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Role of mast cell chymase in angiotensin-induced vascular contraction of hamster cheek pouch microvessels.

We investigated the contribution of chymase-dependent conversion of angiotensin I to angiotensin II in hamster cheek pouch. To investigate the converting activities in intact tissues, angiotensin I or II was applied to microvessels of the intact cheek pouch, and the vascular contractile response was recorded. Angiotensin I or angiotensin II (20 nM) induced a rapid contraction of arterioles, irrespective of their diameter. In the presence of I mM captopril, there was no contraction in response to angiotensin I in arterioles < 25 microm in diameter, whereas contraction was still observed in larger arterioles. Chymostatin (100 microM) treatment also reduced the response to angiotensin I in arterioles > 40 microm in diameter. Treatment with 1 mM captopril and 100 microM chymostatin resulted in the loss of response to angiotensin I, but not to angiotensin II, in all arterioles. Treatment of microvessels with 100 microg/ml compound 48/80 enhanced angiotensin I-induced vascular contraction response, suggesting the significance of mast cells as a source of cheek pouch chymase.

Angiotensin I↗

Identification and sequencing of the Syrian Golden hamster (Mesocricetus auratus) p16(INK4a) and p15(INK4b) cDNAs and their homozygous gene deletion in cheek pouch and pancreatic tumor cells.

Previous studies have shown that the p16(INK4a) tumor suppressor gene is inactivated in up to 98% of human pancreatic cancer specimens and 83% of oral squamous cell carcinomas. Inactivation of the related p15(INK4b) gene has also been identified in a number of tumors and cell lines, however, its role as an independent tumor suppressor remains to be elucidated. Chemically-induced tumors in the Syrian Golden hamster (Mesocricetus auratus) have been shown to be excellent representative models for the comparative development and progression of a number of human malignancies. The purpose of this study was to determine the importance of the p16(INK4a) and p15(INK4b) genes in two experimental hamster models for human pancreatic and oral carcinogenesis. First, hamster p16(INK4a) and p15(INK4b) cDNAs were cloned and sequenced. The hamster p16(INK4a) cDNA open reading frame (ORF) shares 78%, 80%, and 81% identity with the human, mouse, and rat p16(INK4a) sequences, respectively. Similarly, the hamster p15(INK4b) cDNA ORF shares 82% and 89% sequence identity with human and mouse p15(INK4b), respectively. Second, a deletion analysis of hamster p16(INK4a) and p15(INK4b) genes was performed for several tumorigenic and non-tumorigenic hamster cell lines and revealed that both p16(INK4a) and p15(INK4b) were homozygously deleted in a cheek pouch carcinoma cell line (HCPC) and two pancreatic adenocarcinoma cell lines (KL5B, H2T), but not in tissue matched, non-tumorigenic cheek pouch (POT2) or pancreatic (KL5N) cell lines. These data strongly suggest that homozygous deletion of the p16(INK4a) and p15(INK4b) genes plays a prominent role in hamster pancreatic and oral tumorigenesis, as has been well established in correlative studies in comparable human tumors. Furthermore, this study supports the comparative importance of the hamster pancreatic and cheek pouch models of carcinogenesis in subsequent mechanistic-, therapeutic-, and preventive-based studies aimed at providing important translational data applicable to pancreatic adenocarcinoma and oral squamous cell carcinoma in humans.

Amino Acid Sequence↗

[Carcinoma of the parotid gland duct. Rare differential diagnosis of a tumor in the cheek].

BACKGROUND: Carcinomas arising in the parotid duct (Stensen's duct) are extremely rare, and only a few cases have been reported. PATIENTS: We present another case of a squamous cell carcinoma of Stensen's duct. Clinical aspects, diagnosis, and therapy are discussed, as is the differential diagnosis of tumors in the cheek region. RESULTS: Results of clinical and imaging investigations are typical of a malignant tumor. Differential diagnosis of a nodule in the region of the Stensen's duct includes salivary and metastatic tumors of the parotid gland and the accessory parotid gland tissue as well as carcinomas of the oral mucosa and the skin that invade the duct. Nonneoplastic conditions may cause swelling in the cheek region that simulates a tumor. Such conditions include salivary calculi, tumor-like inflammatory nodules, strictures of the duct, congenital stenosis, and diverticulum. CONCLUSIONS: The preoperative diagnosis of a primary Stensen's duct carcinoma remains difficult. Diagnosis requires clinical, histological, and intraoperative exclusion of a primary tumor originating elsewhere in the cheek region as well as metastatic disease and nonneoplastic lesions.

