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At least 937 records · Page 52Linked to original sources
PubMed1996

Suprafibromuscular facelifting with periosteal suspension of the superficial musculoaponeurotic system and fat pad of Bichat rotation. Tightening the net.

OBJECTIVE: To design a facelifting technique that improves the safety of the facial nerve in extended facelifting; improves methods of fixation of the elevation of the nasolabial folds, the melolabial folds, the corner of the mouth and the malar fat pad; and augments the malar and submalar areas without implants. DESIGN: After a retrospective review of previous modified "composite" technique facelift results (307 patients over 4 years), a suprafibromuscular facelift technique was evolved through 22 fresh cadaver dissections. The resulting technique was applied to 73 patients, 61 females and 12 males, who were followed up for 6 to 18 months. METHODS: Preauricular dissection was subcutaneous for about 4 cm. An incision was made through the superficial musculoaponeurotic system (SMAS) at the level of the body of the zygoma. Dissection over the malar eminence was performed under the orbicularis muscle. Mid-cheek dissection was performed over the fibromuscular SMAS in th layer of areolar tissues that lines it. A rotation of the fat pad of Bichat (or buccal fat pad) was used, when indicated, to augment the cheek. Stabilization of the elevation of the nasolabial fold, the melolabial fold, and the corner of the mouth was obtained by the use of suspension sutures from the SMAS to the malar eminence. Stabilization of the malar fat pad was provided by the laterally directed flap of SMAS that was sutured to the temporal fascia. The patients were followed up for 6 to 18 months and evaluated for stability of the correction and facial nerve complications. RESULTS AND CONCLUSION; The facelift corrections (nasolabial fold, melolabial fold, malar fat pad shift) were stable over the follow-up period. No facial nerve injuries were seen.

Adipose Tissue↗
PubMed2007

Periosteal margin in soft-tissue sarcoma.

BACKGROUND: Soft-tissue sarcomas frequently rest in contact with bone. The purpose of the study was to evaluate the risk of local recurrence for sarcomas adjacent to bone and to determine whether the periosteum provides an adequate margin of resection. METHODS: Fifty patients with soft-tissue sarcomas abutting bone were treated at a single institution between 1990 and 2004. All patients had high-grade, T2 (>5 cm), nonmetastatic disease in the lower extremity. Bone contact was verified by preoperative magnetic resonance imaging (MRI) and/or computed tomography (CT) scans. Forty-three of 50 patients received preoperative radiation with a mean dose of 50 Gy. In 11 cases a composite resection of bone and soft tissue was performed. In 39 cases the excision involved only soft tissue. RESULTS: True bone invasion was verified by histopathologic examination in 3 of 50 cases (6%). Local recurrence in the soft tissues developed in 8 of 50 (16%) patients. In no case did the recurrence involve destruction of cortical bone or erosion into bone. The recurrent tumor resided against the region of previous bone contact in 1 of 8 cases. There was no statistically significant difference in local recurrence between patients who had composite bone resection and patients who had soft-tissue resection only (P = .87). CONCLUSIONS: Relatively few sarcomas are able to penetrate cortical bone. Composite bone and soft-tissue resections are indicated primarily for frank bone invasion. In the absence of this, the periosteum is an adequate surgical margin for sarcomas treated with wide excision and radiation.

Adolescent↗
PubMed1995

Mechanical loading stimulates the release of transforming growth factor-beta activity by cultured mouse calvariae and periosteal cells.

We have shown earlier that mechanical stimulation by intermittent hydrostatic compression (IHC) inhibits bone resorption and stimulates bone formation in cultured fetal mouse calvariae (Klein-Nulend et al., 1986, Arthritis Rheum., 29: 1002-1009). The production of soluble bone factors by such calvariae is also modified (Klein-Nulend et al., 1993, Cell Tissue Res., 271:513-517). Transforming growth factor-beta (TGF-beta) is an important local regulator of bone metabolism and is produced by osteoblasts. In this study, the release of TGF-beta activity as a result of mechanical stress was examined in organ cultures of neonatal mouse calvariae, in primary cultures of calvariae-derived osteoprogenitor (OPR) cells, and in more differentiated osteoblastic (OB) cells. Whole calvariae and calvariae-derived cells were cultured in the presence or absence of IHC for 1-7 days and medium concentrations of active as well as total TGF-beta were measured using a bioassay. IHC (maximum 13 kPa, maximal pressure rate 32.5 kPa/sec) was generated by intermittently (0.3 Hz) compressing the gas phase above the cultures. We found that mechanical loading by IHC stimulated the release of TGF-beta activity from cultured calvariae by twofold after 1 day. IHC also stimulated the release of TGF-beta activity from calvariae-derived cells after 1 and 3 days. The absolute amounts of TGF-beta activity released were lower in OPR cells than in OB cells, but the stimulatory effect of IHC was greater in OPR cells. Total TGF-beta (active and bound) released into the medium was not affected by IHC. IHC did not change the dry weight of the organ cultures, nor the DNA or protein content of the cell cultures. These data show that mechanical perturbation of bone cells, particularly OPR cells, enhances the activation of released TGF-beta. We conclude that modulation of TGF-beta metabolism may be part of the response of bone tissue to mechanical stress.

Animals↗
PubMed1991

Case report 686. Stress fracture at distal end of femur simulating "periosteal desmoid".

A 13-year-old female presented after repeated trauma with pain of the distal end of the thigh. The findings on plain films, bone scan, and CT were indeterminate. MRI accurately demonstrated a fracture line with bone marrow edema, suggesting the diagnosis of stress fracture. MRI patterns of stress fracture were considered and the importance of establishing the correct diagnosis was emphasized.

Adolescent↗
PubMed1995

Mechanically induced periosteal bone formation is paralleled by the upregulation of collagen type one mRNA in osteocytes as measured by in situ reverse transcript-polymerase chain reaction.

Reverse transcript polymerase chain reaction (RT-PCR) was developed for use in situ to measure mechanically mediated changes in gene expression activity in osteocytes within dense cortical bone. Using the functionally isolated turkey ulna model of bone adaptation, the left ulna of 6 old adult (36-40 months) male turkeys were subject to 4 weeks of a mechanical regimen consisting either of (1) 3000 microstrain at 1 Hz for 5 minutes/day or (2) 500 microstrain at 30 Hz for 10 minutes/day. The right ulna of each bird remained intact and served as control. Only a small percentage of osteocytes in the intact control bones and the 3000 microstrain ulnae showed any evidence of mRNA for collagen (each 1.2% +/- 0.3%). However, mRNA for collagen type I was strongly evident in 92.4% (+/-2%) of the osteocytes within the ulnae subject to the high frequency, low magnitude load. Sense primer control sections from both experimental and intact animals were used to verify that only osteocytes of the loaded bone had elevated the level of collagen mRNA. This high frequency, low magnitude mechanical stimulus was also sufficient to stimulate substantial new bone formation (14% +/- 5% over intact controls), whereas the low frequency, high magnitude stimulus failed to elicit any bone formation (-3% +/- 7%). These experiments show that specific mechanical regimens can activate the osteocyte's expression of a message responsible for the synthesis of proteins remote from the site where the formation of bone is ultimately to occur, even under systemic distress such as aging. Further, these data suggest that osteocytes perceive the strain environment and that they play a role in orchestrating the modeling/remodeling response. By developing a technique as flexible and powerful as RT-PCR for use in dense cortical bone, determining the relative contribution of specific proteins to the transduction of regulatory signals to formative or resorptive responses is facilitated.

Adaptation, Physiological↗