hydrated species whereas sorbed U exhibited specific adsorption as monomeric and dimeric U(VI)-carbonate complexes. Sorption proved site specific. These differences in site specificity and sorption mechanism may account forthe difficulties associated with predicting Sr and U loading and removal kinetics using MST.

Possible in situ formation of meteoritic nanodiamonds in the early Solar System

Grains of dust that pre-date the Sun provide insights into their formation around other stars and into the early evolution of the Solar System. Nanodiamonds recovered from meteorites, which originate in asteroids, have been thought to be the most abundant type of presolar grain. If that is true, then nanodiamonds should be at least as abundant in comets, because they are thought to have formed further out in the early Solar System than the asteroid parent bodies, and because they should be more pristine. Here we report that nanodiamonds are absent or very depleted in fragile, carbon-rich interplanetary dust particles, some of which enter the atmosphere at speeds within the range of cometary meteors. One interpretation of the results is that some (perhaps most) nanodiamonds formed within the inner Solar System and are not presolar at all, consistent with the recent detection of nanodiamonds within the accretion discs of other young stars. An alternative explanation is that all meteoritic nanodiamonds are indeed presolar, but that their abundance decreases with heliocentric distance, in which case our understanding of large-scale transport and circulation within the early Solar System is incomplete.

Identification of iron sulphide grains in protoplanetary disks

Sulphur is depleted in cold dense molecular clouds with embedded young stellar objects, indicating that most of it probably resides in solid grains. Iron sulphide grains are the main sulphur species in cometary dust particles, but there has been no direct evidence for FeS in astronomical sources, which poses a considerable problem, because sulphur is a cosmically abundant element. Here we report laboratory infrared spectra of FeS grains from primitive meteorites, as well as from pyrrhotite ([Fe, Ni](1-x)S) grains in interplanetary dust, which show a broad FeS feature centred at approximately 23.5 micrometres. A similar broad feature is seen in the infrared spectra of young stellar objects, implying that FeS grains are an important but previously unrecognized component of circumstellar dust. The feature had previously been attributed to FeO. The observed astronomical line strengths are generally consistent with the depletion of sulphur from the gas phase, and with the average Galactic sulphur/silicon abundance ratio. We conclude that the missing sulphur has been found.

Osteochondritis dissecans of the humeral capitellum. Diagnosis and treatment

Elbow pain seen in the at-risk athlete, such as a baseball player (in particular, a pitcher) or gymnast, should raise suspicion for OCD. OCD of the humeral capitellum remains a difficult problem to treat. Once radiographic changes are obvious, long-term studies suggest that half of affected individuals will be symptomatic. Currently, the key to successful treatment is early detection. Gymnasts, in general, fare worse in returning to sport. The reason is not entirely clear but is likely related to the amount of force directed across the elbow and the nature of the sport. Pitchers sometimes can be returned, but to another position. Radiographs remain the screening test of choice but can give the surgeon a false sense of security, because changes early in the disease process may not be obvious radiographically. Views at 45 degrees flexion and contralateral elbow views are helpful. The advent of MR imaging now allows the practicing orthopaedic surgeon to assess very early lesions effectively that might otherwise be underappreciated on radiographs. With more advanced lesions, radiographic findings are more obvious and demonstrate the more classic capitellar fragment with a surrounding zone of lucency. MR imaging is this setting is helpful in assessing the overlying articular cartilage and, hence, the stability of the fragment. In the absence of obvious loose bodies or mechanical symptoms, rest is the first step in treatment. If symptoms persist, then operative intervention is indicated. About half of these patients heal with nonoperative treatment. Pretreatment assessment of fragment viability has not traditionally been incorporated into the treatment algorithm. Recent anecdotal evidence suggests that stability and viability of a fragment can be assessed using intravenous contrast. Knowledge of the fragment viability could allow those lesions likely to heal without surgical intervention to be distinguished from those requiring surgical intervention. The procedure should be chosen based on the size of the lesion and the integrity of the subchondral bone. Subchondral drilling and microfracture can only resurface defects and cannot reconstitute subchondral bone. Autologous chondrocyte implantation has limited ability to address subchondral bone loss, whereas autograft and allograft osteochondral transplantation can restore subchondral bone. Most authors would agree that there is no role currently for reduction and fixation of long-standing, free loose bodies. No consensus exists regarding acute dislodging of an in situ loose fragment. Long-term results after radiographic changes are present suggest a degenerative course in about half the patients. Whether the newer techniques of cartilage resurfacing will significantly impact the natural history of this process remains to be seen.

