Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 28
Filtrar
Filtros adicionais











País/Região como assunto
Intervalo de ano
1.
J Pediatr Nurs ; 2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31324414

RESUMO

PURPOSE: The present study aimed to highlight the feeding challenges of infants with cleft lip and/or palate (CLP) that caregivers encounter and analyze the alternative interventions they perform based on their experiences in the preoperative period. DESIGN AND METHODS: Parents of 200 infants with CLP were asked to complete our questionnaire. The prenatal feeding preparations, preoperative processes, and feeding challenges and modifications to overcome these difficulties were evaluated. RESULTS: One-third of the caregivers stated that they had received feeding education prenatally. Sixty-five percent of the parents stated that they were not successful in breastfeeding. Infants with isolated cleft lip had minor feeding difficulties, whereas the ones with cleft palate had some major challenges such as aspiration, choking, and inadequate growth. Parents also reported that 59.5% of the infants with cleft had stayed in the intensive care units following birth. Moreover, 42% of the infants were initially fed by nasogastric or orogastric tube. Out of the 166 infants with cleft palate, 31.9% used palatal obturators. CONCLUSIONS: We have reviewed the various feeding difficulties of the infants with clefts and highlighted the results of the interventions performed to overcome these difficulties for better nutrition and growth. PRACTICE IMPLICATIONS: In the light of our findings, further studies should be conducted and additional educational programs should be implemented for both healthcare providers and parents to increase families' awareness regarding cleft feeding, prevent unnecessary and improper feeding interventions in infants with clefts, and alleviate the burden of feeding difficulties for both parents and infants.

2.
Sci Rep ; 9(1): 3172, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30816272

RESUMO

Fibroblasts turn into cancer associated fibroblasts (CAFs) in the tumour microenvironment. CAFs have recently attracted attention for their function as a regulator of immune cell recruitment and function in addition to their tumour-promoting roles. In this study, we aimed to determine the role of CAFs on monocyte recruitment and macrophage polarization in breast cancer. CAFs, which were α-SMA expressing fibroblasts in contrast to normal fibroblasts (NFs), effectively recruited monocytes. Recruitment of monocytes by CAFs might be mediated by monocyte chemotactic protein-1 (MCP-1) as well as stromal cell-derived factor-1 (SDF-1) cytokines. CAFs differentiated the recruited monocytes into M2-like macrophages which are capable of exerting their immunosuppressive roles via the PD-1 axis. CAF-educated monocytes exhibited strong immune suppression unlike NF-educated monocytes and enhanced the motility/invasion of breast cancer cells in addition to increasing the expressions of epithelial-mesenchymal transition (EMT)-related genes and vimentin protein in cancer cells. CAF-educated M1 macrophages displayed increased expression of M2 markers and production of anti-inflammatory cytokine IL-10 in contrast to decreased production of pro-inflammatory cytokine IL-12 compared with control M1 macrophages; suggesting that CAFs were also able to induce the trans-differentiation of M1 macrophages to M2 macrophages. We then investigated the relationship between the infiltration of CAFs and tumour associated macrophages (TAMs) using tissue samples obtained from breast cancer patients. High grade of CAFs significantly correlated with the number of TAMs in human breast cancer tissue samples. It was also associated with higher Ki-67 proliferation index, and higher tumour volume. This result is in line with our finding of increased breast cancer cell proliferation due to the effects of CAF-educated monocytes in vitro. Our results concluded that CAFs play pivotal roles in sculpturing the tumour microenvironment in breast cancer, and therapeutic strategies to reverse the CAF-mediated immunosuppressive microenvironment should be taken into consideration.

