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Tissue Overlying (tissue + overlying)
Selected AbstractsA Method of Augmenting the Cheek Area Through SMAS, subSMAS, and Subcutaneous Tissue Recruitment During Facelift SurgeryDERMATOLOGIC SURGERY, Issue 3 2003Dominic A. Brandy MD BACKGROUND As the human face ages, there is a depletion of fat that occurs in the submalar region. Various techniques such as fat transfers, fillers, alloplastic implants, and composite rhytidectomies have been used to augment this area in the past. OBJECTIVE To describe a technique that augments the submalar areas during facelift surgery without the use of fat transfer, fillers, alloplastic implants, or a risky composite technique. METHOD An oval is scribed over the depressed submalar areas preoperatively. During facelift surgery, a fusiform area is scribed over the SMAS. This fusiform is scribed so that the medial end is directed at the center of the submalar depression, and the lateral end is toward the posterior earlobe. A defect is created within the lateral aspect of the fusiform, but not the medial portion. The fusiform is subsequently closed with a 2-0 Ethibond suture using three horizontal mattress sutures and two interrupted sutures. Upon closure of this defect, SMAS, subSMAS, and subcutaneous tissue overlying the SMAS are recruited into the submalar defect by the simple phenomenon of dog-ear formation. Additionally, there is a component of frank elevation of the tissues inferior to the medial aspect of the fusiform and submalar space. RESULTS The aforementioned technique has been performed on 123 patients over 7 years and has resulted in consistently good improvement in the submalar space. The procedure is not difficult to learn, and good results can be achieved with initial cases. The learning curve was not found to be steep, with good results being achieved quickly. CONCLUSION Depression of the submalar space plays a significant role in creating an aged face. In the past, various fillers and/or alloplastic implants have been used to augment this region. A low-risk method is described that mobilizes SMAS, subSMAS, and subcutaneous tissues into the submalar space through the phenomenon of dog-ear formation after fusiform closure. [source] Characterization of cartilagenous tissue formed on calcium polyphosphate substrates in vitroJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 3 2002Stephen D. Waldman Abstract Successful joint resurfacing by tissue-engineered cartilage has been limited, in part, by an inability to secure the implant to bone. To overcome this, we have developed the methodology to form a cartilage implant in vitro consisting of a layer of cartilagenous tissue overlying a porous, biodegradable calcium polyphosphate (CPP) substrate. As bone will grow into the CPP after implantation, it will result in anchorage of the cartilage. In this study, the cartilagenous tissue formed in vitro after 8 weeks in culture was characterized and compared to native articular cartilage. Light microscopic examination of histological sections showed that there was a continuous layer of cartilagenous tissue on, and integrated with the subsurface of, the CPP substrate. The in vitro -formed tissue achieved a similar thickness to native articular cartilage (mean ± SEM: in vitro = 0.94 ± 0.03 mm; ex vivo = 1.03 ± 0.01 mm). The cells in the in vitro -formed tissue synthesized large proteoglycans (Kav ± SEM: in vitro = 0.27 ± 0.01; ex vivo = 0.27 ± 0.01) and type II collagen similar to the chondrocytes in the ex-vivo cartilage. The in vitro -formed tissue had a similar amount of proteoglycan (GAG ,g/mg dry wt.: in vitro = 198 ± 10; ex vivo = 201 ± 13) but less collagen than the native cartilage (hydroxyproline ,g/mg dry wt.: in vitro = 21 ± 1; ex vivo = 70 ± 8). The in vitro -formed tissue had only about 3% of the load-bearing capacity and stiffness of the native articular cartilage, determined from unconfined mechanical compression testing. Although low, this was within the range of properties reported by others for tissue-engineered cartilage. It is possible that the limited load-bearing capacity is the result of the low collagen content and further studies are required to identify the conditions that will increase collagen synthesis. © 2002 Wiley Periodicals, Inc. J Biomed Mater Res 62:323,330, 2002 [source] Pacinian corpuscle in the juxtaoral organ of ChievitzJOURNAL OF ORAL PATHOLOGY & MEDICINE, Issue 7 2004Fumio Ide The juxtaoral organ of Chievitz (JOOC) is a normal permanent anatomical structure located within the soft tissue overlying the angle of the mandible in the buccotemporal space. Although the sensory organ nature of JOOC, repeatedly mentioned in German publications, has been neglected in the last decade by the American anatomists and pathologists, we incidentally found JOOC-type squamous epithelium accompanied by Pacinian corpuscles. This fortuitous finding appears to be the first report of the authentic Paciniform nerve endings within JOOC, supporting its mechanosensory function. [source] Antiepileptic Drugs in the Management of Cluster Headache and Trigeminal NeuralgiaHEADACHE, Issue 2001Todd D. Rozen MD Cluster headache and trigeminal neuralgia are relatively rare but debilitating neurologic conditions. Although they are clinically and diagnostically distinct from migraine, many of the same pharmacologic agents are used in their management. For many patients, the attacks are so frequent and severe that abortive therapy is often ineffective; therefore, chronic preventive therapy is necessary for adequate pain control. Cluster headache and trigeminal neuralgia have several distinguishing clinical features. Cluster headache is predominantly a male disorder; trigeminal neuralgia is more prevalent in women. Individuals with cluster headaches often develop their first attack before age 25; most patients with trigeminal neuralgia are between age 50 