Hyponatremia in the postoperative craniofacial pediatric patient population: a connection to cerebral salt wasting syndrome and management of the disorder

Hyponatremia after cranial vault remodeling has been noted in a pediatric patient population. If left untreated, the patients may develop a clinical hypoosmotic condition that can lead to cerebral edema, increased intracranial pressure, and eventually, to central nervous system and circulatory compromise. The hyponatremia has traditionally been attributed to the syndrome of inappropriate secretion of antidiuretic hormone (SIADH); however, in our patients the treatment has been resuscitation with normal saline as opposed to fluid restriction (the accepted treatment of SIADH), thus placing the diagnosis of SIADH in question. Patients who developed hyponatremia after intracranial injury or surgery were, until recently, grouped together as having SIADH. However, there are diagnosis and treatment differences between SIADH and another distinct but poorly understood disorder that is designated cerebral salt wasting syndrome (CSW). CSW is associated with increased urine output and increased urine sodium concentration and volume contraction, and it is frequently seen after a central nervous system trauma. We therefore developed a prospective study to evaluate the cause of the sodium imbalance.Ten consecutive pediatric patients who underwent intracranial surgery for various craniosynostotic disorders were postoperatively monitored in the pediatric intensive care unit for hemodynamic, respiratory, and fluid management. The first four patients were evaluated for electrolyte changes and overall fluid balance to determine the consistency with which these changes occurred. The remaining six patients had daily (including preoperative) measurement of serum electrolytes, urine electrolytes, urine osmolarity, serum antidiuretic hormone (ADH), aldosterone, and atrial natriuretic hormone (ANH). All patients received normal saline intravenous replacement fluid in the postoperative period. All of the patients developed a transient hyponatremia postoperatively, despite normal saline resuscitation. Serum sodium levels as low as 128 to 133 mEq per liter (normal, 137 to 145 mEq per liter) were documented in the patients. All patients had increased urine outputs through the fourth postoperative day (>1 cc/kg/h). The six patients who were measured had an increased ANH level, with a peak value as high as 277 pg/ml (normal, 25 to 77 pg/ml). ADH levels were low or normal in all but one patient, who had a marked increase in ADH and ANH. Aldosterone levels were variable. On the basis of these results, all but one patient showed evidence of CSW characterized by increased urine output, normal or increased urine sodium, low serum sodium, and increased ANH levels. The other patient had similar clinical findings consistent with CSW but also had an increase in ADH, thus giving a mixed laboratory picture of SIADH and CSW. The association of CSW to cranial vault remodeling has previously been ignored. This study should prompt reevaluation of the broad grouping of SIADH as the cause of all hyponatremic episodes in our postoperative patient population. An etiologic role has been given to ANH and to other, as yet undiscovered, central nervous system natriuretic factors. All of the patients studied required normal saline resuscitation, a treatment approach that is contrary to the usual management of SIADH. These findings should dictate a change in the postoperative care for these patients. After cranial vault remodeling, patients should prophylactically receive normal saline, rather than a more hypotonic solution, to avoid sodium balance problems.

Telemedicine in the sleep laboratory: feasibility and economic advantages of polysomnograms transferred online