3.
Lasers Surg Med ; 51(6): 538-549, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30706950

RESUMO

OBJECTIVE: The aim of this study was to evaluate the effect of relatively novel approach of application of polychromatic light waves on flap survival of experimental musculocutaneous flap model and to investigate efficacy of this modality as a delay procedure to increase vascularization of zone 4 of transverse rectus abdominis musculocutaneous (TRAM) flap. METHODS: Twenty-one Wistar rats were randomized and divided into 3 experimental groups (n = 7 each). In group 1 (control group), after being raised, the TRAM flap was sutured back to its bed without any further intervention. In group 2 (delay group), photobiomodulation (PBM) was applied for 7 days as a delay procedure, before elevation of the flap. In group 3 (PBM group), the TRAM flap was elevated, and PBM was administered immediately after the flap was sutured back to its bed for therapeutic purpose. PBM was applied in 48 hours interval from 10 cm. distance to the whole abdominal wall both in groups 2 and 3 for one week. After 7 days of postoperative follow-up, as the demarcation of necrosis of the skin paddle was obvious, skin flap survival was further evaluated by macroscopic, histological and microangiographic analysis. RESULTS: The mean percentage of skin flap necrosis was 56.17 ± 23.68 for group 1, 30.92 ± 17.46 for group 2 and 22.73 ± 12.98 for group 3 PBM receiving groups 2 and 3 revealed less necrosis when compared to control group and this difference was statistically significant. Vascularization in zone 4 of PBM applied groups 2 and 3 was higher compared to group 1 (P = 0.001). Acute inflammation in zone 4 of group 1 was significantly higher compared to groups 2 and 3 (P = 0.025). Similarly, evaluation of zone 1 of the flaps reveled more inflammation and less vascularization among the samples of the control group (P = 0.006 and P = 0.007, respectively). Comparison of PBM receiving two groups did not demonstrate further difference in means of vascularization and inflammation density (P = 0.259). CONCLUSION: Application of PBM in polychromatic fashion enhances skin flap survival in experimental TRAM flap model both on preoperative basis as a delay procedure or as a therapeutic approach. Lasers Surg. 51:538-549, 2019. © 2019 Wiley Periodicals, Inc.

4.
Angle Orthod ; 89(4): 575-582, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30694706

RESUMO

OBJECTIVES: To compare growth-related changes of skeletal and upper airway features of unilateral cleft lip and palate subjects (UCLP) with non-cleft control (NCC) subjects by using lateral cephalograms. MATERIALS AND METHODS: The sample comprised 238 subjects, collected cross-sectionally, divided into 2 groups: 94 with UCLP, and 144 NCC, subdivided into 4 groups according to their growth stages by using cervical vertebral maturation stage (CVMS). The subgroups were defined as early childhood (stage 1), prepubertal (stage 2: CVMS I and II), pubertal (stage 3: CVMS III and IV), and postpubertal (stage 4: CVMS V and VI). RESULTS: The maxilla was more retrognathic at stages 2, 3, and 4 in females with UCLP. The mandible was more retrognathic in UCLP at stage 1 in males, and stages 2 and 3 in females. ANB (angle between NA plane and NB plane) was significantly smaller in UCLP subjects at stage 4 for both sexes. A vertical growth pattern was seen in UCLP subjects except males at stages 2 and 3, and females at stage 2. Posterior airway space was significantly narrower at all stages in males and after stage 1 in females. Middle airway space was significantly wider at all stages in females and after stage 1 in males. Epiglottic airway space was significantly narrower in males at stage 3. CONCLUSIONS: Age- and sex-dependent differences in skeletal morphology and upper-airway widths of the UCLP subjects were identified when compared with controls.

5.
J Craniofac Surg ; 29(8): 2195-2197, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30320680

RESUMO

Accompanying neurologic disorders directly affect psychosocial development of cleft lip and/or cleft palate (CLP) patients and make it difficult for their family to look after them properly. The aim of this study was to investigate the diversity and the incidence of additional neurologic malformations in children with CLP and to evaluate their effects on cleft care. All patients who applied to our Cleft and Craniofacial Center between July 2014 and July 2017 were included in the study. Demographic and perioperative data such as gender, cleft type, syndromic status of the patient, associated neurologic anomalies, timing and duration of operation, hospitalization period, and follow-up period in the intensive care unit are all recorded. All patients received an interdisciplinary evaluation including pediatric neurology specialists in terms of mental and/or motor developmental delay, epilepsy, and other neurologic disorders. After detailed neurologic examination, 83 (3.8%) out of 2190 were reported as having a neurologic defect. The most leading neurologic disorder was found to be mental-motor retardation in 57 children followed by epileptiform disorders detected in 36 children. In 22 patients, rare intracranial pathologies were detected on magnetic resonance imaging. According to our results, having a neurologic pathology increases the need for intensive care unit stay by 5 times in these patients. There was statistically significant relationship between hospitalization period, age of cleft surgery, and neurologic pathologies in these patients. Neurologic disorders could complicate cleft care, cause delays in the planned surgery schedule, and increase perioperative and postoperative morbidity.

