INNOVATIVE CLINICAL TECHNOLOGY Secondary cleft nasoplasty at primary school age: Quantitative evaluation of the efficacy of resorbable plates Jarred McDaniel, MD, Brendan J Alleyne, Arun K Gosain, MD, FACS University Hospitals Case Western Reserve, Cleveland, OH INTRODUCTION: Secondary cleft nasal deformity in children of primary school age can result in permanent impact to self-esteem. However, how best to address this deformity before completion of nasal growth remains controversial, since harvest of septal cartilage can negatively affect nasal growth. METHODS: 53 patients underwent secondary cleft nasoplasty with resorbable plate placement. All patients had standardized preopera- tive and early postoperative photographs. Thirty patients had late postoperative photographs (average 25.3 months). Basilar photo- graphs were analyzed using Mirror software (Canfield Scientific, Inc.) for height and width of each nostril, height and width of the nose, and deviation of the nasal tip from midline. Patients without available pre- or postoperative photographs were excluded. RESULTS: In patients with unilateral clefts improvement in nostril width, nostril height, tip height, and tip deviation were found to be statistically significant in early postoperative photos; improvements in nostril height, tip height, and tip deviation remained significant in late photos. In patients with bilateral clefts improvement in nostril height and tip height were found to be significant in early postoper- ative photos, with improvement in nostril height remaining signifi- cant long-term. CONCLUSIONS: To our knowledge this is the first report of quan- titative data regarding nasal outcomes following secondary cleft na- soplasty utilizing resorbable plates for tip support. This study dem- onstrates that significant and sustained improvements in nasal appearance are possible using this technique with minimal compli- cations. This technique spares native cartilage and reduces the poten- tial for nasal growth disturbance, making it practical to perform cleft nasoplasty during the critical period of self-esteem development. Creation of a nonoperative, true orthotopic human gastric cancer murine model using electrocoagulation Jasneet Singh Bhullar, MD, MS, Ahmad K Alomari, MD, Gokulakkrishna Subhas, MD, MRCSCEd, Tafadzwa Makarawo, MD, Boris Silberberg, MD, Jacqueline Tilak, BSc(Hons), Vijay K Mittal, MD, FACS Providence Hospital & Medical Centers, Southfield, MI INTRODUCTION: Orthotopic mouse models of human gastric can- cer represent an important in vivo tool for testing chemotherapeutic agents and intraluminal factors. Currently, the reported orthotopic murine models of gastric cancer require an operative procedure in- volving either injection of tumor cells or implantation of tumor tissue in stomach layers. The resultant tumor does not grow from the mucosal surface of the stomach, thus it does not mimic the human disease process. METHODS: Low dose gastric mucosal electrocoagulation was done transorally at 2 predetermined points 3mm apart at the body of stomach through a specially designed polyethylene catheter. Fol- lowed by an instillation of SNU-16 human gastric cancer tumor cells (1x10 6 cells) in 16 SCID mice. Three control mice underwent electrocoagulation alone and three mice underwent cell line instilla- tion alone (n=6). Five mice were euthanized at 1 and 2 months and remaining at 3 months. RESULTS: Gastric tumors were detected in 10/16 treated mice, starting at first month. Tumor growth started from intraluminal mu- cosal surface. Over time there was an increase in tumor growth, tumor volume and metastasis to lymph nodes and surrounding or- gans. Control mice did not have any local or metastatic tumors. CONCLUSIONS: Our model is minimally invasive, easy to create, and overcomes the limitations of the existing models while mimick- ing the human disease in biological behavior. This model opens new doors for further studies in tumor transformation, role of intralumi- nal factors and targeted therapies, which were not possible earlier. This is the first report of a true orthotopic gastric cancer murine model. Near infrared spectroscopic tomography for cerebral monitoring of stroke and intracranial hemorrhage Tigran Gevorgyan, MD, Harry L Graber, PhD, Douglas S Pfeil, BS, Sundeep Mangla, MD, Frank C Barone, PhD, Jenny Libien, MD, PhD, Jean Charchaflieh, MD, DrPH, FCCM, FCCP, John G Kral, MD, PhD, FACS, Randall L Barbour, PhD, Daniel C Lee, MD State University of New York Downstate Medical Center, Brooklyn, NY, Interfaith Medical Center, Brooklyn, NY INTRODUCTION: Near-infrared spectroscopic (NIRS) tomogra- phy is an evolving and portable technology with potential capability for cerebral monitoring in critical care. This is a validation study of acute cerebral ischemia and hemorrhage in non-human primates (NHP). METHODS: During experimentally induced stroke by unilateral microcatheter occlusion of the middle cerebral artery we used a NIRS imager with a 270 source-detector channel array for cerebral moni- toring of anesthetized Bonnet Macaques. Continuous recordings of total hemoglobin (Hbtotal) levels were obtained from each channel. Comparative analyses were performed pre/post events and between cerebral hemispheres. We also performed post-procedure CT, MRI, and post-mortem brain histopathology. RESULTS: NIRS findings concurred with histopathology, CT, and MRI during acute cerebral ischemia and subarachnoid hemorrhage. Significant localized decreases in Hbtotal resulting from contrast boluses mimicking transient ischemia were noted (19 injections: sta- tistically significant left-right differences in 15 cases [n=15, p210-5]; inter-hemispheric differences had expected direction- ality in 18 of 19 cases). Regional verapamil injections increased Hb- total levels on the ipsilateral side [p=210-8], whereas diffuse subarachnoid hemorrhage produced bilaterally increased Hbtotal compared to baseline levels [p=510-5]. Following microcatheter-induced cerebral ischemia, Hbtotal levels fell in the region corresponding to the occluded artery, compared to the same region in the contralateral cerebral hemisphere [p10-13]. S59 © 2012 by the American College of Surgeons ISSN 1072-7515/12/$36.00 Published by Elsevier Inc. http://dx.doi.org/10.1016/j.jamcollsurg.2012.06.166