The costs for polysomnography (PSG) and alternative diagnostic procedures for sleep-disordered breathing are challenging public health care systems. We wanted to determine if a telemedicine protocol with online transfer of PSGs from a remote site could be cost-effective and clinically useful while improving patient access to full PSG. Fifty-nine PSGs were performed in 54 pulmonary patients with suspected sleep-disordered breathing at a remote hospital. The data were transferred by File Transfer Protocol (FTP) via the Internet to Walter Reed Army Medical Center (WRAMC) for scoring and interpretation. The results were faxed back to the remote hospital. Clinical utility was assessed by evaluating the reasons for patient referral and the resulting diagnoses. The economic benefits were calculated by comparing direct expenses of the telemedicine protocol with costs for contracting PSGs at outside sleep laboratories. A total of 93% (55) of all PSGs were transferred successfully online. Of the 54 patients, 47 had PSGs performed for diagnosis (including three split-night studies), 8 underwent treatment titration, and 1 patient had both overnight studies. Diagnoses were obstructive sleep apnea in 43 patients, central sleep apnea in 2, and upper airway resistance syndrome in 2. The disease conditions were defined as severe in 27 patients, moderate in 12 patients, and mild in 8 patients. Each PSG cost $700 (including costs for lost transmissions) compared to $1,250 for referral to a private sleep laboratory. A savings of $550 per study was realized with the telemedicine protocol. The online transfer of PSGs from a remote site to a centralized sleep laboratory is technically feasible and clinically useful. Telemedicine offers an effective alternative for cost reduction in sleep medicine while improving patient access to specialized care in remote areas.

Anaesthesia in the United Nations Military Hospital, Dili, East Timor

An analysis of the anaesthesia caseload of the United Nations Military Hospital and its predecessors over the first 12 months of operation from September 1999 has been performed. Most patients were East Timorese civilians or Australian Military personnel. General anaesthesia using the ULCO Portable Field Anaesthesia Machine was most commonly administered.

Closure of an oronasal fistula in an irradiated palate by tissue and bone distraction osteogenesis

Uses for distraction osteogenesis in the craniofacial skeleton have expanded during the last decade. It has become an important rung in the reconstructive ladder for correction of difficult defects. Distraction of irradiated bone has been successfully performed in an animal model but has not been reported in human subjects. We present a case of distraction osteogenesis in a patient with multiple failed reconstructive attempts to close an irradiated palatal defect. An additional benefit included improvement in support of the upper lip from bone transported and the potential for placing dental implants.

Osteochondritis dissecans of the humeral capitellum. Diagnosis and treatment

Elbow pain seen in the at-risk athlete, such as a baseball player (in particular, a pitcher) or gymnast, should raise suspicion for OCD. OCD of the humeral capitellum remains a difficult problem to treat. Once radiographic changes are obvious, long-term studies suggest that half of affected individuals will be symptomatic. Currently, the key to successful treatment is early detection. Gymnasts, in general, fare worse in returning to sport. The reason is not entirely clear but is likely related to the amount of force directed across the elbow and the nature of the sport. Pitchers sometimes can be returned, but to another position. Radiographs remain the screening test of choice but can give the surgeon a false sense of security, because changes early in the disease process may not be obvious radiographically. Views at 45 degrees flexion and contralateral elbow views are helpful. The advent of MR imaging now allows the practicing orthopaedic surgeon to assess very early lesions effectively that might otherwise be underappreciated on radiographs. With more advanced lesions, radiographic findings are more obvious and demonstrate the more classic capitellar fragment with a surrounding zone of lucency. MR imaging is this setting is helpful in assessing the overlying articular cartilage and, hence, the stability of the fragment. In the absence of obvious loose bodies or mechanical symptoms, rest is the first step in treatment. If symptoms persist, then operative intervention is indicated. About half of these patients heal with nonoperative treatment. Pretreatment assessment of fragment viability has not traditionally been incorporated into the treatment algorithm. Recent anecdotal evidence suggests that stability and viability of a fragment can be assessed using intravenous contrast. Knowledge of the fragment viability could allow those lesions likely to heal without surgical intervention to be distinguished from those requiring surgical intervention. The procedure should be chosen based on the size of the lesion and the integrity of the subchondral bone. Subchondral drilling and microfracture can only resurface defects and cannot reconstitute subchondral bone. Autologous chondrocyte implantation has limited ability to address subchondral bone loss, whereas autograft and allograft osteochondral transplantation can restore subchondral bone. Most authors would agree that there is no role currently for reduction and fixation of long-standing, free loose bodies. No consensus exists regarding acute dislodging of an in situ loose fragment. Long-term results after radiographic changes are present suggest a degenerative course in about half the patients. Whether the newer techniques of cartilage resurfacing will significantly impact the natural history of this process remains to be seen.

