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PubMed2001

Reossification of the orbital wall following ventral translocation of the fronto-orbital bar and cranial vault remodeling.

The purposes of this study were to determine the extent of ossification of the orbit following ventral translocation of the fronto-orbital bar and to find out whether age at the time of the procedure and presence of a concomitant syndrome adversely affect ossification. A retrospective review of 27 patients with craniosynostosis was conducted at the St. Louis Children's Hospital and the Children's Hospital of Oklahoma. Patients with preoperative, perioperative, and postoperative three-dimensional computed tomography scans were included. Eighty-eight percent of the lateral orbital wall defects and 92 percent of the defects within the roof of the orbit ossified completely in the postoperative period. When syndromic patients were compared with nonsyndromic patients (based on clinical findings only), three of the 19 syndromic defects and three of the 30 nonsyndromic defects demonstrated incomplete ossification in the lateral orbital wall (p > 0.05). Similarly, two of the 19 syndromic defects and two of the 30 nonsyndromic defects demonstrated incomplete ossification within the roof of the orbit (p > 0.05). With respect to age at the time of the procedure, four of the 37 defects and two of the 12 defects demonstrated incomplete ossification in the lateral orbital wall for age at the time of the procedure less than 12 months and greater than 12 months, respectively (p > 0.05). Similarly, two of the 37 defects and two of the 12 defects had incomplete ossification within the roof of the orbit for age at the time of the procedure less than 12 months versus more than 12 months, respectively (p > 0.05). Ossification of the orbital wall and roof is complete in the majority of cases within 1 year after the procedure, and neither age at the time of the procedure nor presence of a concomitant syndrome adversely affects ossification of the orbit after ventral translocation of the fronto-orbital bandeau.

Bone Transplantation↗

PubMedDate not supplied

Lateral ridge augmentation and implant placement: an experimental study evaluating implant osseointegration in different augmentation materials in the canine mandible.

The present study investigated the osseointegration of dental implants with a titanium plasma-sprayed surface (TPS) in regenerated and native bone in an experimental dog study. Initially, lateral bone defects were created in the alveolar ridge on both sides of the mandible. Two months later, lateral ridge augmentation was performed with (1) autogenous corticocancellous block grafts, (2) autogenous corticocancellous block grafts and e-PTFE membrane, (3) tricalcium phosphate particles and e-PTFE membrane, or (4) canine-derived demineralized freeze-dried bone allograft particles and e-PTFE membrane. After 4 months, membranes were removed, and non-submerged titanium implants were placed in regenerated bone (test implants) and in native bone (control implants). Two months later, the animals were sacrificed and non-decalcified orofacial sections were evaluated histometrically. All implants demonstrated high percentages (59% to 75%) of bone-to-implant contact, with no significant differences across the various treatment groups. The different grafting techniques did not significantly influence the location of first bone-to-implant contact and the horizontal bone width at the most coronal bone level.

Alveolar Ridge Augmentation↗

PubMed1990

Fetal lateral cerebral ventriculomegaly: associated malformations and chromosomal defects.

In 267 consecutive cases of fetal lateral cerebral ventriculomegaly, additional fetal malformations were detected by ultrasonography in 209 (78%) of the cases. On the basis of the ultrasound findings, the patients were subdivided into three groups: (i) isolated ventriculomegaly (n = 58), (ii) ventriculomegaly and open spina bifida only (n = 172), and (iii) ventriculomegaly and other malformations (n = 37) with or without spina bifida. Antenatal karyotyping was performed in 64 cases from groups (i) and (iii), and 11 (18%) of the fetuses had chromosomal abnormalities. The incidence of chromosomal abnormalities was strongly related to the presence of multisystem malformations. Thus, only 3% of fetuses with isolated ventriculomegaly as opposed to 36% of those with additional malformations had chromosomal defects. Furthermore, the degree of ventriculomegaly in the chromosomally abnormal fetuses was relatively mild. In the chromosomally normal fetuses, mild, static ventriculomegaly was associated with apparently normal subsequent mental development.

Abnormalities, Multiple↗

PubMed1978

Vision screening in children tested at 7, 11, and 16 years.

Distant vision screenings of a national sample of children were performed at the ages of 7, 11, and 16. Many children with normal vision at one screening showed defects at later screenings, and altogether 18% of children with normal vision at the age of 7 had defects by the time they were 16. Twelve per cent of those with normal vision at 7 and 11 had developed a visual defect by the age of 16. Apparent improvements between screenings probably resulted largely from technical difficulties inherent in testing young children. The results clearly indicate the importance of regular vision screening during the school years and the need for comprehensive but flexible back-up services.

Adolescent↗

PubMed2004

Contained femoral defects: biomechanical analysis of pin augmentation in cement.

