RESUMO
The modulation of K+ channels plays a crucial role in cell migration and proliferation, but the effect of K+ channels on human cutaneous wound healing (CWH) remains underexplored. This study aimed to determine the necessity of modulating K+ channel activity and expression for human CWH. The use of 25 mM KCl as a K+ channel blocker markedly improved wound healing in vitro (in keratinocytes and fibroblasts) and in vivo (in rat and porcine models). K+ channel blockers, such as quinine and tetraethylammonium, aided in vitro wound healing, while Ba2+ was the exception and did not show similar effects. Single-channel recordings revealed that the Ba2+-insensitive large conductance Ca2+-activated K+ (BKCa) channel was predominantly present in human keratinocytes. NS1619, an opener of the BKCa channel, hindered wound healing processes like proliferation, migration, and filopodia formation. Conversely, charybdotoxin and iberiotoxin, which are BKCa channel blockers, dramatically enhanced these processes. The downregulation of BKCa also improved CWH, whereas its overexpression impeded these healing processes. These findings underscore the facilitative effect of BKCa channel suppression on CWH, proposing BKCa channels as potential molecular targets for enhancing human cutaneous wound healing.
Assuntos
Fibroblastos , Hidrolases , Humanos , Animais , Ratos , Suínos , Movimento Celular , Regulação para Baixo , Canais de Potássio Ativados por Cálcio de Condutância Alta , CicatrizaçãoRESUMO
OBJECTIVES: This retrospective study aims to compare long-term stability between the mandibular setback surgery-early (MSE) approach, involving minimal orthodontics, and the mandibular setback conventional surgery (MCS) approach, involving sufficient orthodontics, in Class III patients with mandibular prognathism. METHODS: Among 210 patients who underwent orthognathic surgery, a total of 40 subjects were enrolled based on standardized inclusion criteria: only mandibular surgery, <5 mm setback difference between right and left of the mandible, orthodontics with fixed appliances, and more than 2 years of follow-up after treatment. These patients were allocated to the MSE (n = 20) and MCS groups (n = 20) according to the duration of presurgical orthodontics. Changes in cephalometric measurements were compared between the MSE and MCS groups before surgery (T0), 1 month after surgery (T1), at the end of treatment (T2), and posttreatment retention (T3). RESULTS: The MSE and MCS groups had a mean presurgical orthodontic duration of 2 and 9.5 months, respectively. From T1 to T2, the MSE group showed a significantly larger forward movement of the mandible than the MCS group (2.1 versus 0.7 mm; P < 0.001). In addition, from T2 to T3 (average 4.6 years), the MSE group presented anterior relapse of 0.6 mm in the mandible, but there were no statistically significant intergroup differences. CONCLUSION: Although the MSE group showed greater postsurgical forward mandibular relapse than the MCS group, the two groups exhibited similar skeletal and dental stability during the posttreatment retention.
Assuntos
Má Oclusão Classe III de Angle , Maxila , Humanos , Seguimentos , Estudos Retrospectivos , Resultado do Tratamento , Maxila/cirurgia , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/cirurgia , Cefalometria , RecidivaRESUMO
BACKGROUND: Although giant congenital melanocytic nevus (GCMN) is regarded as premalignant, the incidence and risk factors of malignant transformation are controversial. OBJECTIVE: This study aimed to share the authors' surgical experience with GCMNs and provide data on their demographics, malignant transformation, and prognosis. METHODS: This single-center, consecutive study included 152 patients with GCMN who visited this center from March 2000 to February 2020. Their medical documentation was reviewed retrospectively, and the nevi were classified according to the size as follows: Group 1, 10 to 19.9 cm (n = 45); Group 2, 20 to 39.9 cm (n = 62); and Group 3, ≥40 cm (n = 45). RESULTS: Seven malignancies were found (4.6%; 4 melanomas, 2 rhabdomyosarcomas [RMS], and 1 malignant peripheral nerve sheath tumor [MPNST]). The risk increased according to the nevus size (2.2% in Group 1, 3.2% in Group 2, and 8.9% in Group 3) but the difference was not statistically significant (p = .3305). CONCLUSION: Malignant transformation from GCMN cannot be ignored. It can include transformation into melanoma, RMS, and MPNST. Early surgical resection and regular follow-up should be performed in patients with nevi ≥10 cm.