Aged↗

Modified bilateral neurovascular cheek flaps: a new technique for reconstruction of extensive upper lip defects.

The authors present a modified bilateral neurovascular cheek flap as a new technique for extensive upper lip reconstruction. The technique is modified from the bilateral neurovascular cheek flap for lower lip reconstruction described by Vatanasapt and colleagues in 1987 by designing rectangular and triangular flaps in the cheek tissues lateral to the lip defect on both the skin and the mucosal sides. This method has the advantage of preserving neurovascular structures as well as the original position of the oral commissure. Five patients are presented with acceptable surgical results. The technique is a good choice for functional reconstruction of near-total or total upper lip defects.

Aged↗

The new-concept full-face-type helmet with removable cheek pads.

BACKGROUND: The American College of Surgeons proposed a method of removing helmets. But the problem with full-face-type helmets is that their shape makes them difficult to remove. METHODS: A dummy doll was fixed to a smooth bed surface in the supine position, and a full-face-type helmet with a hook attached to the vertex was placed on the doll's head. A spring balance was attached to the hook, traction was applied to the helmet through the spring balance, and the maximum tension needed to completely remove the helmet was measured. RESULTS: A tension of 13.2 +/- 1.8 kg was found. But when cheek pads were removed, the tension required to remove the helmet was 1.7 +/- 0.2 kg. CONCLUSION: We devised a full-face-type helmet that uses removable cheek pads so that helmet removal can be performed safely by removing only the cheek pads in the event of an accident.

Cervical Vertebrae↗

A simplified transblepharoplasty subperiosteal cheek lift.

Surgical treatment of the aging face is continuing to evolve. Recent emphasis has focused on managing the malar region, specifically ptosis of the cheek pad. Several authors have described techniques for correcting facial aging changes in the midface through an endoscopic approach or transblepharoplasty approach. The latter procedure requires a lateral canthoplasty, which adds technical difficulty and potential complications to the procedure. We have modified these procedures and now perform a simplified transblepharoplasty subperiosteal cheek lift without routine canthoplasty or canthopexy. Sixty patients who had this procedure were evaluated. Analysis of these patients revealed that our simplified approach to transblepharoplasty subperiosteal cheek lift provides excellent correction of midfacial aging changes with a low incidence of postoperative complications. This article describes this technique and reviews our results.

Adult↗

Periapical curettage: an alternative surgical approach to infected mandibular cheek teeth in horses.

OBJECTIVE: To evaluate an alternative surgical method for treating periapical infection of the mandibular cheek teeth of horses. DESIGN: Retrospective study. ANIMALS: Eleven horses (3-13 years) with periapical mandibular tooth infection. METHODS: Hospital records (1992-2002) of horses that had periapical curettage for the treatment of mandibular cheek tooth root infection were retrieved. Clinical signs, radiographic, and surgical reports were reviewed. Outcome was obtained by telephone questionnaire for 7 horses and by physical examination in 2. RESULTS: Eleven horses (14 infected mandibular molariform teeth) had periapical curettage. Two horses were lost to follow-up. Mean follow-up was 41 months; 2 horses had subsequent tooth repulsion, 7 (78%) horses healed completely although 2 horses still had some local mandibular swelling. CONCLUSION: Periapical curettage, which allows alveolar drainage, appears to be a viable treatment option for periapical infections of equine mandibular cheek teeth. CLINICAL RELEVANCE: Periapical curettage can be performed simply, without expensive imaging or surgical equipment, and thus is useful for both referral and first opinion practice.

Animals↗

Differential expression of type I cytokeratins in hamster cheek pouch epithelium following treatment with dimethylbenzanthracene.