Although in the proximal tibia the need for pin augmentation of cemented giant cell tumor defects depends on whether the defect is contained, there is controversy regarding the role for pins in the distal femur. The current study investigated whether Steinmann pin augmentation offers biomechanical advantages in cement reconstruction of contained defects of the lateral femoral condyle. Twelve pairs of human femurs were used. They were tested either with the bone intact, with a standardized contained defect in the lateral condyle, with a defect repaired with cement alone, and with a defect repaired with pins in the cement. Intact specimens had significantly higher load to failure than specimens with a defect. In the repaired specimens there were no significant differences in stiffness, peak load to failure, and energy to failure between the specimens repaired with just cement or augmented with pins. This study did not show any significant biomechanical advantage of this configuration of Steinmann pin reinforcement in cement for contained defects of the lateral femoral condyle.

Biomechanical Phenomena↗

PubMed2001

A gain-of-function mutation in IAA28 suppresses lateral root development.

The phytohormone auxin is important in many aspects of plant development. We have isolated an auxin-resistant Arabidopsis mutant, iaa28-1, that is severely defective in lateral root formation and that has diminished adult size and decreased apical dominance. The iaa28-1 mutant is resistant to inhibition of root elongation by auxin, cytokinin, and ethylene, but it responds normally to other phytohormones. We identified the gene defective in the iaa28-1 mutant by using a map-based positional approach and found it to encode a previously uncharacterized member of the Aux/IAA gene family. IAA28 is preferentially expressed in roots and inflorescence stems, and in contrast to other Aux/IAA genes, IAA28 transcription is not induced by exogenous auxin. Studies of the gain-of-function iaa28-1 mutant suggest that IAA28 normally represses transcription, perhaps of genes that promote lateral root initiation in response to auxin signals.

Amino Acid Sequence↗

PubMed2003

[Repair of articular cartilage defect with homogeneous chondrocytes combined with pluronic].

OBJECTIVE: To investigate the possibility of repairing the cartilage cartilage defect with homogeneous chondrocytes combined with Pluronic. METHODS: Homogeneous cartilage chondrocytes of adult New Zealand rabbits were harvested and cultured in vitro, which were marked by 3H-TdR and mixed with Pluronic. The medial or lateral condyle defects were made (phi 4 mm, extending down to the calcified zone) in 20 rabbits. In the experimental group, the right defects were repaired by homogeneous chondrocytes combined with Pluronic; in the control group, the left defects were repaired by Pluronic only or were left un-repaired. The animals were sacrificed in the 4th, 8th and 16th weeks after operation respectively. The repair results were observed and the cell source of repair tissue was distinguished. RESULTS: In the experimental group, the cartilage defects were repaired by the cartilage-like tissue after 8 weeks of operation; the defects were completely filled with mature cartilage tissue, which integrated smoothly with articular cartilage 16 weeks later. In the control group, only a small amount fibrous tissues were seen on the surface of defects. Autoradiographic assessment showed that the repair cells came from the implants, but not from self-chondrocytes. CONCLUSION: It is a good way to repair articular cartilage defects with homograft of tissue engineering cartilage. It is a convenient method to mark with 3H-TdR to discriminate the resource of the repair cells.

Animals↗

PubMedDate not supplied

Repair of large articular cartilage defects with implants of autologous mesenchymal stem cells seeded into beta-tricalcium phosphate in a sheep model.

Tissue engineering has long been investigated to repair articular cartilage defects. Successful reports have usually involved the seeding of autologous chondrocytes into polymers. Problems arise because of the scarcity of cartilage tissue biopsy material, and because the in vitro expansion of chondrocytes is difficult; to some extent, these problems limit the clinical application of this promising method. Bone marrow-derived mesenchymal stem cells (MSCs) have been proved a potential cell source because of their in vitro proliferation ability and multilineage differentiation capacity. However, in vitro differentiation will lead to high cost and always results in decreased cell viability. In this study we seeded culture-expanded autologous MSCs into bioceramic scaffold-beta-tricalcium phosphate (beta-TCP) in an attempt to repair articular cartilage defects (8 mm in diameter and 4 mm in depth) in a sheep model. Twenty-four weeks later, the defects were resurfaced with hyaline-like tissue and an ideal interface between the engineered cartilage, the adjacent normal cartilage, and the underlying bone was observed. From 12 to 24 weeks postimplantation, modification of neocartilage was obvious in the rearrangement of surface cartilage and the increase in glycosaminoglycan level. These findings suggest that it is feasible to repair articular cartilage defects with implants generated by seeding autologous MSCs, without in vitro differentiation, into beta-TCP. This approach provides great potential for clinical applications.

Animals↗

PubMed1992

Anterior skull base reconstruction with the pericranial flap after craniofacial resection.

