Soft Tissue Alterations Research Articles

BMP5 and the Molecular, Skeletal, and Soft-Tissue Alterations in short ear Mice

Mutations at the mouse short ear (se) locus alter the formation and repair of skeletal structures and the development of several soft tissues. Most of the developmental effects of the gene have been studied using a spontaneous mutation reported over 70 years ago. Here we show that this mutation consists of a nonsense mutation in a secreted signaling molecule called bone morphogenetic protein 5 (BMP5). This small sequence alteration, in combination with previously reported translocation and deletion mutations, provides strong genetic evidence that BMP5 is the normal product of the se locus. Transcripts from the Bmp5 gene are expressed at the earliest stages of normal skeletal development in patterns that closely resemble the shapes of forming skeletal elements. The gene is also expressed at several sites of soft tissue abnormalities previously reported in se animals, including lungs, liver, ureter, bladder, and intestines. The combined genetic, biochemical, and expression data suggest that BMP5 is a key signal used to initiate formation of particular skeletal elements and is required for normal development of several soft tissues as well.

Teratology Study of a Cross-Linked Polyacrylate Superabsorbent Polymer

The developmental toxicity (embryo-fetal toxicity/teratogenicity) of FAVOR SAB-922 SK, cross-linked polyacrylate superabsorbent (PAS), administered as an inhaled dust in concentrations of 0.3, 1.0, and 10.0 mg/m3 for 6 h/day from day 6 through day 15 of gestation was investigated in time-mated Sprague-Dawley rats. On day 20 of presumed gestation, the rats were asphyxiated with carbon dioxide, necropsied, and examined for pregnancy. Gravid uteri were examined for the number and status of implants, early and late resorptions, live and dead fetuses, and the number of corpora lutea in each ovary. Fetuses were weighed, sexed, and examined for external, soft tissue, and skeletal alterations. There were 315, 297, 299, and 286 liveborn fetuses from 25, 25, 23, and 24 litters in the four respective groups. Fetal processing and evaluations were conducted in compliance with FDA “Good Laboratory Practice Regulations; Final Rule.” The results indicate that breathing PAS in concentrations as high as 10 mg/m3 did not cause statistically significant or biologically important differences in dam body weight, caesarean-sectioning or litter data or the incidences of gross external, soft tissue or skeletal alterations, as compared with the control group values. No alterations believed to be related to PAS occurred in the fetuses of dams exposed to PAS at incidences that exceeded the ranges reported historically. Based on these data, both the developmental and maternal no-observable-effect-levels (NOEL) were greater than the dosage inhaled by rats exposed to the 10 mg/m3 concentration of respirable particulate PAS.

Upper airway obstruction in the syndromal craniosynostoses

This series of consecutive cases details the prevalence and management of upper airway obstruction in the syndromal craniosynostoses (Crouzon, Apert and Pfeiffer syndromes). Upper airway obstruction presents more frequently in Crouzon and Pfeiffer syndrome when presenting early and during the intermediate years. Those patients with Apert syndrome appear relatively free of this problem. Management has been directed toward increasing the size of the nasopharyngeal space by soft tissue alterations (uvulopalatopharyngoplasty, soft palatal split and adenotonsillectomy) with success. Le Fort III advancement osteotomy has been reserved for those more extreme cases, again with objective airway improvement. These techniques have removed the necessity for the progression to tracheostomy in these cases.

Soft-tissue alterations associated with acute, extended open reduction and internal fixation or orbital fractures.

