The role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the role of the expression of PPAR-gamma gene in the adipogenesis in hemangioma evolution.</p><p><b>METHODS</b>Routine immunohistochemistry staining of Perilipin A, the marker antigen of adipocytes, was performed to observe the adipogenesis in hemangioma. Immunofluorescence staining of PPAR-gamma, the important transcription factor in promoting adipogenesis, was carried out to observe its location in hemangioma tissue, with the co-staining of alpha-SMA and CD31. And RT-PCR was used to examine the expression of PPAR-gamma gene in hemangioma in different stages.</p><p><b>RESULTS</b>In the evolution of hemangioma, the number of adipocytes increased continuously. And the tumor was replaced by fibrofatty tissue finally. PPAR-gamma was located in the nuclei of perivascular cell in hemangioma tissue. The expression of PPAR-gamma gene in hemangioma increased in the evolution of hemangioma, but still was lower than that in normal fat tissue from children.</p><p><b>CONCLUSION</b>The expression of PPAR-gamma in the perivascular cells suggests that they may contribute to the adipogenesis in hemangioma involution.</p>

Orbicular oris muscle flap wrapped by acellular dermis for the treatment of upper lip atrophy in children / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the treatment of upper lip atrophy resulted by previous therapy.</p><p><b>METHODS</b>From Mar. 2008 to Mar. 2012, 4 cases with upper lip atrophy resulted by radiotherapy and sclerosing agent injection were treated with lower orbicularis oris muscle flap wrapped by acellular dermis. The thickness and height of upper lip were increased to improve the lip atrophy.</p><p><b>RESULTS</b>Primary wound healing was achieved in all the 4 cases. All the patients were followed up for 3 years with obvious improvement and inconspicuous scar.</p><p><b>CONCLUSION</b>The volume of lower lip in children is not sufficient as donor site. The lower orbicularis oris muscle flap wrapped by acellular dermis can effectively improve the lip thickness and vermilion portion of upper lip.</p>

Segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the segmental monobloc osteotomy and bi-directional distraction for the treatment of Crouzon syndrome in an infant.</p><p><b>METHODS</b>A 9-month-old female infant underwent monobloc osteotomy through combined intra- and extra-cranial way. The facial skull was divided into frontal, orbital and maxillary segments. The external distractor was used to move the frontal segment, orbital segment and midface forward. The internal distractor was used to move the maxilla downward. The consolidation lasted for 3 months after distraction.</p><p><b>RESULTS</b>The osteotomy and distraction were successfully completed. The distraction distance reached 18 mm, showing by distractor. The real distraction distance of facial bone was 12 mm, documented by 3-D image. The skull deformity and severe depression of midface improved a lot. The exophthalmos and underbite were corrected. The obstructive sleep apnea also improved markedly. However, the downward movement of maxilla was limited.</p><p><b>CONCLUSIONS</b>Monobloc osteotomy with external distractor, as well as maxillary distraction, could be used for Crouzon syndrome in infant. It is safe and effective method which can be performed in an early age for Crouzon syndrome with obstructive sleep apnea.</p>

Treatment of airway obstruction with mandibular distraction osteogenesis in Pierre Robin syndrome / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility of mandibular distraction osteogenesis (MDO) in the treatment of airway obstruction in Pierre Robin syndrome (PRS).</p><p><b>METHODS</b>From 2007 to 2009, 8 newborns with PRS were treated with MDO. The mandibular distractors were fixed after bilateral oblique mandibular osteotomy. The distraction was started one day after operation, three times a day. The distraction distance was 1.2 mm per day until it reached about 12 -20 mm (mean 15 mm).</p><p><b>RESULTS</b>The distraction was successfully completed in 8 cases with no complication. The distraction distance reached 15 mm, as we expected. The discontinuity cyanosis, inspiratory dyspnea, dystithia were improved after distraction.</p><p><b>CONCLUSIONS</b>MDO is feasible and safe for the treatment of airway obstruction in PRS.</p>

Management of congenital scalp defects in infants / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the management of congenital scalp defects in infants.</p><p><b>METHODS</b>From 1996 to 2008, 6 infants with congenital scalp defects were treated with dressing change, flap transposition, or tissue expansion combined with skull defect reconstruction.</p><p><b>RESULTS</b>Parietal scalp defects in 6 cases were healed after treatment. 5 cases were followed up for 3 months to one year. 2 cases had scalp alopecia in some areas. The scar was inconspicuous in the other 3 cases.</p><p><b>CONCLUSIONS</b>Dressing change is suitable for small scalp defect, while flap transposition should be used for medium defect. For large full-thickness cranial defect, dressing change and tissue expansion should be performed at the first stage, followed by skull defect reconstruction and expanded flap transposition.</p>

Diagnosis and treatment of children sinus pericranii / 中华整形外科杂志

<p><b>OBJECTIVE</b>To discuss the diagnosis and treatment of children sinus pericranii (SP).</p><p><b>METHODS</b>From Jan. 2000 to Dec. 2008, 12 cases of SP were treated. The clinical data and CT results were studied. If the SP had no communication with the intracranial vessels, DSA was performed to know its venous drainage. The operation procedures included excision of bump, followed by hemostasis. Then the local flap was used to cover the cranial defect.</p><p><b>RESULTS</b>12 cases all had scalp bump whose size was changed with body position. Three-dimensional CT showed a crater-like depression and multiple honeycomb diploic holes in the skull. 6 cases with venous malformation received DSA. 12 patients were operated.</p><p><b>CONCLUSIONS</b>SP can be diagnosed with typical CT results and symptoms. DSA should be performed if the communication with the intracranial vessels is existed. The main methods include operation, embolization and reserved observation. Medicine injection is not recommended due to the high risk.</p>