Auricular Reconstruction: Indications for Autogenous and Prosthetic Techniques

LEARNING OBJECTIVES

After studying this article, the participant should be able to: 1. Describe the alternatives for auricular reconstruction. 2. Discuss the pros and cons of autogenous reconstruction of total or subtotal auricular defects. 3. Enumerate the indications for prosthetic reconstruction of total or subtotal auricular defects. 4. Understand the complexity of and the expertise required for prosthetic reconstruction of auricular defects. The indications for autogenous auricular reconstruction versus prosthetic reconstruction with osseointegrated implant-retained prostheses were outlined in Plastic and Reconstructive Surgery in 1994 by Wilkes et al. of Canada, but because of the relatively recent Food and Drug Administration approval (1995) of extraoral osseointegrated implants, these indications had not been examined by a surgical unit in the United States. The purpose of this article is to present an evolving algorithm based on an experience with 98 patients who underwent auricular reconstruction over a 10-year period. From this experience, the authors conclude that autogenous reconstruction is the procedure of choice in the majority of pediatric patients with microtia. Prosthetic reconstruction of the auricle is considered in such pediatric patients with congenital deformities for the following three relative indications: (1) failed autogenous reconstruction, (2) severe soft-tissue/skeletal hypoplasia, and/or (3) a low or unfavorable hairline. A fourth, and in our opinion the ideal, indication for prosthetic ear reconstruction is the acquired total or subtotal auricular defect, most often traumatic or ablative in origin, which is usually encountered in adults. Although prosthetic reconstruction requires surgical techniques that are less demanding than autogenous reconstruction, construction of the prosthesis is a time-consuming task requiring experience and expertise. Although autogenous reconstruction presents a technical challenge to the surgeon, it is the prosthetic reconstruction that requires lifelong attention and may be associated with late complications. This article reports the first American series of auricular reconstruction containing both autogenous and prosthetic methods by a single surgical team.

Thermal capsulorrhaphy for instability of the shoulder: multidirectional and posterior instabilities

Early results of thermal capsulorrhaphy appear to be favorable and the procedure seems safe when used appropriately to enhance shoulder stability, either in isolation or combination with other arthroscopic procedures. Basic science research has shown that the capsular response to thermal energy and its effect on the mechanical properties of the tissue is dependent on both time and temperature. Additional work is needed to better understand the tissue's healing response and the time required to restore its mechanical properties. Although short-term results are encouraging, longer-term follow-up and studies cited in peer-reviewed publications are needed.

Growth restriction of cranial sutures in the fetal lamb causes deformational changes, not craniosynostosis

Newborns with in utero cranial vault molding can present with severe forms of plagiocephaly. Intrauterine constraint has been proposed as one cause for craniosynostosis. The purpose of this experiment was to investigate whether rigid plate fixation across a fetal cranial suture, representing a severe form of growth restriction in utero, would lead to cranial suture fusion in a fetal lamb model. Six fetal lambs at 85 to 95 days gestation (term = 145 days) underwent laparotomy, hysterotomy, fetal coronal scalp incision, and miniplate screw fixation across the right coronal suture in utero. Two unoperated twins and four unoperated age-matched lambs were used as controls (n = 12). Animals were killed at both 4 and 8 weeks postoperatively. Fetal head analysis consisted of gross examination, photography, basilar and lateral radiographs, and three-dimensional computed tomographic scans. Cranial suture analysis consisted of imaging by computed tomographic scan (axial and sagittal cuts) and histology of experimentally plated coronal sutures, contralateral nonplated coronal sutures and twin control coronal sutures. Gross examination, radiographs, and three-dimensional computed tomographic analysis of heads with cranial suture plating showed ipsilateral forehead flattening, contralateral forehead bossing, superiorly displaced ipsilateral orbital rim, anterolateral projection of ipsilateral malar eminence, and anterior position of the ipsilateral ear point compared with the contralateral side of the same animal and normal controls. There was no change in nasal root, chin point, or predentition occlusal plane. Although analysis of the plated coronal sutures by computed tomographic scans showed diminished width or even stenosis, the histology revealed narrowed but patent experimental coronal sutures at 4 and 8 weeks. Contralateral, nonplated coronal sutures were not only patent, but widened compared with normal control sutures. This finding may have represented compensatory changes in the contralateral coronal suture caused by growth restriction at the plated suture. These data demonstrate that intrauterine growth restriction across a cranial suture caused by compression plate fixation resulted in deformational skull changes, not craniosynostosis. In addition, these data strongly support a role for in utero positional molding secondary to growth restriction in the maternal pelvis as a cause for nonsynostotic plagiocephaly seen in newborns.