Soft-tissue alterations associated with radical degloving of the overlying soft tissues during extended open reduction and rigid internal fixation of facial fractures involving 51 orbits in 36 patients were studied. In all patients, the blepharoplasty skin muscle flap incision was employed in conjunction with, as necessary, a gingivobuccal sulcus and coronary incisions. Patients were evaluated between 6 and 20 months after surgery. Physical examination and standardized photographs were used for assessment. Ectropion developed in 2 lids (4%), and 10 lids (20%) had increased scleral show. Thirteen of the 51 lids (25%) revealed lateral canthal displacement; all 13 lids underwent canthal stripping. Cheek pad displacement developed in 8 patients (22%), all of whom had complete maxillary degloving without soft-tissue resuspension. No patient had frontal nerve palsy. Depression in the temporal area was noted in all patients in whom the temporalis was mobilized. Remote incisions and soft-tissue degloving used for extended open reduction and internal fixation are associated with morbidity that can be minimized by meticulous technique and soft-tissue repositioning at closure.

Imaging of the Hip Joint

The authors reviewed the applications and limitations of computed tomography (CT) and magnetic resonance (MR) imaging in the assessment of the most common hip disorders. Magnetic resonance imaging is the most sensitive technique in detecting osteonecrosis of the femoral head. Magnetic resonance reflects the histologic changes associated with osteonecrosis very well, which may ultimately help to improve staging. Computed tomography can more accurately identify subchondral fractures than MR imaging and thus remains important for staging. In congenital dysplasia of the hip, the position of the nonossified femoral head in children less than six months of age can only be inferred by indirect signs on CT. Magnetic resonance imaging demonstrates the cartilaginous femoral head directly without ionizing radiation. Computed tomography remains the imaging modality of choice for evaluating fractures of the hip joint. In some patients, MR imaging demonstrates the fracture even when it is not apparent on radiography. In neoplasm, CT provides better assessment of calcification, ossification, and periosteal reaction than MR imaging. Magnetic resonance imaging, however, represents the most accurate imaging modality for evaluating intramedullary and soft-tissue extent of the tumor and identifying involvement of neurovascular bundles. Magnetic resonance imaging can also be used to monitor response to chemotherapy. In osteoarthrosis and rheumatoid arthritis of the hip, both CT and MR provide more detailed assessment of the severity of disease than conventional radiography because of their tomographic nature. Magnetic resonance imaging is unique in evaluating cartilage degeneration and loss, and in demonstrating soft-tissue alterations such as inflammatory synovial proliferation.

Salivary function of persons with hereditary epidermolysis bullosa

Oral alterations of the hard and/or soft tissues are commonly associated with the different types of epidermolysis bullosa (EB). The relationship of oral soft and hard tissue changes to the disease mechanisms in different EB types remains to be elucidated. The purpose of this investigation was to evaluate selected aspects of salivary function in a healthy control population and in persons affected with different types of EB. Sixty-one patients with EB, representing all the major types of EB, and 36 unaffected persons were examined to measure their stimulated salivary flow rates and salivary levels of IgA, albumin, and total protein. Our results show that none of the types of EB demonstrated a decreased salivary flow rate. However, patients with recessive dystrophic EB had significantly elevated salivary IgA, albumin, and total protein levels. The increased IgA level seen in this form of EB appears most likely to be related to the high prevalence of oral blistering rather than the result of altered mucosal immune function. Despite severe cutaneous and extracutaneous involvement associated with inherited EB, we found no evidence to support the hypothesis of abnormal salivary function or mucosal immunity in this disease. Taken together, these findings suggest that the rampant dental caries seen in the severe forms of EB are likely attributable to nonsalivary factors such as enamel involvement, soft tissue alterations, and/or diet. Alternatively, there may be mucosal immunity or salivary enzyme alterations that influence oral disease in these patients, but these were not evaluated in this investigation.

Methods and applications of three-dimensional imaging in orthopedics

Computed tomography is a commonly used technique for detecting pathological alterations in soft tissues and the skeleton. Three-dimensional images of the skeleton are very useful for planning surgical treatment and monitoring therapy, but unfortunately mental reconstruction of complex three-dimensional anatomical structures from conventional tomography is very difficult. This article describes a process by which automated analysis of the regions of interest in the computed tomographic (CT) images yields the contours of the surfaces which can be presented pseudo-three-dimensionally using Phong's lighting model and Gouraud's shading methods. Three applications in the areas of orthopedics and neurosurgery demonstrate the efficacy of the method.