7.
J Craniofac Surg ; 29(5): 1332-1333, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29608474

RESUMO

Hemangiomas are the most common tumors of childhood with an average incidence of 10%. It is unusual for hemangiomas, which are already rarely seen isolated on the palate, to coexist with cleft palate as in the authors' patient. Four months old baby was admitted with isolated Veau 2 cleft palate and a red-purple colored raised lesion involving almost the whole right side of the hard palate. Magnetic resonance imaging revealed intensive contrasting solid nodule with a lobulated contour that was covering the right half of the hard palate, measuring 2.2×1.3 cm. To reduce the size of the vascular lesion 7 mg/d oral propranolol treatment was initiated. Following reduction in the size of hemangioma, the cleft palate was repaired at 11 months of age. Single mucoperiosteal flap from the left side of the palate preserving the major palatine artery was elevated whereas right mucoperisteal flap was minimally dissected not to interfere with the hemangioma. No intraoperative and postoperative complications in both the early and late term were experienced. As a result, since early palatal repair is important to obtain ideal speech outcomes in cleft patients, repair should be performed in similar patients with hemangiomas without delaying the timing.


Assuntos
Fissura Palatina/cirurgia , Hemangioma/cirurgia , Neoplasias Palatinas/cirurgia , Retalhos Cirúrgicos/transplante , Fissura Palatina/diagnóstico por imagem , Comorbidade , Feminino , Seguimentos , Hemangioma/diagnóstico por imagem , Humanos , Lactente , Neoplasias Palatinas/diagnóstico por imagem , Palato Duro/diagnóstico por imagem , Palato Duro/cirurgia , Cuidados Pré-Operatórios , Propranolol/administração & dosagem , Técnicas de Sutura
8.
Am J Orthod Dentofacial Orthop ; 153(4): 489-495, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29602340

RESUMO

INTRODUCTION: The aim of this retrospective study was to assess the influence of presurgical nasoalveolar molding (NAM) on skeletal development in patients with operated unilateral cleft lip and palate at 5 years of age. MATERIALS: Lateral cephalometric radiographs of 26 unilateral cleft lip and palate patients who had undergone presurgical NAM (NAM group) and 20 unilateral cleft lip and palate patients who did not have any presurgical NAM (non-NAM group) were analyzed. The radiographs were digitally traced using Quick Ceph Studio software (version 3.5.1.r (1151); Quick Ceph Systems, San Diego, Calif). Independent samples t tests were performed for statistical analysis. RESULTS: No significant differences were observed in sagittal and vertical skeletal measurements between the NAM and non-NAM groups. CONCLUSIONS: NAM resulted in no significant difference in skeletal development in unilateral cleft lip and palate patients compared with those without NAM in early childhood.


Assuntos
Processo Alveolar/anormalidades , Fenda Labial/terapia , Fissura Palatina/terapia , Nariz/anormalidades , Rinoplastia , Processo Alveolar/cirurgia , Cefalometria/métodos , Pré-Escolar , Fenda Labial/diagnóstico por imagem , Fenda Labial/cirurgia , Fissura Palatina/diagnóstico por imagem , Fissura Palatina/cirurgia , Feminino , Humanos , Masculino , Maxila/cirurgia , Nariz/diagnóstico por imagem , Nariz/cirurgia , Ortodontia Corretiva/métodos , Aparelhos Ortopédicos , Estudos Retrospectivos , Rinoplastia/métodos , Aço Inoxidável , Resultado do Tratamento
9.
J Craniofac Surg ; 29(1): e100-e103, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28212126