Lip service for the stiff upper lip

Lip augmentation procedures can restore volume and shape to the aging, thin upper lip, but some patients may develop problematic lip tightness. This stiff upper lip is manifested by a restricted smile and an adynamic central upper lip. We have had success in treating postreconstruction and postaugmentation stiff upper lip with a therapeutic device and treatment regimen. This therapy alleviated tightness and inability to smile. Also, the change in lip commissure-to-commissure distance in repose and when smiling improved after treatment.

An infrared spectral match between GEMS and interstellar grains

Infrared spectral properties of silicate grains in interplanetary dust particles (IDPs) were compared with those of astronomical silicates. The approximately 10-micrometer silicon-oxygen stretch bands of IDPs containing enstatite (MgSiO3), forsterite (Mg2SiO4), and glass with embedded metal and sulfides (GEMS) exhibit fine structure and bandwidths similar to those of solar system comets and some pre-main sequence Herbig Ae/Be stars. Some GEMS exhibit a broad, featureless silicon-oxygen stretch band similar to those observed in interstellar molecular clouds and young stellar objects. These GEMS provide a spectral match to astronomical "amorphous" silicates, one of the fundamental building blocks from which the solar system is presumed to have formed.

Increased IGF-I and IGF-II mRNA and IGF-I peptide in fusing rat cranial sutures suggest evidence for a paracrine role of insulin-like growth factors in suture fusion

Premature cranial suture fusion, or craniosynostosis, can result in gross aberrations of craniofacial growth. The biology underlying cranial suture fusion remains poorly understood. Previous studies of the Sprague-Dawley rat posterior frontal suture, which fuses at between 12 and 20 days, have suggested that the regional dura mater beneath the cranial suture directs the overlying suture's fusion. To address the dura-suture paracrine signaling that results in osteogenic differentiation and suture fusion, the authors investigated the possible role of insulin-like growth factors (IGF) I and II. The authors studied the temporal and spatial patterns of the expression of IGF-I and IGF-II mRNA and IGF-I peptide and osteocalcin (bone morphogenetic protein-4) protein in fusing posterior frontal rat sutures, and they compared them with patent coronal (control) sutures. Ten Sprague-Dawley rats were studied at the following time points: 16, 18, and 20 days of gestation and 2, 5, 10, 15, 20, 30, 50, and 80 days after birth (n = 110). Posterior frontal and coronal (patent, control) sutures were analyzed for IGF-I and IGF-II mRNA expression by in situ hybridization by using 35S-labeled IGF-I and IGF-II antisense riboprobes. Levels of IGF-I and IGF-II mRNA were quantified by counting the number of autoradiograph signals per cell. IGF-I and osteocalcin immunoreactivity were identified by avidin-biotin peroxidase immunohistochemistry. IGF-I and IGF-II mRNA were expressed in dural cells beneath fusing sutures, and the relative mRNA abundance increased between 2 and 10 days before initiation of fusion. Subsequently, IGF-I and IGF-II mRNA were detected in the suture connective tissue cells at 15 and 20 days during the time of active fusion. In contrast, within large osteoblasts of the osteogenic front, the expression of IGF-I and IGF-II mRNA was minimal. However, IGF-I peptide and osteocalcin protein were intensely immunoreactive within these osteoblasts at 15 days (during the period of suture fusion). These data suggest that the dura-suture interaction may be signaled in a paracrine fashion by dura-derived growth factors, such as IGF-I and IGF-II. These peptides, in turn, stimulate nearby osteoblasts to produce bone-promoting growth factors, such as osteocalcin.