Assuntos
Melanoma , Neurofibrossarcoma , Nevo Pigmentado , Nevo , Neoplasias Cutâneas , Transformação Celular Neoplásica , Humanos , Melanoma/epidemiologia , Melanoma/etiologia , Melanoma/cirurgia , Neurofibrossarcoma/complicações , Nevo Pigmentado/congênito , Nevo Pigmentado/epidemiologia , Nevo Pigmentado/cirurgia , Estudos Retrospectivos , Neoplasias Cutâneas/epidemiologia , Neoplasias Cutâneas/patologia , Neoplasias Cutâneas/cirurgiaRESUMO
Many defined approaches (DAs) for skin sensitization assessment based on the adverse outcome pathway (AOP) have been developed to replace animal testing because the European Union has banned animal testing for cosmetic ingredients. Several DAs have demonstrated that machine learning models are beneficial. In this study, we have developed an ensemble prediction model utilizing the graph convolutional network (GCN) and machine learning approach to assess skin sensitization. The model integrates in silico parameters and data from alternatives to animal testing of well-defined AOP to improve DA predictivity. Multiple ensemble models were created using the probability produced by the GCN with six physicochemical properties, direct peptide reactivity assay, KeratinoSens™, and human cell line activation test (h-CLAT), using a multilayer perceptron approach. Models were evaluated by predicting the testing set's human hazard class and three potency classes (strong, weak, and non-sensitizer). When the GCN feature was used, 11 models out of 16 candidates showed the same or improved accuracy in the testing set. The ensemble model with the feature set of GCN, KeratinoSens™, and h-CLAT produced the best results with an accuracy of 88% for assessing human hazards. The best three-class potency model was created with the feature set of GCN and all three assays, resulting in 64% accuracy. These results from the ensemble approach indicate that the addition of the GCN feature could provide an improved predictivity of skin sensitization hazard and potency assessment.
Assuntos
Cosméticos , Dermatite Alérgica de Contato , Alternativas aos Testes com Animais/métodos , Animais , Dermatite Alérgica de Contato/etiologia , Humanos , Aprendizado de Máquina , PeleRESUMO
Osteoporosis is a disease caused by impaired bone remodeling that is especially prevalent in elderly and postmenopausal women. Although numerous chemical agents have been developed to prevent osteoporosis, arguments remain regarding their side effects. Here, we demonstrated the effects of loganin, a single bioactive compound isolated from Cornus officinalis, on osteoblast and osteoclast differentiation in vitro and on ovariectomy (OVX)-induced osteoporosis in mice in vivo. Loganin treatment increased the differentiation of mouse preosteoblast cells into osteoblasts and suppressed osteoclast differentiation in primary monocytes by regulating the mRNA expression levels of differentiation markers. Similar results were obtained in an osteoblast-osteoclast co-culture system, which showed that loganin enhanced alkaline phosphatase (ALP) activity and reduced TRAP activity. In in vivo experiments, the oral administration of loganin prevented the OVX-induced loss of bone mineral density (BMD) and microstructure in mice and improved bone parameters. In addition, loganin significantly increased the serum OPG/RANKL ratio and promoted osteogenic activity during bone remodeling. Our findings suggest that loganin could be used as an alternative treatment to protect against osteoporosis.