Developmental Toxicity Study of Orally Administered Lithium Hypochlorite in Rats

The purpose of this study was to examine the developmental toxicity of lithium hypochlorite in Sprague-Dawley rats. Groups of 25 pregnant rats received lithium hypochlorite at dosages of 0 (vehicle-reverse osmosis deionized water), 10, 50, 100, or 500 mg/kg/day, via oral gavage once daily on days 6 through 15 of gestation. The test solution was not adjusted for ion concentration. All dosages were given at a volume of 10 m/kg per day, adjusted daily for body weight. The rats were given RO deionized water for drinking, to prevent ingestation of chlorine or any other ions except those provided by the test substance. Clinical signs, body weight, and feed consumption were recorded daily during the dosage and postdosage periods. Caesarean-sectioning of the rats occurred on day 20 of gestation. Evaluations were made for pregnancy, number and placement of implantations, early and late resorptions, fetal viability, and number of corpora lutea. Fetuses were subsequently examined for gender, body weight, and gross external, soft tissue, and skeletal alterations. Significant (p ≤ 0.05 to p ≤ 0.01) maternal toxicity was observed in the 500 mg/kg per day dosage group, which included maternal death, clinical signs, gross necropsy findings, and inhibited maternal body weight gain and feed consumption. These effects were consistent with those expected from chlorine toxicity. The only effects of this dosage on embryo-fetal development were small reversible delays in growth (decreased fetal body weight, wavy ribs and delayed ossification of the thoracic vertebrae (bifid centra), forepaw and hindpaw phalanges, and metatarsal and metacarpal bones). Average values for corpora lutea, implantation sites, litter sizes, live and dead fetuses, and resorptions were comparable in the five dosage groups andlor were within the range observed historically. On the basis of these data, both the maternal no-observable-adverse-effect level (NOAEL) and the developmental NOAEL for lithium hypochlorite were 100 mg/kg per day. These data are in agreement with other studies and demonstrate that developmental toxicity of lithium hypochlorite does not occur in the absence of overt maternal toxicity.

Magnetic resonance imaging (MRI): a new tool in experimental toxicologic pathology.

Magnetic Resonance Imaging (MRI) is a noninvasive imaging technique that provides multidimensional images of the soft tissues of the body. This imaging technique has proven to be an excellent diagnostic and experimental tool for the detection of pathologic alterations in soft tissues, as well as an adjunct screening method for following the genesis, progression, or regression of chemically induced lesions in the same live animal. Future applications of MRI technology in small animals include MRI microscopy, mapping of vascular or circulatory alterations, measurement of perfusion and diffusion rates of body fluids, and acquisition of cell metabolic states in combination with Nuclear Magnetic Resonance (NMR) spectroscopy, all of which will contribute immensely to the advancement of toxicologic and biomolecular research.

Precision rhinoplasty. Part II: Prediction.

This retrospective study was undertaken to investigate the soft-tissue response rate to the skeletal and soft-tissue alterations following a rhinoplasty. Ninety-eight patients, 80 females and 18 males, with a mean follow-up of 13 months, were included in this study. The tracings of the outline of preoperative cephaloxerograms and life-size photographs were superimposed on the postoperative ones, and the differences were measured and confirmed with measurements of intraoperative resected segments. The soft-tissue response to skeletal alterations was measured in seven different zones. Zone 1 (nasion) and zone 7 (nasal spine area) had the lowest mean response rate of approximately 25 percent. Zone 2 (proximal bridge) and zone 3 (midbridge) had a 60 percent response rate. Zone 4 (supratip area) had a 43 percent response, zone 5 had a 41 percent response, and zone 6 had a 40 percent response rate. There were statistically significant differences among the response rates of thick, medium, and thin noses. Age was an important factor in zones 1, 4, 5, 6, and 7. The patient's sex did not influence the soft-tissue response rate to skeletal alterations. The soft-tissue response in relation to the alar base narrowing was about 52 percent. This study reveals a predictable soft-tissue response to skeletal alterations on all zones except zone 7 (nasal spine area).