RESUMO

Submucous cleft palate (SMCP) is a relatively rare variant of the common pathology of cleft palate with specific anatomic and clinical features. Even though there are many surgical options defined previously to correct the SMCP, correction of the velopharyngeal insufficiency and obtaining ideal speech results remains as a challenge. The aim of this article was to compare the speech benefits of Furlow double opposing Z plasty and posterior pharyngeal flap operation combined with intravelar veloplasty for the correction of SMCP using objective assessment tools. This study reviewed 29 patients who underwent either superiorly based posterior pharyngeal flap combined with intravelar veloplasty or Furlow palatoplasty for submucous cleft palate repair between years 2005 and 2011. The mean standard deviation age at palate repair was 123.6 ±â€Š65.8 months and the mean follow-up period was 31.2 ±â€Š15.9 months. The postoperative results demonstrated that in both groups significantly correction has been achieved in means of velopharygeal closure (P values for Furlow and pharyngeal flap groups are 0.012 and 0.001 respectively). The correction of the nasalance scores obtained depending on the surgical procedure for /sa/ and /ka/ syllables demonstrated significantly more benefit with pharyngeal flap combined with intravelar veloplasty than Furlow palatoplasty (P = 0.026 for each). In the treatment of submucous clefts, both Furlow palatoplasty and pharyngeal flap procedure combined with intravelar veloplasty appear to be effective whereas for the patients having significant signs of hypernasality, contribution of pharyngeal flap may be taken into consideration.


Assuntos
Enxerto de Osso Alveolar , Fissura Palatina/cirurgia , Palato Mole/cirurgia , Complicações Pós-Operatórias , Distúrbios da Fala , Insuficiência Velofaríngea , Enxerto de Osso Alveolar/efeitos adversos , Enxerto de Osso Alveolar/métodos , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Avaliação de Processos e Resultados (Cuidados de Saúde) , Faringe/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estudos Retrospectivos , Distúrbios da Fala/diagnóstico , Distúrbios da Fala/etiologia , Retalhos Cirúrgicos , Resultado do Tratamento , Insuficiência Velofaríngea/diagnóstico , Insuficiência Velofaríngea/etiologia
10.
Ann Plast Surg ; 79(3): 304-311, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28430676

RESUMO

BACKGROUND: Biological hydroxyapatite (HA), has several mechanical and physical advantages over the commercially available synthetic apatite (CAP-HA). The aim of this in vivo study was to investigate the effect of osteoinductive "bone-like hydroxyapatite" obtained from simulated body fluid (SBF) combined with osteoinductive "boron" (B) on bone healing. MATERIALS: Bone like nanohydroxyapatite (SBF-HA) was precipitated from 10× simulated body fluid (10×SBF). Thirty Sprague-Dawley rats were randomly divided into 5 experimental groups (n = 6 each). The groups were involving blank defect, chitosan, SBF-HA, SBF-HA/B, and CAP-HA. Two biparietal round critical sized bone defect was created using a dental burr. The rats were sacrificed respectively at the end of second and fourth months after surgery and their calvarium were harvested for further macroscopic, microtomographic, and histologic evaluation. RESULTS: The SBF-HA/B group demonstrated the highest mineralized matrix formation rates (30.69 ± 3.73 for the second month, 62.68 ± 7.03 for the fourth month) and was significantly higher than SBF-HA and the CAP-HA groups. The SBF-HA/B group demonstrated the highest mineralized matrix formation rates (30.69 ± 3.73 for the second month, 62.68 ± 7.03 for the fourth month) and was significantly higher than SBF-HA and the CAP-HA groups. In means of bone defect repair histologically, the highest result was observed in the SBF-HA/B group (P < 0.001). CONCLUSIONS: The "bone-like hydroxapatite" obtained from simulated body fluid is worth attention when both its beneficial effects on bone healing and its biological behavior is taken in consideration for further bone tissue engineering studies. It appears to be a potential alternative to the commercially available hydroxyapatite samples.


