OBJECTIVETo introduce our experience in diagnosis and treatment of 33 patients with Tessier craniofacial clefts.

METHODS33 patients with craniofacial clefts were classified by Tessier classification. According to the type and severity of the clefts, various techniques, from simple local flap transfer to complicated osteotomy and bone grafting were used to correct the deformity in 29 patients.

RESULTSAll patients who underwent corrective operation were satisfied with the result, and there were no complications.

CONCLUSIONS(1) Tessier classification is very important for plastic surgeon to find potential craniofacial deformities related to main signs. (2) No. 7 cleft is one of most common Tessier craniofacial clefts. (3) Each Tessier cleft is unique, therefore, the treatment plans cannot be standardized. Specific corrective operation must be performed on each patient according to the type and severity of the cleft, including simple local flap transfer to complicated osteotomy and bone grafting or distraction osteogenesis.

Craniofacial Abnormalities ; classification ; diagnosis ; surgery ; Humans

OBJECTIVETo investigate the expression of Fas/FasL in infantile hemangiomas and discuss the role of Fas/FasL in the pathologic evolution of infantile hemangioma.

METHODThe EnVision immunohistochemical stain and RT-PCR technique was used to examine the expression of Fas/FasL protein and mRNA in the infantile hemangiomas.

RESULTS(1) In the early and middle proliferating stage, a number of infantile hemangioma cells expressed Fas. In the late proliferating stage, the number of positive cells increased obviously and the expression of Fas mRNA was reaching the strongest level. In the early regressing stage the Fas still existed in some cells and after that the expression decreased quickly. (2) Up to the middle proliferating stage, there were a few of FasL(+) cells foound. In the late proliferating stage, the number of FasL(+) cells increased significantly. From the early regressing stage, the number of FasL(+) cells decreased rapidly and disappeared.

CONCLUSIONThere may exist significant correlation between the expression of Fas/FasL and the development of the infantile hemangioma cells. The apoptosis of the infantile hemangioma cells mediated by Fas/ FasL may be the major reason of the spontaneous involution of infantile hemangioma.

Apoptosis ; Child ; Child, Preschool ; Fas Ligand Protein ; metabolism ; Hemangioma ; metabolism ; pathology ; Humans ; Hyperplasia ; Infant ; RNA, Messenger ; metabolism ; Signal Transduction ; fas Receptor ; metabolism

OBJECTIVETo investigate the biological characters of human skin fibroblasts in fibroblast populated collagen lattice (FPCL).

METHODSThe human fibroblasts were cultured in 3D and the collagen of the rat tail was also prepared. They were examined with the comprising cell cycle and apoptosis, mRNA expression of TGF beta1, and fibronectin, and cell morphology.

RESULTSThe flow cytometry showed that the G0/G1, stage cells were 79% +/- 3%, 87% +/- 2% after the 7 days and 14 days separately, and there were not apoptosis peak observed. RT-PCR analysis revealed that the mRNA expression of TGF beta1, and fibronectin had no difference between human skin fibroblasts cultured in 3D and 2D. Electron microscope showed the cells were plenty of chromatin and organelles.

CONCLUSIONSThe proliferation of the human skin fibroblasts in FPCL is slow, but its biological viability is better.

Animals ; Cell Culture Techniques ; Cell Division ; Cells, Cultured ; Collagen ; Extracellular Matrix ; Fibroblasts ; cytology ; Humans ; Rats ; Skin ; cytology ; Tissue Engineering ; methods

OBJECTIVETo study the expression and significance of structural proteins, VEGF and Ang-1 in cavernous venous malformations of the body surface.

METHODSTissue samples came from 25 cases of cavernous venous malformations, 12 cases of normal moderate veins and 12 cases of normal small veins. Envision immunohistochemical stain was used to investigate the expression of IV collagen, fibronectin, laminin, VEGF and Ang-1. The results were analyzed semi-quantitatively.