Implications of Smokeless Tobacco Use Among Athletes.

In brief: This literature review delineates the current status of smokeless tobacco. It discusses the prevalence and terminology as well as periodontal effects, buccal mucosal and soft-tissue alterations, leukoplakia, cancer, carcinogenic components, hemodynamic alterations, and potential addiction. It is clear that physicians and dentists should discourage their patients from using smokeless tobacco. Young people particularly may be influenced by popular sports figures and celebrities who convey the erroneous impression that smokeless tobacco is harmless.

The wrist: a preliminary report on high-resolution MR imaging.

Excellent spatial resolution is required to demonstrate the complex region of the wrist, with its diverse structures comprising bone, cartilage, and ligaments. Magnetic resonance (MR) imaging was done with a Magnetom imaging system operating at 1.0 T. Use of a flat surface coil enabled excellent spatial resolution and a section thickness of 4 mm. Twenty-nine patients with navicular nonunion or pseudarthrosis, rheumatoid arthritis, recent fractures, soft-tissue alterations, and bone tumors were examined. All patients had undergone radiography and bone scintigraphy. In this limited sampling, MR was found to detect and characterize marrow and articular alterations more accurately, and earlier, than either of those modalities.

The histology of periapical inflammatory lesions in permanent molars in monkeys

Pulpal necrosis was induced by opening the chambers for 1 wk and then sealing them with amalgam. This consistently produced periapical pathosis. The nature of this pathosis was studied as well as the prominent direction of spread of inflammation. Histological examination showed that the inflammation tended to move most frequently toward the furcation. Hard tissue resorption and soft tissue alterations occurred consistently; the periodontal ligament seemed to be resistant to the spread of inflammation, which tended to move through the marrow. The nature of the lesion was predominantly of two cell types with a predominance of macrophages and neutrophilic leukocytes.

CT of thyroglossal duct cysts.

A retrospective analysis of surgically proved cases of thyroglossal duct cysts was performed in an attempt to determine the characteristics of these lesions using computed tomography (CT). We evaluated 12 preoperative cases and two cases with postoperative complications. Ten patients with lesions that could be confused either clinically or radiographically with these cysts were also evaluated to develop a systemized radiologic differential diagnostic approach for the evaluation of anterior triangle neck lesions. CT enables the differentiation of thyroglossal duct cysts from other anterior triangle lesions based on location, CT values, and alterations in the adjacent soft tissues.

Oral tissue alterations associated with the use of smokeless tobacco by teen-agers: Part I. Clinical findings

The use of smokeless tobacco appears to be finding its way onto middle school, high school, and college campuses as a socially acceptable and popular habit. Numerous reports in the literature have described the oral changes that appear to be associated with the use of smokeless tobacco in adults. Such information is unavailable for the lower age groups. A study was therefore undertaken to determine the prevalence and frequency of oral hard- and soft-tissue alterations associated with the use of smokeless tobacco in a teen-age population. High school students in grades 9 to 12 were evaluated on a random basis. From a total sample of 1,119 students, 117 users of smokeless tobacco were identified. Four distinct lesions associated with smokeless tobacco use were identified clinically: (1) hyperkeratotic or erythroplakic lesions of the oral mucosa, (2) gingival or periodontal inflammation, (3) a combination of oral mucosal lesions and periodontal inflammation, and (4) cervical erosion of the teeth. Among the smokeless tobacco users. 113 were boys and 4 were girls. Fifty-seven (48.7 percent) of the users had soft-tissue lesions and/or periodontal inflammation or erosion of dental hard tissues. Ninety-nine of the 117 users were Caucasian, 6 were Hispanic, 1 was black, 1 was Asian, 1 was an American Indian, and 6 failed to identify an ethnic origin. Use ranged from one to twenty “dips” per day, with an average time per dip of 30 minutes. Most users had been dipping for an average of 2 years, and twelve different tobacco brands were identified.

