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Biomedical subjects

J A Persing

Publications and source records attributed to J A Persing.

At least 19 recordsLinked to original sources

Biomaterials in the face: benefits and risks.

An extensive review of biomaterials in the face was conducted in an American Society of Maxillo-facial Surgeons-sponsored biomaterials symposium. The symposium was held in Boston, MA, immediately preceding the 1998 annual meeting of the ASPRS/PSEF. The scope of the symposium extended from current reconstructive techniques for the facial skeleton, including autogenous bone and biomaterials, to potential application of new techniques in molecular biology that may enable the body's own tissues to be engineered to provide bone and cartilage to reconstruct the facial skeleton. The authors review the presentations and relevant literature on biomaterials in the face. The following topics are reviewed: current reconstructive techniques using autogenous bone grafts, methyl methacrylate cranioplasty, demineralized bone, and hydroxyapatite; biomaterials used for rigid fixation, including metallic and bioabsorbable implants; biomaterials used for facial augmentation, including porous polyethylene, hard-tissue replacement, and ceramic biomaterials; biofilm, or a layered polysaccharide matrix secreted by bacteria on the surface of implants; and potential means of inducing bone formation by directing the body's own tissues through cytokine interaction, gene transfer, and tissue engineering.

Absorbable Implants↗

Modified Le Fort III osteotomy in adult Crouzon disease.

The authors present a unique case of a woman with Crouzon disease who was treated for symptomatic exorbitism with a modified Le Fort III osteotomy. Midface advancement with reduction of exorbitism was accomplished without intermaxillary fixation. The technical details are described.

Adult↗

Intracranial pressure in single-suture craniosynostosis.

In this paper, we review the incidence of increased intracranial pressure in children with single-suture craniosynostosis. The major studies in this area are presented, along with their limitations. A rational treatment plan including multidisciplinary team management is recommended. All patients with proven synostosis should be followed closely, whether or not surgery is chosen. Continued clinical and basic science research are necessary to further clarify the ramifications of asymptomatic elevations of intracranial pressure in these patients.

Child↗

Secondary craniofacial management following initial correction of nonsyndromic craniosynostosis.

Marked technical improvements in the surgical management of craniosynostosis have come hand-in-hand with refinements in anesthesia, intensive care, and radiographic image analysis. At the beginning of the second century of the care of these patients, we now have a variety of sophisticated options that represent safer, more physiologically sound and aesthetically more pleasing options for the correction of secondary problems in craniosynostosis.

Cephalometry↗

Frequent clones of p53-mutated keratinocytes in normal human skin.

The multiple genetic hit model of cancer predicts that normal individuals should have stable populations of cancer-prone, but noncancerous, mutant cells awaiting further genetic hits. We report that whole-mount preparations of human skin contain clonal patches of p53-mutated keratinocytes, arising from the dermal-epidermal junction and from hair follicles. These clones, 60-3000 cells in size, are present at frequencies exceeding 40 cells per cm2 and together involve as much as 4% of the epidermis. In sun-exposed skin, clones are both more frequent and larger than in sun-shielded skin. We conclude that, in addition to being a tumorigenic mutagen, sunlight acts as a tumor promoter by favoring the clonal expansion of p53-mutated cells. These combined actions of sunlight result in normal individuals carrying a substantial burden of keratinocytes predisposed to cancer.

Adult↗

Squamous cell carcinoma of the lip in a 19-month-old child: a case report.

Squamous cell carcinoma of the lip is rarely seen in children. We present the case of a 19-month-old child, without known risk factors, who developed invasive squamous cell carcinoma involving the skin and underlying muscle of the lip. The histology of the tumor was invasive squamous cell carcinoma of the keratoacanthoma type. The distinction between this lesion and keratoacanthoma is often difficult and rests on the findings of invasion and significant atypia. Due to the extremely low incidence of squamous cell carcinoma in children, there are few therapeutic guidelines pertaining specifically to infants or children. This patient underwent wide local excision as definitive treatment. Currently, it is 24 months after excision of the tumor and he remains free of clinical recurrence.

Carcinoma, Squamous Cell↗

Cranial plate and screw fixation in infancy: an assessment of risk.

Sixty-seven surgeons, members of the International Craniofacial Surgery Society, responded to a questionnaire focused on assessing the incidence and risk of cranial plate and screw translocation intracranially in infants undergoing cranial surgery. Despite screws, plates, and wires being evident intracranially in individual cases, no apparent increase in seizure frequency or susceptibility to head trauma was noted in this preliminary study.

Bone Plates↗

Squamous cell carcinoma growth in irradiated tissue: a murine model for quantitative assessment of treatment.