RESULTSThe distribution of structural proteins in cavernous venous malformations is similar to moderate and small veins, but the expression in venous malformations is less obviously. VEGF expression in cavernous venous malformations and small veins is stronger obviously than moderate veins. Ang-1 expression in small veins is stronger remarkably than cavernous venous malformations and moderate veins.

CONCLUSIONThe abnormal expression of structural proteins may be an important factor in etiopathology and progress of cavernous venous malformations. There is disturbance of blood vessel remodelling in the sinusoid of cavernous venous malformations, with which the less expression of Ang-1 may be related.

Angiopoietin-1 ; metabolism ; Collagen Type IV ; metabolism ; Fibronectins ; analysis ; Hemangioma, Cavernous ; metabolism ; Humans ; Laminin ; metabolism ; Vascular Endothelial Growth Factor A ; metabolism ; Veins ; abnormalities ; metabolism

OBJECTIVETo investigate the clinical pathology of cavernous venous malformations of the body surface.

METHODSTissue samples of cavernous venous malformations from 42 cases were stained with hematoxylin and eosin to observe the pathologic structure. The clinical manifestations and case history were summarized accordingly.

RESULTSThere was no distribution difference of the malformation in sex and body sides, but with obvious difference in anatomic sites. The malformation occurred most frequently at the head and neck, more frequently at extremities and least frequently at the trunk. According to pathologic structure, cavernous venous malformations of the body surface can be divided into three types: the cellular, the canaliform and the mixed.

CONCLUSIONThe cause of distribution difference in anatomic sites remains unclear. Internal hemorrhage and infection may account for the increased growth and ache of the lesion. The different pathologic structure of the malformation may cause different clinical manifestations.

Adolescent ; Adult ; Aged ; Arteriovenous Malformations ; complications ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infection ; etiology ; Male ; Middle Aged ; Pain ; etiology ; Sex Factors ; Skin ; blood supply ; pathology ; Veins ; abnormalities

OBJECTIVETo investigate the effects of chitosan on the biological activities of the fibroblasts derived from different tissues.

METHODSThe biological activities of the fibroblasts derived from different tissues were evaluated with a MTT method for fibroblast proliferation, photic and electronic microscope for morphologic and subcellular structure, 3H-proline uptake method for collagen secretion and ELISA box for the secretion of TGF-beta 1, FGF-AB, and IL-8.

RESULTSThis study showed that the chitosan inhabited the proliferation of the fibroblasts and the secretion of the TGF-beta 1, FGF-AB and collagen of the fibroblasts with a dose-depended manner in the normal skin, hypertrophic scar and keloid groups, but it stimulated the IL-8. However, there were no significant differences among the three groups (P > 0.05).

CONCLUSIONThe chitosan could inhibit the growth, proliferation, biosynthesis and secretion of the fibroblasts, and it may be used to treat different scars.

Adolescent ; Adult ; Cell Division ; drug effects ; Chitin ; analogs & derivatives ; pharmacology ; Chitosan ; Dose-Response Relationship, Drug ; Female ; Fibroblast Growth Factors ; secretion ; Fibroblasts ; drug effects ; metabolism ; ultrastructure ; Hemostatics ; pharmacology ; Humans ; Interleukin-8 ; secretion ; Male ; Microscopy, Electron ; Peptide Fragments ; secretion ; Transforming Growth Factor beta ; secretion

OBJECTIVETo investigate the distribution, phenotype and development of pericytes in infantile hemangioma.

METHODSFifty-two infantile hemangioma samples were included in our study. alpha-SMA was used as the marker antigen to observe the distribution of pericytes. Transmission electron microscope and TUNEL method were used to analyze the apoptosis of pericytes.

RESULTSIn the early and middle proliferating stage, there existed many pericytes in hemangioma; Pericytes together with endothelial cells generated vasculogenesis. In the late proliferating stage, many pericytes became apoptotic. In the early involuting stage, there were only a few of pericytes around the microvessels; After that, the microvessels became obstruction progressively and pericytes disappeared finally.