Cytokeratin (CK) expression in untreated, paraffin-treated or dimethylbenzanthracene (DMBA)-treated hamster cheek pouch epithelium was investigated utilizing monoclonal antibodies AE1 or AE3, which react with type I or type II CKs, respectively, and by in situ hybridization utilizing type I CK-specific probes. The latter were isolated from a cDNA library of hamster cheek pouch mRNA and designated CK 13 and CK 10 based on their respective homologies (> 95% amino acids) with murine CK 13 and human CK 10. Treatment of hamster cheek pouch epithelium with DMBA resulted in increased expression of type I CK, detected immunohistochemically with monoclonal AE1, but decreased expression of type II CKs detected with AE3. Despite an overall increase in type I CKs, in situ hybridization demonstrated differential expression of type I CKs with altered distribution of CK 13 mRNA and reduced expression of CK 10 mRNA, providing additional sensitive markers for DMBA-associated changes in CKs. These changes were constant at 2 to 22 weeks in the pre-neoplastic and neoplastic epithelium following the initial application of DMBA.

9,10-Dimethyl-1,2-benzanthracene↗

Lipoxygenase inhibitors block O2 responses of hamster cheek pouch arterioles.

The hypothesis that a lipoxygenase is involved in arteriolar oxygen reactivity was tested in the superfused hamster cheek pouch preparation by assessment of the effects of three lipoxygenase inhibitors on the response of arterioles to changes in superfusate PO2. Superfusion of hamster cheek pouches with nordihydroguaiaretic acid (NDGA), 5,8,11,14-eicosatetraynoic acid (20 microM ETYA), or 100 microM 1-phenyl-3-pyrazolidone (phenidone) decreased (10 microM NDGA) or eliminated (30 microM NDGA, ETYA, or phenidone) the constriction of arterioles induced by elevation of superfusate oxygen tension. The response of the arterioles to the alpha 1-adrenergic agonist phenylephrine was not significantly affected by these inhibitors, an indication that the decreased oxygen response was not due to a nonspecific decrease in arteriolar reactivity. These data suggest that arteriolar oxygen reactivity in the hamster cheek pouch might involve a lipoxygenase or other noncyclooxygenase oxygen-dependent biochemical pathway that can be inhibited by NDGA, ETYA, and phenidone.

5,8,11,14-Eicosatetraynoic Acid↗

Tobacco-related-compound-induced nitrosative stress injury in the hamster cheek pouch.

The nitric oxide radical (*NO) released from tobacco-related compounds induces DNA damage, protein modifications, and cellular toxicity through the formation of peroxynitrite (ONOO-), the reaction product of *NO and the oxygen radical, superoxide. We hypothesize that tobacco-related compounds are cytotoxic and induce quantifiable DNA single-strand breaks in immortalized hamster cheek pouch (POII) cells, and that an amino acid marker of ONOO- injury, namely, 3-nitrotyrosine (3-NT), is detectable in hamster cheek pouch tissues chronically exposed to these compounds. We observed a dose-dependent decrease in POII cell viability with increasing tobacco-related compound concentrations, as well as a dose-dependent increase in DNA strand breaks. Semi-quantitative immunohistochemistry showed intense 3-NT immunoreactivity in hamster tissues treated with tobacco-related compounds compared with controls (p < 0.005). Our results suggest that tobacco-related compounds, including nicotine, are genotoxic, and that 3-NT is a quantifiable marker of ONOO- damage in intact hamster cheek pouch tissues.

Animals↗

Studies on drug absorption from oral cavity. II. Influence of the unstirred water layer on absorption from hamster cheek pouch in vitro and in vivo.

The influence of the unstirred water layer (UWL) adjacent to the membrane surface of the hamster cheek pouch on absorption was studied in vitro and in vivo. The tissue uptake rate of 14C-laurylalcohol was determined in vitro and the value of the effective resistance of UWL (RW) was calculated. RW values were reduced by increasing the stirring rate of the mucosal solution. In vitro permeation of 14C-benzoic acid into the serosal compartment was also increased in the well-stirred condition. Thus, the existence of UWL as an effective diffusion barrier for drug absorption from the hamster cheek pouch was suggested. To clarify the influence of the existence of UWL on the absorption in vivo, the apparatus for luminal stirring was newly devised. When the luminal solution was well-stirred, the absorption of benzoic acid in the lower pH region significantly increased, resulting in the disappearance of the shift of pH-absorption curve for benzoic acid. Furthermore, the luminal stirring increased the absorption rate constant for salicylic acid. From these experimental results, it is suggested that UWL plays a part of barriers against drug permeation in the hamster cheek pouch.