Cranial vault deformity and intracranial hypertension secondary to cephalic molding at delivery: a case and its management

Cephalic molding at birth has been traditionally felt to be benign, resulting in only a transient and self-correcting cranial deformity. However, we report a 6-month-old infant who presented with extensive cephalic molding at birth in combination with persistent brachyturricephaly from unilateral coronal synostosis and occipital deformation. Helmet therapy over a 3-month period failed despite patient compliance and numerous adjustments. Intracranial hypertension developed, as documented by multiple occipital bony erosions on computed tomographic scan and by an elevated direct intracranial pressure reading. The cranial vault asymmetry was corrected in two surgical stages: (1) occipital bar advancement, temporoparietal bone remodeling, and midline sagittal strip compression to reduce vertical height, followed in 3 months by (2) fronto-orbital advancement and remodeling.

Nasal expansion in the fetal lamb: a first step toward management of cleft nasal deformity in utero

The cleft nasal deformity, a combination of malpositioned cartilage and tissue and postrepair scarring, is a difficult problem to correct. To harness the potential of scarless fetal wound healing, in utero repair of cleft lip and palate deformities has been studied but the fetal cleft nose deformity has not been addressed. The purpose of this study was to manipulate the fetal nasal shape in utero as a first step toward restoration of normal nasal form in cleft nasal deformities. To do this, preformed hypertonic sponges were placed into the right nostril of eight fetal lambs during the second trimester (when scarless cutaneous wound repair is known to occur). Then, the size and shape of fetal nasal structures were analyzed after selected time periods (1, 2, and 6 weeks) with measurements, routine histologic examination, and three-dimensional computed tomographic scans of the experimentally expanded noses compared with the control nonexpanded noses of the birth twins or age-matched specimens. Results showed that experimentally expanded nasal structures had markedly increased in septal length measurement, in nostril area (doubled), and in intranasal volume (more than doubled). Histology showed normal cellular elements without scarring in the tissue sections from the expanded nasal areas. In conclusion, the shape of nasal tissue can be manipulated without scarring in second-trimester fetal lambs after placement of a nasal expansion device. This study is an experimental first step toward restoring normal nasal form by repositioning alar cartilages and soft tissue during fetal cleft repair.

Large arteriovenous malformations of the face: aesthetic results with recurrence control

Large facial arteriovenous malformations are problematic for patients because of grotesque disfigurement, risk of rapid enlargement, and life-threatening rupture. Successful treatment of these relentless complex lesions is one of the most difficult challenges facing plastic surgeons. From a series of 300 large facial arteriovenous malformations, 85 patients were treated with embolization and excision; six of these cases (representing six separate anatomic regions: labial, auricular, eyelid, cheek, chin, and occipitoparietal) were selected for review. The purpose of this article was to look critically at the management of these six facial arteriovenous malformations, including patient presentation, angiographic procedures, surgical planning and technique, and postoperative long-term follow-up care. Lessons learned from the six representative cases provide clues for the management of large facial arteriovenous malformations and demonstrate the possibilities of recurrence and their occasionally relentless behavior. The cases show that long-term control of these lesions with acceptable aesthetic results can be achieved. The mainstay of treatment includes the following: (1) selective intra-arterial embolization with fine catheters and direct lesional embolization; (2) judicious resection and reconstruction with local or expanded tissue flaps; and (3) careful follow-up with serial examinations, duplex, and arteriography.

The combination of endoscopy and distraction osteogenesis in the development of a canine midface advancement model