CONCLUSIONSThe pericyte is one of the major constitutive cells of hemangioma. The vasculogenesis, development and disappearance of microvessels undertaken by pericytes and endothelial cells lead to the pathologic evolution of infantile hemangioma.

Child ; Child, Preschool ; Female ; Hemangioma ; pathology ; Humans ; Infant ; Male ; Microcirculation ; Neovascularization, Pathologic ; pathology ; Pericytes ; pathology

OBJECTIVETo improve sternal elevation for pectus excavatum to be more simple, less injured and less recurrent.

METHODSWe modified procedures for the sternal elevation for pectus excavatum by dispersal of the shortened fibrous bundle connection with central tendon of the diaphragm, correction of the reverse angle of sternocostales joins, transverse cuneiform anterior osteotomy of sternum and reconnection of oblique resected costal cartilage.

RESULTSSince March 1997, 8 children (4 - 10-year-old) with the pectus excavatum have been treated by this modified sternal elevation, 4 of them who suffer from quick heart pulse improved their heart rate immediately during the operation, all patients have less bleeding and good cosmetic appearance without any complications. There were satisfactory results without recurrence after 6 months to 1 year follow-up.

CONCLUSIONThe modified sternal elevation for pectus excavatum is safe, effective and reliable method.

Child ; Child, Preschool ; Female ; Follow-Up Studies ; Funnel Chest ; surgery ; Humans ; Male ; Sternum ; surgery

OBJECTIVETo distinguish non involuting congenital hemangioma (NICH) and infantile hemangioma (IH) by comparing the pathological structure and marker antigen expression.

METHODSFrom Jan. 2005 to Aug. 2010, 39 paraffin-embedded samples, including 13 cases of NICH, 13 cases of proliferating IH and 13 cases of involuting IH, were collected from operation. Hematoxylin-eosin staining was used to observe the pathological structure. Immunohistochemical analysis was also performed to investigate the expression of Glut-1.

RESULTSThe lobules of capillaries were well-defined in NICH. The lobules were surrounded by abundant fibrous tissue. The capillaries were often large and integrity in NICH. There were few mitosis and apoptosis in endothelial cells and stromal cells in NICH. While in IH, the pathologic findings were totally different. Immunochemistry revealed that the Glut-1 was expressed in endothelial cells of IH, but not in NICH.

CONCLUSIONSNICH has a steady histologic structure and low proliferation, while the endothelial cells in proliferative IH has a high proliferation. Glut-1 can be used as the reliable marker antigen for differential diagnosis of NICH and proliferative infantile hemangiomas.

Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Glucose Transporter Type 1 ; metabolism ; Hemangioma ; congenital ; diagnosis ; pathology ; Humans ; Infant ; Male

OBJECTIVETo investigate the role of releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus in the correction of the congenital blepharoptosis.

METHODSTwenty-seven patients with 40 eyes of blepharoptosis were undergoing the treatment. It was performed by releasing the fibrous bundles across the levator muscle between the medial canthus and lateral canthsus near the top of tarsus to correct the mild and moderate blepharoptosis. A further procedure can also be added to by folding the levator aponeurosis if necessary. In the severe blepharoptosis, the frontalis aponeurose flap may be applied for the suspension as well during the operation.

RESULTSOf the 40 eyes in 27 cases with mild, moderate and severe blepharoptosis were treated by using this method, with 38 eyes corrected satisfactorily and 2 eyes corrected mostly in the following-ups from 3 months to 1 year.

CONCLUSIONThe above mentioned technique may be a good, simple and effect method to corret congenital blepharoptosis.

Adolescent ; Blepharoplasty ; methods ; Blepharoptosis ; congenital ; surgery ; Child ; Eyelids ; surgery ; Facial Muscles ; Humans ; Oculomotor Muscles ; surgery ; Surgical Flaps