and 70. Cluster headaches are strongly associated with tobacco smoking and triggered by alcohol consumption; trigeminal neuralgia can be triggered by such stimuli as shaving and toothbrushing. Although the pain in both disorders is excruciating, cluster headache pain is episodic and unilateral, typically surrounds the eye, and lasts 15 to 180 minutes; the pain of trigeminal neuralgia lasts just seconds and is usually limited to the tissues overlying the maxillary and mandibular divisions of the trigeminal nerve. Cluster headache is unique because of its associated autonomic symptoms. Although the pathophysiology of cluster headache and trigeminal neuralgia are not completely understood, both appear to have central primary processes, and these findings have prompted investigations of the effectiveness of the newer antiepileptic drugs for cluster headache prevention and for the treatment of trigeminal neuralgia. The traditional antiepileptic drugs phenytoin and carbamazepine have been used for the treatment of trigeminal neuralgia for a number of years, and while they are effective, they can sometimes cause central nervous system effects such as drowsiness, ataxia, somnolence, and diplopia. Reports of studies in small numbers of patients or individual case studies indicate that the newer antiepileptic drugs are effective in providing pain relief for trigeminal neuralgia and cluster headache sufferers, with fewer central nervous system side effects. Divalproex has been shown to provide effective pain control and to reduce cluster headache frequency by more than half in episodic and chronic cluster headache sufferers. Topiramate demonstrated efficacy in a study of 15 patients, with a mean time to induction of cluster headache remission of 1.4 weeks (range, 1 day to 3 weeks). In the treatment of trigeminal neuralgia, gabapentin has been shown to be effective in an open-label study. When added to an existing but ineffective regimen of carbamazepine or phenytoin, lamotrigine provided improved pain relief; it also may work as monotherapy. Topiramate provided a sustained analgesic effect when administered to patients with trigeminal neuralgia. The newer antiepileptic drugs show considerable promise in the management of cluster headache and trigeminal neuralgia. [source] Eruption cyst formation associated with cyclosporin AJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 5 2003A case report Abstract Background: Cyclosporin A (CyA) is a potent immunomodulatory agent with a wide range of applications. Despite its therapeutic value, multiple adverse effects of CyA have been identified. This case report describes eruption cyst formation as a possible adverse effect of CyA administration during tooth eruption in a boy treated with CyA as a consequence of a cardiac transplantation. The clinical diagnosis of eruption cyst was confirmed by histopathological examination. Treatment: The periodontal treatment consisted of supragingival and subgingival scaling, followed by surgical removal of the tissues overlying the crowns of the teeth associated with eruption cysts, and flap surgery in the region of gingival overgrowth. The patient was then placed on quarterly periodontal supportive therapy and his immunosuppressive medication was switched from CyA to tacrolimus. Results: Twenty months after therapy, neither new cyst formation nor recurrence of gingival overgrowth was registered. Conclusion: Formation of an eruption cyst may be an adverse effect of CyA in children with erupting teeth. Zusammenfassung Hintergrund: Cyclosporin A (CyA) ist potentes immunmodulierendes Pharmakon mit einer breiten Applikationsmöglichkeit. Unabhängig von seinem therapeutischen Wert sind multiple Nebeneffekte von CyA beschrieben worden. Dieser Fallbericht beschreibt die Bildung einer Zyste beim Zahndurchbruch als eine mögliche Nebenwirkung von CyA Medikation bei einem Jungen, der mit CyA wegen einer Herztransplantation behandelt wurde. Die klinische Diagnose der Zystenbildung wurde histopathologisch bestätigt. Behandlung: Die parodontale Behandlung bestand in supragingivaler und subgingivaler Zahnreinigung gefolgt von der chirurgischen Entfernung des die Zahnkronen überdeckenden Gewebes, was mit der Zystenbildung verbunden war, und der Lappenchirurgie in der Region der gingivalen Wucherung. Der Patient wurde dann in das vierteljährliche parodontale Recall übernommen, und seine immunsuppressive Medikation wurde von CyA zu Tacrolimus verändert. Ergebnisse: 20 Monate nach der Therapie wurde weder eine neue Zystenbildung noch eine Wiederkehr der gingivalen Wucherung registriert. Schlussfolgerung: Die Bildung einer Durchbruchszyste kann eine Nebenwirkung bei der CyA Medikation bei Kindern während des Zahndurchbruchs sein. Résumé La cyclosporine A (CyA) est un agent immuno-modulateur puissant avec un large éventail d'applications. Malgré sa valeur thérapeutique, de multiples effets secondaires CyA ont été identifiés. Ce rapport de cas décrit une formation de kystes d'éruption qui pourrait être un effet secondaire possible de l'administration de CyA durant l'éruption dentaire chez un garçon traité par CyA à la suite d'une transplantation cardiaque. Le diagnostic clinique du kyste d'éruption a été confirmé par l'histopathologie. Le traitement parodontal a consisté en détartrage et surfaçage suivis par l'enlèvement chirurgical des tissus recouvrant les couronnes des dents associés aux kystes d'éruptions, et une chirurgie par lambeaux dans la région d'accroissement gingivale. L'enfant a bénéficié d'un suivi parodontal trimestriel et sa médication immunosuppressive est passée du CyA au tacrolimus. Vingt mois après le traitement, ni la formation de kystes ni la réapparition d'hypertrophie gingivale n'a été enregistrée. La formation de kystes d'éruption pourrait donc être un effet secondaire de l'utilisation de la CyA chez les enfants au moment de l'éruption des dents. [source] | ||||||||||