The requirements for reconstruction in patients with midface hypoplasia can be formidable: a bicoronal scalp incision, Le Fort III or monobloc skeletal advancement, harvesting and insertion of bone grafts, application of rigid (and occasionally intermaxillary) fixation, blood transfusions, and prolonged operative time and hospitalization. The introduction of the endoscope offers the possibility of minimally invasive surgery with improved visualization of the osteotomy sites. The development of distraction osteogenesis as a surgical technique allows controlled and gradual advancement of the osteotomized skeletal segment and associated soft tissue. The purpose of this study was to develop a canine model of an endoscopically assisted Le Fort III osteotomy with attendant midface distraction. Four mongrels (20 kg in weight) were study subjects. Three 2-cm skin incisions were made (two perpendicular to the zygomaticomaxillary suture and one perpendicular to the nasofrontal suture). The soft tissue and periosteum were evaluated bluntly. Retractors specially designed for the project created a space for endoscopic visualization. Bilateral zygomatic, nasofrontal, and medial orbital wall osteotomies, corticotomies, or both were performed under endoscopic visualization using a reciprocating saw; the medial orbital wall sectioning was specifically not completed (i.e., corticotomy) to avoid laceration of the mucosa and attendant bleeding. The pterygomaxillary osteotomy was completed with an osteotome and mallet. Finally, the nasal septum was only partially divided with an osteotome to avoid excessive blood loss. Four distraction devices were placed across the above-noted osteotomies (two across the nasofrontal osteotomy and one across each lateral osteotomy). The animals were distracted 1 mm per day for 16 to 40 days after surgery (16-40 mm of linear distraction). Cephalograms and computed tomography scans were obtained before and after distraction. The animals were killed after remaining in fixation for 4 to 6 weeks after distraction. All soft tissue was removed and the skull was examined. Photos were obtained throughout the experiment for documentation. The study demonstrated that Le Fort III osteotomies can be performed successfully via small incisions with endoscopic assistance in canine subjects with excellent visualization and minimal bleeding. The advancement of the midface segment can be achieved by activation of an external distraction device.

Epitaxial growth of nanophase magnetite in Martian meteorite Allan Hills 84001: implications for biogenic mineralization

Crystallographic relationships between magnetite, sulfides, and carbonate rosettes in fracture zones of the Allan Hills (ALH) 84001 Martian meteorite have been studied using analytical electron microscopy. We have focused on those magnetite grains whose growth mechanisms can be rigorously established from their crystallographic properties. Individual magnetite nanocrystals on the surfaces of carbonates are epitaxially intergrown with one another in "stacks" of single-domain crystals. Other magnetite nanocrystals are epitaxially intergrown with the surfaces of the carbonate substrates. The observed magnetite/carbonate (hkl) Miller indices orientation relationships are (1, 1,3)m ¿¿ (1, 1 ,0)c and (1, 1 ,1)m ¿¿ (0,0, 3)c with lattice mismatches of approximately 13% and approximately 11%, respectively. Epitaxy is a common mode of vapor-phase growth of refractory oxides like magnetite, as is the spiral growth about axial screw dislocations previously observed in other magnetite nanocrystals in ALH 84001. Epitaxy rules out intracellular precipitation of these magnetites by (Martian) organisms, provides further evidence of the high-temperature (> 120 degrees C) inorganic origins of magnetite in ALH 84001, and indicates that the carbonates also have been exposed to elevated temperatures.

Studies in cranial suture biology: regional dura mater determines overlying suture biology

The influence of dura mater on adjacent cranial sutures is significant. By better understanding the mechanisms of normal suture fusion and the role of the dura mater, it may be possible to delineate the events responsible for the premature suture fusion seen in craniosynostosis. In the Sprague-Dawley rat, the posterior frontal suture normally fuses between 12 and 20 days of postnatal life and has proved to be an excellent model to describe normal suture fusion. The purpose of this study was to document the critical role that the dura mater-suture complex may play on cranial suture biology. Forty Sprague-Dawley rats at 8 days of age were divided into two groups of 20 animals each. The control group (group A) had surgical disruption of the dura mater-calvarial interface. This was accomplished by elevating a strip of cranium inclusive of the posterior frontal and sagittal sutures and replacement of the cranial strip back to its anatomic position, all with the dura mater left intact. The experimental group (group B) had the same calvarial elevation (strip craniectomy), but the sutural anatomy/alignment was rotated 180 degrees. This rotation placed the posterior frontal suture into the sagittal suture's anatomic position and the sagittal suture into the posterior frontal suture's anatomic position. All of these procedures were accomplished by leaving the underlying dura mater intact. Animals were killed at 20, 30, 40, and 50 days (12, 22, 32, and 42 days postoperatively), and tissue sections were examined with hematoxylin and eosin staining. Group A (control) showed normal but delayed suture activity. The posterior frontal suture fused, and the sagittal suture remained patent. Fusion was delayed, not beginning before 20 days (12 days postoperative) and showing complete fusion between 30 and 40 days. Group B (180-degree calvarial rotation) demonstrated that the suture in the posterior frontal anatomic position (actual sagittal suture) fused between 20 and 40 days, whereas the suture in the sagittal anatomic position (actual posterior-frontal suture) remained patent throughout the study. This study demonstrates that the location of the dura mater-suture complex is important in determining either suture patency or closure in this model. Normal closure of the suture overlying the posterior frontal dura mater demonstrates that the dura mater itself, or forces derived in specific cranial locations, determines the overlying suture biology.