Administration, Buccal↗

Histological study on the postnatal development and sequence of eruption of the maxillary cheek-teeth of rabbits (Oryctolagus cuniculus).

The development and sequence of eruption of the maxillary cheek-teeth of rabbits were studied by histological methods. The presence of three deciduous molars which were replaced by correspondent premolars and of three permanent molars without predecessors was confirmed. The eruption of the maxillary deciduous molars was shown to begin at 4 days postnatally and that of the permanent molar at 9 days, while the eruption of the premolars occurs from 24 days on, replacing the deciduous molars which are exfoliated. The last tooth to erupt is the M3. At 32 days all the permanent cheek-teeth are erupted. The deciduous molars are completely developed at birth, root resorption starting at 4 days. On the first day the premolars are in the bell stage and in the M1 and M2 amelogenesis is taking place. After 27 days the development of the permanent maxillary cheek-teeth is completed. Dentinogenesis, amelogenesis and cementogenesis were observed in all of them.

Age Factors↗

[Intervention effect of an inducible nitric oxide synthase inhibitor on carcinogenesis of hamster cheek pouch carcinoma].

OBJECTIVE: To observe the expression changes of VEGF, iNOS and the level of MVD and NO during the evolution of Golden hamster cheek pouch carcinogenesis. To study the effect of NO in carcinogenesis in the pouch of hamster, and to investigate the effect of NOS inhibitor L-NAME in interfering with carcinogenesis. METHODS: 90 golden hamsters were divided into three groups: 40 in experiment group, 40 in control group and 10 in blank group. DMBA was painted on hamster's cheek pouch in experiment and control group, L-NAME was given to hamster in experiment group at the dose of 0.02 ml/g. Hamsters were killed at 6, 9, 12 and 16th weeks, respectively. The blank group was killed at the 16th week. SABC immunohistochemistry assay was used to detect the expression of iNOS, VEGF and factor VIII-related antigen. MVD was measured. The level of NO was measured by Spectrophotometry. RESULTS: The difference between control group and experiment group at the 12th week and 16th week was observed. The difference of positive expression rate of iNOS in all group was significant and difference between blank group and control group was significant. The difference of positive expression rate of VEGF in all group was significant and difference between blank group and control group at the 12th and 16th week was significant; there was significant difference in every group MVD from the 6th week control group to the 16th week control. There were significant difference among the control group, except the 6th week of experiment and control group. CONCLUSION: There is an increased expression of iNOS and the level of NO, as well MVD during the evolution of Golden hamster cheek pouch carcinogenesis from slightly dysplasia to invasive carcinoma. NO plays an important role during the evolution of carcinogenesis, and iNOS inhibitor L-NAME can inhibit the carcinogenesis.

Animals↗

[Treatment results of radiotherapy for squamous cell carcinoma of the cheek mucosa].

The results of radiotherapeutic treatment in 71 patients with squamous cell carcinoma of the cheek mucosa were reviewed. The actuarial 5-year local control rate was 100% for T1 (8 patients), 62% for T2 (43), 65% for T3 (17) and 0% for T4 (3). The patients were divided into four groups according to treatment modality; group 1 was treated by radiotherapy alone (R), group 2 by radiotherapy combined with chemotherapy of BLM or PEP (R + C), group 3 by external radiotherapy followed by surgery (R + S) and group 4 by a combination of radiotherapy, chemotherapy and surgery (R + C + S). The 5-year local control rate was 44% for R (11 patients), 61% for R + C (39), 63% for R + S (6) and 80% for R + C + S (15). Nine of 14 cases or 64% of the surgical specimens in the R + C + S group showed no tumor cells microscopically, a rate comparable with the 5-year local control rate of the R + C group. Including the results of secondary treatment by surgery for recurrent cases, the ultimate local control rate was 83% in both the R and R + C groups. The local control rate was 88% for carcinoma located in the anterior half of the cheek and 53% for that in the posterior cheek. The results suggested that tumors extending to the bucco-alveolar sulci would be more difficult to control by radiotherapy alone, with or without chemotherapy.