Assuntos
Apatitas/química , Líquidos Corporais/química , Substitutos Ósseos/química , Compostos de Boro/química , Engenharia Tecidual/métodos , Animais , Materiais Biomiméticos/química , Distribuição Aleatória , Ratos Sprague-Dawley
11.
J Craniofac Surg ; 28(2): 413-417, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28033190

RESUMO

Velopharyngeal insufficiency (VPI) is certainly one of the most important problems confronted after cleft palate repairs. In this study, it was aimed to evaluate the preoperative and postoperative speaking results of patients who underwent modified superior-based pharyngeal flap. Sixty-six children who underwent modified superiorly based pharyngeal flap for treatment of VPI between 2005 and 2013 were retrospectively reviewed. The study population was evaluated in 2 distinctive groups depending on their preoperative velopharyngeal closure pattern as: coronal closure pattern or noncoronal closure patterns (ie, circular, sagittal with or without the presence of a Passavant ridge). The speech outcome of the patients was evaluated using the objective assessment tools of nasopharyngoscopy and nasometer. Coronal closure pattern was determined in 24 patients (36.4%) and noncoronal closure pattern in 42 patients (63.6%). The mean follow-up period was 14.67 ±â€Š3.90 and 13.74 ±â€Š3.53 months in the coronal and noncoronal groups, respectively. The results demonstrated that the postoperative nasalance scores of all syllables except (m) and (n) were found to be significantly lower compared to those of the preoperative period (P < 0.001). However, no significant difference between the preoperative and postoperative results was observed in means of closure pattern. The surgical approach of modified superior-based pharyngeal flap for treatment of VPI appears to be effective regardless of the preoperatively determined closure pattern.


Assuntos
Fissura Palatina/cirurgia , Complicações Pós-Operatórias/cirurgia , Retalhos Cirúrgicos , Insuficiência Velofaríngea , Pré-Escolar , Endoscopia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Bucais/efeitos adversos , Procedimentos Cirúrgicos Bucais/métodos , Avaliação de Processos e Resultados (Cuidados de Saúde) , Faringe/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Insuficiência Velofaríngea/etiologia , Insuficiência Velofaríngea/cirurgia , Esfíncter Velofaríngeo/cirurgia , Técnicas de Fechamento de Ferimentos
12.
Ann Plast Surg ; 77(5): 494-498, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27070687

RESUMO

Cleft lip and palate (CL/P) is one of the leading congenital deformities among the world. Children born with CL/P experience problems with feeding, speech, hearing, and dentition. In developed countries, CL/P patients are receiving optimal health care involving multidisciplinary team approach and staged surgical operations, whereas in developing countries, there is severe shortage of both medical and financial sources. To overcome these limitations, humanitarian surgical missions are essential. The aim of this article is to share our experience of humanitarian surgical mission in Uzbekistan consisting of 6 consecutive visits between 2009 and 2014. The series of these humanitarian activities consisting of 6 consecutive visits was organized by the cooperation of Interplast Turkiye and governmental Turkish Coordination and Cooperation Agency. After initial evaluation, triage at the initial setting and prompt anesthesia evaluation among many more of them, 529 patients mostly with cleft, craniofacial, or congenital deformities were operated. The success of this type of mission is not solely based on the expertise of the team members, but also meticulous planning, patient selection, good coordination with the local colleagues and communication. At this point, caregivers attending from a culturally close and similar language-spoken countries will certainly have more advantages in achieving a mission. Volunteer surgical missions for congenital deformities can be an important relief for this burden in developing countries. Nevertheless, training the native surgeons and supporting the plastic surgery foundations in these countries are as important as providing the necessary health care by such humanitarian missions.


Assuntos
Altruísmo , Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Missões Médicas/organização & administração , Procedimentos Cirúrgicos Ortognáticos , Procedimentos Cirúrgicos Reconstrutivos , Humanos , Avaliação de Processos e Resultados (Cuidados de Saúde) , Turquia , Uzbequistão
13.
Cleft Palate Craniofac J ; 53(4): 453-63, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26506043