Locoregional recurrent and distant metastases from squamous cell carcinomas, despite multimodality therapy, remain troublesome clinical realities. Discrepancies in success rates of various surgery and radiation treatment regimens dealing with these problems are confusing to the clinician attempting to recommend the most beneficial treatments. There is a need for an experimental model to assess therapeutic effectiveness quantitatively from which guidelines for developing clinical trials may be suggested. In this study, we provide such a model. We injected DBA-2 mice with defined numbers of KLN-205 squamous carcinoma cells to obtain baseline growth characteristics; 216 animals had no previous irradiation. The remaining 131 received 30 Gy irradiation to the right leg 50 days before injection of the tumor cells. Tumor incidence, growth and number, and location of tumor metastasis were determined in both previously irradiated and nonirradiated groups. The data demonstrate a growth-retardant effect on tumor groups by the previous irradiation (tumor bed effect). The data also show that the incidence of hematogenously spread metastases was more frequent in mice in which tumors developed in previously irradiated tissue than in mice with tumors in nonirradiated tissue.

Animals↗

A rapid in vitro assay of cellular chemomigration in an epithelial carcinoma cell line.

We have studied the chemomigration activity of an epithelial carcinoma cell line using a modified 96-well Boyden chamber apparatus consisting of upper and lower wells separated by an 8-microns pore polycarbonate filter. Cells from the malignant squamous carcinoma cell line A-431 were plated in the upper wells over a collagen IV-coated filter. In chemokinesis assays, the cells were allowed to migrate toward NIH 3T3 fibroblast-conditioned medium or control media in the lower wells for 6 hours at 37 degrees C with 10% CO2. A-431 cells preferentially migrate across the barrier toward conditioned media but not control media. Control normal keratinocytes showed no migration. A highly metastatic melanoma cell line and poorly metastatic melanoma cell line, in which chemomigration has been shown previously to correlate with metastatic potential, were used as positive and negative cellular controls. This system provides a rapidly quantifiable method by which the invasion characteristics of multiple cell lines can be studied simultaneously in a single assay using the 96-well format.

3T3 Cells↗

Repair of critical size rat calvarial defects using extracellular matrix protein gels.

In this study the authors examined the capacity of gels of reconstituted basement membrane, laminin, and type I collagen to mediate repair of critical size defects in rat calvaria. Although autografts are widely used to repair bone defects caused by trauma or surgical treatment of congenital malformations, neoplasms, and infections, an adequate quantity of graft is not always available. Allogenic bone is readily available, but its use is associated with an increased incidence of nonunion, fatigue fracture, and rejection. Biologically active, purified components of basement membranes, which have been shown to promote osteogenic differentiation and angiogenesis in vitro and type I collagen (the major constituent of bone extracellular matrix) can be formed into native isotonic space-filling gels. In this study critical size calvarial defects were created in retired male Sprague-Dawley rats. Thirty-six animals were divided into seven groups. Group 1 (control) received no treatment for the defects. Group 2 animals were implanted with methylcellulose. Groups 3, 4, 5, and 6 were implanted with gels of type I collagen, reconstituted basement membrane, or laminin, respectively. The last group of three animals (Group 7) was implanted with 100 micrograms of type I collagen gels (identical to Group 3) and sacrificed at 20 weeks following a single CT scan to determine if complete healing could be obtained with this method given sufficient time. Except for rats in the type I collagen group that was evaluated by multiple computerized tomography (CT) scans biweekly from 2 to 12 weeks, bone repair was evaluated using CT at 12 weeks. Healing was quantified using three-dimensional reconstruction of CT. Following the final CT scan in each experimental group, animals were sacrificed, and a sample of tissues was evaluated by conventional histology. Animals treated with type I collagen gels showed 87.5% repair of the area of the defects at 12 weeks and 92.5% repair by 20 weeks. Increasing the gel volume 1.5 x accelerated complete repair to 3 months. Murine-reconstituted basement membrane and laminin gels induced 55.5% and 46.3% repair, respectively, at 3 months. In untreated control animals 7% repair of the area of the defects showed at 3 months. Histological analysis confirmed new bone formation in partial and completely healed defects. Bioengineered native collagen gels may have wide applicability for bone repair as an alternative bone graft material alone, in combination with autograft or marrow aspirate, or as a delivery system for osteogenic growth factors.

Animals↗

Vascular lesions of the cranial base.

Vascular lesions can be classified broadly into two groups on the basis of cellular proliferation characteristics: hemangiomas and vascular malformations. Additional lesions include a heterogeneous group of vascular tumors such as those represented by hemangiopericytoma and those with a frankly malignant course. Those lesions located around the cranial base remain challenging and difficult clinical problems. The care of patients with these problems is complex; it frequently will need a full spectrum of individuals from many disciplines involved in many diverse aspects of management: medical, radiologic, anesthetic, and surgical. Fortunately, advances in science and technology have markedly expanded our capability in treating these patients and have allowed us increasing safety and ease in dealing with previously untreatable and unresectable lesions.

Brain Neoplasms↗