Assuntos
Osteogênese , Osteoporose , Feminino , Animais , Camundongos , Iridoides , Osteoblastos , Osteoporose/tratamento farmacológicoRESUMO
OBJECTIVES: The purpose of this retrospective study was to evaluate the accuracy of intraoral scan (IOS) images in the maxillary and mandibular arches with orthodontic brackets. MATERIAL AND METHODS: From digital impressions of 140 patients who underwent orthodontic treatment, consecutive IOS images were selected based on standardized inclusion criteria: Two pre-orthodontic IOS images (IOS1 and IOS2) of permanent dentition with fully erupted second molars and IOS images obtained immediately after orthodontic bracket bonding (IOSb). Superimpositions were performed to evaluate the reproducibility of repeated IOS images. Accuracy of IOSb images was analyzed by comparing the average surface errors between IOS1c and IOS2c images, which were IOS images cut based on the same region of the interest as between IOS1 and IOSb images. RESULTS: A total of 84 IOS images was analyzed. The average surface errors between IOS1 and IOS2 images were 57 ± 8 µm and 59 ± 14 µm in the maxillary and mandibular arch, respectively, and their reliability was almost perfect. The average errors between IOSb and IOS1c images exhibited an increase, which measured 97 ± 28 µm in the maxillary arch and 95 ± 29 µm in the mandibular arch. These surface deviations between IOSb and IOS1c images were significantly larger in each region as well as entire dentition (P < 0.001) compared to those between IOS1c and IOS2c images. CONCLUSIONS: The average surface errors of the scans with brackets showed increased values compared with those without brackets. This suggests that orthodontic brackets could affect the trueness of intraoral scan images. CLINICAL RELEVANCE: It is necessary for clinicians to consider the effect of brackets on digital impression when using IOS images in orthodontic patients.
Assuntos
Braquetes Ortodônticos , Desenho Assistido por Computador , Arco Dental/diagnóstico por imagem , Técnica de Moldagem Odontológica , Humanos , Imageamento Tridimensional , Modelos Dentários , Reprodutibilidade dos Testes , Estudos RetrospectivosRESUMO
OBJECTIVES: To evaluate the linear, angular, and volumetric changes of soft tissue after clockwise repositioning of the maxillo-mandibular complex in skeletal class III patients using three-dimensional (3D) stereophotogrammetry and to determine the correlation between changes in the skeletal and soft tissue variables. METHODS: This study included 18 skeletal class III patients who underwent two-jaw surgery; superior impaction and clockwise rotational movement of the maxilla with the rotation center at upper incisors, and setback of the mandible. Lateral cephalograms and 3D photographs taken before and 6 months after surgery were compared. RESULTS: After maxillary impaction of anteriorly 1.7âmm and posteriorly 3.1âmm, and mandibular setback of 8.7âmm, the volume of lower lip and chin region decreased significantly by 33.6âcm3 (13% net change, Pâ<â0.001), while paranasal and upper lip region volume increased by 3.2âcm3 (2%) and 7.2âcm3 (4%), respectively. CONCLUSION: The clockwise rotation of maxillo-mandibular complex in class III patients significantly reduced lower lip and chin volume with minimal increase in paranasal and upper lip volumes. 3D stereophotogrammetry can provide quantitative evaluation of facial soft tissue volumetric changes.
Assuntos
Má Oclusão Classe III de Angle , Cefalometria , Humanos , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/cirurgia , Mandíbula/diagnóstico por imagem , Mandíbula/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Fotogrametria , RotaçãoRESUMO
PURPOSE: The aims of this study were to compare the presurgical conditions, surgical changes, and postsurgical changes in patients with skeletal Class III malocclusion with different degrees of horizontal relapse after mandibular setback surgery (MS) with minimal presurgical orthodontics (MPO) and to identify the factors contributing to this relapse. MATERIALS AND METHODS: For this retrospective study, 33 consecutive patients who underwent MS-MPO were selected. Lateral cephalograms were taken preoperatively (T0), 1 month after surgery (T1), and at orthodontic debonding (T2). Patients were divided into low relapse (LR; n = 18; relapse, <1 mm) and high relapse (HR; n = 15; relapse, >2 mm) groups based on the cephalometric distance of mandibular horizontal relapse. Paired t test, independent t test, and Pearson correlation analysis were used to evaluate surgical (T0 to T1) and postsurgical (T1 to T2) changes in the skeletodental variables and to explore the relation between surgical changes and horizontal relapse. RESULTS: Compared with the LR group, the HR group exhibited more upward movement with counterclockwise rotation of the mandible from T1 to T2. The HR group presented at T0 with a more prognathic mandible, greater vertical facial height, and a positive overbite. In addition, the HR group presented more posterior movement with clockwise rotation of the mandible, increased overjet, and decreased overbite from T0 to T1. Horizontal relapse of the mandible was positively correlated with the amount of setback and clockwise rotation of the mandible and the change in overjet and was negatively correlated with the change in overbite. CONCLUSIONS: Mandibular instability was related to the extent of setback and clockwise rotation of the mandible, decreased overbite, and increased overjet during MS-MPO.