RESUMO

OBJECTIVE: To determine the efficacy of a newly developed scaffold (col/ß-TCP) in a preclinical rat model as compared with the gold standard treatment (autograft) and control scaffolds (PLLA/PCL). DESIGN: Fifty-six Sprague-Dawley rats were randomized into four experimental groups, and critical-sized alveolar defects (7 × 4 × 3 mm) were created in each animal. Group A was the blank defect group, group B received autograft, group C received col/ß-TCP scaffolds, and group D received PLLA/PCL blend scaffolds to fill the bone defects. New bone formation was assessed radiomorphometrically, histomorphometrically, and molecular-biologically at 1 and 4 months following surgery. RESULTS: Radiomorphometrically, the best new bone volume rate at 1 month (43.7%) and 4 months (45.4%) was observed in the autograft group, and the difference was significantly higher than in the other three groups (P < .005, P < .001, P < .001 for 1 month and P = .004, P < .001, P < .001 for 4 months). Even though the new bone volume rate in the col/ß-TCP group (21.5%) was higher than that of the PLLA/PCL group (18.2%), the difference was not significant (P = .08). Molecular-genetic analysis revealed significantly higher BSP and ALP gene expression levels in the autograft and col/ß-TCP groups than in the blank defect group (P = .002 and P = .004). CONCLUSION: The engineered tissue scaffolds described herein have great potential as an alternative treatment option when cost, donor region morbidity, and duration of hospitalization are considered.


Assuntos
Fosfatos de Cálcio/química , Colágeno/química , Osteogênese , Poliésteres/química , Tecidos Suporte , Animais , Ratos , Ratos Sprague-Dawley , Engenharia Tecidual
14.
Am J Orthod Dentofacial Orthop ; 148(4): 576-86, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26432313

RESUMO

INTRODUCTION: The craniofacial morphology of subjects with cleft lip and palate differs from that of subjects without clefts. Subjects with bilateral cleft lip and palate tend to have maxillary retrognathism, a smaller mandible with an obtuse gonial angle, greater anterior upper and lower facial heights, and retroclined maxillary incisors. The purposes of this research were to compare the skeletal and upper-airway features of subjects with bilateral cleft lip and palate with the same features in control subjects without clefts and to determine the growth-related changes at different growth stages. METHODS: The sample comprised 212 subjects divided into 2 groups: 68 with bilateral cleft lip and palate, and 144 controls without clefts; each group was further divided into 4 subgroups according to growth stage using the cervical vertebral maturation stage method. The subgroups were defined as early childhood (stage 1), prepubertal (stage 2), pubertal (stage 3), and postpubertal (stage 4). The cephalometric variables were evaluated with 2-way analysis of variance and the Bonferroni test. RESULTS: Maxillary position showed no significant differences between the male groups. The maxilla was more prognathic at stage 2 and became more retrognathic at stages 3 and 4 in the females. The mandible was more retrusive in the bilateral cleft lip and palate subjects at stage 1 in males and at stages 3 and 4 in females. ANB was larger at stages 1 and 2, and it became similar to the controls at stages 3 and 4 in male and female bilateral cleft lip and palate subjects. Vertical growth was seen in the bilateral cleft lip and palate subjects regardless of sex, and no change was observed with age. Posterior airway space was narrower in all stages (except for stage 1 in females). Middle airway space was wider after stage 1 in the male and female bilateral cleft lip and palate subjects. Inferior airway space was narrower in the male bilateral cleft lip and palate patients at the early childhood and pubertal stages. CONCLUSIONS: Age- and sex-dependent differences in skeletal morphology and upper-airway widths of the bilateral cleft lip and palate subjects were identified when compared with the control subjects without clefts.


Assuntos
Fenda Labial/fisiopatologia , Fissura Palatina/fisiopatologia , Ossos Faciais/crescimento & desenvolvimento , Faringe/crescimento & desenvolvimento , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Estudos de Casos e Controles , Cefalometria/métodos , Vértebras Cervicais/crescimento & desenvolvimento , Criança , Pré-Escolar , Fenda Labial/patologia , Fissura Palatina/patologia , Ossos Faciais/patologia , Feminino , Seguimentos , Humanos , Masculino , Mandíbula/crescimento & desenvolvimento , Mandíbula/patologia , Maxila/crescimento & desenvolvimento , Maxila/patologia , Faringe/patologia , Puberdade/fisiologia , Retrognatismo/patologia , Retrognatismo/fisiopatologia , Fatores Sexuais , Dimensão Vertical , Adulto Jovem
15.
Microsurgery ; 35(7): 553-9, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26303979