Adult↗

[Expression and significance of inducible nitric oxide synthase and vascular endothelial growth factor in carcinogenesis of hamster cheek pouch].

BACKGROUND & OBJECTIVE: Inducible nitric oxide synthase (iNOS) and vascular endothelial growth factor (VEGF) are related to carcinogenesis and development of tumors. This study was to explore the correlations of the expression of iNOS and VEGF to the angiogenesis in carcinogenesis of Golden hamster cheek pouch. METHODS: A total of 50 Golden hamsters were divided into 2 groups: 40 in experiment group, 10 in control group. DMBA was painted on the cheek pouches of the hamsters in experiment group, but not in control group. The hamsters in experiment group were killed at the 6th, 9th, 12th, and 16th weeks, respectively; 10 at each time. The hamsters in control group were killed at the 16th week. The expression of iNOS and VEGF and microvessel density (MVD) in carcinogenesis in the pouches of hamsters were detected by SABC immunohistochemistry; the level of nitric oxide (NO) was measured by spectrophotometry. RESULTS: Both iNOS and VEGF expression were negative in the pouches of the hamsters in control group, but they increased gradually from the 6th to 16th week in experiment group (P<0.05). The level of NO increased from the 6th to 16th week, too, and the difference between each 2 groups was significant (P<0.05). MVD was significantly higher in iNOS- and VEGF-positive group than in iNOS- and VEGF-negative group (P<0.05). CONCLUSIONS: NO plays an important role in the carcinogenesis of Golden hamster cheek pouch. iNOS and VEGF may exert interactions in tumor angiogenesis.

9,10-Dimethyl-1,2-benzanthracene↗

Repair of nasal tip and alar defects using cheek-based 2-stage flaps: an alternative to the median forehead flap.

OBJECTIVE: To describe our use of cheek-based 2-stage transposition flaps for repairing Mohs surgery defects of the lower third of the nose. DESIGN: Retrospective case series. SETTING: Private dermatologic day surgery facility. Patients Twenty-eight patients with defects of the lower third of the nose after Mohs surgery. Intervention Ten alar and 18 nasal tip defects repaired using cheek-based 2-stage transposition flaps. MAIN OUTCOME MEASURES: Acceptability of procedure to patient, complications, and appearance from photographic records. RESULTS: The procedures were well tolerated and achieved good cosmetic results without major complications. CONCLUSIONS: These flaps allow repair of extensive defects of the nasal tip and ala with the patient under local anesthesia. This approach provides an alternative to the median forehead flap for nasal tip repairs.

Adult↗

Nasal tip projection changes related to cheeks and lip.

Nasal profiles are altered in almost every rhinoplasty operation. Often neglected in diagnosis and surgery are alterations in profiles of the cheeks and upper lip that should be made at the same time. We show aesthetic effects produced by alterations in these structures and describe how we measure and record the adjustment. A few examples of results are presented to indicate the techniques used and the importance of including changes in profiles of the cheeks and upper lip in cosmetic rhinoplastic diagnosis and treatment.

Cheek↗

Closure of total cheek defects with two combined myocutaneous free flaps.

Closure of a large, full-thickness defect after radical ablation of advanced cancers in the oropharyngeal region has often presented problems. We designed the one-stage, microsurgical free transfer of two musculocutaneous flaps-the latissimus dorsi flap and the serratus anterior flap-with one common nutrient pedicle formed by the thoracodorsal vessels. The serratus anterior flap was turned into the buccal mucosal defect, while the latissimus dorsi flap was placed in the cheek cutaneous defect. The flaps were then revascularized by anastomosing the nutrient thoracodorsal vessels to the selected recipient vessels. This particular procedure was successfully achieved in two clinical cases with large, full-thickness defects in the cheek. Functional disabilities after removal of two muscles were unexpectedly minimal in both cases.

Cheek↗