No one reconstructive method is always satisfactory, especially when considering repair of a region such as the anterior skull base. Increased morbidity and mortality is directly related to failure of the reconstruction to adequately isolate the cranial cavity from the respiratory tract. Those surgeons performing craniofacial resections for lesions of the paranasal sinuses and anterior skull base must be familiar with a variety of reconstructive techniques which they can utilize depending upon the surgical defect that must be closed. For those small to moderate size defects of the anterior fossa we recommend using the inferiorly based pericranial flap to effect a repair. For larger defects extending laterally from the midline to involve a portion of the orbital roof, a laterally based flap of temporalis and pericranium can be used to provide successful anterior skull base reconstruction. Larger defects of the cranio-orbito-facial region will require additional methods of repair utilizing distant vascularized flaps.

Craniotomy↗

PubMed2006

Matrix metalloproteinase-9 regulates graft bone resorption.

OBJECTIVE: To explore the relationship between bone resorption and matrix metalloproteinase-9 (MMP-9) expression in autogenous and allogenic bone grafts. MATERIALS AND METHODS: A total of 18 critical-size (10 x 15 mm) defects were created in rabbit mandibles bilaterally. Three groups of six defects each were grafted with autogenous endochondral (EC) bone, autogenous intramembranous (IM) bone, and allogenic IM bone. Three months later, the defects were retrieved for quantitative analysis on the basis of histology, immunohistochemistry, and in situ hybridization. RESULTS: A close relationship existed between MMP-9 expression and graft bone resorption. The parallel between MMP-9 expression and graft bone resorption suggested that bone resorption was accomplished in part by increased MMP-9 production evident in preosteoclasts and osteoclasts. CONCLUSIONS: MMP-9 plays an important role in graft bone resorption. Autogenous EC bone grafts express higher levels of MMP-9 leading to more resorption than autogenous or allogenic IM bone grafts.

Acid Phosphatase↗

PubMed1996

Chemotactic responses to an attractant and a repellent by the polar and lateral flagellar systems of Vibrio alginolyticus.

Chemotactic responses in Vibrio alginolyticus, which has lateral and polar flagellar systems in one cell, were investigated. A lateral-flagella-defective (Pof+ Laf-) mutant, which has only a polar flagellum, usually swam forward by the pushing action of its flagellum and occasionally changed direction by backward swimming. When the repellent phenol was added, Pof+ Laf- cells moved frequently forward and backward (tumbling state). The tumbling was derived from the frequent changing between counter-clockwise and clockwise (CW) rotation of the flagellar motor, as was confirmed by the tethered-cell method. Furthermore, we found that the tumbling cells did not adapt to the phenol stimulus. When the attractant serine was added, the phenol-treated cells ceased tumbling and swam smoothly, adapting to the attractant stimulus after several minutes. We isolated chemotaxis-defective (Che-) mutants from the Pof+ Laf- mutant; the tumbling mutants were not isolated. One interesting mutant swam backwards continuously, with its flagellum leading the cell and its flagellar motor rotating CW continuously. A polar-flagella-defective mutant (Pof- Laf+) stopped swimming after phenol addition and then recovered swimming ability within 10 min, indicating that lateral flagella can adapt to the repellent stimulus. This may represent a functional difference between the two flagellar systems in Vibrio cells, and between the chemotaxis systems affecting the two types of flagella.

Adaptation, Physiological↗

PubMed1994

Linkage localization of the thoraco-abdominal syndrome (TAS) gene to Xq25-26.

The thoraco-abdominal syndrome (TAS) presents a closure defect confined to the ventral midline, manifested as ventral hernia of various degrees in all affected individuals and antero-lateral diaphragmatic defect manifested almost exclusively in affected males. The syndrome is inherited as an X-linked dominant trait affecting blastogenesis (XLB mutation). We studied 27 members of the TAS family for linkage on the X chromosome. The best lod score of 5.5 at theta 0.04 was found for the HPRT locus on Xq26.1. A multilocus lod score of 12.4 was observed when the linkage analysis utilized additional markers in Xq25-26.

Abdomen↗

PubMedDate not supplied

Systemic endotoxin and gastric mucosal pH are the best parameters to predict lethal outcome in a porcine model of abdominal sepsis according to multivariate analysis.

This study was devised to identify sepsis-relevant parameters that early and reliably predict a lethal outcome in intra-abdominal sepsis. In 18 Duroc pigs, peritonitis was induced through standardized gastrotomy. Twelve hours later the defect was oversewn and the abdominal cavity lavaged thoroughly. Sepsis relevant parameters were measured before initiating therapy, and 30 min later animals were extubated and observed for a period of 6 days under adequate analgesia with free access to water and food. All parameters were correlated with survival postoperatively. In the treatment group, 7 out of 18 pigs (39%) died within the observation period. Endotoxin level at 30 min after initiation of therapy [17.9 EU/mL (+/- 12.1) vs. 110.9 EU/mL (+/- 21); p <.001] and Delta pHi [0.015 (+/- 0.011) vs. -0.039 (+/- 0.013); p =.016] were identified as the two parameters with highest predictive power regarding mortality in a multivariate analysis. In conclusion measurement of endotoxin and gastric tonometry should gain wider clinical application in septic patients.