Studies in cranial suture biology: regional dura mater determines in vitro cranial suture fusion

Craniosynostosis results in alterations in craniofacial growth that create cosmetic abnormalities and functional deficits, yet the biology underlying cranial suture fusion remains unknown. The purpose of the present study was to show that regional dura mater can induce suture fusion while in an organ culture system in cranial sutures programmed to remain patient. To accomplish this, we studied mouse cranial sutures, since in this model the posterior frontal suture (analogous to the human metopic suture) fuses in both in vivo and in vitro environments while all other sutures remain patent. We demonstrated that when mouse sagittal sutures (programmed to remain patent) were rotated or translocated to overlie the posterior frontal dura then grown in organ culture systems, suture fusion occurred. Twenty-four-day-old CD-1 mice (time when the posterior frontal suture was patent) were divided into three groups of 50 (n = 165: three groups of 50 cultured and three groups of 5 uncultured controls). Group A (unrotated control group) was characterized by a strip of posterior frontal and sagittal suture with underlying dural tissue grown in organ culture systems for up to 30 days and resulted in persistent patency of the sagittal suture and fusion of the posterior frontal suture in an anterior-to-posterior direction. Group B (rotated experimental group) was characterized by 180-degree suture rotation while in vitro and resulted in patency of the posterior frontal suture over the sagittal dura and fusion of the sagittal suture over the posterior frontal dura in a posterior-to-anterior suture direction. Group C (translocated experimental group) was characterized by translocation or shifting of sutures while in vitro and resulted in patency of the posterior frontal suture over the sagittal dura and fusion of the sagittal suture over the posterior frontal dura in an anterior-to-posterior suture direction. These data from the in vitro rotation and translocation experiments indicate that the "regional" posterior frontal dura determined in vitro cranial suture fusion. Molecular mechanisms behind this process are thought to involve inductive tissue interactions of the dural cells with the suture cells by means of growth factor-mediated signal pathways.

Studies in cranial suture biology: IV. Temporal sequence of posterior frontal cranial suture fusion in the mouse

The biology underlying normal and premature cranial suture fusion remains unknown. To develop a model for normal cranial suture fusion, the temporal sequence of the posterior frontal cranial suture fusion in the mouse was determined. To do this, all the cranial sutures of three distinct strains of mice (CD-1, CF-1, and C57bl-6) were studied histologically for fusion at sequential time points. Two studies were set up using group A mice (n = 72, all sutures studied) and group B mice (n = 78, only the posterior frontal suture studied, but more precisely along its anatomic length). In the group A cranial suture study, mice were sacrificed starting at newborn age and then every 5 days until age 50 days. In addition, two mature mice (250 days old) from each strain were sacrificed. In all three mouse strains, histologic examinations showed that the anterior frontal, sagittal, coronal, lambdoid, and occipitointerparietal sutures remained patent at up to 50 days of age and were patent in the 250-day mature mice. However, examination of the midpoint of the posterior frontal suture showed patency at 30 days, partial fusion at 35 days, and complete fusion by 40 days. These data prompted the posterior frontal suture fusion study. In the group B posterior frontal suture fusion study, mice were sacrificed at age 23 days and then every 2 days until 47 days of age. The anterior, midpoint, and posterior aspects of the posterior frontal suture were examined: The anterior aspect fused between 25 and 29 days; the midpoint fused between 31 and 37 days; and the posterior aspect fused between 39 and 45 days. These data indicate that fusion of the posterior frontal cranial suture in the mouse proceeds in a defined temporal sequence from an anterior to posterior direction in three distinct strains of mice, while in the same mice all other cranial sutures remain patent. By describing and understanding the fusion of the normal posterior frontal suture, a biologic basis of normal suture development and fusion can be established and used as a comparison for murine cranial sutures altered surgically, biochemically (with growth factors), or genetically (with craniosynostotic phenotypes).