Assuntos
Ortodontia , Procedimentos Cirúrgicos Ortognáticos , Cefalometria , Seguimentos , Humanos , Má Oclusão Classe III de Angle , Mandíbula/cirurgia , Maxila , Recidiva , Estudos RetrospectivosRESUMO
PURPOSE: A biodegradable magnesium alloy system has been developed as a substitute for conventional plates and screws made of titanium or absorbable polymer. However, previous studies were limited to small animal experiments using screws or wires. In the present study, we preliminarily evaluated the biocompatibility and effectiveness of human standard-size biodegradable magnesium-based plates and screws in facial fractures of beagles. MATERIALS AND METHODS: Fracture lines were created bilaterally in the zygomatic arches of 6 beagles. They were fixed in situ with plates and screws made of magnesium alloy mixed with calcium and zinc (experimental group) or absorbable polymer (control group). Laboratory testing, radiologic imaging, histologic analysis, and mechanical testing were performed 4 weeks postoperatively. RESULTS: Inflammatory reactions were not significantly increased in any animal. Mechanical testing showed greater ultimate load and structural stiffness in the experimental group. In the histologic analysis, the void area and bone regeneration area were increased in the experimental, and the implant area and soft tissue area were increased in the control group. Radiologically, 3-dimensional micro-computed tomography showed no differences in the bone gap area between the 2 groups. A temporary increase in hydrogen gas around the magnesium implants regressed spontaneously and did not affect bone healing significantly. CONCLUSIONS: Magnesium-based biodegradable plates and screws showed good biocompatibility and offered considerable stability for fixating facial bone fractures in the early bone-healing process. These results show the possibilities for the future development of magnesium alloy plates and screws for craniomaxillofacial fixation in humans.
Assuntos
Implantes Absorvíveis , Placas Ósseas , Parafusos Ósseos , Ossos Faciais/lesões , Fixação Interna de Fraturas/instrumentação , Magnésio , Fraturas Cranianas/cirurgia , Ligas , Animais , Materiais Biocompatíveis , Cães , Ossos Faciais/cirurgia , Fixação Interna de Fraturas/métodos , Masculino , Teste de Materiais , Distribuição Aleatória , Resultado do TratamentoRESUMO
BACKGROUND: Blood loss during cleft palate surgery has been investigated in previous research, but there is no report regarding blood loss when performing Furlow's double opposing Z-plasty (DOZ). In the present study, we evaluated intraoperative blood loss in patients with cleft palate who underwent the DOZ procedure. MATERIALS AND METHODS: Intraoperative blood loss was prospectively investigated in 59 patients undergoing palatoplasty with DOZ by a single surgeon between August 2012 and July 2013. Demographic factors and clinical status, including cleft type and palatal gap, were recorded. Blood loss was evaluated by measuring the change in weight of a suction bottle, suction line, and gauze balls. RESULTS: Mean blood loss was 16.61 ± 10.33 mL, which accounted for 5% of total blood volume. Male sex, older age, severe cleft type, larger palatal gap, relaxed incision, and increased operative time contributed to greater blood loss. The amount of intraoperative bleeding could be predicted by the following equation: Blood loss = -5.64 + 6.18 (male patients) + 7.58 (severe type cleft) + 0.88 X age (months) + 0.84 X palatal gap (mm). CONCLUSIONS: We found that the DOZ technique causes mild blood loss, but bleeding amount tended to increase in older male patients with a severe cleft and a larger palatal gap. The use of relaxed incisions during palatoplasty and prolonged operation times also contributed to greater blood loss.
Assuntos
Perda Sanguínea Cirúrgica/estatística & dados numéricos , Fissura Palatina/cirurgia , Procedimentos Cirúrgicos Bucais/métodos , Procedimentos de Cirurgia Plástica/métodos , Feminino , Humanos , Lactente , Masculino , Duração da Cirurgia , Estudos Prospectivos , Fatores de RiscoRESUMO
The psychologic stress on the child and family, which arise from hemangiomas, the most common neoplasm of childhood, cannot be overestimated. This study determined the preoperative and postoperative psychosocial status and variation among Oriental children with hemangiomas and their families by questionnaire. Thirty patients who underwent surgery for hemangiomas were assessed for preoperative and postoperative psychosocial status by questionnaire. The distribution of the total mean score and variation between the preoperative and postoperative status was estimated. Based on these results, the significance was statistically analyzed according to variable determinants. This study showed that hemangiomas have harmful effects on psychosocial status of patients and families. After corrective surgery, an improvement in psychosocial status was noted with respect to the self-esteem category or categories related to social activity, and in the following variables, women, face, and dissatisfaction with appearance. When the authors care for patients with hemangiomas and their families, the psychosocial health must be presumed to be at particular risk. Earlier surgical interventions with esthetic concerns have permitted the patient and family the opportunity to reduce the psychologic impact that the hemangioma may otherwise have.
Assuntos
Hemangioma , Estresse Psicológico , Criança , Hemangioma/complicações , Hemangioma/epidemiologia , Hemangioma/psicologia , Hemangioma/cirurgia , Humanos , Pais , Autoimagem , Estresse Psicológico/epidemiologia , Estresse Psicológico/etiologia , Estresse Psicológico/psicologia , Estresse Psicológico/cirurgia , Inquéritos e QuestionáriosRESUMO
Malignant peripheral nerve sheath tumors are rare tumors that originate from Schwann cells. Patients with neurofibromatosis type 1 are prone to develop these tumors. Due to their rarity and lack of established treatment, the prognosis of malignant peripheral nerve sheath tumors is poor. A retrospective study was conducted on children treated for malignant peripheral nerve sheath tumors at the Seoul National University Children's Hospital between 2007 and 2016. Eleven patients were diagnosed with malignant nerve sheath tumors at a median age of 12 years, eight of whom had neurofibromatosis type 1. All the patients underwent chemotherapy and received surgical resection, and 5 patients relapsed. The 2-year overall survival rate was 72.7%, and the 2-year event-free survival rate was 58.2%. Univariate analysis was performed to assess the correlations between the clinical factors. There was no statistically significant difference in the overall survival rate according to the patients' clinical factors. However, there was a decreasing trend in the relationship between the event-free survival rate and the prevalence of neurofibromatosis type 1. Regular follow up of neurofibromatosis type 1. Regular follow-up of neurofibromatosis type 1 patients may identify detection of early relapse of malignant peripheral nerve sheath tumors. Genetic studies of these patients and tumors may identify opportunities for targeted therapy.
Assuntos
Neurilemoma/mortalidade , Neurilemoma/terapia , Neurofibromatose 1/mortalidade , Neurofibromatose 1/terapia , Adolescente , Criança , Pré-Escolar , Intervalo Livre de Doença , Feminino , Humanos , Lactente , Masculino , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
BACKGROUND: Microtia is a congenital deformity of the external ear that occurs in 1 of every 5000 births. Microtia reconstruction using traditional two-dimensional templates does not provide highly detailed ear shapes. Here, we describe the feasibility of using a three-dimensional (3D) ear model as a reference. MATERIALS AND METHODS: Seven children aged from 11 to 16 (6 grade III and 1 grade II microtia) were recruited from Seoul National University Children's Hospital, Korea. We generated 3D-computer-aided design models of each patient's ear by performing 3D laser scanning for a mirror-transformed cast of their normal ear. The 3D-printed ear model was used in microtia reconstruction surgery following the Nagata technique, and its shape was compared with the casted ear model. RESULTS: One patient experienced irritation caused by accidently pouring resin into the external auditory meatus, and another had minor skin necrosis; both complications were successfully treated. The average percentage differences of the superior, inferior, anterior, posterior, and lateral views between the casted and 3D-printed ear models were 1.17%, 1.48%, 1.64%, 1.80%, and 5.44%, respectively (average: 2.31%), where the difference between the casted ear models and traditional two-dimensional templates were 16.03% in average. CONCLUSIONS: Our results show that simple microtia reconstruction can be performed using 3D ear models. The 3D-printed ear models of each patient were consistent and accurately represented the thickness, depth, and height of the normal ear. The availability of the 3D-printed ear model in the operating room reduced the amount of unnecessary work during surgery.
Assuntos
Microtia Congênita/cirurgia , Modelos Anatômicos , Procedimentos de Cirurgia Plástica/métodos , Impressão Tridimensional , Adolescente , Criança , Feminino , Seguimentos , Humanos , Masculino , Procedimentos de Cirurgia Plástica/instrumentação , Resultado do TratamentoRESUMO
PURPOSE: The effects of recombinant human bone morphogenetic protein-2 (rhBMP-2) and osteogenically differentiated adipose tissue-derived stem cells (ADSC) on new bone formation in high-speed distraction osteogenesis of adult rabbit cranium were investigated. MATERIALS AND METHODS: A total of 41 adult rabbits were used in the study. Distraction began after a 5-day latency period at a rate of 1.5 mm twice a day until 10-mm length gain was obtained both in the control group, where a bone defect was induced, and in the experimental group, in which ADSC (group A), rhBMP-2 (group B), or both (group C) were injected in the distraction gap after distraction. At 4, 8, and 12 weeks after distraction, computed tomography analysis was done to determine the bone defect dimension and bone mineral density (BMD), while histologic examination was also done to calculate bone formation ratio. RESULTS: Bone defect dimension significantly decreased in groups B and C, compared with the control group, at 4 and 12 weeks after distraction. BMD was significantly increased in groups B and C at 4 weeks. On histologic examination, bone formation ratio was significantly increased in group C only at 12 weeks. CONCLUSION: This study suggests that the use of rhBMP-2 in combination with or without ADSC is helpful to promote bone regeneration in high-speed distraction osteogenesi s of adult rabbit cranium.
Assuntos
Tecido Adiposo/citologia , Proteína Morfogenética Óssea 2/farmacologia , Osteogênese por Distração/métodos , Crânio , Transplante de Células-Tronco , Fator de Crescimento Transformador beta/farmacologia , Animais , Masculino , Osteotomia , Coelhos , Proteínas Recombinantes/farmacologia , Tomografia Computadorizada por Raios XRESUMO
Depression frequently accompanies in Parkinson's disease (PD). Previous research suggested that dopamine (DA) and serotonin systems are closely linked with depression in PD. However, comprehensive studies about the relationship between these two neurotransmitter systems are limited. Therefore, the purpose of this study is to evaluate the effect of dopaminergic destruction on the serotonin system. The interconnection between motor and depression was also examined. Two PET scans were performed in the 6-hydroxydopamine (6-OHDA) lesioned and sham operated rats: [(18) F]FP-CIT for DA transporters and [(18) F]Mefway for serotonin 1A (5-HT(1A)) receptors. Here, 6-OHDA is a neurotoxin for dopaminergic neurons. Behavioral tests were used to evaluate the severity of symptoms: rotational number for motor impairment and immobility time, acquired from the forced swim test for depression. Region-of-interests were drawn in the striatum and cerebellum for the DA system and hippocampus and cerebellum for the 5-HT system. The cerebellum was chosen as a reference region. Nondisplaceable binding potential in the striatum and hippocampus were compared between 6-OHDA and sham groups. As a result, the degree of DA depletion was negatively correlated with rotational behavior (R(2) = 0.79, P = 0.003). In 6-OHDA lesioned rats, binding values for 5-HT(1A) receptors was 22% lower than the sham operated group. This decrement of 5-HT(1A) receptor binding was also correlated with the severity of depression (R(2) = 0.81, P = 0.006). Taken together, this research demonstrated that the destruction of dopaminergic system causes the reduction of the serotonergic system resulting in the expression of depressive behavior. The degree of dopaminergic dysfunction was positively correlated with the impairment of the serotonin system. Severity of motor symptoms was also closely related to depressive behavior.
Assuntos
Encéfalo/metabolismo , Transtorno Depressivo/metabolismo , Proteínas da Membrana Plasmática de Transporte de Dopamina/metabolismo , Neurônios Dopaminérgicos/metabolismo , Transtornos dos Movimentos/metabolismo , Receptor 5-HT1A de Serotonina/metabolismo , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/efeitos dos fármacos , Transtorno Depressivo/diagnóstico por imagem , Modelos Animais de Doenças , Dopamina/metabolismo , Neurônios Dopaminérgicos/diagnóstico por imagem , Neurônios Dopaminérgicos/efeitos dos fármacos , Transtornos dos Movimentos/diagnóstico por imagem , Oxidopamina , Piperazinas , Tomografia por Emissão de Pósitrons , Piridinas , Compostos Radiofarmacêuticos , Ratos Sprague-Dawley , Serotonina/metabolismo , TropanosRESUMO
PURPOSE: Cranial distraction osteogenesis (DO) has many advantages for correcting skull deformities: Thus, DO is extensively used for the treatment of skull deformities. However, diverse, unexpected complications are associated with this procedure. In this study, we present the surgical outcomes and complications of DO. Moreover, we propose a modified protocol for DO to reduce complications. METHODS: This is a retrospective study on managed patients that underwent DO between March 2008 and May 2013. Their clinical courses were reviewed. Distraction protocols were individually inspected, and the final surgical outcomes, including complications, were evaluated. RESULTS: During the study period, a total of ten patients (seven boys and three girls) were treated at our institute. The median distraction period was 20.5 days (ranging from 17 to 50 days). The range of total distraction length was 19-22 mm. The median consolidation period was 96 days (ranging from 0 to 343 days). All patients achieved the goals of distraction. At follow-up evaluations, all patients, except one, showed good surgical outcomes in both head shape and neurologic symptoms. There were six patients with wound complications during the treatment period. Among them, the distractors were removed early in three patients. Interestingly, even these three patients, without a sufficient consolidation period, showed good outcomes. CONCLUSIONS: Although DO has many merits for correcting skull deformities, it frequently causes severe wound complications. To reduce these complications, we propose a modified protocol with a minimal or even no consolidation period.
Assuntos
Craniossinostoses/cirurgia , Encefalocele/cirurgia , Osteogênese por Distração/métodos , Crânio/cirurgia , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Osteogênese por Distração/efeitos adversos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
The purpose of this study is to evaluate the efficacy of glucose transporter protein 1 (GLUT1) antibody-conjugated iron oxide nanoparticles (Fe3O4 NPs) as magnetic resonance imaging (MRI) molecular imaging agents for differentiating infantile hemangioma from vascular malformation in the hemangioma animal model. The conjugation of Fe3O4 NPs with anti-GLUT1 antibodies leads to a significantly increased uptake of NPs by human umbilical vein endothelial cells. MRI imaging following the intravenous injection of GLUT1 antibody-Fe3O4 NPs yielded a significantly lower signal intensity than did unconjugated Fe3O4 NPs. Upon histological examination of the GLUT1 antibody-Fe3O4 NPs, Prussian blue-stained NPs were identified in CD31-positive endothelial cells of hemangioma. In contrast, when treated with unconjugated Fe3O4 NPs, Prussian blue-stained NPs were found in macrophages rather than in endothelial cells. GLUT1 antibody conjugation can effectively target the injected Fe3O4 NPs to GLUT1-positive tumor cells in infantile hemangioma.