1,25-Dihydroxyvitamin D3 injections into rat fetuses : effects on fetal plasma calcium, plasma phosphate and mineral content

The in vivo effects of 1,25-(OH)2D3 were assessed using fetuses from normal and thyroparathyroidectomized (TPTX) pregnant rats. 21.5-day old decapitated fetuses from TPTX mothers exhibited lowered basal plasma calcium, elevated basal plasma phosphate and an increased percentage of total ash compared to intact littermates. In decapitated fetuses from normal mothers, neither plasma calcium nor plasma phosphate was changed. Subcutaneous injection of 1 micrograms of 1,25-(OH)2D3/kg of body weight to 19.5-day old fetuses (intact or deprived of their parathyroid glands by decapitation) from TPTX mothers induced a marked rise in plasma calcium levels (2.01 and 3.66 mg/dl, respectively) 48 h later. Little change occurred in fetuses from normal mothers (1.06 mg/dl in decapitated and no change in intacts). A decrease in plasma phosphate levels was observed with the same dose in both decapitated and intact fetuses from TPTX mothers (- 1.39 and - 0.65 mg/dl, respectively), while no modification was found in fetuses from normal females. Therefore, the hypersensitivity of fetuses from TPTX mothers to 1,25-(OH)2D3 was unrelated to the development of the fetal hyperparathyroidism secondary to maternal TPTX. The percentage of ash was unchanged in decapitated fetuses from TPTX mothers and was increased in intact littermates after 1,25-(OH)2D3 treatment. However, these values for total ash may represent alterations in bones and/or soft tissues.

Follow-up examinations: 30 years of Imhäuser clubfoot treatment.

The author describes his own methods of clubfoot treatment used over 30 years on more than 2,000 children. Correction of form and restoration of function are the two goals of the orthopaedic surgeon. Early treatment consists of closed reduction of forefoot deformity and of varus of the heel, and of operative correction of equinus deformity. Function is restored by a training program developed and introduced by the author for evertors and dorsiflexor muscles. Treatment starting at a later age must take into consideration that in the course of time increasing deformity of all bones and joints as well as marked alterations of soft tissues occur. In these cases closed measures are ineffective and operative measures necessary. After straightening the foot operatively, it is necessary to maintain the normalized position by means of an exterior removable plastic cast until the translocated tibialis anterior muscle can fulfil this task. The later the clubfoot is treated, the longer the period for which these casts are required. The author reexamined nearly 400 feet of adults whom he had treated during their baby or childhood years. The late results of three groups are demonstrated: (a) cases treated before the age of 2; (b) cases treated between 2 and 7 years; (c) cases treated at the age of 7 years or later. Good late results were observed in a surprisingly high percentage of the cases. The author's method--based on a pathophysiological approach--seems to represent real progress in the treatment of idiopathic clubfeet.

Soft tissue abnormalities at fracture of the scaphoid.

In a retrospective examination of the films from 53 cases with fracture of the scaphoid it was possible to demonstrate soft tissue alterations within the scaphoid fossa. All these cases were examined adequately, i.e. with correct projections and satisfactory penetrating exposure. A somewhat higher quality of the views was obtained on industrial film.

The retrorectal space

Ninety-nine adults with an enlarged retrorectal space on barium enema examination have been evaluated. Measurements were based on previously described methods using the lateral view of the barium filled rectum. In 38.4% of the cases there was no lesion (normal variations). The rest were classified as inflammatory conditions, tumours, and miscellaneous lesions. It is concluded that an increased width of the presacral space per se does not necessarily connote a lesion. Pathological widening of the space is usually associated with changes of the contour of the rectum, abnormalities of the sacrum, or other alterations of the presacral soft tissues.

New horizons in the diagnosis of skeletal and soft tissue alterations of the head and neck by means of xeroradiography

New horizons in the diagnosis of skeletal and soft tissue alterations of the head and neck by means of xeroradiography