RESUMO

BACKGROUND: Oral contraceptives, which may lead to thrombotic events, are widely used drugs by women in reproductive age, some of whom might need emergent or elective microsurgical intervention. This study was planned to investigate the effects of combined oral contraceptives (COC) on arterial anastomosis patency in female rat model. METHODS: A third generation COC (ethinyl estradiol and desogestrel) was used in this study. A total of 50 female Wistar albino rats were included. The rats were divided into two groups. Experimental group received 0.03 mg ethinyl estradiol/0.15 mg desogestrel with gastric catheter for 20 days before the surgery. Afterward, the femoral arteries of all rats were divided and anastomosed. The patency of the anastomoses were assessed surgically (at 15 min, 7th day) and radiologically with Doppler ultrasonography (at 3rd and 7th days). The samples were examined using light microscopy, scanning electron microscopy (SEM), and transmission electron microscopy (TEM). RESULTS: The early patency assessed in the 15th min showed arterial flow in all rats. But at the 7th day 68% of the anastomosis were patent in the COC group while 100% of the anastomosis were patent in the control group as demonstrated surgically and radiologically (P = 0.004). Microscopic examination showed an increase in cytoplasmic organelles and activation of endothelial cells in all rats in the experimental group that received COCs. CONCLUSION: The present study demonstrated the negative effects of the use of COCs on anastomosis patency in rats.


Assuntos
Anticoncepcionais Orais Combinados/efeitos adversos , Desogestrel/efeitos adversos , Etinilestradiol/efeitos adversos , Artéria Femoral/efeitos dos fármacos , Artéria Femoral/cirurgia , Microcirurgia , Procedimentos Cirúrgicos Vasculares , Anastomose Cirúrgica , Animais , Anticoncepcionais Orais Combinados/administração & dosagem , Desogestrel/administração & dosagem , Etinilestradiol/administração & dosagem , Feminino , Artéria Femoral/patologia , Ratos , Ratos Wistar
16.
J Craniofac Surg ; 25(6): 1980-4, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25377956

RESUMO

Development of normal speech is the primary goal of successful palatoplasty. The purpose of this study was to determine the importance of the contribution of vomer flap to palatoplasty procedure for speech function. Eighty-one children who underwent 2 flap palatoplasty procedures for cleft palate repair between 2002 and 2010 were retrospectively reviewed in 3 groups. Group 1 underwent palatoplasty without contribution of vomer flap. Group 2 underwent palatoplasty with standard dissection of vomer flap, whereas group 3 underwent palatoplasty with extended dissection of vomer flap. Speech function of the patients was evaluated using objective assessment tools such as nasopharyngoscopy and nasometer. Eighty-one children who underwent 2 flap palatoplasty were included in this study. The mean age at palatoplasty was 10.17 months, and mean length of follow-up was 72.33 months. For most syllables, patients repaired using extended vomer flap demonstrated lower nasalance scores. Nasopharyngoscopic examination revealed velopharyngeal motility in 24 patients (80%) in group 1 and in 20 (83.3%) and 23 (85.2%) patients in groups 2 and 3, respectively (P = 0.930). In velopharyngeal closure, there were only 5 patients (18.5%) in group 3, whereas there were 6 patients (25.0%) for group 2 and 10 patients (33.3%) for group 1 with no closure (P = 0.311). Although most optimum results were observed in the group with extended dissection of the vomer flap, contribution of the extended vomer flap to the repair of the soft palate did not lead to significantly better speech results.