Assuntos
Transportador de Glucose Tipo 1/metabolismo , Hemangioma/diagnóstico , Imageamento por Ressonância Magnética/métodos , Nanopartículas de Magnetita/química , Imagem Molecular/métodos , Malformações Vasculares/diagnóstico , Animais , Corantes/química , Meios de Contraste/química , Diagnóstico Diferencial , Feminino , Compostos Férricos/química , Ferrocianetos/química , Células Endoteliais da Veia Umbilical Humana , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Nus , Modelos AnimaisRESUMO
PURPOSE: Conchal cartilage is widely used in the field of plastic surgery, but donor-site morbidity is inevitable when all of the conchal cartilage is harvested. To maintain ear shape, the authors introduce a new method using an absorbable plate to reconstruct the conchal central strut after total harvesting of the conchal cartilage. METHODS: In total, 18 subjects underwent surgery, and 14 subjects who were followed up for more than 12 months were included in this article. Before the total harvesting of the conchae, an absorbable plate was adjusted to the proper curvature and length. After harvesting, the central strut was reconstructed by the precrafted absorbable plate. When the harvested cartilage was too large or one implant was not sufficient to reconstruct the central strut, an additional implant was added to the cymba conchae.Outcomes were evaluated by photogrammetry and questionnaires. Seven items were selected to evaluate the shape of the ear and conchal cavity. The authors compared preoperative and postoperative photographs, looking at proportion indices of 7 items using Photoshop. Ten assessors who did not participate in the operation were also shown preoperative and postoperative photographs and answered questionnaires about the shapes of the ear, conchal cavity, and conchal central strut. RESULTS: Except for the effective conchal cavity height index, no statistically significant differences were observed between preoperative and postoperative ear shapes. Additionally, the questionnaire showed excellent assessments for all items. CONCLUSIONS: Reconstruction of the central strut using an absorbable plate after total harvest of the conchal cartilage was a simple and effective method to prevent ear collapse.
Assuntos
Implantes Absorvíveis , Pavilhão Auricular/cirurgia , Cartilagem da Orelha/transplante , Procedimentos de Cirurgia Plástica/métodos , Adolescente , Adulto , Pavilhão Auricular/anatomia & histologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Fotogrametria , Procedimentos de Cirurgia Plástica/instrumentação , Adulto JovemRESUMO
The nasal septum plays an important role in nose development. East Asians are believed to have inherent hypoplasia of the nasal septum because East Asians have smaller noses than whites do. However, there have been no studies of nasal septum differences between whites and East Asians. We compared the nasal septum and its components in Koreans and whites using computed tomographic scan data. Twenty-seven patients of white origin and 64 patients of Korean origin older than 20 years were enrolled in this study between 2008 and 2012. We evaluated a total of 9 measurement items (5 for the nasal bones and septa as well as 4 for the external nose morphology). Sex differences in whites were the same as those in Koreans. Nasal bridge length and cartilaginous nasal bridge length were significantly longer in whites than in Koreans. However, there were no significant differences in nasal height, nasal tip projection, nasal bone length, total septal area, or most components of the nasal septum between the samples. The relative proportions of the cartilaginous septum divided by the total septal area were negatively correlated with the relative proportions of the perpendicular plate in both groups. Differences in the external nasal morphology between whites and Koreans are not caused by differences in the nasal septum.
Assuntos
Povo Asiático , Septo Nasal/anatomia & histologia , Nariz/anatomia & histologia , População Branca , Adulto , Idoso , Cefalometria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nariz/cirurgia , Valores de Referência , República da Coreia , Rinoplastia/métodos , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
BACKGROUND: The aim of this research was to investigate whether covering of the distracted cranial bone segment with a polycaprolactone (PCL) membrane (guided bone formation) would accelerate the process of osteogenesis in high-speed distraction of adult rabbit. METHODS: Eighteen 24-weeks old, 3.0 to 3.5 âkg, male New Zealand rabbits underwent routine gradual cranium distraction (group 1), distraction at high speed without the membrane (group 2), and distraction at high speed with a PCL membrane covering the cranium at the distraction gap (group 3). Five days after the cranial osteotomy, the distraction process was initiated at 3â mm per day (1.5 âmm twice a day) in group 2 and group 3, and 1â mm per day (0.5 âmm twice a day) in group 1 until 10 âmm of length gain was achieved. At the consolidation 4 and 6 weeks, the bone mineral density was analyzed by a computerized tomography imaging protocol. The bone formation ratio of each group was compared with Hematoxylin and Eosin stain. The collagen formation of each group was analyzed by Massons' trichrome staining. RESULTS: Radiographic imaging and quantitative data indicated a significant increase in bone mineral density in group 1 and group 3 compared with group 2. Bone formation ratio in histologic analysis showed an increase in group 1 and group 3. Collagen synthesis in group 2 was significantly increased in distraction gap. In group 3, collagen fibers were significantly decreased underneath the PCL membrane. CONCLUSIONS: Polycaprolactone membrane covering the bone distraction gap provides an environment for faster bone formation in high-speed distraction.