Abdomen↗

PubMed2005

[The development of concepts of female (in)continence. Pathophysiology, diagnostics and surgical therapy].

The integral theory postulates that defect ligaments and fascias, which impair the supporting function of the vaginal wall, can cause stress urinary incontinence as well as urgency and voiding dysfunction. The anatomical and pathophysiologic basis for these dysfunctions are presented. Voiding dysfunctions can be treated by the substitution of defect structures using the principle of "restoration of structure leads to restoration of function". Essential elements of this therapeutic algorithm are suburethral vaginal slings (retropubic or transobturatoric), further a posterior sling, which runs through the fossa ischiorectalis and suspends the vaginal vault near the sacrospinal ligaments, thus reconstructing defect uterosacral ligaments. In cystoceles, lateral and medial defects can be restored by ventral meshes, which are fixed at the arcus tendineus fasciae pelvis by lateral transobturatoric slings. The use of polypropylene slings and meshes is well-founded because they are well tolerated in the tissues and through the development of scar tissue lead to neoligaments with long-lasting therapeutic effects.

Female↗

PubMed1988

The rhombotrapezius myocutaneous and osteomyocutaneous flaps.

As more radical surgery is being performed for head and neck cancer, an increasing variety of flaps for reconstruction have been developed. The more common myocutaneous flaps for large defects are the pectoralis major, trapezius, and latissimus dorsi flaps. The lower trapezius flap, which is used for reconstruction of large lateral facial defects, is a relatively thin flap. The rhombotrapezius flap described in this article provides bulk for augmentation of facial defects. The flap, which includes the trapezius and rhomboid muscles, also offers a longer pedicle with a greater arc of rotation. This flap may include the medial border of the scapula when bone is necessary. The addition of the rhomboid muscles incorporates the dorsal scapular artery, which gives an additional blood supply to the flap. We believe that the rhombotrapezius, myocutaneous, and osteomyocutaneous flaps have a significant advantage over previously described flaps in the treatment of defects that need greater bulk and length for adequate reconstruction.

Evaluation Studies as Topic↗

PubMed2002

[Microsurgical repair of syndactyly of the fingers in children].

OBJECTIVE: To evaluate the effectiveness of microsurgical technique for repairing syndactyly of the fingers in children. METHODS: Microsurgical repair of syndactyly of the fingers was performed in 32 children. The skin joining the syndactyly was incised and relaxed under microscope, and dorsal metacarpal flap of comparable size was used to repair the lateral skin defect of the finger and also to reconstruct the finger web. RESULTS: All the flaps survived without scar leaving on the lateral skin of the fingers, and the reconstruction of the finger web was satisfying. CONCLUSION: Microsurgical technique is applicable in the surgical repair of syndactyly of the fingers in children.

Child↗

PubMed1988

Distally based lateral plantar artery island flap.

We report on the reconstruction of the lateral metatarsal head defect by a distally based lateral plantar artery island flap using the flexor digitorum brevis muscle. The pedicle for this flap was provided by a retrograde lateral plantar artery. We found that this flap was relatively simple and easy to perform and could cover large defects better than any other conventional local flap.

Adult↗

PubMed2004

Basic fibroblast growth factor up-regulates the expression of vascular endothelial growth factor during healing of allogeneic bone graft.

Recently we reported that basic fibroblast growth factor (bFGF) improved the healing of allogeneic bone grafts. However, the mechanism of action of the bFGF was not known. Therefore, the present study was designed to identify the expression pattern of vascular endothelial growth factor (VEGF) in the presence of bFGF reconstituted in demineralized intramembranous bone matrix (DBMIM) during the healing of allogeneic bone grafts. Eighteen critical size (15 mm x 10 mm) defects were created on rabbit mandibles bilaterally. Three groups of six defects each were grafted with allogeneic bone alone, allogeneic bone and DBMIM, and allogeneic bone and bFGF reconstituted in DBMIM. Three weeks later, the defects were retrieved for immunohistochemistry and in situ hybridization for VEGF. The percentage of positive staining area was quantified by using image analyzer. The increase (517%) in the expression of VEGF mRNA was accompanied by an increase (492%) of immunoreactive VEGF protein in allogeneic bone graft augmented by bFGF reconstituted in DBMIM. A close correlation existed between levels of VEGF production and the amount of newly formed bone. The results show that bFGF reconstituted in DBMIM markedly up-regulated the expression of VEGF in the grafted area. Basic FGF augments the healing of allogeneic bone grafts by enhancing vascularization through the up-regulation of VEGF.

Animals↗