Assuntos
Fissura Palatina/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fala/fisiologia , Retalhos Cirúrgicos/cirurgia , Vômer/cirurgia , Dissecação/métodos , Endoscopia/métodos , Feminino , Seguimentos , Humanos , Lactente , Masculino , Mucosa Nasal/cirurgia , Nasofaringe/patologia , Palato Mole/fisiologia , Palato Mole/cirurgia , Faringe/fisiologia , Faringe/cirurgia , Estudos Retrospectivos , Resultado do Tratamento , Insuficiência Velofaríngea/diagnóstico , Voz/fisiologia
17.
Plast Reconstr Surg ; 133(4): 499e-510e, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24675202

RESUMO

BACKGROUND: This study investigated whether the in vivo osteogenic differentiation potential of adipose-derived mesenchymal stem cells is enhanced by 17ß-estradiol. METHODS: Thirty Sprague-Dawley rats were randomized and divided into five experimental groups. For the surgical procedure, biparietal full-thickness bone defects (7 mm in diameter) were created. A chitosan-hydroxyapatite scaffold was used as the vehicle system for 17ß-estradiol-loaded nanoparticles and adipose-derived mesenchymal stem cells. The first group, the blank defect group, was the control group. The defects were filled with either scaffold, estradiol, and scaffold; scaffold and adipose-derived mesenchymal stem cells; or estradiol, scaffold, and adipose-derived mesenchymal stem cells as experimental groups. The rats were killed at the end of weeks 4 and 12, and their calvariae were harvested for histologic and microtomographic evaluation. RESULTS: Micro-computed tomographic evaluation of estradiol, scaffold, and adipose-derived mesenchymal stem cells revealed the highest median value (82.59 ± 17.17), and the difference was significant compared with the blank defect group (p = 0.004). Histologic samples demonstrated a significant difference between experimental groups for bone defect repair at the end of weeks 4 and 12 (p = 0.003 and p < 0.001). The estradiol, scaffold, and adipose-derived mesenchymal stem cell group had the highest median score (3.00 ± 0.0) at week 12, which was significantly higher than scores for the scaffold and adipose-derived mesenchymal stem cell group and the blank defect group. CONCLUSION: 17ß-Estradiol appears to be a novel and promising agent for future cell-based bone tissue-engineering studies.


Assuntos
Estradiol/farmacologia , Células-Tronco Mesenquimais/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Osteogênese/fisiologia , Animais , Diferenciação Celular , Nanopartículas , Ratos , Ratos Sprague-Dawley , Engenharia Tecidual , Tecidos Suporte
18.
Cleft Palate Craniofac J ; 49(4): 494-7, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21740165

RESUMO

Asymmetric velopharyngeal incompetence (VPI) may be caused by neuromuscular disorders, trauma, tumor resection, cleft palate, or unilateral hypoplasia of the velum and pharynx. However, VPI due to isolated unilateral hypoplasia is extremely rare. In this case report, a 4-year-old girl with unilateral palate hypoplasia and her two-staged management is presented. The speech quality of the patient improved noticeably after these procedures. The first stage allowed us to make the second stage pharyngeal flap more conservatively than possible in a one-stage procedure. We think that this two-step procedure could be an alternative to other methods in the treatment of asymmetric VPI.


Assuntos
Palato/anormalidades , Palato/cirurgia , Insuficiência Velofaríngea/etiologia , Insuficiência Velofaríngea/cirurgia , Feminino , Humanos , Lactente , Retalhos Cirúrgicos
20.
J Craniofac Surg ; 21(5): 1645-7, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20856069

RESUMO

Congenital fusion of upper and lower jaw is rare. Only 35 bony syngnathia have been reported up to date, and 9 of them revealed posterior topography. A 10-day-old female infant with facial asymmetry, limited mouth opening, and cardiac murmurs is presented. The radiological findings revealed congenital bony fusion of right coronoid process of the mandible to posterior maxillary region and right palatal shelf agenesis of palatal bone, which seems to be the first case in the literature. Classification systems of bony syngnathia and applied treatment procedures for palatal closure and release of the bony fusion are discussed.


Assuntos
Mandíbula/anormalidades , Maxila/anormalidades , Anormalidades Maxilofaciais/cirurgia , Palato Mole/anormalidades , Zigoma/anormalidades , Anormalidades Múltiplas/cirurgia , Feminino , Humanos , Recém-Nascido , Mandíbula/cirurgia , Maxila/cirurgia , Micrognatismo/cirurgia , Palato Mole/cirurgia , Zigoma/cirurgia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA