Sample records for buccal mucosa flaps

  1. A comparitive study of buccal mucosa graft and penile pedical flap for reconstruction of anterior urethral strictures

    Institute of Scientific and Technical Information of China (English)

    SA Ying-long; XU Yue-min; QIAN Yong; JIN San-bo; FU Qiang; ZHANG Xin-ru; ZHANG Jiong; GU Baojun


    @@ Anterior urethral strictures, where the length is more than 2 cm, are best treated by substitution urethroplasy with either preputial/penile skin flaps or free grafts.~1 The use of dartos pedicled flaps has many advantages in terms of increased survival thanks to its own vascularization. Recently, buccal mucosa has become increasingly popular among urologists for urethral replacement when local penile skin is unavailable.~2 Both penile skin flaps and buccal mucosa grafts have emerged as reliable urethral substitutes with comparable long-term results.~(3,4) These urethral substitutes are traditionally placed on the ventral aspect of the stricture and have a success rate of about 85%.~5 Recently, dorsal placement of the free graft has been described, allowing the skin patch/buccal mucosa to be spread and fixed on the tunica albuginea of the corporal bodies overlying the strictured segment of the urethra.~6 This location offers a better outcome. We reviewed our experience with dorsal and ventral onlay substitution urethroplasty using free buccal mucosa and pedicled penile/preputial flaps to determine the outcome and particular problems associated with each technique.

  2. Simultaneous reconstruction of the oral commissure, lip and buccal mucosa with microvascular transfer of combined first-second toe web and dorsalis pedis flap. (United States)

    Ciudad, Pedro; Maruccia, Michele; Sapountzis, Stamatis; Chen, Hung-Chi


    The reconstruction of oral commissure, lip and mucosa defects following tumour resection is a challenging task to the reconstructive surgeon owing to the increasing aesthetic and functional demands. The authors describe a case in which the use of combined first-second toe web with dorsalis pedis flap was transferred and an optimal result was achieved for the oral commissure, lip and buccal mucosa following resection of squamous cell carcinoma and local flap failure.

  3. Reconstruction of Buccal Mucosa, Upper and Lower Lip Defect Using Free Radial Forearm Flap with Palmaris Longus Tendon: A Case Presentation

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    Kamran Khazaeni


    Full Text Available Introduction: Advanced lip carcinomas can invade adjacent structures. Performing surgery for these cancers will lead to defects in this anatomically and functionally important area and will cause post-op difficulties such as drooling, speech alterations and aesthetic considerations, if not properly managed. Case Report: In this study, we will introduce a radial forearm free flap with palmaris longus tendon to reconstruct a defect of a large lower lip carcinoma. Our patients was a male in the 7th decade of life with an advanced lower lip carcinoma invading the full thickness of the buccal mucosa, left commissure and the left third of the upper lip. Resection was performed with adequate margins; checked by frozen sections and radical modified neck dissection was also performed on the left side. Free radial forearm flap with palmaris longus tendon was harvested and anastomosed in the neck. Four months after surgery commissurroplasty was done and the flap volume reduced Conclusion: The radial forearm free flap with palmaris longus tendon provides a good functional lip with a reasonable aesthetics in our patient. The patient was satisfied with the result and there were no functional complaints such as drooling reported by him. We think that this flap could be a flap of choice for reconstruction of the large, full thickness lip defects.

  4. Case Report: Use of reinforced buccal mucosa graft over gracilis muscle flap in management of post high intensity focused ultrasound (HIFU) rectourethral fistula (United States)

    Jai, Shrikant; Ganpule, Arvind; Singh, Abhishek; Vijaykumar, Mohankumar; Bopaiah, Vinod; Sabnis, Ravindra; Desai, Mahesh


    High intensity focused ultrasound (HIFU) has come forward as alternative treatment for carcinoma of the prostate. Though minimally invasive,HIFUhas potential side effects. Urethrorectal fistula is one such rare side effect. Management of these fistulas has been described by Vanni et al. This case report describes points of technique that will help successful management of resilient rectourethral fistula. Urinary and faecal diversion in the form of suprapubic catheter and colostomy is vital. Adequate time between stoma formation, fistula closure and then finally stoma closure is needed. Lithotomy position and perineal approach gives best exposure to the fistula. The rectum should be dissected 2cm above the fistula; this aids in tension free closure of the rectal defect. Similarly buccal mucosal graft was used on the urethra to achieve tension free closure. A good vascular pedicle gracilis muscle flap is used to interpose between the two repairs. This not only provides a physical barrier but also provides a vascular bed for BMG uptake. Perfect haemostasis is essential, as any collection may become a site of infection thus compromising results.  We strongly recommend rectourethral fistula be directly repaired with gracilis muscle flap with reinforced buccal mucosa graft without attempting any less invasive repairs because the “first chance is the best chance”. PMID:28299181

  5. Use of buccal mucosa in hypospadias repair. (United States)

    Cruz-Diaz, Omar; Castellan, Miguel; Gosalbez, Rafael


    Hypospadias is an embryological disorder that results in an abnormal ventral positioning of the urethral meatus. Among multiple surgical techniques described to correct this anomaly, the use of buccal mucosa grafts has gained popularity among pediatric urologists, pediatric surgeons and plastic surgeons. Buccal mucosa grafts have shown favorable histological changes that result in an excellent scaffold for urethral reconstructive surgery. This review describes the evolution of the use of buccal mucosa grafts in hypospadias repair.

  6. Osteolipoma of the buccal mucosa. (United States)

    de Castro, Alvimar-Lima; de Castro, Eni-Vaz-Franco-Lima; Felipini, Renata-Callestini; Ribeiro, Ana-Carolina-Prado; Soubhia, Ana-Maria-Pires


    Lipomas are benign mesenchymal neoplasms of soft tissue that can be found in any part of the human body. Conversely, their presence in the oral mucosa is rather uncommon, with approximately 4% of the cases occurring in the oral cavity. In such cases, they are likely to have originated from mature adipose tissue and to be among several described histological variants of lipomas, which are identified according to the predominant type of tissue. There is a rare lipoma, known as an osteolipoma or an ossifying lipoma; however, little has been written this type of lipoma characterized by a classical lipoma with areas of osseous metaplasia. Considering the few cases of oral osteolipomas previously described in the English-related literature and the consequent risk of misdiagnosis and overtreatment, this paper describes an extreme case of an osteolipoma affecting the buccal mucosa of an adult patient. This paper focuses particularly on the pathogenesis of this lesion and the discussion of a correct diagnosis.

  7. Speech and swallowing outcomes in buccal mucosa carcinoma

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    Sunila John


    Full Text Available Buccal carcinoma is one of the most common malignant neoplasms among all oral cancers in India. Understanding the role of speech language pathologists (SLPs in the domains of evaluation and management strategies of this condition is limited, especially in the Indian context. This is a case report of a young adult with recurrent squamous cell carcinoma of the buccal mucosa with no deleterious habits usually associated with buccal mucosa carcinoma. Following composite resection, pectoralis major myocutaneous flap reconstruction, he developed severe oral dysphagia and demonstrated unintelligible speech. This case report focuses on the issues of swallowing and speech deficits in buccal mucosa carcinoma that need to be addressed by SLPs, and the outcomes of speech and swallowing rehabilitation and prognostic issues.

  8. Delayed buccal fat pad herniation: An unusual complication of buccal flap in cleft surgery

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    Tuli Puneet


    Full Text Available Buccal musculomucosal flap is commonly used in cleft palate surgery for providing additional lining when nasal mucosa is inadequate. We report an unusual complication of progressively increasing fat herniation from the sutured donor site which started appearing on the third postoperative day. This necessitated excision of the protruding fat pad on the seventh postoperative day. The possible mechanism and precautions for prevention of this complication are discussed.

  9. A disguised tuberculosis in oral buccal mucosa. (United States)

    Nanda, Kanwar Deep Singh; Mehta, Anurag; Marwaha, Mohita; Kalra, Manpreet; Nanda, Jasmine


    Tuberculosis is a major cause of morbidity and mortality worldwide. It is a chronic granulomatous disease that can affect any part of the body, including the oral cavity. Oral lesions of tuberculosis, though uncommon, are seen in both the primary and secondary stages of the disease. This article presents a case of tuberculosis of the buccal mucosa, manifesting as non-healing, non-painful ulcer. The diagnosis was confirmed based on histopathology, sputum examination and immunological investigation. The patient underwent anti-tuberculosis therapy and her oral and systemic conditions improved rapidly. Although oral manifestations of tuberculosis are rare, clinicians should include them in the differential diagnosis of various types of oral ulcers. An early diagnosis with prompt treatment can prevent complications and potential contaminations.

  10. Reconstruction of Buccal Mucosa, Upper and Lower Lip Defect Using Free Radial Forearm Flap with Palmaris Longus Tendon: A Case Presentation

    Directory of Open Access Journals (Sweden)

    Kamran Khazaeni


    The radial forearm free flap with palmaris longus tendon provides a good functional lip with a reasonable aesthetics in our patient. The patient was satisfied with the result and there were no functional complaints such as drooling reported by him. We think that this flap could be a flap of choice for reconstruction of the large, full thickness lip defects.

  11. Electroosmotic flow as a result of buccal iontophoresis--buccal mucosa properties. (United States)

    Moscicka-Studzinska, Aleksandra; Kijeńska, Ewa; Ciach, Tomasz


    The objective of this study was to investigate and to better understand the properties of buccal mucosa as a semipermeable membrane and a portal for drug administration by iontophoretic and electroosmotic means. In vitro experiments showed that buccal mucosa at the pH of about 7.4 behaved as a cation-exchange membrane and non-linear resistor. It had lower resistance and was more permeable for water than a skin. The electroosmotic volume flow through mucosa depended on current density, mucosa resistance and electrolyte concentration. Sodium dodecyl sulfate (in concentration range 0.001-0.005 mol L(-1)) and urea (in concentration range 0.42-1.67 mol L(-1)) did not promote a water transfer through buccal mucosa, however, both substances enhanced flow through the skin.

  12. Histopathological changes of free buccal mucosa and colonic mucosa grafts after translation to dog bladder

    Institute of Scientific and Technical Information of China (English)

    XU Yue-min; LI Tai; SA Ying-long; QIAO Yong; ZHANG Hui-zhen; ZHANG Xin-ru; ZHANG Jiong; CHEN Zhong; XIE Hong; SI Jie-min


    @@ Over the past years, more cases using buccal mucosa for urethral reconstruction have been reported.1-4 The excellent early results with this tissue led some authors to extend their indications for its use. However, patients with complex, long-segment urethral strictures and significant scar tissue formation after the failure of previous urethroplasty, still present an operative challenge. The buccal mucosa may not be useful for the treatment of the complicated lengthy urethral strictures because of limited material.

  13. Incidence of bone metastasis in carcinoma buccal mucosa

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    Virendra Bhandari


    Full Text Available Introduction: Head and neck cancer is a leading health problem in India due to the habit of chewing tobacco and bad oral and dental hygiene. Carcinoma buccal mucosa is more common and is 2.5% of all malignancies at our center. Most of the patients present in stage III and IV and the survival in these cases is not very good. Bone metastasis in advanced cases of carcinoma buccal mucosa is rarely reported in the world literature. Materials and Methods: We present here cases developing bone metastasis in carcinoma buccal mucosa in last 5 years. These patients were young with loco-regionally advanced disease where bone metastasis developed within 1-year of definitive treatment. Results: The flat bones and vertebrae were mainly involved and the survival was also short after diagnosis of metastasis despite the treatment with local Radiotherapy and chemotherapy. Conclusion: The exact cause of metastasis cannot be proved, but the probability of subclinical seedling of malignant cells before the eradication of the primary tumor should be considered along with advanced local and nodal disease with high grade of tumor.

  14. Myoepithelial carcinoma of buccal mucosa: A rare tumor. (United States)

    Lata, Jeevan; Ahmad, Fahad; Chand, Vimal


    Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months.

  15. Nicotine permeability across the buccal TR146 cell culture model and porcine buccal mucosa in vitro

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Rassing, Margrethe Rømer


    The present study was conducted to investigate and compare the effect of pH and drug concentration on nicotine permeability across the TR146 cell culture model and porcine buccal mucosa in vitro. As a further characterization of the TR146 cell culture model, it was explored whether the results were...... comparable for bi-directional and uni-directional transport in the presence of a transmembrane pH gradient. Nicotine concentrations between 10(-5) and 10(-2) M were applied to the apical side of the TR146 cell culture model or the mucosal side of porcine buccal mucosa. Buffers with pH values of 5.5, 7...... concentrations of nicotine, the P(app) values decreased, which can partly be explained by an effect on the paracellular pathway. Similar results were also obtained when using the models for bi-directional as well as for uni-directional studies. The TR146 cell culture model may be used as model for buccal...

  16. Ex Vivo Correlation of the Permeability of Metoprolol Across Human and Porcine Buccal Mucosa

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Marxen, Eva; Pedersen, Anne Marie Lynge;


    .0. In addition, hematoxylin-eosin and Alcian blue-van Gieson were used as tissue stains to evaluate the histology and the presence of acidic polysaccharides (e.g., mucins), respectively. The permeability of metoprolol was decreased in human buccal mucosa by almost twofold when compared with porcine buccal mucosa...

  17. Perineal urethrostomy stenosis repair with buccal mucosa: description of technique and report of four cases. (United States)

    Kamat, Nagesh


    Perineal urethrostomy stenosis can be a difficult problem to treat, especially in patients with balanitis xerotica obliterans. We have devised a technique of using the buccal mucosa, with the idea of forming a composite stoma comprising skin and buccal mucosa. We describe the technique and short-term results in 4 patients.

  18. Myoepithelial carcinoma of buccal mucosa: A rare tumor

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    Jeevan Lata


    Full Text Available Myoepithelial carcinoma is a rare neoplasm of salivary glands that account for < 1% of all salivary gland tumors. The most common sites of involvement are major salivary glands mainly parotid gland. Intraorally, it can arise from minor salivary glands; palate is the most common site of occurrence. It also occurs in nasopharynx, paranasal sinuses, nasal cavity and larynx in head and neck region. Myoepithelial tumors were first described in 1943. Their malignant variant, myoepithelial carcinoma, was first reported by Stromeyer et al., in 1975, characterized by distinct morphologic heterogeneity and an infiltrative growth pattern into adjacent tissues. Here, we report a rare case of a 55-year-old female with myoepithelial carcinoma of buccal mucosa. It was also rare because of unusual location of tumor. Our patient was treated with wide local resection and remained free of disease for 15 months.

  19. Micronucleus frequency in buccal mucosa cells of mobile phone users. (United States)

    Hintzsche, Henning; Stopper, Helga


    Mobile phones are being used extensively throughout the world, with more than four billion accounts existing in 2009. This technology applies electromagnetic radiation in the microwave range. Health effects of this radiation have been subject of debate for a long time, both within the scientific community and within the general public. This study investigated the effect of mobile phone use on genomic instability of the human oral cavity's mucosa cells. 131 Individuals donated buccal mucosa cells extracted by slightly scraping the oral cavity with a cotton swab. Every participant filled out a questionnaire about mobile phone use including duration of weekly use, overall period of exposure and headset usage. 13 Individuals did not use mobile phones at all, 85 reported using the mobile phone for three hours per week or less, and 33 reported use of more than three hours per week. Additionally, information on age, gender, body weight, smoking status, medication and nutrition was retrieved. For staining of the cells a procedure using alpha-tubulin-antibody and chromomycin A(3) was applied. Micronuclei and other markers were evaluated in 1000 cells per individual at the microscope. A second scorer counted another 1000 cells, resulting in 2000 analyzed cells per individual. Mobile phone use did not lead to a significantly increased frequency of micronuclei.

  20. Ex vivo correlation of the permeability of metoprolol across human and porcine buccal mucosa. (United States)

    Meng-Lund, Emil; Marxen, Eva; Pedersen, Anne Marie L; Müllertz, Anette; Hyrup, Birgitte; Holm, Rene; Jacobsen, Jette


    The pH partition theory proposes a correlation between fraction of unionized drug substance and permeability. The aim of this study was to compare the permeability of metoprolol and mannitol in ex vivo human and porcine buccal mucosa models at varying pH to validate whether the porcine permeability model is predictive for human buccal absorption. Human (n = 9-10) and porcine (n = 6-7) buccal mucosa were mounted in a modified Ussing chamber, and the kinetics of metoprolol and mannitol transport was assessed for a period of 5.5 h with the pH values of donor medium set at 7.4, 8.5, and 9.0. In addition, hematoxylin-eosin and Alcian blue-van Gieson were used as tissue stains to evaluate the histology and the presence of acidic polysaccharides (e.g., mucins), respectively. The permeability of metoprolol was decreased in human buccal mucosa by almost twofold when compared with porcine buccal mucosa with a positive correlation (r(2) = 0.96) between the permeability assessed in porcine and human buccal mucosa. There was no change in the degree of either epithelial swelling or desquamation when treating with the pH 9.0 donor medium for 5.5 h. These data suggest that buccal mucosa from pigs can be used to predict human buccal absorption.

  1. One-stage and two-stage penile buccal mucosa urethroplasty

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    G. Barbagli


    Full Text Available The paper provides the reader with the detailed description of current techniques of one-stage and two-stage penile buccal mucosa urethroplasty. The paper provides the reader with the preoperative patient evaluation paying attention to the use of diagnostic tools. The one-stage penile urethroplasty using buccal mucosa graft with the application of glue is preliminary showed and discussed. Two-stage penile urethroplasty is then reported. A detailed description of first-stage urethroplasty according Johanson technique is reported. A second-stage urethroplasty using buccal mucosa graft and glue is presented. Finally postoperative course and follow-up are addressed.

  2. Raman mapping of oral buccal mucosa: a spectral histopathology approach (United States)

    Behl, Isha; Kukreja, Lekha; Deshmukh, Atul; Singh, S. P.; Mamgain, Hitesh; Hole, Arti R.; Krishna, C. Murali


    Oral cancer is one of the most common cancers worldwide. One-fifth of the world's oral cancer subjects are from India and other South Asian countries. The present Raman mapping study was carried out to understand biochemical variations in normal and malignant oral buccal mucosa. Data were acquired using WITec alpha 300R instrument from 10 normal and 10 tumors unstained tissue sections. Raman maps of normal sections could resolve the layers of epithelium, i.e. basal, intermediate, and superficial. Inflammatory, tumor, and stromal regions are distinctly depicted on Raman maps of tumor sections. Mean and difference spectra of basal and inflammatory cells suggest abundance of DNA and carotenoids features. Strong cytochrome bands are observed in intermediate layers of normal and stromal regions of tumor. Epithelium and stromal regions of normal cells are classified by principal component analysis. Classification among cellular components of normal and tumor sections is also observed. Thus, the findings of the study further support the applicability of Raman mapping for providing molecular level insights in normal and malignant conditions.

  3. Cytokeratin expression in human fetal tongue and buccal mucosa

    Indian Academy of Sciences (India)

    M M Vaidya; Sharda S Sawant; Anita M Borges; N K Naresh; Manda C Purandare; A N Bhisey


    Expression of cytokeratins (CK), a subset of intermediate filament (IF) proteins in epithelia, is developmentally regulated. CK expression may also change after malignant transformation. Our earlier studies on CK expression in human oral tumours and pre-cancerous lesions have shown specific changes in CK expression. We analysed CK expression in human tongue and buccal mucosa (BM) in fetuses in the embryonic age group of 16 to 27 weeks using biochemical and immunohistochemical techniques to find out whether there is any similarity in CK expression in human oral squamous cell carcinomas (SCC) and fetal oral tissues. CK 1, 8 and 18 were detected in a majority of samples using both techniques. Our earlier studies had shown aberrant expression of CK 1 and 18 in many of the oral SCC and leukoplakias. Studies by immunohistochemistry showed that these different CK antigens were expressed in different cell layers. CK 1(2) were present in the stratified epithelial layers whereas CK 8 and 18 were restricted to glandular epithelium. Till 27 weeks of gestation, both tongue and BM expressed CK 1, 8 and 18 along with CK 6 and 16. Thus, fetal tissues showed some similarities in CK pattern with their respective SCC.

  4. Metastasis of Renal Cell Carcinoma to the Buccal Mucosa 19 Years after Radical Nephrectomy

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    Hernani Gil-Julio


    Full Text Available Renal cell carcinoma (RCC has high metastatic potential, which requires early diagnosis to optimize the chance of cure. Metastasis of RCC to the head and neck region is less common and metastasis to the buccal mucosa is extremely rare. This phenomenon occurs mostly in patients with generalized dissemination, especially with lung metastases. In this article we report a case of buccal mucosa metastasis from RCC in a 65-year-old man who presented 19 years after undergoing a left radical nephrectomy for clear cell RCC. Surgical excision of the buccal lesion was performed without evidence of recurrence or new metastatic lesions after 6 years of followup. To our knowledge, this is the first case of metastasis to the buccal mucosa from a RCC reported in the literature.

  5. HIV infection induces morphometrical changes on the oral (buccal mucosa and tongue) epithelial cells. (United States)

    Pompermayer, Adriane Bastos; Gil, Francisca Berenice Dias; França, Beatriz Helena Sottile; Machado, Maria Ângela Naval; Trevilatto, Paula Cristina; Fernandes, Angela; de Lima, Antônio Adilson Soares


    The aim of this study was to assess morphological and morphometrical alterations of oral squamous epithelial cells in type 1 HIV infected individuals. Oral smears were collected from tongue and buccal mucosa of 30 HIV infected (experimental) and 30 non-infected (control) individuals by liquid-based exfoliative cytology. The cells were morphologically analyzed and the nuclear area (NA), the cytoplasmic area (CA) and the nucleus-to-cytoplasm area ratio (NA/CA) were calculated. No morphological differences were found between the groups. The mean values of CA were decreased in tongue (P=.00006) and buccal mucosa (P=.00242) in HIV infected individual, while mean values of NA were increased (P=.00308 and .00095, respectively) in the same group. NA/CA ratio for experimental group was increased in both collected places, with P=.00001 (tongue) and P=.00000 (buccal mucosa). This study revealed that HIV infection was able to induce morphometrical changes on the oral epithelial cells.

  6. Enhanced delivery of ketobemidone through porcine buccal mucosa in vitro via more lipophilic ester prodrugs

    DEFF Research Database (Denmark)

    Hansen, L.B.; Christrup, Lona Louring; Bundgaard, H.


    The in vitro penetration of ketobemidone and various ester prodrugs through porcine buccal mucosa in a modified Ussing chamber was investigated in order to support the selection of a prodrug derivative with optimal buccal absorption. The nine esters studied included carboxylic acid and carbonate...... esters formed at the phenolic hydroxy group of ketobemidone. The esters were all rapidly hydrolyzed to the parent drug in a porcine buccal epithelial homogenate and only free ketobemidone was detected in the receptor compartment of the Ussing chamber. All the ester prodrugs showed enhanced rates...

  7. A comparative ex vivo drug permeation study of beta-blockers through porcine buccal mucosa. (United States)

    Amores, Sonia; Lauroba, Jacinto; Calpena, Ana; Colom, Helena; Gimeno, Alvaro; Domenech, José


    Apparent permeability coefficients (kp) of a series of beta-blockers: acebutolol, atenolol, labetalol, metoprolol, oxprenolol and propranolol, through porcine buccal mucosa were determined. The aim of the study was to determine the permeation parameters (apparent permeability coefficient, kp; flux, J; and lag time, TL) as a measure of the intrinsic permeability of porcine buccal mucosa to these drugs, in order to predict the efficacy of their possible administration through human buccal mucosa. A positive linear correlation was observed between the apparent permeability coefficient, kpand the partition coefficient, P. Oxprenolol and propranolol are the drugs that presented the highest values of kp: 0.3231×10(2) cm/h and 0.5666×10(2) cm/h, respectively. Multiple linear regression (MLR) using least square estimation was performed on the data set with logkpas dependent variable and the descriptors as predictor variables. The potential systemic capacity after a buccal administration was predicted by estimating the plasma concentrations at steady-stated (Css). Considering the entire process of permeation ex vivo, propranolol and oxprenolol would seem to be the best candidates for administration through the buccal mucosa.

  8. Formulation of unidirectional release buccal patches of carbamazepine and study of permeation through porcine buccal mucosa

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    Parthasarathy Govindasamy


    Conclusions: The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic delivery of carbamazepine.

  9. Effect of cryoprotectants for maintaining drug permeability barriers in porcine buccal mucosa

    DEFF Research Database (Denmark)

    Marxen, Eva; Axelsen, Mary Carlos; Pedersen, Anne Marie Lynge;


    if permeability barriers for small molecules (nicotine and diazepam) were maintained after freezing porcine buccal mucosa with cryoprotectants to -80°C. Combinations of dimethyl sulfoxide, bovine serum albumin, glycerol and sucrose were used as cryoprotectants. The permeability of nicotine and diazepam across...... tissue. Freezing with or without cryoprotectants did not significantly affect the flux of diazepam compared to fresh tissue. Only minor histological changes were seen in frozen/thawed porcine buccal mucosa compared to fresh tissue. In conclusion, permeability barriers for nicotine and diazepam were...

  10. Use of buccal myomucosal flap for palatal lengthening in cleft palate patient: Experience of 20 cases

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    Don Varghese


    Full Text Available Background: The purpose of this review was to assess the effectiveness of the buccal myomucosal flap in secondary repairs of cleft palate in 20 patients. Patients and Methods: Totally, 20 patients, who underwent secondary palatoplasty between 5 years and 8 years in which a buccal myomucosal flap was used, were reviewed retrospectively. All patients had undergone at least one previous attempted repair at other institutions. Indications for the secondary repair included velopharyngeal incompetence and/or oronasal fistula. Patients were evaluated preoperatively for oronasal fistula status, velopharyngeal competence, nasal resonance, speech quality, and nasal escape. Results: The buccal myomucosal flap was used in all 20 patients, and there was marked increase in the quality of speech as well as nasal regurgitation decreased. In patients with levator dysfunction due to poor primary surgery and glottal speech the results were inconclusive Conclusion: Palate re-repair combined with a buccal myomucosal flap, occasionally in conjunction with other techniques, is an effective method for correcting failed cleft palate repairs. Minimum donor site morbidity and complication makes the buccal flap a useful armamentarium of a cleft surgeon.

  11. Histopathological evaluation of urethroplasty with dorsal buccal mucosa: an experimental study in rabbits

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    Geovanne F. Souza


    Full Text Available PURPOSE: Buccal mucosa is a widely accepted tissue for urethroplasty. The exact healing and tissue integration process, mainly the histological characteristics of dorsal buccal mucosa graft urethroplasty when used dorsally to reconstruct the urethral plate has not previously been assessed, and thus we developed an experimental model to address this question. MATERIALS AND METHODS: In 12 New Zealand rabbits (weight 2.5 kg we surgically created a dorsal penile urethral defect. A buccal mucosa graft was sutured to the corpora and tunica albuginea, and the ventral urethra anastomosed to this new urethral plate. The animals were divided in three groups and sacrificed 1, 3 and 6 weeks after surgery (groups 1, 2 and 3. A retrograde urethrogram was obtained at autopsy in the last group and the penis analyzed histologically with hematoxylin-eosin and Masson's staining. RESULTS: The urethrograms showed no evidence of fistula or stricture. In group 1 the histopathological analysis showed submucosal lymph-mononuclear inflammatory edema, numerous eosinophils and squamous epithelium integrated into the adjacent urothelium. In group 2 there was no evidence of an inflammatory response but rather complete subepithelial hyaline healing, which was more marked in group 3. CONCLUSION: Healing of buccal mucosa grafts to reconstruct the urethral plate can be achieved by total integration of the squamous epithelium with the urothelium, maintaining the original histological properties of the graft with no fibrosis or retraction.

  12. An improved cryopreservation method for porcine buccal mucosa in ex vivo drug permeation studies using Franz diffusion cells. (United States)

    Amores, Sonia; Domenech, José; Colom, Helena; Calpena, Ana C; Clares, Beatriz; Gimeno, Álvaro; Lauroba, Jacinto


    The use of isolated animal models to assess percutaneous absorption of molecules is frequently reported. The porcine buccal mucosa has been proposed as a substitute for the buccal mucosa barrier on ex vivo permeability studies avoiding unnecessary sacrifice of animals. But it is not always easy to obtain fresh buccal mucosa. Consequently, human and porcine buccal mucosa is sometimes frozen and stored in liquid nitrogen, but this procedure is not always feasible. One cheaper and simpler alternative is to freeze the buccal mucosa of freshly slaughtered pigs in a mechanical freezer, using DMSO and albumin as cryoprotective agents. This study compared the ex vivo permeability parameters of propranolol hydrochloride through porcine buccal mucosa using a Franz diffusion cell system and HPLC as detection method. The freezing effects on drug permeability parameters were evaluated. Equally histological studies were performed. Furthermore, the use of the parameter transmucosal water loss (TMWL) as an indicator of the buccal mucosa integrity was evaluated just as transepidermal water loss (TEWL) is utilized for skin integrity. The results showed no difference between fresh and frozen mucosal flux, permeability coefficient or lag time of propranolol. However, statistical significant difference in TMWL between fresh and frozen mucosa was observed.

  13. Formulation of unidirectional release buccal patches of carbamazepine and study of permeation through porcine buccal mucosa

    Institute of Scientific and Technical Information of China (English)

    Parthasarathy Govindasamy; Bhaskar Reddy Kesavan; Jayaveera Korlakunta Narasimha


    Objective:To achieve transbuccal release of carbamazepine by loading in unidirectional release mucoadhesive buccal patches. Methods:Buccal patches of carbamazepine with unidirectional drug release were prepared using hydroxypropyl methyl cellulose, polyvinyl alcohol, polyvinyl pyrrolidone and ethyl cellulose by solvent casting method. Water impermeable backing layer (Pidilite® Biaxially-oriented polypropylene film) of patches provided unidirectional drug release. They were evaluated for thickness, mass uniformity, surface pH and folding endurance. Six formulations FA2, FA8, FA10, FB1, FB14 and FB16 (folding endurance above 250) were evaluated further for swelling studies, ex vivo mucoadhesive strength, ex vivo mucoadhesion time, in vitro drug release, ex vivo permeation, accelerated stability studies and FTIR and XRD spectral studies. Results: The ex vivo mucoadhesion time of patches ranged between 109 min (FA10) to 126 min (FB14). The ex vivo mucoadhesive force was in the range of 0.278 to 0.479 kg/m/s. The in vitro drug release studies revealed that formulation FA8 released 84%and FB16 released 99.01%of drug in 140 min. Conclusions: The prepared unidirectional buccal patches of carbamazepine provided a maximum drug release within specified mucoadhesion period and it indicates a potential alternative drug delivery system for systemic delivery of carbamazepine.

  14. An animal model of buccal mucosa cancer and cervical lymph node metastasis induced by U14 squamous cell carcinoma cells. (United States)

    Zhao, Xin; Pang, Liang; Qian, Yu; Wang, Qiang; Li, Yong; Wu, Mingyi; Ouyang, Zilan; Gao, Zhi; Qiu, Lihua


    The buccal mucosa is the site with the highest risk of contracting a malignancy in habitual betel quid chewers who expose the buccal mucosa to high doses of carcinogens. Of all oral cancers, those of the buccal mucosa are associated with the poorest prognoses. Therefore, it would be helpful to have an animal model to evaluate new treatment modalities for buccal mucosa cancer. In the present study, we evaluated whether the imprinting control region (ICR) mouse animal model could be employed as a cancer model for buccal mucosa cancer. Sixty male ICR mice were randomly divided into two groups, a normal group (n=10) and a cancer-induced group (n=50). Each mouse in the cancer group was inoculated with 0.05 ml U14 cancer cell suspension (1×10(7)/ml) on the buccal mucosa. Histological staining and gene expression assays revealed that neck lymph node metastasis animal models were established. After 20 days, the cheek tumor formation rate of the ICR mice reached 100%. Furthermore, the neck lymph node metastasis rate was 53%. We identified that U14 cells produce strong metastasis in ICR mice. Metastasis of the tumor to the lymph node began with carcinoma metastasis encroaching on the marginal sinus. Then it infiltrated to the cortex and medulla and the infiltration continued until the normal lymph node structure was completely damaged. This animal model may be employed in medical research on buccal mucosa cancer and cervical lymph node metastasis. In conclusion, our findings indicate that U14 cell-induced mouse buccal mucosa cancer may be a potential cancer model for human buccal mucosa squamous cell carcinoma.

  15. A Case of Hyalinizing Clear Cell Carcinoma, So-Called Clear Cell Carcinoma, Not Otherwise Specified, of the Minor Salivary Glands of the Buccal Mucosa

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    Takahiro Yamanishi


    Full Text Available Hyalinizing clear cell carcinoma (HCCC, so-called clear cell carcinoma, not otherwise specified (CCC (NOS, of the salivary glands is a rare and low-grade malignant tumor. We report a case of HCCC so-called CCC (NOS (referred to as HCCC of the minor salivary gland of the buccal mucosa. A 52-year-old woman had presented with a gradually growing and indolent mass in the right buccal mucosa for about two years. The first biopsy histopathologically suggested the possibility of malignancy derived from the minor salivary glands. A month later, she visited our hospital. The tumor measured approximately 1.5 cm in diameter and was elastic hard, smooth, and well movable. Image examinations demonstrated internal homogeneity of the lesion, which had a smooth margin, in the right buccal mucosa. Complete tumor resection followed by covering with a polyglycolic acid sheet and fibrin glue spray was performed without surgical flap reconstruction. Histopathological findings revealed proliferating tumor cells with clear cytoplasm surrounded by hyalinizing stroma in the submucosal minor salivary glands. Immunohistochemical stains revealed these tumor cells to be positive for epithelial cell markers but negative for myoepithelial ones. These findings confirmed the diagnosis of HCCC. Good wound healing and no evidence of local recurrence and metastasis have been shown since surgery.

  16. Verruciform xanthoma of buccal mucosa: A case report with review of literature

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    Sudhir Bhalerao


    Full Text Available Verruciformxanthoma (VX is an uncommon benign mucocutaneous lesion of unknown etiology. It appears as a papule or single plaque with verrucous or papillomatous surface and variable color from reddish pink to gray. It occurs primarily in the masticatory mucosa. Histologically, VX is characterized by the presence of parakeratinized epithelium with thin rete ridges and connective tissue papillae extending up to the surface. The papillae characteristically consist of foam cells, also called xanthoma cells. We report a case of VX in the buccal mucosa and discuss their clinical and histopathological findings.

  17. The role of tobacco as an etiological agent for oral cancer: Cytomorphometrical analysis of the buccal mucosa in tobacco users

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    Megha Singh


    Conclusion: The results confirmed that tobacco chewing and smoking influenced the cytomorphology of normal appearing buccal mucosa and the degree of these changes were found to be greater in chewers as compared to smokers.

  18. Buccal mucosa carcinoma: surgical margin less than 3 mm, not 5 mm, predicts locoregional recurrence

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    Chiou Wen-Yen


    Full Text Available Abstract Background Most treatment failure of buccal mucosal cancer post surgery is locoregional recurrence. We tried to figure out how close the surgical margin being unsafe and needed further adjuvant treatment. Methods Between August 2000 and June 2008, a total of 110 patients with buccal mucosa carcinoma (25 with stage I, 31 with stage II, 11 with stage III, and 43 with Stage IV classified according to the American Joint Committee on Cancer 6th edition were treated with surgery alone (n = 32, surgery plus postoperative radiotherapy (n = 38 or surgery plus adjuvant concurrent chemoradiotherapy (n = 40. Main outcome measures: The primary endpoint was locoregional disease control. Results The median follow-up time at analysis was 25 months (range, 4-104 months. The 3-year locoregional control rates were significantly different when a 3-mm surgical margin (≤3 versus >3 mm, 71% versus 95%, p = 0.04 but not a 5-mm margin (75% versus 92%, p = 0.22 was used as the cut-off level. We also found a quantitative correlation between surgical margin and locoregional failure (hazard ratio, 2.16; 95% confidence interval, 1.14 - 4.11; p = 0.019. Multivariate analysis identified pN classification and surgical margin as independent factors affecting disease-free survival and locoregional control. Conclusions Narrow surgical margin ≤3 mm, but not 5 mm, is associated with high risk for locoregional recurrence of buccal mucosa carcinoma. More aggressive treatment after surgery is suggested.


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    Rizal Rivandi


    Full Text Available Buccal advancement flap is one of the many ways of treating oro antral fistula. This technique is frequently used by dentists because it is easier to do and has several advantages compared to other techniques. This paper reports a case of oro antral fistula caused by complication of a tooth extraction, with discussions about definition, ethics and other therapies of oro antral fistula.

  20. Ectopic compound odontoma in the buccal mucosa: report of a rare case. (United States)

    Venigalla, Aparna; Guttikonda, Leela Krishna; Nelakurthi, Hasini; Babburi, Suresh; Pinisetti, Soujanya; Kotti, Ajay Banerji; Kalapala, Lavanya


    Eruption of tooth into extraosseous locations is an extremely rare condition. We report a case of a six-year-old girl child with tooth-like structure erupting from the right buccal mucosa. Clinical, radiographic, and histopathologic examination suggested the diagnosis of compound odontoma. Very few cases have been reported so far, where tooth has been located completely in the soft tissue and a variety of names have been used for that condition. A brief review of the literature and the ambiguity in naming the situation is discussed.

  1. Carcinoma Buccal Mucosa Underlying a Giant Cutaneous Horn: A Case Report and Review of the Literature

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    Sunil Kumar


    Full Text Available Cutaneous horn is a conical, dense, and hyperkeratotic protrusion that often appears similar to the horn of an animal. Giant cutaneous horns are rare; no incidence or prevalence has been reported. The significance of cutaneous horns is that they occur in association with, or as a response to, a wide variety of underlying benign, premalignant, and malignant cutaneous diseases. A case of giant cutaneous horn of left oral commissure along with carcinoma left buccal mucosa is reported here as an extremely rare oral/perioral pathology.

  2. Ectopic Compound Odontoma in the Buccal Mucosa: Report of a Rare Case

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    Aparna Venigalla


    Full Text Available Eruption of tooth into extraosseous locations is an extremely rare condition. We report a case of a six-year-old girl child with tooth-like structure erupting from the right buccal mucosa. Clinical, radiographic, and histopathologic examination suggested the diagnosis of compound odontoma. Very few cases have been reported so far, where tooth has been located completely in the soft tissue and a variety of names have been used for that condition. A brief review of the literature and the ambiguity in naming the situation is discussed.

  3. Sequence of changes in rat buccal mucosa induced by zinc deficiency. (United States)

    Hsu, D; Meyer, J; Gerson, S; Daniel, J


    In weanling rats, after receiving a zinc-deficient diet (less than 1 ppm) for 4 wk, the buccal mucosa appears hyperplastic. This study determines changes at earlier stages of the lesion. After 9 days of deficiency, the keratin layer had partially converted to parakeratosis and thickened, and the size of the capillary bed was increased. After 18 days, the keratin layer was fully parakeratotic and thickened further. The cellular layer was thickened. The mitotic rate was doubled and rete ridges were convoluted. After 27 days, the keratin and cellular layers were further thickened, and the mitotic rate remained elevated. The rete ridges were further convoluted. The number of mast cells was doubled and the size of the vascular bed had increased further. These findings suggest early and late interactions between the epithelium and lamina propria. After four days on a control diet following 27 days of zinc deficiency, the mucosa returned normal.

  4. Giant Cell Fibroma of the Buccal Mucosa with Laser Excision: Report of Unusual Case (United States)

    Bagheri, Fatemeh; Rahmani, Somayyeh; Azimi, Somayyeh; Bigom Taheri, Jamileh


    Giant Cell Fibroma (GCF) was described as a new entity of fibrous hyperplastic soft tissue. It seems that stimulus from an unexplained origin can have a role in its etiology. Histopathologically GCF is consisted of multinucleated fibroblasts that have oval shape nuclei within the eosinophilic cytoplasm. Surgical excision is the treatment of choice and recurrence is very rare. Here we report a case of relatively large GCF in a 54-year-old man. Gingiva is the common location of GCF. As in our case, it may be mistaken as irritation fibroma especially if it is on the buccal mucosa, the most common location for fibroma. Correct diagnosis is based on biopsy and clinical examination to see surface texture roughness. To minimize bleeding because of its large size an excisional biopsy with Diod laser was performed under local anesthesia for this patient. PMID:26351504

  5. Pathology of advanced buccal mucosa cancer involving masticator space (T4b

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    N P Trivedi


    Full Text Available BACKGROUND: Buccal mucosa cancer involving masticator space is classified as very advanced local disease (T4b. The local recurrence rate is very high due to poor understanding of the extent of tumor spread in masticator space and technically difficult surgical clearance. The objective of this study is to understand the extent of tumor spread in masticator space to form basis for appropriate surgical resection. MATERIALS AND METHODS: All consecutive patients with T4b-buccal cancer underwent compartment resection, with complete anatomical removal of involved soft-tissue structures. Specimens were systematically studied to understand the extent of invasion of various structures. The findings of clinical history, imaging and pathologic evaluation were compared and the results were evaluated. RESULTS: A total of 45 patients with advanced buccal cancer (T4b were included in this study. The skin, mandible and lymph nodes were involved in 30, 24 and 17 cases respectively. The pterygoid muscles were involved in 34 cases (medial-pterygoid in 12 and both pterygoids in 22 cases and masseter-muscle in 32 cases. Average distance for soft-tissue margins after compartment surgery was 2 cm and the margins were positive in 3 cases. The group with involvement of medial pterygoid muscle had safest margin with compartment surgery while it was also possible to achieve negative margins for group involving lateral pterygoid muscle and plates.The involvement of pterygomaxillary fissure was area of concern and margin was positive in 2 cases with one patient developing local recurrence with intracranial extension. At 21 months median follow-up (13-35 months, 38 patients were alive without disease while two developed local recurrence at the skull base.CONCLUSIONS: T4b buccal cancers have significant soft-tissue involvement in the masticator space. En bloc removal of all soft-tissues in masticator space is advocated to remove tumor contained within space. The compartment

  6. Giant Panda (Ailuropoda melanoleuca) Buccal Mucosa Tissue as a Source of Multipotent Progenitor Cells. (United States)

    Prescott, Hilary M A; Manning, Craig; Gardner, Aaron; Ritchie, William A; Pizzi, Romain; Girling, Simon; Valentine, Iain; Wang, Chengdong; Jahoda, Colin A B


    Since the first mammal was cloned, the idea of using this technique to help endangered species has aroused considerable interest. However, several issues limit this possibility, including the relatively low success rate at every stage of the cloning process, and the dearth of usable tissues from these rare animals. iPS cells have been produced from cells from a number of rare mammalian species and this is the method of choice for strategies to improve cloning efficiency and create new gametes by directed differentiation. Nevertheless information about other stem cell/progenitor capabilities of cells from endangered species could prove important for future conservation approaches and adds to the knowledge base about cellular material that can be extremely limited. Multipotent progenitor cells, termed skin-derived precursor (SKP) cells, can be isolated directly from mammalian skin dermis, and human cheek tissue has also been shown to be a good source of SKP-like cells. Recently we showed that structures identical to SKPs termed m-SKPs could be obtained from monolayer/ two dimensional (2D) skin fibroblast cultures. Here we aimed to isolate m-SKPs from cultured cells of three endangered species; giant panda (Ailuropoda melanoleuca); red panda (Ailurus fulgens); and Asiatic lion (Panthera leo persica). m-SKP-like spheres were formed from the giant panda buccal mucosa fibroblasts; whereas dermal fibroblast (DF) cells cultured from abdominal skin of the other two species were unable to generate spheres. Under specific differentiation culture conditions giant panda spheres expressed neural, Schwann, adipogenic and osteogenic cell markers. Furthermore, these buccal mucosa derived spheres were shown to maintain expression of SKP markers: nestin, versican, fibronectin, and P75 and switch on expression of the stem cell marker ABCG2. These results demonstrate that giant panda cheek skin can be a useful source of m-SKP multipotent progenitors. At present lack of sample numbers

  7. Increased numbers of mast cells in the hyperplastic buccal mucosa of the zinc-deficient rat. (United States)

    Kreavich, M E; Meyer, J; Waterhouse, J P


    Six weanling male Sprague Dawley rats were fed a diet containing 0.4 ppm Zn and seven were fed an identical diet except for 40 ppm Zn. After 4 weeks, specimens of buccal mucosa in the region facing the molar teeth were removed. Paraffin sections, cut at 6 micron, were stained with toluidine blue, and tracings made of five sections per animal, spaced no less than 60 micron apart. Counts of mast cells of five sections length of section were made in a superficial zone of the lamina propria of 50 micron width and a deeper zone of 250 micron width. The average number of mast cells, per mm in the subepithelial zone of the experimental animals was 15.4, the range 9.2-33.1. The control average was 4.0; the range was 2.9-5.3. No increase was found in the deeper zone. The epithelium was parakeratotic and its thickness was increased two-fold. In the peripheral portion of the section, cellular and keratin layers were evenly increased in thickness, but in the central portion a disproportionate, nearly four-fold increase occurred in the keratin layer and a lesser increase in the cellular layer.

  8. [Use of new solcoseryl-containing Diplan-denta C film in the treatment of injuries of the buccal mucosa]. (United States)

    Abakarova, D S


    Clinical efficiency of bilayer adhesive dental film Diplan-denta C with solcoseryl in the treatment of postoperative wounds of the buccal mucosa and the effects of this film on the course of wound process were evaluated. The course of wound process in 39 patients with postoperative injuries of the buccal mucosa treated with Diplan-denta XD and Diplan-denta C films and traditional local therapy (0.05% chlorohexidine bigluconate solution and solcoseryl dental adhesive paste) was compared. In the study group Diplan-denta XD film with chlorohexidine was used for local therapy during the first 1-3 days after the injury and Diplan-denta C film with solcoseryl was used in subsequent days until epithelialization; in controls irrigations of the oral cavity with chlorohexidine bigluconate solution (0.05%) were carried out during the first 1-3 days and applications of solcoseryl dental adhesive paste were made during subsequent days until epithelialization. The results indicate that the use of Diplan-denta C film optimized the treatment of the buccal mucosa wounds.

  9. Tissue engineered pre-vascularized buccal mucosa equivalents utilizing a primary triculture of epithelial cells, endothelial cells and fibroblasts. (United States)

    Heller, M; Frerick-Ochs, E V; Bauer, H-K; Schiegnitz, E; Flesch, D; Brieger, J; Stein, R; Al-Nawas, B; Brochhausen, C; Thüroff, J W; Unger, R E; Brenner, W


    Artificial generated buccal mucosa equivalents are a promising approach for the reconstruction of urethral defects. Limiting in this approach is a poor blood vessel supply after transplantation, resulting in increased morbidity and necrosis. We generated a pre-vascularized buccal mucosa equivalent in a tri-culture of primary buccal epithelial cells, fibroblasts and microvascular endothelial cells, using a native collagen membrane as a scaffold. A successful pre-vascularization and dense formation of capillary-like structures at superficial areas was demonstrated. The lumen size of pre-formed blood vessels corresponded to the capillary size in vivo (10-30 μm). Comparing native with a highly cross-linked collagen membrane we found a distinct higher formation of capillary-like structures on the native membrane, apparently caused by higher secretion of angiogenic factors such as PDGF, IL-8 and angiopoietin by the cells. These capillary-like structures became functional blood vessels through anastomosis with the host vasculature after implantation in nude mice. This in vitro method should result in an accelerated blood supply to the biomaterial with cells after transplantation and increase the succes rates of the implant material.

  10. Penile Circular Fasciocutaneous (McAninch) Flap as an Option for Complex Anterior Urethral Stricture in Case of Non-Viable Buccal Mucosal Graft (United States)

    Vijayganapathy, Sundaramoorthy; Mallya, Ashwin; Sreenivas, Jayaram


    The penile circular fasciocutaneous flap (FCF) is employed in the successful single stage reconstruction of long segment complex anterior urethral strictures especially when buccal mucosa is unavailable due to various reasons. A 65-year-old gentleman, chronic smoker and tobacco chewer, hypertensive on treatment, presented with obstructive lower urinary tract symptoms for 8 months. He had no prior urethral catheterization. On examination, he had circumcised penis, with stenosis of the external urethral meatus. Glans had no changes suggesting balanitis xerotica obliterans. Suprapubic cystostomy was done as he developed acute urinary retention during evaluation. Retrograde urethrogram (RGU) showed pan-anterior urethral stricture. He was planned for substitution urethroplasty. On oral cavity examination, he had moderate trismus with oral submucous fibrosis. As buccal mucosal graft was unavailable, he was planned for FCF. A ventral onlay tubularization FCF urethroplasty from meatus to bulbar urethra based on dartos dorsal pedicle was done. His postoperative recovery was uneventful. Pericatheter RGU did not show extravastion and he voided well with Qmax 14 ml/second. He is doing well at follow-up. PMID:27630900

  11. In vitro, ex vivo and in vivo examination of buccal absorption of metoprolol with varying pH in TR146 cell culture, porcine buccal mucosa and Göttingen minipigs

    DEFF Research Database (Denmark)

    Holm, René; Meng-Lund, Emil; Andersen, Morten B.;


    This work studied the buccal absorption of metoprolol in vitro, ex vivo and in vivo as a function of buffered pH at 7.4, 8.5, 9.0 and 9.5. Permeability studies showed a correlation (r(2)=0.92) between in vitro TR146 cell culture and ex vivo porcine buccal mucosa in a modified Ussing chamber...

  12. In vitro permeation through porcine buccal mucosa of caffeic acid phenetyl ester (CAPE) from a topical mucoadhesive gel containing propolis. (United States)

    Ceschel, G C; Maffei, P; Sforzini, A; Lombardi Borgia, S; Yasin, A; Ronchi, C


    Recent studies have shown that propolis has on the oral cavity appreciable antibacterial, antifungal and antiviral actions, as well as anti-inflammatory, anaesthetic and cytostatic properties. In light of these studies, an assessment of the diffusion and permeation of caffeic acid phenetyl ester (CAPE) through porcine buccal mucosa was considered useful as a possible application in the stomatological field. To do so, a mucoadhesive topical gel was prepared to apply to the buccal mucosa. The gel was formulated in such a way as to improve the solubility of the propolis, conducting to an increase of the flux. The mucosal permeation of CAPE from the formulation was evaluated using Franz cells, with porcine buccal mucosa as septum between the formulation (donor compartment) and the receptor phase chamber. The diffusion through the membrane was determined by evaluating the amount of CAPE present in the receiving solution, the flux and the permeation coefficient (at the steady state) in the different formulations at set intervals. Qualitative and quantitative determinations were done by HPLC analysis. From the results, CAPE allowed a high permeability coefficient in comparison to the coefficient of other molecules, as expected from its physical-chemical structure. Moreover, the developed gel improved the CAPE flux approximately 35 times more with respect to an ethanol solution formulated at the same gel concentration. The developed gel was also tested in order to evaluate the mucoadhesive behaviour and comfort in vivo on 10 volunteers in a period of 8 h. The in vivo evaluation of mucoadhesive gel revealed adequate comfort and non-irritancy during the period of study and it was well accepted by the volunteers.

  13. Prelamination of Neourethra with Uterine Mucosa in Radial Forearm Osteocutaneous Free Flap Phalloplasty in the Female-to-Male Transgender Patient

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    Christopher J. Salgado


    Full Text Available Radial forearm free flap phalloplasty is the most commonly performed flap for neophallus construction in the female-to-male (FtM transgender patient. Urological complications, however, can arise quite frequently and can prevent the patient from urinating in the standing position, an important postsurgical goal for many. Using mucosa to construct the fixed urethra and to prelaminate the penile urethra has been successful in reducing urologic complications, particularly strictures and fistulas. Until now, only buccal, vaginal, colonic, and bladder sites have been described as sources for these mucosal grafts. We present the successful use of uterine mucosa for prelamination of the neourethra in an FtM patient who underwent hysterectomy and vaginectomy at the prelamination stage of a radial forearm phalloplasty. Three months postoperatively, the patient was able to void while standing and showed no evidence of stricture or fistula on retrograde cystogram. These results suggest that uterine mucosa may be used for prelamination of the penile neourethra in patients undergoing phalloplasty.

  14. Correlation of changes in capillary supply and epithelial in the hyperplastic buccal mucosa of zinc-deficient rats. (United States)

    Meyer, J; Stohle, M R; Stablein, M J


    Lengths of capillaries and epithelial dimensions were measured on tracings of sections of buccal mucosa stained for the alkaline phosphatase from rats on a zinc-deficient diet. The diet-deficient animals showed the following increases over controls; length of capillaries X 2.67; thickness of cell layer, X1.47; thickness of keratin layer. X2.82; basal layer length: surface length ratio, X1.41. Lengthening of the basal layer and the capillaries showed high positive correlations with thickening of the basal layer cell layer. Lengthening of the capillaries exceeded the lengthening of the basal layer cell layer amd the thickening of the epithelium but fell short of the increased anabolic performance of the epithelium as quantitated in previous investigations.

  15. Total Reconstruction of the Upper Lip Using Bilateral Nasolabial Flaps, Submental Flap, and Mucosa Graft following Complete Resection for Squamous Cell Carcinoma

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    O. G. Oseni


    Full Text Available Lip reconstruction following resection for tumour or following extensive trauma may pose a challenge. This is more so when the resection is total and a complete lip has to be constructed. We present a case of lip reconstruction following a total resection of the upper lip. The procedure used in this case was a combination of bilateral nasolabial flaps with a submental flap and buccal mucosal graft lining. We believe that this provides an alternative method of total upper lip reconstruction with minimal disruption of the facial aesthesis.

  16. Dental prosthesis and buccal lesions in the elderly Prótesis dentales y lesiones mucosas en el adulto mayor

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    Eduardo Enrique Castillo Betancourt


    Full Text Available Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship with the lesions of the oral mucosa. The square chi tests and the analysis of relative risk were use to determine the association between the variables, also we used a logistical regression model to determine the independent relationship of each factor with the presence of the lesions. Results: We was a 12% of the people with stomatitis sub prosthesis, 8% presented lesions growth hyperplasic and 5,6% they were have angular queilitis. The lesions in the oral mucosa increased in people with prosthesis in not well state, bad hygiene this and in the female sex. Conclusion: the chronic lesions were the more prevalence in this study and they were very related with factors like: state of the conservation the prosthesis, time use, hygiene this and sex of the individual; but when determining the independent influence from each factor with the presence lesions, we established that only the state of conservation of the prosthesis and their hygiene affected of the important way to the old men of this study.Fundamento: las lesiones bucales en los ancianos son muy frecuentes y constituyen un problema de salud debido a las consecuencias que provocan. Objetivo: describir las características de las prótesis removibles usadas por la población de 60 y más años de edad y su relación con las lesiones de la mucosa oral. Métodos: se realiz

  17. Urethroplasty with buccal mucosa graft or penile skin graft for anterior urethral stricture?

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    Alejandro Rojas


    Full Text Available Actualmente el tratamiento para la estrechez de uretra considera diversas técnicas, entre ellas la uretroplastía de aumento utilizando tejidos provenientes de distintas partes del cuerpo, siendo los más utilizados la mucosa oral y la piel prepucioescrotal. Sin embargo ¿existen diferencias en el éxito entre ambos tejidos? Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos una revisión sistemática, que incluye 18 estudios que abordan esta pregunta, entre ellos seis estudios prospectivos. Realizamos una tabla de resumen de los resultados utilizando el método GRADE. Concluimos que existe incertidumbre sobre la superioridad de una técnica sobre otra porque la certeza de la evidencia es muy baja. Se necesita con urgencia una nueva revisión sistemática en este tópico ya que existen estudios publicados con posterioridad a la revisión más reciente que podrían entregar una certeza mayor.

  18. The Folded Buccal Musculomucosal Flap for Large Palatal Fistulae in Cleft Palate

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    Shinji Kobayashi, MD


    Conclusion: The f-BMMF is able to cover both sides without a raw surface and a mucosal graft even in cases of large fistula closure, although BMMF cannot usually cover both oral and nasal sides of a fistula. The advantages of this procedure are that it does not require second surgery to release the pedicle and that its distal island mucosa can be used to monitor engraftment. This proposed method seems to be an appealing alternative.

  19. Refinement of velopharyngoplasty in patients with cleft palate by covering the pharyngeal flap with nasal mucosa from the velum. (United States)

    Stoll, C; Hochmuth, M; Meister, P; Soost, F


    The velopharyngoplasty performed using the popular Sanvenero-Rosselli method improves the speech quality of patients with cleft palate suffering from persistent velopharyngeal insufficiency despite successful closure of the hard and soft palates. However, often a relatively narrow pharyngeal bridge results due to healing not only by granulation and scar contraction, but also due to the insertion of the inferior tip of the flap into a narrow bed. Elevation of two velar flaps with nasal mucosa to cover the exposed muscular undersurface of the pharyngeal flap produces a broader recipient bed into which the pharyngeal flap can be spread. The speech quality of 27 patients treated with this modified method (group B) was compared with that of 27 patients without this modification (group A). Eight weeks after velopharyngoplasty (followed by uneventful wound healing) the speech quality of group B was significantly better than that of group A (pvelum is an important modification of velopharyngoplasty for the improvement of speech quality.

  20. Purple bamboo salt has anticancer activity in TCA8113 cells in vitro and preventive effects on buccal mucosa cancer in mice in vivo. (United States)

    Zhao, Xin; Deng, Xiaoxiao; Park, Kun-Young; Qiu, Lihua; Pang, Liang


    Bamboo salt is a traditional healthy salt known in Korea. The in vitro anticancer effects of the salt were evaluated using a 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyltetrazolium bromide (MTT) assay in TCA8113 human tongue carcinoma cells. At 1% concentration, the growth inhibitory rate of purple bamboo salt was 61% higher than that of sea salt (27%). Apoptosis analysis of the cancer cells was carried out using 4,6-diamidino-2-phenylindole (DAPI) staining to investigate the mechanism of the anticancer effects in tongue carcinoma cells. Purple bamboo salt induced a stronger apoptotic effect than sea salt. An Institute of Cancer Research (ICR) mouse buccal mucosa cancer model was established by injecting mice with U14 squamous cell carcinoma cells. Following injection, the wound at the injection site was smeared with salt samples. It was observed that the tumor volumes for the group treated with purple bamboo salt were smaller than those from the sea salt treatment and control groups. The sections of buccal mucosa cancer tissue showed that canceration in the purple bamboo salt group was weaker compared with that in the sea salt group. Similar results were observed in the lesion section of the cervical lymph. Using reverse transcription-polymerase chain reaction (RT-PCR) and western blotting, the purple bamboo salt group demonstrated an increase in Bcl-2-associated X protein (Bax) and a decrease in B cell lymphoma-2 (Bcl-2), inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) expression, compared with the sea salt and control groups. The results demonstrated that purple bamboo salt had improved in vivo buccal mucosa cancer preventive activity compared with sea salt in mice.

  1. The extended free lateral arm flap for buccal soft tissue reconstruction after buccal cancer%游离延展上臂外侧皮瓣修复颊癌术后软组织缺损

    Institute of Scientific and Technical Information of China (English)

    陈勇; 杨旭东; 李威; 陈修娟; 胡勤刚


    目的 探讨游离延展上臂外侧皮瓣修复颊癌术后软组织缺损的临床疗效.方法 2011年1月至8月,应用游离延展上臂外侧皮瓣一期修复3例颊癌扩大切除术造成的软组织缺损,术前应用多普勒血流探测仪测量后桡侧副动脉无变异后,根据其走行,以及术中软组织缺损的面积、形态设计皮瓣,皮瓣均越过肱骨外上髁,面积为9 cm ×5 cm~10 cm×6 cm,血管蒂长约10 cm.供区创面直接拉拢缝合.结果 3例皮瓣均成活,其中1例因局部负压过大造成血管危象,经手术探查,减轻局部负压,术后皮瓣逐渐恢复正常.术后随访6~10个月,患者均无复发,颊部外观形态及功能恢复良好,2例供区局部有麻木感,6个月后症状减轻.结论 游离延展上臂外侧皮瓣厚度适宜、血供可靠,是修复颊癌术后软组织缺损的较好方法.%Objective To summary the application of the extended free lateral arm flaps for buccal soft tissue reconstruction after buccal cancer.Methods From January to August 2011,three patients underwent the operation of buccal defect reconstruction using the extended free lateral arm flap in onestage.PRCA was identificated with the Doppler probe.According to the mark of PRCA,size and shape of defects,the flaps were designed and extended to the lateral epicondyle of humerus.The flap size ranged from 9 cm × 5 cm to 10 cm × 6 cm with a pedicle of 10 cm in length.The wounds at donor sites were closed directly.Results Vascular crisis happened in one case due to local negative pressure,which resolved after emergency management.All the flaps survived completely.The patients were followed up for 6 to 10 months with no recurrence.Both the esthetic and functional results were satisfactory.Two cases suffered from numb feeling in donor sites which alleviated six months later.Conclusions The extended free lateral arm flap has reliable blood supply with appropriate thickness.It is an optional method for reconstruction of

  2. Reconstrução uretral com retalho autógeno de mucosa bucal após uretrostomia, em cães Urethral reconstruction with autogenous buccal mucosa graft following urethrostomy in dogs

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    Neusa Margarida Paulo


    Full Text Available OBJETIVO: Verificar se fragmentos de mucosa bucal autógena poderiam ser adequados para reconstrução uretral na presença de tecido fibroso, e se tal procedimento poderia determinar a formação de fístulas e ou saculações nos sítios implantares. MÉTODOS: Sete cães adultos foram submetidos à uretrostomia pré-escrotal. Após 40 dias, a uretrostomia foi corrigida por meio da implantação de fragmentos de mucosa bucal na parede ventral da uretra. Os animais foram observados durante 40 dias, quando então, foram submetidos a exames radiográficos e sacrificados para estudo histológico. RESULTADOS: Todos os animais apresentaram cistite e fístulas uretro-cutâneas de duração média de vinte dias foram observadas em seis deles. O aspecto radiográfico aos 40 dias após a reconstrução uretral mostrou: continuidade luminal em sete animais e presença de saculações na parede ventral da uretra em seis, sem interferência na qualidade do jato urinário. As características histológicas indicam integração completa da mucosa bucal ao sítio receptor. CONCLUSÃO: O implante em retalho ventral, com fragmentos de mucosa bucal autógena é adequado para correção de defeito uretral produzido por uretrostomia no cão embora possa ocorrer a formação de saculações no sítio do selamento.PURPOSE: To verify if the buccal mucosa autogen would be suitable for urethral reconstruction in a presence of fibrous tissue and if the procedures could determine the formation of fistulas and saculation at the receptor sites. METHODS: Seven adult dogs was subjected to pre-escrotal uretrostomy. After 40 days, the urethrostomy was corrected through the inplantation of the buccal mucosa fragments at ventral wall of the urethra. The dogs were observed during 40 days, when, it were subjected to radiografic examination and slaughtered to histological study. RESULTS: All animals showed cystitis and urethrocutaneous fistula in average time of 20 days. The

  3. Immunohistochemical comparison of CD5, lambda, and kappa expression in primary and recurrent buccal mucosa-associated lymphoid tissue (MALT) lymphomas. (United States)

    Tanaka, Toshiaki; Kitabatake, Kenichirou; Iino, Mituyoshi; Goto, Kaoru


    Mucosa-associated lymphoid tissue (MALT) lymphoma is a type of extranodal marginal zone B-cell lymphoma and is a distinct subtype of non-Hodgkin's lymphoma.Primary MALT lymphomas can also occur in the oral cavity, although their appearance in this location is rare. The neoplastic cells of which MALT lymphomas are composed express B-cell antigens and show monotypic immunoglobulin expression with light-chain restriction.Although neoplastic MALT lymphoma cells do not express CD5, previous studies have shown that CD5 positive MALT lymphomas are more prone to dissemination than those that do not express CD5. Moreover, there are some reports that describe kappa- and lambda- dual light chain expression in B cell malignant neoplasms.A 66-year-old Japanese woman with swelling of the right buccal mucosa was referred to our hospital. The lesion was excised and was pathologically diagnosed as a MALT lymphoma tumor with a t(11;18)(q21;q21) chromosome translocation.Swelling of the right buccal mucosa recurred 2 years later. The recurrent tumor was then excised and pathologically diagnosed as MALT lymphoma.Immunohistochemical examination of CD5, lambda, and kappa expressions revealed that the primary tumor was positive for CD5, kappa, and lambda, but the recurrent tumor was weakly positive for CD5 and kappa.With respect to lambda positivity, the recurrent tumor showed negativity.Our study suggests that immunohistochemical expression of CD5, kappa, and lambda in oral MALT lymphoma have the risk of recurrence.We first described the recurrence of CD5 positive MALT lymphoma in the oral cavity and compared the immunohistochemical expressions of CD5, lambda, and kappa between the primary and recurrent tumors.

  4. Oxidative Stress on Buccal Mucosa Wound in Rats and Rule of Topical Application of Ethanolic Extracts of Mauli Banana ( Musa acuminata Stem

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    Wenda Fitriati Noora


    Full Text Available The present study was undertaken to evaluate the effect of a topical application of ethanolic extracts of Mauli banana stem on oxidative status in buccal mucosa wounds of rats. The sets involved three groups, P0 was the negative control; P1 was treated with alocair topically; and P2 was treated with ethanolic extracts of Mauli banana stem topically, respectively, 24h after wound creation for 3 days. The oxidative stress status was evaluated by monitoring the SOD, CAT activity, MDA and CC levels. Ethanolic extracts of Mauli banana stem showed significantly increased in SOD activity, decreased in MDA levels, and no significant change both in CAT activity and CC levels compared to negative control. These results showed that The ethanolic extracts of Mauli banana stem might affect the oxidative stress status during wound healing process.

  5. Buccal mucosa is a promising graft in Peyronie’s disease surgery. Our experience and a brief literature review on autologous grafting materials

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    Andrea Fabiani


    Full Text Available Aim: Peyronie’s Disease (PD is an under reported acquired benign condition that, at the moment, is not curable with medical therapy. Surgery represent the gold standard of treatment. Surgical approaches are several and they consist in “plication techniques” or plaque incision/excision with grafting of resulting albuginea defect. Among grafting procedures, albuginea defect substitution with autologous materials demonstrated over the years not inferior results respect to heterologous grafts. Buccal mucosa graft (BMG is not usually emphasized in many review articles and clinical series are yet limited. Methods: We present our experience with seventeen plaque incision procedures and BMG in surgical correction of complex penile curvatures due to PD performed in a period of 30 months. Our analyses was focused on buccal mucosa graft characteristics as major determinant of the surgical success. We also conducted a brief literature review on autologous grafting materials used in reconstructive penile surgery for PD. Results: Our cosmetics and functional results consists in a 100% of functional penile straightening with no relapses and 5,8% of de novo erectile dysfunction. Mean age was 56.4 years, mean follow-up of 22.5 (6-36 months. No complications graft related were observed. Operative time was 115.3 minutes in mean. Over 94% of patients referred they were “really much better” and “much better” satisfied based on PGI-I questionnaire administrated at the last follow- up visit. Conclusion: BMG is revealing as an optimal choice for reconstructive surgery in PD. Anatomical characteristics consisting in the great elasticity, the quick integration time and the easy harvesting technique lead to high cosmetics and functional success rate, without omitting economical and invasiveness aspects.

  6. Comparative evaluation of genotoxicity by micronucleus assay in the buccal mucosa over comet assay in peripheral blood in oral precancer and cancer patients. (United States)

    Katarkar, Atul; Mukherjee, Sanjit; Khan, Masood H; Ray, Jay G; Chaudhuri, Keya


    Early detection and quantification of DNA damage in oral premalignancy or malignancy may help in management of the disease and improve survival rates. The comet assay has been successfully utilised to detect DNA damage in oral premalignant or malignancy. However, due to the invasive nature of collecting blood, it may be painful for many unwilling patients. This study compares the micronucleus (MN) assay in oral buccal mucosa cells with the comet assay in peripheral blood cells in a subset of oral habit-induced precancer and cancer patients. For this, MN assay of exfoliated epithelial cells was compared with comet assay of peripheral blood leucocytes among 260 participants, including those with oral lichen planus (OLP; n = 52), leukoplakia (LPK; n = 51), oral submucous fibrosis (OSF; n = 51), oral squamous cell carcinoma (OSCC; n = 54) and normal volunteers (n = 52). Among the precancer groups, LPK patients showed significantly higher levels of DNA damage as reflected by both comet tail length (P cigarette + khaini > cigarette smokers > areca + khaini > areca. There was no significant difference in the comet length and MNi frequency between males and females who had oral chewing habits. An overall significant correlation was observed between MNi frequency and comet tail length with r = 0.844 and P comet assay in peripheral blood cells is perfectly reflected by the MN assay on oral exfoliated epithelial cells, and MNi frequency can be used with the same effectiveness and greater efficiency in early detection of oral premalignant conditions.

  7. Pu-erh tea has in vitro anticancer activity in TCA8113 cells and preventive effects on buccal mucosa cancer in U14 cells injected mice in vivo. (United States)

    Zhao, Xin; Qian, Yu; Zhou, Ya-Lin; Wang, Rui; Wang, Qiang; Li, Gui-Jie


    Pu-erh tea is a functional tea production in China. The functional effects should be proved. The oral cancer preventive and antimetastatic effects of Pu-erh tea in vitro and in vivo have been studied respectively. Pu-erh tea showed an inhibitory effect on human tongue carcinoma TCA8113 cells proliferation tested by 3-(4,5-Dimethyl-2-Thiazolyl)-2,5-Diphenyltetrazolium Bromide assay and induced TCA8113 apoptosis shown anticancer effect. The antimetastatic effect of Pu-erh tea in TCA8113 cells was proved by the decreasing of matrix metalloproteinases (MMPs) and increasing of tissue inhibitors of metalloproteinases (TIMPs) mRNA transcription. In the animal experiments, the tumor volumes and lymph node metastasis rates of Pu-erh tea-treated mice were smaller than control mice. Pu-erh tea reduced the levels of the serum proinflammatory cytokines interleukin (IL)-6, IL-12, tumor necrosis factor-α, and interferon-γ to a greater extent compared with the control mice, and the levels of 200 μg/mL treatment was more close to the normal mice than 100 μg/mL treated mice. Pu-erh tea also significantly induced apoptosis in tissues of mice (P Pu-erh tea has cancer preventive and anti-metastatic effects on buccal mucosa cancer, the higher concentration get better efficiency.

  8. SIMF和FSG修复老年患者颊癌术后缺损的对照研究%Control study on submental island flap and free skin graft in buccal reconstruction of buccal defects after resection of buccal cancers by in aged patients

    Institute of Scientific and Technical Information of China (English)

    梁刚; 郑田; 季平; 何平; 赵洪伟


    Objective To observe and evaluate the clinical effect of submental island myocutaneous flap(SIMF) and free skin graft(FSG) for the reconstruction of buccal defect resulted from the buccal carcinomas .Methods Forty-four aged aging patients di-agnosed with the buccal carcinomas were operated by the total dissection of primary tumor and selective neck dissection and recon-structed simultaneously with SIMF(19 cases) and FSG(25 cases) .The degree of postoperative cheek shape ,limitation of mouth o-pening ,speech sound ,and function of chewing were observed and analyzed .Results Eighteen SIMFs were completely survived .The residual muscle flap had a good blood supply after the debridement of skin island in one case ,the successful rate of flaps was 94 .7%(18/19) while 100% (25/25) .The donor site of SIMF was sutured directly .Follow-up was taken in 12 months for all patients .In SIMF group ,the degree of postoperative cheek shape ,limitation of mouth opening ,speech sound ,and function of chewing were bet-ter than those of FSG group in FSG group(P0 .05) .Conclusion The submental island flap is an excellent choice for the reconstruction of cheek defects in aging patients af-ter resection of buccal carcinoma .With acceptable cosmetic ,functional results and reasonable oncological saftety ,SIMF has a prom-ising prospect in head and neck surgery .%目的:探讨颏下岛状皮瓣(SIMF)和游离皮片(FSG)在修复老年患者颊癌术后颊部缺损的临床应用效果。方法44例老年颊癌患者行颊癌根治术和颈淋巴清扫术后同期分别应用颏下SIMF(n=19)和FSG(n=25)修复颊部缺损。比较两组患者术后颊部外形恢复程度、开口受限程度、语音功能、咀嚼功能等情况。结果 SIM F组1例出现皮岛坏死,清创后发现肌瓣血运良好,其余全部成活,皮瓣移植成功率94.7%(18/19),供区直接拉拢缝合FSG组的移植成功率为100.0%(25/25

  9. Comparison Between End-to-end Anastomosis and Buccal Mucosa Graft in Short Segment Bulbar Urethral Stricture: a Meta-analysis Study

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    Prahara Yuri


    Full Text Available Aim: to compare long term follow-up between end-to-end urethroplasty and bucal mucosal graft for the management of patients with short bulbar urethral stricture. Methods:we conducted a meta-analysis of cohort studies. Literature research was performed on the MEDLINE, Science Direct, and EMBASE database including studies from 1980 through 2014. The inclusion criteria were patients with short bulbar urethral strictrure (sized ≤3 cm undergoing end-to-end anastomosis (EE and buccal mucosa graft (BMG with the complication of voiding symptoms and sexual dysfunction ≥12 months. Pooled risk ratio (RRs and 95% confidence interval (CIs were calculated using Mantzel-Haenzel method, while the heterogeneity were determined through I2 value. Data analysis were done using Stata software version 10.0 (StataCorp. Results:We analyze 10 studies in this meta-analysis. Sexual dysfunction following EE and BMG were found in 24.6% (45/183 patients and 9.1% (11/122 patients, respectively (overall RR 2.54; 95% CI: 1,44-4,47; p=0.001. Voiding symptoms following EE and BMG were found in 14% (8/57 patients and 12.5% (7/56 patients, respectively (overall RR 0.77; 95% CI: 0.3–2.0; p=0.591. Furthermore, stricture recurrent following EE and BMG were 8.4% (8/107 and 30% (14/46, respectively (overall RR 0.38; 95% CI: 0.17–0.84; p=0.016. The effectiveness of EE and BMG were found to be equal as both demonstrated few complications. BMG were found to be superior than EE terms of minimal sexual dysfunction complication. On the contrary, EE were found to be superior than BMG in terms of stricture recurence following short bulbar urethral stricture surgery. Conclusion:BMG can be considered as the primary treatment rather than EE for managing short urethral stricture cases.

  10. Cell proliferation in lichen planus of the buccal mucosa with special regard to a therapy with an aromatic retinoid (RO 10-9359). Proliferationsverhalten des oralen lichen planus unter besonderer Beruecksichtigung einer Therapie mit aromatischem Retinoid (RO 10-9359)

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    Bauer, G.


    The proliferative activity of buccal mucosa epithelium in 16 patients suffering from oral lichen planus was studied by using (/sup 3/H)-thymidine labelling technique in vitro and histometric methods. Autoradiographic sections of two groups of lesions (12 with atrophic and 4 with acanthotic epithelium) were compared with the buccal mucosa of 19 healthy controls investigated in the same way. Determinations comprised separate and combined labelling indices of the basal and suprabasal progenitor compartment (LIsub(bas), LIsub(sbas), LIsub(total)) in relation to basal cells as well as to surface of the epithelium. The following results were obtained. The values of LIsub(total) per 100 basal cells were increased in both groups of lesions, whereby the relation of LIsub(bas):LIsub(sbas) shifted markedly to LIsub(bas), in particular in the atrophic lesions. When relating the total of labelled nuclei to surface length, however, an increase could be confirmed only in acanthotic lesions, whereas most atrophic lesions showed a decrease. This indicates an impaired capacity of the atrophic epithelium to maintain regenerative steady state. This imbalance could also be confirmed by counting the total of basal cells per surface length, which were significantly lowered in atrophic lesions as compared with acanthotic ones as well as normal mucosa. From the results it can be concluded that the renewal activity of the epithelium in atrophic lesions of lichen planus mucosae becomes virtually deficient, though determination of LIsub(total) referred to basal cells simulates a slight increase. Thus, for detecting intrinsic imbalances in the proliferative equilibrium of squamous epithelium, correlation of progenitor compartment labelling to external surface as the site of continuous cell loss is required.

  11. Multipaddled anterolateral thigh chimeric flap for reconstruction of complex defects in head and neck.

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    Canhua Jiang

    Full Text Available The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14-23 cm and the mean width was 4.9 (range: 2.5-7 cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck.

  12. Buccal Mucosal Graft Urethroplasty

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    Angela M. Arlen


    Full Text Available At our institution, the majority of buccal mucosal graft urethroplasties are performed using a two-team approach with an otolaryngologic surgeon. We report our two-surgeon experience with buccal mucosal grafting for reconstruction of all anterior urethral strictures. Twenty-four men underwent autologous buccal mucosal graft urethroplasty between October 2001 and September 2008 for recurrent urethral stricture disease. Twenty-two underwent a single-stage repair and two underwent a two-stage repair. Medical charts were retrospectively reviewed for demographics, comorbidities, etiology, location and length of stricture, and prior interventions in order to identify predictors of buccal urethroplasty success, defined as no evidence of stricture recurrence. All patients underwent retrograde urethrogram and cystoscopy. Operative and anesthesia times were evaluated. We determined an overall success rate of 83.3% (20 of 24 cases. Mean anesthesia time for single-stage urethroplasty was 155 min and mean operative time was 123 min. One of the two two-stage urethroplasties experienced stricture recurrence (50%. The single-stage buccal graft success rate was 86.4% (19 of 22 cases. Two of the four who developed recurrent stricture disease that required intervention had undergone a previous mesh urethroplasty. Complications developed in four of 24 patients (16.6%, including superficial wound infection (one, superficial wound dehiscence (two, and abscess/fistula formation requiring reoperation (one. The buccal mucosa is an ideal tissue for both single- and two-stage substitution urethroplasty for patients with recurrent stricture disease. Our two-surgeon technique minimizes anesthesia and operative times, and contributes to the overall high success rate and relatively low complication rate.

  13. Lesions of the buccal mucosa in elderly. A study performed in five family doctor´s office of health area III in Cienfuegos city.

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    Beatriz García Alpízar


    Full Text Available Fundament: Bucal lesions in aged persons are very frequent and are not the same in many countries and regions. To know about them is of great importance for we can plan preventive activities and medical services for their attention Objective: To describe the more frequent intraoral mucous lesions in individuals with 60 years old and more. Methods: Descriptive study with a sample of 270 aged persons (both sexes, obtained through simple random sample out of a universe of 1014 individuals with 60 years old and more, from Area III in Cienfuegos. Detailed physical examination was applied to all the studied patients as well as a questionnaire where data of interest were engulfed. Results: From all studied cases, the 26.7% presented some type of bucal lesion, predominantly in women (17.8%. The more frequent lesions were: sub prosthesis stomatitis (10%, leukoplasia (6.2%, and fissuratum epulis (4.4%. The more frequent anatomic localizations of these lesions were: the palatum durum with 27 cases of sub prosthesis stomatitis, the alveolar sulcus with 11 fissuratum epulis, and the jugal mucosa with 4 cases of candidiasis and 7 leukoplasias. Conclusions: A high percentage of this geriatric population presented some type of bucal mucosa lesions, women were the most affected, lesions of prosthetic origin were predominant, as well as pre malignant lesions. The predominant localizations of the lesions were the palatum durum, the alveolar sulcus, and the jugal mucosa.

  14. Daily rhythm variations of the clock gene PER1 and cancer-related genes during various stages of carcinogenesis in a golden hamster model of buccal mucosa carcinoma

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    Ye H


    Full Text Available Hua Ye, Kai Yang, Xue-Mei Tan, Xiao-Juan Fu, Han-Xue LiDepartment of Oral and Maxillofacial Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of ChinaBackground: Recent studies have demonstrated that the clock gene PER1 regulates various tumor-related genes. Abnormal expressions and circadian rhythm alterations of PER1 are closely related to carcinogenesis. However, the dynamic circadian variations of PER1 and tumor-related genes at different stages of carcinogenesis remain unknown. This study was conducted to investigate the daily rhythm variation of PER1 and expression of tumor-related genes VEGF, KI67, C-MYC, and P53 in different stages of carcinogenesis.Materials and methods: Dimethylbenzanthracene was used to establish a golden hamster model of buccal mucosa carcinogenesis. Hamsters with normal buccal mucosa, precancerous lesion, and cancerous lesion were sacrificed at six different time points during a 24-hour period of a day. Pathological examination was conducted using routine hematoxylin and eosin staining. PER1, VEGF, KI67, C-MYC, and P53 mRNAs were detected by real-time reverse transcriptase polymerase chain reaction, and a cosinor analysis was applied to analyze the daily rhythm.Results: PER1, VEGF, C-MYC, and P53 mRNA exhibited daily rhythmic expression in three carcinogenesis stages, and KI67 mRNA exhibited daily rhythmic expression in the normal and precancerous stages. The daily rhythmic expression of KI67 was not observed in cancerous stages. The mesor and amplitude of PER1 and P53 mRNA expression decreased upon the development of cancer (P<0.05, whereas the mesor and amplitude of VEGF, KI67, and C-MYC mRNA increased upon the development of cancer (P<0.05. Compared with the normal tissues, the acrophases of PER1, VEGF, and C-MYC mRNA occurred earlier, whereas the acrophases of P53 and KI67 mRNA lagged remarkably in the precancerous lesions. In the cancer stage, the acrophases

  15. 阴茎腹外侧皮瓣耦合法尿道成形Ⅰ期修复阴茎阴囊型尿道下裂%Ventral-lateral penile skin flap combined with mucosa or skin grafting for urethroplasty: single-stage procedure for penoscrotal hypospadias

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    谢林海; 李强; 李森恺; 周传德; 李峰永; 周宇; 丁健; 曹玉娇; 张思娅


    目的 评价阴茎腹外侧皮瓣在尿道成形中的作用.方法 根据解剖特点设计一个含畸形尿道海绵体的阴茎腹外侧皮瓣.横断短缩的尿道板以彻底矫直阴茎,尿道板缺损段移植颊黏膜或包皮内板皮片,与皮瓣耦合成形尿道,Ⅰ期修复原发阴茎阴囊型尿道下裂.结果 本组共16例患者.所用阴茎腹外侧皮瓣均血供良好、长宽足够、术后无坏死.移植组织7例为颊黏膜,9例为包皮内板皮肤.术后并发症包括尿道口狭窄2例(12.5%)和尿道口腹侧小块组织坏死而遗留大口型尿道下裂1例(6.25%).余患者Ⅰ期治愈,无并发症,术后随访0.5~2.0年,阴茎无弯曲,外观良好,尿道开口正位.结论 应用腹外侧皮瓣耦合移植组织成形尿道有利于阴茎矫直,术后尿道瘘及狭窄发生率低,是修复阴茎阴囊型尿道下裂的较好术式.%Objective To evaluate the effect of ventral-lateral penile skin flap in urethroplasty. Methods While performing single-stage procedure for penoscrotal hypospadias, a ventral-lateral penile skin flap including abnormal corpus spongiosum that beneath it was formed according to its anatomical characteristic, the u-rethral plate was transected to complete penile straightening, the plate defect was corrected by buccal mucosa or inner foreskin grafting. The neourethra was constructed with a combination of the flap, the plate, and the graft. Results Totally 16 patients were included. The flap was well vascularized and wide enough, long enough for urethroplasty, no flap necrosis occurred postoperatively. Buccal mucosa and inner foreskin grafting were performed in 7 and 9 cases, respectively. Complications were meatus stricture in 2 cases and necrosis of small piece of ventral glanular tissue in 1 case. The former demanded second operation; the latter resulted in a me-gameatus. The remaining cases were cured without complications. All patients were followed for 0. 5 to 2. 0 years, penile appearance was

  16. Diagnóstico del carcinoma escamoso de la mucosa bucal: reporte de 5 casos Diagnosis of the squamous carcinoma of the buccal mucous: report of 5 cases

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    JE Baudo


    Full Text Available Es indudable que el cáncer bucal causa un importante número de muertes a nivel mundial. El cáncer invasivo puede permanecer largo tiempo bajo cambios macroscópicos inespecíficos, sólo la biopsia permite su diagnóstico. La técnica más utilizada es la rutina con hematoxilina - eosina, actualmente se agrega a la misma otras que contribuyen a clarificar el diagnóstico, por ejemplo la inmunohistoquímica, que en muchos casos determinará la estirpe de una neoplasia.It is certain that the cancer buccal cause an important number of deaths at world level. The cancer invasivo can remain long time low changes macroscopic unspecific, the biopsy only allows its diagnosis. The more used technique is the routine with hematoxylin - eosin, at the moment is added to the same others that contribute to clarify the diagnosis, for example the inmunohistoquímica that will determine the stock of a neoplasia in many cases.

  17. Microvascular free flap reconstruction for head and neck cancer in a resource-constrained environment in rural India

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    Nirav P Trivedi


    Full Text Available Introduction: Reconstruction with free flaps has significantly changed the outcome of patients with head and neck cancer. Microsurgery is still considered a specialised procedure and is not routinely performed in the resource-constrained environment of certain developing parts of India. Materials and Methods: This article focuses on the practice environment in a cancer clinic in rural India. Availability of infrastructure, selection of the case, choice of flap, estimation of cost and complications associated with treatment are evaluated and the merits and demerits of such an approach are discussed. Results: We performed 22 cases of free flaps in a six-month period (2008-2009. Majority (17 of the patients had oral cancer. Seven were related to the tongue and eight to the buccal mucosa. Radial forearm free flap (RFF: 9 and anterolateral thigh flap (ALT: 9 were the most commonly used flaps. A fibula flap (1 was done for an anterior mandible defect, whereas a jejunum free flap (1 was done for a laryngopharyngectomy defect. There were six complications with two re-explorations but no loss of flaps. Conclusion: Reconstruction with microvascular free flaps is feasible in a resource-constrained setup with motivation and careful planning.

  18. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, Hanne Mørck; Rassing, M R


    (app) of mannitol obtained in analog studies using porcine buccal mucosa in an Ussing chamber. The effect of the exposure on the electrical resistance of the TR146 cell culture model and the porcine buccal mucosa was measured, and the degree of protein leakage due to GC exposure was investigated in the TR146 cell...... culture model. The porcine buccal mucosa was approximately ten times less permeable to mannitol than the TR146 cell culture model. The P(app)TC. Increased P(app) values correlated with a decrease in the electrical resistance of the TR146 cell culture model and the porcine buccal mucosa. GC was shown...

  19. Influencing factors of micronucleus frequency of exfoliated buccal mucosa cells of male workers in gas stations%加油站男工口腔黏膜脱落细胞微核率的影响因素

    Institute of Scientific and Technical Information of China (English)

    邹云锋; 李琴; 黄炯丽; 卿利; 陈康成; 邱毅; 苏晶; 梁桂强; 张丽娥


    Objective To explore the influencing factors of micronucleus frequencies in exfoliated oral mucosa cells of male workers in gas stations.Methods A total of 145 male workers in gas stations were chosen as the objects in Nanning.The basic information,smoking and drinking habits,occupational history of the workers were collected by questionnaire.The mieronucleus test was applied in exfoliated cells of buccal mueosa to reflect genetic damage.Results Spearman rank correlation analysis showed that micronucleus frequencies of male workers in gas stations were significantly associated with smoking,drinking,type of work and length of occupation (rs=0.166-0.277,P<0.05).Multivariate logistic regression analysis showed that smoking and drinking habits,type of work were significantly associated with increasing micronucleus frequencies (P<0.05).Conclusion Smoking,drinking,and type of work may be associated with higher micronucleus frequencies in exfoliated oral mucosa cells of the investigated male workers in gas stations.%目的 探讨加油站男工口腔黏膜脱落细胞微核率(OMN)与职业相关因素(工种、工龄)及吸烟、饮酒的关系.方法 选择南宁市145名加油站男工为研究对象,通过问卷调查收集研究对象基本信息、吸烟史、饮酒史和职业史,通过口腔黏膜脱落细胞微核试验计算OMN.结果 Spearman秩相关分析结果显示,吸烟、饮酒、工种、工龄与加油站男工OMN有关(rs值为0.166~0.277,P<0.05).非条件Logistic回归分析结果表明,吸烟、饮酒、工种为加油员与加油站男工OMN的升高有关联(P<0.05).结论 不良的生活习惯与职业相关因素可能与本次调查的加油站男工口腔黏膜脱落细胞OMN的升高有关.

  20. Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue. (United States)

    Al-Juboori, Mohammed Jasim


    Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist.

  1. Conservative Socket Regeneration with Buccal Wall Defect Using Guided Tissue (United States)

    Al-Juboori, Mohammed Jasim


    Progressive alveolar bone resorption after tooth extraction may lead to surgical and prosthetic-driven difficulties, especially when deciding to use a dental implant to replace the extracted tooth. This case report discusses an irreparable lower left second premolar tooth with a periodontal lesion on the buccal side. A preservative tooth extraction was performed. Then, the socket was grafted with bovine bone, a collagen membrane was placed between the buccal bone and the attached gingiva, covering the bone dehiscence buccally, and the socket without a flap was raised. After a 6-month healing period, there was minimal socket width resorption and a shallow buccal vestibule. The implant was placed with high primary stability and sufficient buccal plate thickness. In conclusion, this guided tissue regeneration technique can minimize alveolar bone resorption in a socket with buccal dehiscence, but technical difficulties and shallowing of the buccal vestibule still exist. PMID:27857817

  2. Pedicled Lip Vermilion Mucosa Muscle Flap for Repairing Unilateral Cleft Lip with Secondary Vermilion Tubercle Defect%带蒂唇红黏膜肌瓣修复单侧唇裂继发唇珠缺失

    Institute of Scientific and Technical Information of China (English)

    常刚; 罗志军; 张莉


    [Objective] To explore the efficacy of pedicle lip vermilion mucosa muscle flap for repairing unilateral cleft lip with secondary vermilion. [Methods] The elliptical incision line in the excessive vermilion of lip of unilateral cleft lip with secondary deformity was designed. Retrograde lip vermilion mucosa muscle flap with the vermilion of lip in the incision line as the distal end and the pedicle at the deep layer of vermilion tubercle was designed. The horizon incision line in the recipient area was devised in the middle of vermilion of lip and intersected with elliptical incision of vermillion. The lip vermilion was dissected along incision line. The compound flap was obtained and transferred to the middle of upper lip. Then the mucosa and muscle layer were sutured. [Results] The appearance of postoperative vermilion tubercles of upper lip in 19 patients were improved obviously, and the scar in recipient and donor area was not conspicuous. [Conclusion] The pedicled lip vermilion mucosa muscle flap for repairing the unilateral cleft lip with secondary vermilion tubercle defect is simple and can draw the material from the neighborhood. The operation is completed by one stage, and has satisfactory efficacy.%[目的]探索使用带蒂唇红黏膜肌肉组织瓣修复单侧唇裂继发唇珠缺失的效果.[方法]在单侧唇裂继发畸形外侧过多的唇红处设计椭圆形切口线,以切口部唇红为唇红黏膜肌肉组织瓣的远端,逆行设计蒂位于重建唇珠部肌层深面的唇红黏膜肌肉组织瓣.唇红中部设计受区水平切口线,与唇红椭圆形切口线相交,依切口线切开唇红,切取复合瓣,水平转移至上唇正中,按黏膜,肌层分别缝合.[结果]19例患者术后上唇唇珠形态明显改善,受、供区瘢痕不明显.[结论]用带蒂唇红黏膜肌肉组织瓣修复单侧唇裂继发唇珠缺失方法简单,就近取材,手术I期完成,疗效满意.

  3. Freqüência e atividade enzimática de Candida albicans isoladas da mucosa bucal de crianças de uma creche da prefeitura de Fortaleza Frequency and enzymatic activity of Candida albicans isolated from the buccal mucosa of children of a day-care center of the city hall of Fortaleza, Ceará, Brazil

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    Everardo Albuquerque Menezes


    Full Text Available As candidíases bucais (também chamadas sapinhos que ocorrem em crianças são causadas por uma deficiência imunológica, bem como por outros fatores tais como má higiene bucal e esterilização inadequada dos utensílios utilizados pelas mesmas, que potencializam a ocorrência dessa infecção fúngica. Considerando esse fato, foram avaliadas a freqüência e a atividade enzimática de Candida sp. isoladas em crianças de uma creche pública (Aprisco na cidade de Fortaleza, Ceará. Foram coletadas amostras da mucosa bucal de 364 alunos de 1 a 5 anos de idade. Elas foram semeadas em ágar Sabouraud dextrose com cloranfenicol, incubadas por 72 horas a 37ºC e identificadas por testes micológicos. Verificou-se que 67 (18% apresentaram leveduras do gênero Candida. A Candida albicans foi a mais freqüente, com 30 isolados (45%, seguida pelas C. tropicalis (31%, C. guilliermondii (17%, C. glabrata (4,5% e C. stellatoidea (1,5%. Com relação às atividades enzimáticas das cepas de Candida albicans, 20% produziram a enzima proteinase e 33%, a fosfolipase. As Candida albicans isoladas da mucosa bucal de crianças dessa creche da prefeitura apresentaram uma fraca atividade enzimática. Assim, conclui-se que essas cepas parecem ter uma baixa virulência.Immunedefficiency is one of the main causes of buccal candidiasis, also called thrush, in children. Other factors like inadequate mouth hygiene and inappropriate sterilization utensils potentialize this fungal infection. Considering these facts, Candida sp. frequency and enzymatic activity were evaluated in 364 stocks from mouth mucous of one to five year-old children from a public day care center in Fortaleza, Ceará (Brazil. The samples were cultured in dextrose Sabouraud with chloranfenicol agar and incubated for 72 hours at 37°C. They were identified by mycological tests. It was verified that 67 samples (18% presented Candida sp. and the most frequent genus was Candida albicans (30

  4. 颊粘膜拭子检测孤独症谱系障碍儿童相关基因多态性的临床应用%The application of buccal mucosa swab in analysis of gene polymorphism in children with ASD

    Institute of Scientific and Technical Information of China (English)

    董睿; 刘毅; 赵冬梅; 杨小萌; 张艳卿; 盖忠涛


    Objective To investigate the feasibility of buccal mucosa swab method to isolate genomic DNA for au-tism spectrum disorders (ASD)-related genetic screening. Methods Buccal mucosa swabs and blood were collected from 41 children with ASD. Genomic DNA was extracted from either blood by using a commercial genomic DNA kit or buccal mucosa swab by using phenol-chloroform-isoamyl alcohol method. The concentration, total quality and purity of genomic DNA were compared between these two methods. Genotyping of the ASD-related methylenetetra-hydrofolate reductase (MTHFR) gene C677T locus was analyzed using PCR-restriction enzymatic digestion and sanger sequencing was per-formed for validation. Results The total quality [(5.87±2.58)μg vs. (2.00±0.92)μg] and concentration [(143.25±72.78) mg/L vs. (66.68±24.43) mg/L] of genomic DNA extracted from buccal mucosa swab were higher than that form blood (P0.05). Genotyping analysis of MTHFR was also consistent between these two methods. Conclusion Buccal mucosa swab is a simple, non-invasive and reliable meth-od to obtain genomic DNA, which can partially replace blood for analysis of ASD-related gene polymorphisms.%目的:探讨应用颊粘膜拭子采集样本以提取DNA进行孤独症谱系障碍(autism spectrum disorder, ASD)相关基因检测的可行性。方法纳入41例ASD患儿。采用棉拭子擦拭患儿颊粘膜,酚-氯仿-异戊醇法抽提基因组DNA;另采集患儿外周静脉血,用试剂盒提取基因组DNA。比较两种取材方法获得的基因组DNA总量、浓度与纯度。应用PCR-限制性酶切法对亚甲基四氢叶酸还原酶(methylenetetra-hydrofolate reduc-tase,MTHFR)基因C677T位点进行基因型分析,比较两种取材法获得的基因分型结果一致性。结果从颊粘膜提取的基因组DNA总量[(5.87±2.58)μg vs.(2.00±0.92)μg]与浓度[(143.25±72.78)mg/L vs.(66.68±24.43)mg/L]高于200µL血液提取的基因组DNA(P<0.01),而

  5. Versatility of radial forearm free flap for intraoral reconstruction

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    Jeremić Jelena V.


    Full Text Available Introduction. The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. Objective. The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. Methods. This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5% or delayed (2 patients, 9.5% reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases, buccal mucosa (5 cases, lip (1 case and a retromolar triangle (2 cases defects, or after hemiglossectomy (7 cases. In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction. Results. An overall success rate was 90.5%. Flap failures were detected in two (9.5% patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis. The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft. Conclusion. The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies. [Projekat Ministarstva nauke Republike Srbije, br. 41006

  6. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Nielsen, H M; Rassing, M R; Nielsen, Hanne Mørck


    and porcine buccal mucosa. Further, the permeability rates of ten beta-adrenoceptor antagonists (acebutolol, alprenolol, atenolol, labetalol, metoprolol, oxprenolol, pindolol, propranolol, timolol and tertatolol) across the TR146 cell culture model and porcine buccal mucosa were related to their lipophilicity...... x 10(-6) cm/s (metoprolol). For propranolol the cellular permeability value (P(c)) was lower than expected, probably due to accumulation in the TR146 cell layers. Limited correlation of permeability with k' was observed both for the TR146 cell culture model and the porcine buccal mucosa, although...

  7. Buccal alterations in diabetes mellitus

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    Negrato Carlos


    Full Text Available Abstract Long standing hyperglycaemia besides damaging the kidneys, eyes, nerves, blood vessels, heart, can also impair the function of the salivary glands leading to a reduction in the salivary flow. When salivary flow decreases, as a consequence of an acute hyperglycaemia, many buccal or oral alterations can occur such as: a increased concentration of mucin and glucose; b impaired production and/or action of many antimicrobial factors; c absence of a metalloprotein called gustin, that contains zinc and is responsible for the constant maturation of taste papillae; d bad taste; e oral candidiasis f increased cells exfoliation after contact, because of poor lubrication; g increased proliferation of pathogenic microorganisms; h coated tongue; i halitosis; and many others may occur as a consequence of chronic hyperglycaemia: a tongue alterations, generally a burning mouth; b periodontal disease; c white spots due to demineralization in the teeth; d caries; e delayed healing of wounds; f greater tendency to infections; g lichen planus; h mucosa ulcerations. Buccal alterations found in diabetic patients, although not specific of this disease, have its incidence and progression increased when an inadequate glycaemic control is present.

  8. Histologia da camada superficial da lâmina própria da prega vocal ao se aplicar retalho pediculado de mucosa: estudo experimental em cães Vocal fold superficial layer of lamina propria histology after the position of mucosa pediculated flap: canine experimental study

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    David Greco Varela


    Full Text Available Os resultados conseguidos até hoje para a correção de sulcos vocais e lesões cicatriciais não são universalmente aceitos. A Técnica do Retalho Pediculado de Mucosa de Prega Vocal consiste na colocação de um retalho de mucosa de prega vocal com pedículo anterior na camada superficial da lâmina própria, abaixo da borda livre. OBJETIVO: Descrever os achados histológicos pós-operatórios ocorridos na camada superficial da lâmina própria de cães ao se aplicar a técnica em questão, tomando-se como parâmetro a variação dos colágenos total, tipo I, tipo III e número de núcleos celulares. FORMA DE ESTUDO: experimental. MATERIAL E MÉTODO: Foram utilizados 15 cães. Numa das pregas foi realizada a intervenção e a contralateral foi deixada como controle. Cada grupo de três cães foi sacrificado em 10, 30, 90, 180 e 360 dias após a cirurgia. As colorações utilizadas foram: H.E. e Syrius Red. RESULTADOS: Os níveis de colágeno total e tipo I apresentaram uma tendência a aumento nos grupos de intervenção nos 90º e 180º dias de pós-operatório, contudo só houve significância estatística no 180º dia (pMany techniques were applied to treat patients with sulcus vocalis and scarred vocal folds. Their results were not good enough. In the Technique of Vocal Fold Pediculated Mucosa Flap, an anterior pediculated flap of vocal fold is positioned on the superficial layer of the lamina propria, below the free margin. AIM: To describe histological postoperative findings on the superficial layer of lamina propria during the application of the technique Vocal Fold Pediculated Mucosa Flap. The following parameters were compared between tested and control groups: total, type I and type III collagen and number of cellular nucleus. STUDY DESIGN: experimental. MATERIAL AND METHOD: Fifteen dogs were used. One vocal fold was submitted to the intervention and the other was left as control. Each group of three dogs was sacrificed on 10, 30

  9. Development and evaluation of tamarind seed xyloglucan-based mucoadhesive buccal films of rizatriptan benzoate. (United States)

    Avachat, Amelia M; Gujar, Kishore N; Wagh, Kishor V


    Mucoadhesive buccal films were developed using tamarind seed xyloglucan (TSX) as novel mucoadhesive polysaccharide polymer for systemic delivery of rizatriptan benzoate through buccal route. Formulations were prepared based on 3(2) factorial design with concentrations of TSX and carbopol 934P (CP) as independent variables. Three dependent variables considered were tensile strength, bioadhesion force and drug release. DSC analysis revealed no interaction between drug and polymers. Ex vivo diffusion studies were carried out using Franz diffusion cell, while bioadhesive properties were evaluated using texture analyzer with porcine buccal mucosa as model tissue. Results revealed that bilayer film containing 4% (w/v) TSX and 0.5% (w/v) CP in the drug layer and 1% (w/v) ethyl cellulose in backing layer demonstrated diffusion of 93.45% through the porcine buccal mucosa. Thus, this study suggests that tamarind seed polysaccharide can act as a potential mucoadhesive polymer for buccal delivery of a highly soluble drug like rizatriptan benzoate.

  10. Evaluation of a mucoadhesive buccal patch for delivery of peptides: in vitro screening of bioadhesion. (United States)

    Li, C; Bhatt, P P; Johnston, T P


    We have assessed the bioadhesive properties of several different mucoadhesive buccal patches. The patches consisted of custom coformulations of silicone polymers and Carbopol 974P. The contact angle of water was measured for each of the test formulations, using an ophthalmic shadow scope. The corresponding work of adhesion between the water and the patches (W1), and between the patches and freshly-excised rabbit buccal mucosa (W2) was then calculated, using a modification of Dupre's equation. The bioadhesive strength between the patches and excised rabbit buccal mucosa was also assessed. The results of the contact-angle measurements indicated that the contact angle decreased with an increase in the amount of Carbopol in the formulation. Additionally, the calculated values of both W1 and W2 increased with an increase in the amount of Carbopol in the buccal-patch formulations. A correlation (r not equal to 0.9808) was found between the measured contact angle and the calculated values for W2. The direct measurement of the force required to separate a buccal patch from excised rabbit buccal mucosa with the INSTRON demonstrated that the adhesive strength increased with an increase in the amount of Carbopol. This preliminary study has shown that the measurement of contact angles alone may provide a useful technique for estimating the work of adhesion, and may serve as a convenient and rapid screening procedure to identify potential mucoadhesive buccal-patch formulations.

  11. In-vitro characterization of buccal iontophoresis: the case of sumatriptan succinate. (United States)

    Telò, Isabella; Tratta, Elena; Guasconi, Barbara; Nicoli, Sara; Pescina, Silvia; Govoni, Paolo; Santi, Patrizia; Padula, Cristina


    Buccal administration of sumatriptan succinate might be an interesting alternative to the present administration routes, due to its non-invasiveness and rapid onset of action, but because of its low permeability, a permeation enhancement strategy is required. The aim of this work was then to study, in-vitro, buccal iontophoresis of sumatriptan succinate. Permeation experiments were performed in-vitro across pig esophageal epithelium, a recently proposed model of human buccal mucosa, using vertical diffusion cells. The iontophoretic behavior of the tissue was characterized by measuring its isoelectric point (Na(+) transport number and the electroosmotic flow of acetaminophen determination) and by evaluating tissue integrity after current application. The results obtained confirm the usefulness of pig esophageal epithelium as an in-vitro model membrane for buccal drug delivery. The application of iontophoresis increased sumatriptan transport, proportionally to the current density applied, without tissue damage: electrotransport was the predominant mechanism. Integrating the results of the present work with literature data on the transport of other molecules across the buccal mucosa and across the skin, we can draw a general conclusion: the difference in passive transport across buccal mucosa and across the skin is influenced by permeant lipophilicity and by the penetration pathway. Finally, buccal iontophoretic administration of sumatriptan allows to administer 6mg of the drug in 1h, representing a promising alternative to the current administration routes.

  12. Lesions of the buccal mucosa in elderly. A study performed in five family doctor´s office of health area III in Cienfuegos city. Lesiones de la mucosa bucal del adulto mayor. Un estudio en cinco consultorios del área III de Cienfuegos.

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    Mikhail Benet Rodríguez


    Full Text Available

    Fundament: Bucal lesions in aged persons are very frequent and are not the same in many countries and regions. To know about them is of great importance for we can plan preventive activities and medical services for their attention Objective: To describe the more frequent intraoral mucous lesions in individuals with 60 years old and more. Methods: Descriptive study with a sample of 270 aged persons (both sexes, obtained through simple random sample out of a universe of 1014 individuals with 60 years old and more, from Area III in Cienfuegos. Detailed physical examination was applied to all the studied patients as well as a questionnaire where data of interest were engulfed. Results: From all studied cases, the 26.7% presented some type of bucal lesion, predominantly in women (17.8%. The more frequent lesions were: sub prosthesis stomatitis (10%, leukoplasia (6.2%, and fissuratum epulis (4.4%. The more frequent anatomic localizations of these lesions were: the palatum durum with 27 cases of sub prosthesis stomatitis, the alveolar sulcus with 11 fissuratum epulis, and the jugal mucosa with 4 cases of candidiasis and 7 leukoplasias. Conclusions: A high percentage of this geriatric population presented some type of bucal mucosa lesions, women were the most affected, lesions of prosthetic origin were predominant, as well as pre malignant lesions. The predominant localizations of the lesions were the palatum durum, the alveolar sulcus, and the jugal mucosa.

    Fundamento: Las lesiones bucales en los ancianos son muy frecuentes y difieren en diferentes países y regiones, conocer sobre estas es de gran importancia pues permite planificar actividades preventivas y servicios médicos para su atención. Objetivo: Describir las lesiones mucosas intraorales más frecuentes en los individuos de 60 años y m

  13. Buccal bone loss after immediate implantation can be reduced by the flapless approach

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    Full Text Available Aim: The aim of this study was to evaluate the buccal bone remodeling after immediate implantation with flap or flapless approach. Material and Methods: The mandibular bilateral premolars of 3 dogs were extracted and immediately three implants were placed in both hemi-arches of each dog. Randomly, one hemi-arch was treated with the flapless approach, while in the contra lateral hemi-arch tooth extractions and implant placement were done after mucoperiosteal flap elevation. Non-submerged healing of 12 weeks was provided for both groups. Histomorphometric analysis was done to compare buccal and lingual bone height loss, bone density and bone-to-implant contact in the groups. Fluorescence analysis was performed to investigate the dynamic of bone remodeling in the different groups. Results: There was a significant association between the surgical flap and the extent of bone resorption around immediate implants. The loss of buccal bone height was significantly lower in the flapless group when compared to the flap group (0.98 mm x 2.14 mm, respectively, p<0.05. The coronal and apical buccal bone densities of the flap group were significantly higher when compared to the lingual components, showing anatomical differences between the bone plates. Fluorescence analysis showed no major differences in bone healing between the flap and flapless groups, supporting that the higher loss of buccal bone height is linked to the anatomic characteristics of this plate and to the negative influence of the detachment of the periosteum in immediate implant therapy. Conclusion: The flapless approach for immediate post-extraction implants reduces the buccal bone height loss.


    Directory of Open Access Journals (Sweden)

    Jasvir Singh* and Pawan Deep


    Full Text Available ABSTRACT: As an alternative to injection pharmaceutical researcher and scientist are trying to explore transdermal and transmucosal route over the last few years. To overcome the deficiency associated with the other route of administration buccal region of oral cavity is an alternative target for the administration of choice of drug. The disadvantages relative with the oral drug delivery is the extensive presystemic metabolism, instability in acidic medium as a result inadequate absorption of the drugs. However parental route may overcome the drawback related with the oral route but these formulations have high cost, supervision is required and least patient compliance. By the buccal route the drug are directly pass through into systemic circulation, less hepatic metabolism and high bioavailability. The aim of the review article is an overview of buccal drug delivery, anatomy of oral mucosa, mechanism of drug penetration and their in-vitro and in-vivo mucoadhesion testing method.

  15. TR146 cells grown on filters as a model of human buccal epithelium

    DEFF Research Database (Denmark)

    Mørck Nielsen, H; Rømer Rassing, M; Nielsen, Hanne Mørck


    The objective of the present study was to characterise the TR146 cell culture model as an in vitro model of human buccal mucosa with respect to the enzyme activity in the tissues. For this purpose, the contents of aminopeptidase, carboxypeptidase and esterase in homogenate supernatants of the TR146...... cell culture model, and human and porcine buccal epithelium were compared. The esterase activity in the intact cell culture model and in the porcine buccal mucosa was compared. Further, the TR146 cell culture model was used to study the permeability rate and metabolism of leu-enkephalin. The activity...... of the three enzymes in the TR146 homogenate supernatants was in the same range as the activity in homogenate supernatants of human buccal epithelium. In the TR146 cell culture model, the activity of aminopeptidase (13.70+/-2.10 nmol/min per mg protein) was approx. four times the activity of carboxypeptidase...

  16. Evaluación de la toxicidad aguda oral e irritación sobre mucosa bucal de la solución CM-95 tratada magnéticamente Oral acute toxicity and irritation on buccal mucosa evaluation of the CM-95 solution magnetically treated

    Directory of Open Access Journals (Sweden)

    Jorge Díaz Bestard


    Full Text Available La Solución CM-95 tratada magnéticamente es un producto en desarrollo que mostró propiedades inmunoestimulantes en ensayos preclínicos, característica que la hacen adecuada como candidata a inmunopotenciador. En este trabajo se evaluaron los posibles efectos tóxicos preclínicos de la Solución CM-95 tratada magnéticamente, por el método de las Clases de Toxicidad Aguda y el de irritación de la mucosa oral, adaptando las normas OECD 423 y la ISO 10993-10, respectivamente. En el método de las Clases de Toxicidad Aguda se utilizó el ensayo límite, en ratas Sprague Dawley hembras, en el cual la dosis estuvo relacionada con el nivel de inducción magnética, en este caso 0,16 T, aplicado a la Solución CM-95; y el volumen a administrar de la misma, calculado sobre la base de 2 ml de la solución por 100 g de peso corporal. La determinación de la irritación de la mucosa oral se llevó a cabo en hámster Sirios Dorados hembras mediante un ensayo a dosis repetidas durante 7 días de tratamiento en la bolsa gular derecha, con pellet de algodón impregnado con 0,5 ml de la solución tratada magnéticamente con la misma inducción. No se encontró mortalidad ni evidencias de signos tóxicos para el ensayo de toxicidad aguda, y se obtuvo un índice de irritación sobre mucosa oral de 0, por lo que la sustancia estudiada se enmarcó como "No clasificada" y "No irritante" según la metodología empleada. Estos resultados complementarán otros estudios toxicológicos para avalar la seguridad de esta Solución para su uso futuro como fármaco por vía oral.CM-95 solution magnetically treated is a product which showed immunologic properties in preliminary tests, characteristic that makes it adequate as inmunopotentiator candidate. In this study the possible preclinical toxic effects of CM-95 Solution magnetically treated were evaluated, by the Acute Toxicity Class method and oral mucosa irritation test, adapting guideline OECD 423 and ISO 10993

  17. Nevus of ota with buccal mucosal pigmentation: a rare case. (United States)

    Shetty, Shishir Ram; Subhas, Babu G; Rao, Kumuda Arvind; Castellino, Renita


    Nevus of Ota is a condition wherein the typical pattern of the bluish black pigmentation is noticed along with the cutaneous distribution of the trigeminal nerve. This condition is most prevalent in Japanese population but comparatively rare among Indians. We report a case of 23-year-old female presented with unilateral pigmented areas over the skin of forehead, malar area, ear and periorbital area. Blackish-blue pigmented areas were also noticed on the sclera. Brownish-black diffuse pigmented areas were also noticed on the buccal mucosa of the same side. The presence of pigmentation on the skin over pinna and oral pigmentation made our case a rare incidence. Oral pigmentations associated with nevus of Ota especially on the buccal mucosa have rarely been reported in the past.

  18. Nevus of Ota with buccal mucosal pigmentation: A rare case

    Directory of Open Access Journals (Sweden)

    Shishir Ram Shetty


    Full Text Available Nevus of Ota is a condition wherein the typical pattern of the bluish black pigmentation is noticed along with the cutaneous distribution of the trigeminal nerve. This condition is most prevalent in Japanese population but comparatively rare among Indians. We report a case of 23-year-old female presented with unilateral pigmented areas over the skin of forehead, malar area, ear and periorbital area. Blackish-blue pigmented areas were also noticed on the sclera. Brownish-black diffuse pigmented areas were also noticed on the buccal mucosa of the same side. The presence of pigmentation on the skin over pinna and oral pigmentation made our case a rare incidence. Oral pigmentations associated with nevus of Ota especially on the buccal mucosa have rarely been reported in the past.

  19. Dental prosthesis and buccal lesions in the elderly


    Beatriz García Alpizar; Mikhail Benet Rodíguez; Eduardo Enrique Castillo Betancourt


    Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship...

  20. Circadian rhythm variation of the clock genes Per1 and cell cycle related genes in different stages of carcinogenesis of buccal mucosa in animal model%鼠口腔黏膜癌变过程中生物钟基因Per1与细胞周期基因昼夜节律的表达

    Institute of Scientific and Technical Information of China (English)

    谭雪梅; 叶华; 杨凯; 陈丹; 唐洪


    Objective To investigate the expression and circadian rhythm variation of biological clock gene Per1 and cell cycle genes p53,CyclinD1,cyclin-dependent kinases (CDK1),CyclinB1 in different stages of carcinogenesis in buccal mucosa and its relationship with the development of buccal mucosa carcinoma.Methods Ninety golden hamsters were housed under 12 hours light-12 hours dark cycles,and the model of buccal squamous cell carcinoma was established by using the dimethylbenzanthracene(DMBA) to smear the golden hamster buccal mucosa.Before the DMBA was used and after DMBA was used 6 weeks and 14 weeks respectively,the golden hamsters were sacrificed at 6 different time points (5 rats per time point) within 24 hour,including 4,8,12,16,20 and 24 hour after lights onset(HALO),and the normal buccal mucosa,precancerous lesions and cancer tissue were obtained,respectively.HE stained sections were prepared to observe the canceration of each tissue.Real time RT-PCR was used to detect the mRNA expression of Per1,p53,CyclinD1,CDK1 and CyclinB1,and a cosine analysis method was applied to determine the circadian rhythm variation of Per1,p53,CyclinD1,CDK1 and CyclinB1 mRNA expression,which were characterized by median,amplitude and acrophase.Results The expression of Per1,p53,CDK1 and CyclinD1 mRNA in 6 different time points within 24 hours in the tissues of three different stages of carcinogenesis had circadian rhythm,respectively.However,the CyclinB 1 mRNA was expressed with circadian rhythm just in normal and cancer tissue (P<0.05),while in precancerous lesions the circadian rhythm was in disorder (P>0.05).As the development of carcinoma,the median of Per 1 and p53 mRNA expression were significantly decreased (P<0.05),yet the median of CDK1,CyclinB1 and CyclinD1 mRNA expression were significantly increased (P<0.05).The amplitude of Per1,p53 and CyclinD1 mRNA expression was significantly decreased as the development of carcinoma (P<0.05),however the amplitude of CDK1 m

  1. Buccal delivery of metformin

    DEFF Research Database (Denmark)

    Sander, Camilla; Nielsen, Hanne Mørck; Jacobsen, Jette


    system. The in vitro TR146 cell culture model was used to study the effect of drug concentration (5-100mM) and the impact of a bioadhesive chitosan formulation (discs) and chitosan in solution (0-20mg/mL) acting as a permeation enhancer. The permeation of metformin occurred by passive diffusion via...... metformin discs and, metformin permeation may be increased due to a combination of bioadhesion and permeation enhancement induced by chitosan, although the permeation enhancing effect of chitosan was not statistically significant. The limited apparent buccal permeability of metformin observed in vitro...

  2. Conscious and anaesthetised Göttingen mini-pigs as an in-vivo model for buccal absorption - pH-dependent absorption of metoprolol from bioadhesive tablets

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Jacobsen, Jette; Andersen, Morten B;


    Abstract The potential of buccal mucosa as a site for systemic absorption has attracted increased attention in recent years creating a need for new predictive in-vivo models. The aim of this study was to evaluate anaesthetised and conscious Göttingen mini-pigs as a model for buccal drug absorption...

  3. Chemokine production by buccal epithelium as a distinctive feature of pediatric Crohn disease

    NARCIS (Netherlands)

    Damen, GM; Hol, J; de Ruiter, L.; Bouquet, J; Sinaasappel, M; van der Woude, J; Laman, JD; Hop, WCJ; Buller, HA; Escher, JC; Nieuwenhuis, EES


    Objectives: Inflammatory bowel diseases (IBD) represent an aberrant immune response by the mucosal immune system to luminal bacteria. Because the oral mucosa harbors the first epithelial cells that interact with microorganisms, we assessed the immunologic activity of buccal epithelium in children wi

  4. Periodontal Responses to Augmented Corticotomy with Collagen Membrane Application during Orthodontic Buccal Tipping in Dogs

    Directory of Open Access Journals (Sweden)

    Dong-Yeol Lee


    Full Text Available This prospective randomized split-mouth study was performed to examine the effects of absorbable collagen membrane (ACM application in augmented corticotomy using deproteinized bovine bone mineral (DBBM, during orthodontic buccal tipping movement in the dog. After buccal circumscribing corticotomy and DBBM grafting into the decorticated area, flaps were repositioned and sutured on control sides. ACM was overlaid and secured with membrane tacks, on test sides only, and the flaps were repositioned and sutured. Closed coil springs were used to apply 200 g orthodontic force in the buccolingual direction on the second and third premolars, immediately after primary flap closure. The buccal tipping angles were 31.19±14.60° and 28.12±11.48° on the control and test sides, respectively. A mean of 79.5 ± 16.0% of the buccal bone wall was replaced by new bone on the control side, and on the test side 78.9±19.5% was replaced. ACM application promoted an even bone surface. In conclusion, ACM application in augmented corticotomy using DBBM might stimulate periodontal tissue reestablishment, which is useful for rapid orthodontic treatment or guided bone regeneration. In particular, ACM could control the formation of mesenchymal matrix, facilitating an even bone surface.

  5. Improvement of buccal delivery of morphine using the prodrug approach

    DEFF Research Database (Denmark)

    Christrup, Lona Louring; Jørgensen, A.; Christensen, C.B.;


    The feasibility of achieving buccal delivery of morphine using the prodrug approach was assessed by studies of bioactivation, in vitro permeation and in vivo absorption. The bioactivation of various morphine-3-esters was studied in human plasma and saliva. The in vitro permeation of morphine...... and various morphine-3-esters was studied using porcine buccal mucosa mounted in Ussing chambers and finally the in vivo absorption of the compounds evaluated following administration in rats. Both the results from the in vitro permeation and from the absorption of the prodrugs studied suggested a parabolic...... relationship to the lipophilicity of the compounds. In the in vitro studies the optimal permeation was achieved for the prodrug morphine-3-propionate having a log P value of approximately 0.7. In contrast to that optimal in vivo absorption was obtained for the prodrug morphine-3-acetate having a log P value...

  6. Lip mucosa transplantation combined with pedicle fascial flap through subconjunctival tunnel repairment for exposure defects of hydroxyapatite prosthesis implant%唇黏膜移植联合带蒂筋膜瓣修补义眼台暴露的临床观察

    Institute of Scientific and Technical Information of China (English)

    金书红; 屠永芳; 韩宝红


    Objective To observe the clinical effect of repairment for exposure defects of hydroxyapatite prosthesis implant with lip mucosa transplantation combined pedicle fascial flap through subconjunctival tunnel.Methods Seventeen patients (17 eyes) with few fascia covered of hydroxyapatite prosthesis implant exposures were treated from April 2009 to February 2015.Part of the exposed hydroxyapatite was grinded off by dental drill.The exposed hydroxyapatite anterior surface was cleaned up and the defect was closed by three or four pedicle fomical fascial flaps combined with lip mueosa graft.Results Sevemeen postoperative patients maintained closure of the defects durhag the follow-up of 6 to 12 months.The lip mucosa transplantation was survived.No hydroxyapatite exposure was observed among 17 patients,no inflammatory granuloma was appeared.Conclusions Treatment of hydroxyapatite exposure is difficult,especially hydroxyapatite prosthesis front a few fascia coverage.The method that with three or four pedicle fomical fascial flaps combined with lip mucosa transplantation is safe and effective.%目的 观察唇黏膜移植联合多个带蒂筋膜瓣经结膜下隧道修补义眼台暴露的临床效果.方法 于2009年4月至2015年2月收治17例羟基磷灰石义眼台暴露患者,义眼台前部未暴露区仅有一层结膜组织覆盖、球筋膜组织极少.用牙科钻头磨削、去除暴露区的部分义眼台,清理创面后,用穹窿部3~4个带蒂筋膜瓣经相应的结膜下隧道覆盖于义眼台暴露区,同时联合唇黏膜移植修补结膜缺损区.结果 17例患者术后唇黏膜成活良好,无炎性肉芽肿出现.术后随访6~12个月,均未再发生义眼台暴露.结论 义眼台前部球筋膜组织极少的义眼台暴露,采用唇黏膜移植联合穹窿部多个带蒂筋膜瓣经结膜下隧道修补是一种安全、有效地治疗方法.

  7. Overview and Future Potential of Buccal Mucoadhesive Films as Drug Delivery Systems for Biologics. (United States)

    Montenegro-Nicolini, Miguel; Morales, Javier O


    The main route of administration for drug products is the oral route, yet biologics are initially developed as injectables due to their limited stability through the gastrointestinal tract and solubility issues. In order to avoid injections, a myriad of investigations on alternative administration routes that can bypass enzymatic degradation and the first-pass effect are found in the literature. As an alternative site for biologics absorption, the buccal route presents with a number of advantages. The buccal mucosa is a barrier, providing protection to underlying tissue, but is more permeable than other alternative routes such as the skin. Buccal films are polymeric matrices designed to be mucoadhesive properties and usually formulated with permeability enhancers to improve bioavailability. Conventionally, buccal films for biologics are manufactured by solvent casting, yet recent developments have shown the potential of hot melt extrusion, and most recently ink jet printing as promising strategies. This review aims at depicting the field of biologics-loaded mucoadhesive films as buccal drug delivery systems. In light of the literature available, the buccal epithelium is a promising route for biologics administration, which is reflected in clinical trials currently in progress, looking forward to register and commercialize the first biologic product formulated as a buccal film.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND : Patients with paradoxical ventricular septal motion are a challenge to anaesthesiologist due to risk of perioperative myocardial ischaemia and sudden cardiac arrest. CASE DESCRIPTION : We present anaesthetic management of a 45year old lady with a diagnosed case of carcinoma left buccal mucosa with paradoxical ventricular septal motion posted for modified radical neck disse ction with radial free flap. CONCLUSION : Although clinical manifestations of this cardiac condition may be mild, there is certainly associated pathology of direct relevance, which carries importance in the anaesthetic management in the peri - operative perio d. Patients with paradoxical ventricular septal motion of any etiology are more prone for perioperative myocardial ischaemia and sudden cardiac arrest, because if cardiac conduction is not maintained properly then it may result in further increase in the p aradoxical ventricular septal motion

  9. 阴茎皮片/口腔黏膜移植物尿道成形术治疗尿道狭窄预后的 Meta 分析%Penile skin/buccal mucosa graft urethroplasty for urethral stricture:a meta -analysis

    Institute of Scientific and Technical Information of China (English)

    葛鹏; 杨新宇; 王子成; 喻希; 林健


    Objectives:To compare and assess the efficacy of penile skin graft (PSG)/buccal mucosa graft (BMG)urethroplasty in the treatment of urethral stricture.Methods:Related papers on the use of PSG/BMG ure-throplasty in the reconstruction of urethral defect associated with urethral stricture were searched via Medline,EM-base,Cochrane library,Web of Science,Scopus and CBMDISC.The data extracted from eligible studies were pooled using Stata 1 2.0 software.Results:A total of 1 1 studies,including 1 0 non -randomized studies and a ran-domized controlled trial,involving 699 patients,were included.The randomized controlled trial demonstrated that success rate of BMG was 90.5% versus 87.5% of PSG (P =0.07).Meta -analysis of non -randomized studies showed overall success rate of urethroplasty with BMG was better than PSG (RR =0.86,95%CI 0.77 -0.96,P =0.008).Subgroup analysis by surgery indicated dorsal -onlay urethroplasty with PSG or BMG had a similar overall success rate (RR =0.90,95% CI:0.77 -1 .06).Conclusion:One -stage dorsal -onlay urethroplasty with PSG or BMG has a comparable success rate in the treatment of anterior urethral stricture.Additional high -quality and large -scale randomized controlled trials are warranted to further validate these conclusions.%目的:比较评价阴茎皮片/口腔黏膜移植物尿道成形术治疗尿道狭窄优劣。方法:利用数据库 Medline,EMbase,Cochrane library,Web of Science,Scopus 和中国生物医学文献数据库,检索关于阴茎皮片/口腔黏膜移植物尿道成形术治疗尿道狭窄临床研究文章,提取资料,应用 State12.0进行 Meta 分析。结果:纳入10个非随机对照研究和1个随机对照试验,共699人。唯一的随机对照试验显示,口腔黏膜组与阴茎皮片组成功率差别无统计学意义(90.5% vs 87.5%,P =0.07)。非随机对照研究 Meta 分析表明,口腔黏膜组优于阴茎皮片组(RR =0.86,95%CI 0.77-0

  10. Buccal health in asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Nora Sexto Delgado


    Full Text Available Background: Buccal health as integral and determinant part of general health makes us find different ways and methods to elevate life quality in the population. Objective: To establish the risk of suffering from dental cavities in asthmatic patients. Methods: A non match case and control study constituted by 100 children selected at simple random from the universe of asthmatic patients belonging to the General Comprehensive doctor offices number 7,9,10, 11, 43, and 44 from Area II in Cienfuegos municipality. The controlled group was selected in the same offices but from the universe of non asthmatic children. The age in both groups was from 6 to 15 years old. Visits to the children´s home were carried out for the record of the information through health oral dental and buccal health knowledge surveys. Results: The index of cavities, lost, and obturated permanent teeth was higher (3, 28 than in the control group (0, 44. The buccal hygiene indexes and the level of knowledge in both groups did not show significant differences. The most used drugs in asthma therapy were salbutamol and ketotifeno which change the buccal milieu. The odds ratio technique between asthmatic and non asthmatic patients showed 4, 9 times more at risk of suffering from dental cavities in the first group. Finally, it can be stated that the asthmatic patients are more at risk of suffering from cavities than the non asthmatic ones, so a program for buccal health in these patients should be performed.

  11. Genotoxic effects of panoramic radiation by assessing the frequency of micronuclei formation in exfoliated buccal epithelium

    Directory of Open Access Journals (Sweden)

    Vidya KB


    Full Text Available Background: Panoramic radiography is one of the most commonly used radiographic methods to complement clinical examination. Ionizing radiation is a well-known mutagen and carcinogen in the human population. So this study was undertaken to evaluate the possible genotoxic effects of panoramic radiation by assessing the frequency of micronuclei formation in the exfoliated buccal epithelium. Methods: 50 patients of either sex in the age range of 15 to 75 years with apparently normal oral mucosa with no adverse habits and without any oral lesions were included in the present study after their consent. Buccal epithelial cells were obtained from the buccal mucosa by scraping with the toothbrush immediately before and after 10 +/- 2 days of exposure to panoramic radiography. Cytological preparations were stained and observed under microscope. Student's paired and lsquo;t' test was used for the comparison between mean frequency of micronuclei in buccal epithelial cells in patients before and after panoramic radiography. Results: Significant increase (P <0.0001 in the frequency of cells with micronuclei and total number of micronuclei after panoramic radiography was detected. Conclusion: The X-radiation emitted during panoramic radiography does induce some genotoxic changes in the form of increased frequency of micronuclei in target buccal epithelial cells. [Int J Res Med Sci 2014; 2(2.000: 541-544

  12. Combined Regenerative and Mucogingival Treatment of Deep Intrabony Defects Associated with Buccal Gingival Recession: Two Case Reports. (United States)

    Santoro, Giacomo; Zucchelli, Giovanni; Gherlone, Enrico

    The case reports presented in this article describe a surgical approach for improving root coverage and regenerative parameters in deep intrabony defects associated with buccal gingival recession. A mandibular canine and a maxillary premolar were treated. The surgical technique consisted of a connective tissue graft (CTG) that was placed and sutured at the inner surface of a coronally advanced envelope flap (CAF), thickening the buccal soft tissue wall of the most coronal extension of the intrabony defect and treated with biomaterials as scaffold. No palatal/lingual flap was elevated. Two years after the surgery, clinically significant root coverage, increased buccal keratinized tissue height and thickness, some minor improvement in the position of the interdental papilla, and clinical attachment level gain were achieved. The radiographs showed bone fill of the intrabony components of the defects. This report encourages a novel application of CAF + CTG + biomaterials to improve both esthetic and regenerative parameters in deep intrabony defects associated with gingival recessions.

  13. Human pharmacokinetics of intravenous, sublingual, and buccal buprenorphine. (United States)

    Kuhlman, J J; Lalani, S; Magluilo, J; Levine, B; Darwin, W D


    Buprenorphine is a potent opioid analgesic used in the treatment of moderate to severe pain. At higher doses, it has demonstrated potential for treating heroin dependence. This study was undertaken to investigate buprenorphine pharmacokinetics by different routes of administration at dosages approximating those used in opioid-dependence studies. Six healthy men who were nondependent but who had a history of heroin use were administered buprenorphine in a crossover design study by intravenous (1.2 mg), sublingual (4.0 mg), and buccal (4.0 mg) routes of administration. Plasma samples were collected up to 96 h and assayed for buprenorphine and norbuprenorphine by negative chemical ionization tandem mass spectrometry. Plasma concentrations of buprenorphine and norbuprenorphine were analyzed by nonlinear regression analysis with standard noncompartmental methods. Buprenorphine biovailability by the sublingual and buccal routes was estimated as 51.4% and 27.8%, respectively, although there was considerable interindividual variability by both routes of administration. The terminal elimination half-lives were longer for the sublingual and buccal routes than for the intravenous route. The extended elimination half-lives may be due to a shallow depot effect involving sequestration of buprenorphine in the oral mucosa. Norbuprenorphine mean peak plasma concentrations were less than 1 ng/mL and were highly variable among different routes of administration and individuals. The terminal elimination half-life of norbuprenorphine was longer than buprenorphine.

  14. Buccal and sublingual vaccine delivery. (United States)

    Kraan, Heleen; Vrieling, Hilde; Czerkinsky, Cecil; Jiskoot, Wim; Kersten, Gideon; Amorij, Jean-Pierre


    Because of their large surface area and immunological competence, mucosal tissues are attractive administration and target sites for vaccination. An important characteristic of mucosal vaccination is its ability to elicit local immune responses, which act against infection at the site of pathogen entry. However, mucosal surfaces are endowed with potent and sophisticated tolerance mechanisms to prevent the immune system from overreacting to the many environmental antigens. Hence, mucosal vaccination may suppress the immune system instead of induce a protective immune response. Therefore, mucosal adjuvants and/or special antigen delivery systems as well as appropriate dosage forms are required in order to develop potent mucosal vaccines. Whereas oral, nasal and pulmonary vaccine delivery strategies have been described extensively, the sublingual and buccal routes have received considerably less attention. In this review, the characteristics of and approaches for sublingual and buccal vaccine delivery are described and compared with other mucosal vaccine delivery sites. We discuss recent progress and highlight promising developments in the search for vaccine formulations, including adjuvants and suitable dosage forms, which are likely critical for designing a successful sublingual or buccal vaccine. Finally, we outline the challenges, hurdles to overcome and formulation issues relevant for sublingual or buccal vaccine delivery.

  15. Closure of oroantral fistula with rotational palatal flap technique

    Directory of Open Access Journals (Sweden)

    David B. Kamadjaja


    Full Text Available Oroantral fistula is one of the common complications following dentoalveolar surgeries in the maxilla. Closure of oroantral fistula should be done as early as possible to eliminate the risk of infection of the antrum. Palatal flap is one of the commonly used methods in the closure of oroantral fistula. A case is reported of a male patient who had two oroantral communication after having his two dental implants removed. Buccal flap was used to close the defects, but one of them remained open and resulted in oroantral fistula. Second correction was performed to close the defect using buccal fat pad, but the fistula still persisted. Finally, palatal rotational flap was used to close up the fistula. The result was good, as the defect was successfully closed and the donor site healed uneventfully.

  16. In vitro release and permeation of oxytocin from a mucoadhesive buccal patch. (United States)

    Li, C; Bhatt, P P; Johnston, T P


    A biocompatible, mucoadhesive patch was evaluated for potential use in the delivery of peptides. The model peptide oxytocin was incorporated into the polymeric patch matrix and the diffusion of oxytocin across excised rabbit buccal epithelium was studied following patch application. Penetration of oxytocin across excised mucosa from an applied patch did not exhibit a characteristic lag time for diffusion, with the steady-state flux of oxytocin being 0.062 +/- 0.019 microgram/cm2/hr. However, when finite-dose diffusion studies were conducted to quantitate transport of oxytocin across rabbit buccal mucosa, the mean apparent permeability coefficient (P), diffusion coefficient (D), partition coefficient (K), and lag time (tlag) were (1.94 +/- 0.74) x 10(-7) cm/sec, (9.20 +/- 1.65) x 10(-8) cm2/sec, 0.13 +/- 0.05 and 1.86 +/- 0.31 hr, respectively. The release of oxytocin from the mucoadhesive buccal patches in vitro proceeded very rapidly during the first 2 hr, with 72% of the amount initially incorporated into the patches released at 24 hr. The disappearance rate of intact, parent oxytocin when an oxytocin solution was placed in direct contact with the serosal and mucosal sides of freshly excised rabbit buccal mucosa was 0.74 +/- 0.34 microgram/cm2/hr and 3.38 +/- 1.07 micrograms/cm2/hr, respectively. Thus, the buccal patch evaluated in these studies appears to be suitable for transmucosal delivery of peptides.

  17. Lipoma in oral mucosa: Two case reports

    Directory of Open Access Journals (Sweden)

    Ali Tavakoli Hoseini


    Full Text Available Lipoma is a common tumor of soft tissue. Its location on the oral mucosa is rare, representing 1% to 5% of benign oral tumors although it is the most mesenchymal tumor of the trunk and proximal por-tions of extremities. Lipoma of the oral cavity may occur in any region. The buccal mucosa, tongue, and floor of the mouth are among the common locations. The clinical presentation is typically as an asymptomatic yellowish mass. The overlying epithelium is intact, and superficial blood vessels are usually evident over the tumor. Other benign connective tissue lesions such as granular cell tumor, neurofibroma, traumatic fibroma and salivary gland lesions (mucocele and mixed tumor might be included in differential diagnosis. We present two cases of oral lipoma in unusual locations: one in junction of soft and hard palate and the other in tongue. Both were rare in the literature.

  18. Reconstruction of anterior maxillary defect with buccal pad fat after excision of melanotic neuroectodermal tumor of infancy (United States)

    Kumar, Dinesh; Rattan, Vidya; Rai, Sachin; Yadav, Shikha; Sahu, Gyana Ranjan


    This paper highlights a rare case of melanotic neuroectodermal tumor of infancy involving the anterior maxilla in a 3-month-old infant. The tumor was excised completely, and the defect was reconstructed with a bilateral buccal pad of fat. The patient has been followed for 2 years without any evidence of recurrence. We propose that for similar anterior maxillary defects in infants and children, a buccal pad of fat can be utilized as an appropriate pedicled flap for coverage after tumor resection. PMID:26981478

  19. Fasciocutaneous flaps

    NARCIS (Netherlands)

    D.E. Tolhurst (David)


    textabstractAbout that time the concept of independent myocutaneous vascular territories (Me Craw and Dibbell, 1977) was beginning to take hold but the deep fascia, sandwiched between muscles and the skin, was largely regarded as an isolating layer of dense, avascular fibrous tissue from which flaps

  20. Efficacy and usability of buccal midazolam in controlling acute prolonged convulsive seizures in children. (United States)

    Ashrafi, Mahmoud Reza; Khosroshahi, Nahid; Karimi, Parviz; Malamiri, Reza Azizi; Bavarian, Behrouz; Zarch, Anoushiravan Vakili; Mirzaei, Mehdi; Kompani, Farshid


    A Prolonged convulsive seizure is the most common neurological medical emergency with poor outcome. An ideal anticonvulsant should be easy-to-use, effective, and safe, and it should also have a long-lasting effect. Benzodiazepines, give via the intravenous or rectal route have generally been used as first-line drugs. In small children, IV access can be difficult and time consuming. Midazolam is a potent anticonvulsant and is rapidly absorbed from the rectal, nasal, and buccal mucosa. Our aim was to evaluate the efficacy and usability of buccal midazolam in controlling seizures in children with acute prolonged seizures, by comparing it with rectal diazepam. Ninety-eight patients were enrolled, with 49 patients in each treatment group. In the buccal midazolam group, 42 (88%) patients were controlled in less than 4 min of drug administration, and all of the patients were controlled within 5 min of drug administration. In the rectal diazepam group, 24 (49%) patients were controlled in less than 4 min and 40 (82%) patients were controlled within 5 min of drug administration. The time for drug administration and drug effect was significantly less with buccal midazolam than with rectal diazepam (p valuediazepam group, 7 (14%) parents were satisfied. Buccal midazolam was significantly more acceptable than rectal diazepam (p valuediazepam but more convenient to use in the controlling acute prolonged seizures in children, especially in situations in which there is a difficulty in gaining IV access, for example, in infants.

  1. In vitro and in vivo evaluation of buccal bioadhesive films containing salbutamol sulphate. (United States)

    Singh, Sanjay; Soni, Rajeev; Rawat, Manoj Kumar; Jain, Achint; Deshpande, Shripad Bhimarao; Deshpande, Shripad Bheemrao; Singh, Sanjeev Kumar; Muthu, Madaswamy Sona


    The aim of present study was to prepare and evaluate buccal bioadhesive films of salbutamol sulphate (SS) for the treatment of asthma. The films were designed to release the drug for a prolonged period of time so as to reduce the frequency of administration of the available conventional dosage forms of SS. The different proportions of sodium carboxymethylcellulose (SCMC) and Carbopol 940P (CP 940P) were used for the preparation of films. Carbopol was used to incorporate the desired bioadhesiveness in the films. The films were prepared by solvent casting method and evaluated for bioadhesion, in vitro drug release and anti asthmatic effect (bronchoprotection) in histamine induced bronchospasm of guinea pigs. In vitro drug release from the film was determined using a modified Franz diffusion cell while bioadhesiveness was evaluated with a modified two-arm balance using guinea pig buccal mucosa as a model tissue. Films containing SCMC : CP 940P ratio of 76 : 24 was found to be the best with moderate swelling along with favorable bioadhesion force and in vitro drug release. The drug release mechanism was found to follow non-Fickian diffusion as release mechanism. The prolonged in vivo effect (bronchoprotection) obtained from the buccal bioadhesive film of SS administered via buccal route may improve the treatment of asthmatic disorders by reducing the frequency of administration which is associated with the tolerance effect of SS. Additionally for the clinical benefit, it is also expected to reduce the major adverse effects of SS such as tachycardia and arrhythmias via buccal absorption.

  2. Dental prosthesis and buccal lesions in the elderly

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    Beatriz García Alpizar


    Full Text Available Fundament: Buccal lesions in the elderly are very frequent and they constitute a problem of health due to the consequences that cause. Objective: to describe the characteristics of the removable prosthesis used by the population of 60 and more years age and their relationship with the lesions of the oral mucosa. Methods: We carried out a study descriptive of cross section in 125 elderly with oral prosthesis. The characteristics of the removable prosthesis were described and their relationship with the lesions of the oral mucosa. The square chi tests and the analysis of relative risk were use to determine the association between the variables, also we used a logistical regression model to determine the independent relationship of each factor with the presence of the lesions. Results: We was a 12% of the people with stomatitis sub prosthesis, 8% presented lesions growth hyperplasic and 5,6% they were have angular queilitis. The lesions in the oral mucosa increased in people with prosthesis in not well state, bad hygiene this and in the female sex. Conclusion: the chronic lesions were the more prevalence in this study and they were very related with factors like: state of the conservation the prosthesis, time use, hygiene this and sex of the individual; but when determining the independent influence from each factor with the presence lesions, we established that only the state of conservation of the prosthesis and their hygiene affected of the important way to the old men of this study.

  3. In vivo human buccal permeability of nicotine

    DEFF Research Database (Denmark)

    Adrian, Charlotte L; Olin, Helle B D; Dalhoff, Kim;


    The aim was to examine the in vivo buccal pH-dependent permeability of nicotine in humans and furthermore compare the in vivo permeability of nicotine to previous in vitro permeability data. The buccal permeability of nicotine was examined in a three-way cross-over study in eight healthy non-smok...

  4. Preparation and evaluation of buccal bioadhesive films containing clotrimazole. (United States)

    Singh, S; Jain, S; Muthu, M S; Tiwari, S; Tilak, R


    Buccal bioadhesive films, releasing topical drugs in the oral cavity at a slow and predetermined rate, provide distinct advantages over traditional dosage forms. The aim of present study was to prepare and evaluate buccal bioadhesive films of clotrimazole for oral candidiasis. The film was designed to release the drug at a concentration above the minimum inhibitory concentration for a prolonged period of time so as to reduce the frequency of administration of the available conventional dosage forms. The different proportions of sodium carboxymethylcellulose and carbopol 974P (CP 974P) were used for the preparation of films. Carbopol was used to incorporate the desired bioadhesiveness in the films. The films were prepared by solvent casting method and evaluated for bioadhesion, in vitro drug release and effectiveness against Candida albicans. In vitro drug release from the film was determined using a modified Franz diffusion cell while bioadhesiveness was evaluated with a modified two-arm balance using rabbit intestinal mucosa as a model tissue. Films containing 5% CP 974P of the total polymer were found to be the best with moderate swelling along with favorable bioadhesion force, residence time and in vitro drug release. The microbiological studies revealed that drug released from the film could inhibit the growth of C. albicans for 6 h. The drug release mechanism was found to follow non-Fickian diffusion.

  5. Transmucosal delivery of oxytocin to rabbits using a mucoadhesive buccal patch. (United States)

    Li, C; Bhatt, P P; Johnston, T P


    A biocompatible, mucoadhesive buccal patch was evaluated in rabbits for transmucosal delivery of peptides. Oxytocin (OT) was incorporated into custom coformulations of Carbopol 974P and silicone polymer and the resulting plasma OT concentration versus time profiles determined following patch application. For comparative purposes, the mean values determined for the elimination half-life (t1/2), volume of distribution (Vd), and the total body clearance (CL) following intravenous injection of OT were 2.9 +/- 0.2 min, 85.3 +/- 6.7 ml, and 20.4 +/- 2.03 ml/min, respectively. Following application of oxytocin-loaded mucoadhesive patches, plasma OT concentrations remained 20- to 28-fold greater from 0.5 to 3.0 hr than control animals administered placebo patches. The steady-state plasma OT concentration (Css) following application of the buccal patches was 80.6 +/- 15.9 pg/ml. The lag-time associated with attainment of the Css was 0.45 +/- 0.18 hr. Steady-state flux (Jss) of oxytocin in vivo was 139 +/- 36.8 ng/hr/cm2. Based on the amount of OT remaining in the patches following removal, the average dose of OT released in vivo was 0.27 +/- 0.024 mg with a bioavailability of 0.1%. No significant alterations in mucosal histology were observed when underlying mucosa to which OT patches had been applied were compared to either control (no patch) mucosa or mucosa underneath placebo patches. The mucoadhesive buccal patches were easy to apply and remove, nonirritating to tissue, and able to continuously deliver a nonapeptide over 3 hr. Based on these preliminary studies, the mucoadhesive buccal patches evaluated may represent an improved transmucosal drug delivery system for peptides and conventional drug substances.

  6. The interpectoral fascia flap. (United States)

    Beer, Gertrude M; Manestar, Andrew; Manestar, Mirjana


    Despite the great number of pedicled and free flaps that are available for defect and contour repair, the number of fascia flaps with an axial blood supply are sparse. Such flaps with their gliding function are mandatory, whenever coverage with very thin, well-vascularized tissue is necessary. To the currently established fascia flaps, (the temporoparietal fascia flap, the radial forearm fascia flap, the lateral arm fascia flap, and the serratus anterior fascia flap), we want to add a new fascia flap, the interpectoral fascia flap. We dissected the interpectoral fascia flap from 20 cadavers. In each of the 40 hemichests, the trunk of the thoracoacromial vessels was selectively injected with red polyurethane and the tissue containing the pectoral branches was separated from the overlying pectoralis major muscle and converted into an independent fascia flap. The maximum flap length was 13.5 cm and the maximum breadth was 10.3 cm. The length of the vascular pedicle before entering the flap was 3.9 cm +/- 1.4 cm with a range of 1.5-6.8 cm. Concerning the arc of rotation, all 40 flaps reached the posterior axillary fold, and 29 flaps (73%) reached the mandibular border. This new fascia flap has applications as pedicled and as free flap. The pedicled flap is used in the neck region, in the axillary region and as gliding tissue between the nipple-areola complex and the pectoralis major muscle. The usage of the fascia flap as a free flap has similar characteristics as the other fascia flaps.

  7. Micronucleus frequency in exfoliated buccal cells from hairdresser who expose to hair products

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    Koh Hui Yee


    Full Text Available Background: Hairdresser is one of the fastest growing occupations in today’s society. Hairdresser help styling, cutting, colouring, perming, curling, straightening hair and various treatment to customer. Somehow, hairdresser are constantly exposed to chemical substances such as aromatic amines, hydrogen peroxide, thioglycolic acid, formaldehyde in hair products which can cause damage to human’s genome. Micronucleus is one of the effective biomarker for processes associated with the induction of DNA damage. Purpose: The aim of this study was to determine the micronucleus frequencies in buccal mucosa epithelial cells of hairdresser who were exposed to chemical of hair products. Method: This study was conducted on twenty female subjects, who were divided into 2 groups: exposed and non-exposed (control group. All subjects recruited were working in the same beauty salon. Buccal cells were obtained from each individual by using cytobrush. The cells were stained with modified Feulgen-Ronssenback method and counting of micronucleus per 1000 cell was done under light microscope. The data were analyzed using independent t-test and one-way Anova (p<0.05. Result: The result showed a significant difference in micronucleus frequency between 2 groups. There were a significantly increase of micronucleus frequency in hairdressers and increase of  micronucleus frequency with the longer duration of exposure. Conclusion: It concluded that the chemical substances of hair products had affected the micronucleus frequency ofthe epithelial cells in buccal mucosa of hairdressers.

  8. Effects of Tobacco Smoking on the Dorsum of the Tongue and Buccal Epithelium (United States)

    Al Shammari, Abdullah Faraj; AL Ibrahim, Ibrahim Khalil; Alaauldeen, Amjad Ibrahim; Merza, Randa Fouad; Ahmed, Hussain Gadelkarim


    Objective: The aim of this study was to assess the effects of tobacco smoking on the dorsum of the tongue and buccal epithelium. Methodology: This case control cross-sectional study was conducted with 174 smoking and non-smoking volunteers living in the city of Hail, Northern KSA. Cytological Materials were obtained from buccal mucosa and dorsum of the tongue, and assessed using cytopathological methods. Results: In buccal smears, cytological atypia was observed in 17 out of 101 (16.8%) smoker cases but only 3/73(4.1%) of the controls. For cytological atypia in buccal and tongue smears, the adjusted odd ratio (OR) and the 95% confidence interval (CI) were found to be 4.7 (1.3-16.8), P < 0.016)) and 4.3 (0.93- 20.2), P <0.06)), respectively, in the two sites. Conclusion: Tobacco smoking is a major risk factor for occurrence of cytological atypia, which might subsequently develop into oral precancerous and cancerous lesions. Oral exfoliative cytology is an easy and cheap non-invasive procedure which appears highly suitable for screening populations at risk of developing oral cancer.

  9. Statistical optimization of insulin-loaded Pluronic F-127 gels for buccal delivery of basal insulin. (United States)

    Das, Nilanjana; Madan, Parshotam; Lin, Senshang


    The principle of statistical optimization was employed to fabricate insulin-loaded Pluronic F-127 (PF-127) gel formulations having the potential for buccal delivery of basal insulin. A two-level resolution III fractional factorial design was applied to simultaneously evaluate five independent formulation variables: PF-127 concentration, insulin concentration, sodium sulfate concentration, hydroxypropylmethyl cellulose (HPMC) concentration, and presence of sodium glycocholate. The amount of insulin released and permeated from gels as well as gelation time and mucoadhesion force of gels were measured and used as dependent response variables for formulation optimization. Optimization of a gel formulation was achieved by applying constrained optimization via regression analysis. In vitro permeation flux of insulin from the optimized formulation through procine buccal mucosa was 93.17 (±0.058, n = 3) μg/cm(2). Plasma insulin levels following buccal administration of the optimized formulation at 10, 25 and 50 IU/kg to healthy rats were found to be dose dependent and basal insulin levels were maintained at least for 8 h. Furthermore, continuous hypoglycemia for at least 8 h was observed with 89%, 51% and 25% of blood glucose reduction, respectively, for these three doses. The results of this investigation conclude the feasibility of development of optimized buccal insulin-loaded Pluronic F-127 gels for basal insulin delivery.

  10. Formulation and evaluation of a bioadhesive patch for buccal delivery of tizanidine

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    Mohamed S. Pendekal


    Full Text Available Tizanidine hydrochloride (THCl is an antispasmodic agent which undergoes extensive first pass metabolism making it a possible candidate for buccal delivery. The aim of this study was to prepare a monolayered buccal patch containing THCl using the emulsification solvent evaporation method. Fourteen formulations were prepared using the polymers Eudragit® RS 100 or Eudragit® RL 100 and chitosan. Polymer solutions in acetone were combined with a THCl aqueous solution (in some cases containing chitosan by homogenization at 9000 rpm for 2 min in the presence of triethyl citrate as plasticizer and cast in novel Teflon molds. Physicochemical properties such as film thickness, in vitro drug release and in vitro mucoadhesion were evaluated after which permeation across sheep buccal mucosa was examined in terms of flux and lag time. Formulations prepared using a Eudragit® polymer alone exhibited satisfactory physicomechanical properties but lacked a gradual in vitro drug release pattern. Incorporation of chitosan into formulations resulted in the formation of a porous structure which did exhibit gradual release of drug. In conclusion, THCl can be delivered by a buccal patch formulated as a blend of Eudragit® and chitosan, the latter being necessary to achieve gradual drug release.

  11. Novel buccal adhesive tablets using Aloe vera L and Sinapis alba--a promising option for improved bioavailability of diltiazem hydrochloride. (United States)

    Sudhakar, Yajaman; Bandyopadhyay, A K


    In the current investigation, white mustard mucilage from whole seeds of Sinapis alba was evaluated for its physical properties and compared with the other mucoadhesive polymers such as hydroxy propyl methylcellulose 5Cps and Carbopol 934P. Further, methanol precipitable solids from whole leaves of Aloe Vera L were used as permeation enhancer. To achieve improved bioavailability of diltiazem, novel buccal adhesive tablets (NBATs) in cup and core fashion designed to achieve unidirectional release towards mucosa were prepared in a three-stage process using specially fabricated punches. The adhesive cups were studied for its shear, tensile, and peel strengths by specially designed apparatus using excised ruminant and porcine buccal mucosa as model substrates. Ex vivo permeation studies in a Franz diffusion cell were conducted through porcine buccal mucosa. Fourier transform infrared spectroscopy studies and differential scanning calorimetry thermographs showed no remarkable interactions. Histopathological studies showed no remarkable damage of buccal mucosa by the NBATs. In vivo studies were conducted on anaesthetized male New Zealand albino rabbits, estimated by reversed-phase high-performance liquid chromatography, and the pharmacokinetics were compared with the oral and intravenous bolus injection. NBATs exhibited a Cmax 74.6 ng/mL, Tmax 3.5 h, t(1/2) 4.36 h. The NBATs prevented salivary scavenging effect and exhibited 82.1% bioavailability.

  12. Three-dimensional canine loop for management of buccally erupted canines

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    Praveen Mehrotra


    Full Text Available Maxillary canines are known as the cornerstones of mouth. They are considered to be important for esthetics and for functional occlusion. Any disturbance in the eruption process leading to an aberrant position will hamper esthetics as well as function. Orthodontic tooth movement of total buccally blocked-out canine is usually difficult as it is related with the problems of severe crowding, midline deviation, involvement of long root movement and risk of gingival recession. Such conditions can be treated orthodontically in various ways, but this clinical innovation helps to correct the buccally placed canines into the arch with a precise control of the canine in all the Three-dimensions (3D of space as well as providing maximum comfort to the patient by placing the canine loop on the palatal surface of the tooth, reducing soreness on the labial mucosa. It can be easily fabricated and activated at chairside for either simultaneous or sequential control in 3D.

  13. Rare carcinoma ex pleomorphic adenoma of the buccal minor salivary gland causing a therapeutic dilemma

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    Yogesh Kini


    Full Text Available Carcinoma ex pleomorphic adenoma (CXPA, as a group, constitutes 12% of malignant salivary gland tumors. We present a case of CXPA of the buccal mucosa in a 17-year-old patient. The buccal mass was of a size of 3.0 cm located in the right cheek. Pleomorphic adenoma was the provisional diagnosis. The tumor was excised under local anesthesia. Histopathological evaluation revealed a pre-existing pleomorphic adenoma. However, on magnification, certain areas showed islands of dysplastic epithelial cells′ invading the fibrous capsule and CXPA was diagnosed. The patient was recalled and secondary surgery of the site performed. No tumor tissue could be detected in the secondary resection specimen. There is no sign of recurrence since 2 years.

  14. Development of buccal adhesive tablet with prolonged antifungal activity: Optimization and ex vivo deposition studies

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    Madgulkar A


    Full Text Available The purpose of the present work was to prepare buccal adhesive tablets of miconazole nitrate. The simplex centroid experimental design was used to arrive at optimum ratio of carbopol 934P, hydroxypropylmethylcellulose K4M and polyvinylpyrollidone, which will provide desired drug release and mucoadhesion. Swelling index, mucoadhesive strength and in vitro drug release of the prepared tablet was determined. The drug release and bioadhesion was dependent on type and relative amounts of the polymers. The optimized combination was subjected to in vitro antifungal activity, transmucosal permeation, drug deposition in mucosa, residence time and bioadhesion studies. IR spectroscopy was used to investigate any interaction between drug and excipients. Dissolution of miconazole from tablets was sustained for 6 h. based on the results obtained, it can be concluded that the prepared slow release buccoadhesive tablets of miconazole would markedly prolong the duration of antifungal activity. Comparison of in vitro antifungal activity of tablet with marketed gel showed that drug concentrations above the minimum inhibitory concentration were achieved immediately from both formulations but release from tablet was sustained up to 6 h, while the gel showed initially fast drug release, which did not sustain later. Drug permeation across buccal mucosa was minimum from the tablet as well as marketed gel; the deposition of drug in mucosa was higher in case of tablet. In vitro residence time and bioadhesive strength of tablet was higher than gel. Thus the buccoadhesive tablet of miconazole nitrate may offer better control of antifungal activity as compared to the gel formulation.

  15. Pectoralis myocutaneous flap for salvage of necrotic wounds

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    Price, J.C.; Davis, R.K.; Koltai, P.J.


    The authors have utilized six pectoralis major myocutaneous flaps in attempts to salvage extensive necrotic wounds of the pharynx and neck. The flap was employed in the following situations: massive necrosis of the entire neck skin with both carotid artery systems exposed, radiation necrosis of the neck skin with exposure of carotid artery, dehiscence of gastric pull-up from pharynx with resultant carotid exposure, failed trapezius flap in a radionecrotic oral cavity, and two cases of pharyngocutaneous fistula with extensive soft tissue necrosis. These flaps achieved healing in all cases. One death occurred 3 weeks following complete cutaneous healing secondary to a ruptured carotid pseudoaneurysm. One flap underwent total skin loss but the entirety of the muscle survived and the fistula was successfully closed with the back of the muscle being subsequently skin grafted. One case of dehiscence of the flap from oral mucosa resulted in a minor exposure of mandible with limited osteoradionecrosis controlled by topical means. This flap has performed extremely well in these precarious and difficult situations that previously may not have been salvageable. It has also been effective in abbreviating the required hospitalization and wound care. The authors conclude that the pectoralis myocutaneous flap should be the primary choice for the management of extensive postsurgical wound necrosis.

  16. Experimental studies of new topical anaesthetics on the oral mucosa. (United States)

    Holst, A; Evers, H


    In order to reduce pain by injection, a frequently used topical anaesthetic is Xylocaine 5% ointment. This preparation, however, has certain limits in effectiveness. A new topical anaesthetic formulation, EMLA (Eutectic Mixture Local Anaesthetics), has been developed. Promising local anaesthetic properties on intact skin made it interesting to investigate the clinical usefulness of EMLA on mucous membranes and to find a suitable time of application. 30 volunteers, 20-40 yr, took part in the study. In two experimental double blind series, the topical anaesthetic effect was compared for EMLA 5% cream, Xylocaine 5% ointment, placebo cream, dry EMLA emulsion in cellulose discs and placebo discs. Application times were 2 and 5 minutes for the first three preparations, 2 minutes for the cellulose discs. The application areas were the alveolar mucosa in the lower buccal fold and the palatal mucosa. The pain by insertion of 27 or 30 gauge dental needles through the mucosa was registered. Xylocaine 5% and EMLA 5% reduced pain perception compared to placebo. For both Xylocaine 5% and EMLA 5% an application time of 2 minutes was found to be enough to produce a high degree of mucosal analgesia in the lower buccal fold. In the palatal area, however, the pain was not totally blocked by any of the investigated preparations but after 5 minutes of application EMLA showed a higher degree of analgesia. EMLA 5% creams was poorly localized at the applied area while the cellulose EMLA discs seemed to be more useful. No side effects were noticed.

  17. Morphologic and cytomorphometric analysis of exfoliated buccal mucosal cells in diabetes patients

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    Prasad H


    Full Text Available Background : It is now known that the disease process of diabetes has effects on various tissues of the body. The following study was done to analyze the effects of diabetes on oral tissues. Aims : To study the morphology and cytomorphometry of the cells obtained in cytologic smears from the buccal mucosa of diabetic patients. Materials and Methods : Smears were obtained from clinically normal buccal mucosa of 50 randomly selected diabetic patients attending the diabetic clinic and the out-patient department and of five healthy subjects as control. Smears were stained using Papanicolaou method, and using a micrometer mean values of nuclear diameter (ND, cell diameter (CD, cytoplasmic diameter (CyD and nucleus: cytoplasm ratio (N: C ratio were obtained for each patient. Diabetic patients were divided into four groups based on the glycosylated hemoglobin (GHb values for comparison. Statistical analysis used : Student′s T-test and Fisher′s F-test. Results : Statistically significant increase in ND (P=0.0367 was found in diabetic patients compared to controls. Degree of glycemic control significantly affected ND (P=0.0042 and N: C ratio (P=0.0055. In general, as the severity of diabetes increases, ND and N: C ratio rise gradually. Conclusions : Diabetes produces definite morphologic and cytomorphometric changes in the buccal mucosa of patients. However, further research in this direction is indicated, to analyze the significance of these findings as a tool for diabetes detection, as well as to obtain deeper insights into its effects on various tissues.

  18. Evaluation of Cytological Alterations of Oral Mucosa in Smokers and Waterpipe Users

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    Soraya Khafri


    Full Text Available Objective: Oral mucosal epithelia of smokers and waterpipe users are more susceptible to malignant alterations. The aim of this study was morphometric evaluation of the effects of using waterpipe on normal oral mucosa.Materials and Methods: In a cross sectional study, cytologic smear samples from the following three different areas: buccal mucosa, lateral surface of the tongue, and floor of the mouth (right were taken from 40 smokers, 40 waterpipe users, and 40 normal individuals. They were then stained using Papanicolaou staining technique. Quantitative cytologic alterations such as nuclear and cytoplasmic size, nuclear-cytoplasmic (N/C ratio, Feret ratio (FR, percent of karriorhexis, vacuolization of cytoplasm, two or multilobed nuclei, inflammation, and candida were evaluated. Quantitative evaluation was performed using MoticPlus 2 software, and 50 cells in each slide were studied. Practitioners were matched with age and sex in three groups.Results: An increase in nuclear size, the N/C ratio, and F.R, while a decrease in cytoplasm size were observed in lateral surface of the tongue, buccal mucosa and floor of the mouth of smokers, waterpipe users and normal individuals, respectively(p≤0.001. No statistically significant differences were observed in percent of karriorhexis, vacuolization of cytoplasm, and two or multilobed nuclei in oral mucosa of smokers, waterpipe users (p=0.8, and normal individuals (p=0.9 in buccal mucosa,tongue, and mouth floor areas. However, the percentage of inflammation and candida in smokers (p<0.001 and waterpipe users (p=0.002 were higher than normal.individualsConclusion: Smoking and using waterpipe are effective in creating some quantitative cytometric alterations in oral mucosa; however, smoking shows greater effect in the cytometric alterations than using waterpipe. Role of cytology in screening and detection of oral mucosa malignancies in smokers and waterpipe users needs further studies.

  19. The gene expression of oral squamous cells carcinomas and buccal mucosa premalignant lesions and the research on the difference of cellular pathways%口腔鳞状细胞癌和颊黏膜癌前病变基因表达和细胞通路的差异性研究∗

    Institute of Scientific and Technical Information of China (English)

    张福军; 张国栋; 杨凯; 梅杰


    Objective To screen and analysis the virulent genes and pathways in golden hamster cheek pouch mucosa precan-cerous lesions and squamous cell carcinomas.Methods The experimental models of golden hamster cheek pouch mucosa precancer-ous lesions and squamous cell carcinomas were induced by DMBA.The total RNA of precancerous lesions and squamous cell carci-nomas of golden hamster cheek pouch was extracted and the cRNA was labeled by Cy3.Then gene chip was used to screen the dif-ferentially expressed genes.At last,the Gene Ontology and pathway was used to analysis the biology function of important virulent genes.Meanwhile,we confirmed the correctness of the results by using the RT-PCR.Results A total of 1 981 differentially ex-pressed genes were detected during the process from precancerous lesions to squamous cell carcinomas (120 genes remained known).One thousand and thirty-seven genes were up-regulated and 944 genes down-regulated.GO analysis showed that these dif-ferentially expressed genes mainly related to the macromolecular metabolism,signal transduction and so on.Pathway analysis showed that 9 pathways were significant changes.14 genes were enriched in above 9 change pathways.Conclusion There were 1 981 differentially expressed genes and 9 abnormal changes pathways during the process from precancerous lesions to squamous cell carcinomas,in which 14 differentially expressed genes led to changes in cellular pathways.These genes might be likely to have the important pathogenic genes in the process of transformation.%目的:筛选出口腔鳞状细胞癌与颊黏膜癌前病变组织中的差异基因,并进行生物信息分析,探讨癌前病变转向鳞癌的分子机制。方法通过二羟甲基丁酸(DMBA)诱导金黄地鼠来建立颊黏膜癌前病变和鳞癌模型,提取病变组织总 RNA,合成单标 Cy3荧光标记的 cRNA,采用基因芯片技术,筛选出两组模型口腔组织中表达差异的基因,对筛选出的差异基因进行功能分

  20. Basaloid Squamous Cell Carcinoma Involving the Alveolar Ridge, Buccal & Lingual Vestibule - A Case Report

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    Supriya Koshti


    Full Text Available Background: Basaloid squamous cell carcinoma of oral mucosa is a rare and aggressive variant of squamous cell carcinoma. They can be differentiated from squamous cell carcinomas by their distinct clinical and histopathological features. Methods: 45 year old female patient presented with extra oral exophytic mass and intra-oral ulcerative lesion on right buccal mucosa and vestibule. The patient was referred for routine blood examination and radiography followed by incisional biopsy. The biopsy specimen was fixed, processed and stained with Hematoxylin and Eosin for further microscopic examination. Results: On microscopic examination basaloid cells were seen proliferating along with dysplastic squamous cells in the connective tissue stroma. Conclusion: Based on the histopathological findings a diagnosis of ′Basaloid squamous cell carcinoma′ was made. The patient was referred to department of Oral and Maxillofacial Surgery for excision of the lesion followed by radiotherapy.

  1. Cerrobend shielding stents for buccal carcinoma patients

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    Karma Yangchen


    Full Text Available Buccal carcinoma is one of the most common oral malignant neoplasms, especially in the South Asian region. Radiotherapy, which plays a significant role in the treatment of this carcinoma, has severe adverse effects. Different types of prosthesis may be constructed to protect healthy tissues from the adverse effects of treatment and concentrate radiation in the region of the tumor mass. However, the technique for fabrication of shielding stent with Lipowitz's alloy (cerrobend/Wood's alloy has not been well documented. This article describes detailed technique for fabrication of such a stent for unilateral buccal carcinoma patients to spare the unaffected oral cavity from potential harmful effects associated with radiotherapy.

  2. Needle-free buccal anesthesia using iontophoresis and amino amide salts combined in a mucoadhesive formulation. (United States)

    Cubayachi, Camila; Couto, Renê Oliveira do; de Gaitani, Cristiane Masetto; Pedrazzi, Vinícius; Freitas, Osvaldo de; Lopez, Renata Fonseca Vianna


    Iontophoresis is a strategy to increase the penetration of drugs through biological membranes; however, its use has been underexplored in mucosa. The aim of this work was to investigate the influence of iontophoresis in the mucosal penetration of prilocaine hydrochloride (PCL) and lidocaine hydrochloride (LCL), which are largely used in dentistry as local anesthetics, when combined in the same formulation. Semisolid hydrogels containing these drugs either alone or in combination were developed at two different pHs (7.0 and 5.8) and presented adequate mechanical and mucoadhesive properties for buccal administration. The distribution coefficients between the mucosa and the formulations (Dm/f) and the in vitro mucosa permeation and retention rates were evaluated for both PCL and LCL. At pH 7.0, the combination of the drugs decreased the Dm/f of PCL by approximately 3-fold but did not change the Dm/f of LCL; iontophoresis increased the permeation rate of PCL by 12-fold and did not significantly change LCL flux compared with the passive permeation rate of the combined drugs. Combining the drugs also resulted in an increase in both PCL (86-fold) and LCL (12-fold) accumulation in the mucosa after iontophoresis at pH 7.0 compared with iontophoresis of the isolated drugs. Therefore, applying iontophoresis to a semisolid formulation of this drug combination at pH 7.0 can serve as a needle-free strategy to speed the onset and prolong the duration of buccal anesthesia.

  3. Buccal mucosal delivery of a potent peptide leads to therapeutically-relevant plasma concentrations for the treatment of autoimmune diseases. (United States)

    Jin, Liang; Boyd, Ben J; White, Paul J; Pennington, Michael W; Norton, Raymond S; Nicolazzo, Joseph A


    Stichodactyla helianthus neurotoxin (ShK) is an immunomodulatory peptide currently under development for the treatment of autoimmune diseases, including multiple sclerosis and rheumatoid arthritis by parenteral administration. To overcome the low patient compliance of conventional self-injections, we have investigated the potential of the buccal mucosa as an alternative delivery route for ShK both in vitro and in vivo. After application of fluorescent 5-Fam-ShK to untreated porcine buccal mucosa, there was no detectable peptide in the receptor chamber using an in vitro Ussing chamber model. However, the addition of the surfactants sodium taurodeoxycholate hydrate or cetrimide, and formulation of ShK in a chitosan mucoadhesive gel, led to 0.05-0.13% and 1.1% of the applied dose, respectively, appearing in the receptor chamber over 5h. Moreover, confocal microscopic studies demonstrated significantly enhanced buccal mucosal retention of the peptide (measured by mucosal fluorescence associated with 5-Fam-ShK) when enhancement strategies were employed. Administration of 5-Fam-ShK to mice (10mg/kg in a mucoadhesive chitosan-based gel (3%, w/v) with or without cetrimide (5%, w/w)) resulted in average plasma concentrations of 2.6-16.2nM between 2 and 6h, which were substantially higher than the pM concentrations required for therapeutic activity. This study demonstrated that the buccal mucosa is a promising administration route for the systemic delivery of ShK for the treatment of autoimmune diseases.

  4. Prediction of outcome in buccal cancers treated with radical radiotherapy based on the early tumor response

    Directory of Open Access Journals (Sweden)

    G V Giri


    Full Text Available Aim of the Study: Aim was to assess the clinical significance of the rate of tumor regression in carcinoma buccal mucosa undergoing radical radiotherapy. Materials and Methods: Sixty six patients were enrolled in the study with proven buccal cancers requiring radical radiotherapy, from 1990 to 1996. Radiotherapy was delivered using a combination of external beam and brachytherapy with preloaded cesium 137 needles. The response to the radiation was assessed at the completion of external beam radiation and 6 weeks after brachytherapy. An analysis correlating various parameters influencing the long term disease free survival and overall survival was done. Results: Response assessed at the end of external beam radiation correlated strongly with the overall survival and the disease free interval (P=0.000. No other factor influenced the survival. Conclusion: The rate of the tumor regression can predict the overall outcome in patients with buccal cancers treated with radiation. Completion of the planned course of radiation in patients who do not show a substantial reduction in size by 4.5 weeks of conventional radiation does not improve the results.

  5. Buccal mucosal ulcer healing effect of rhEGF/Eudispert hv hydrogel. (United States)

    Park, Jeong Sook; Yoon, Joon Il; Li, Hong; Moon, Dong Cheul; Han, Kun


    We have studied the effect of rhEGF on the buccal mucosal ulcer healing. rhEGF was rapidly degraded upon incubation with the hamster buccal mucosal homogenates; The degradation of rhEGF was significantly inhibited by sodium lauryl sulfate (SLS). Eudispert hv hydrogel and Polycarbophil 974P hydrogel were prepared for rhEGF delivery and their mucoadhesiveness was measured by the Instron method. The mucoadhesive force of Eudispert hv was significantly greater than that of Polycarbophil 974P. Moreover, rhEGF in Eudispert hv hydrogel remained stable for about 2 months. To evaluate the ulcer healing effect of rhEGF, the buccal mucosal ulcer was induced in golden hamsters using acetic acid. At 24 h after administration of rhEGF/Eudispert hv hydrogel, the ulcerous area was decreased compared with rhEGF solution and, as a result, the curative ratio was 36.8 +/- 5.68%. By the addition of SLS (0.5%) to Eudispert hv hydrogel, the curative ratio increased 1.5 times. The mechanism of the action was probably due to a combination of protection of the drug against proteases present in mucosa and prolongation of the release of rhEGF from the formulation at the site of action.

  6. The Use of Buccal Fat Pad in the Treatment of Oral Submucous Fibrosis: A Newer Method

    Directory of Open Access Journals (Sweden)

    K. Saravanan


    Full Text Available Purpose of the study. This study was to evaluate the use of buccal fat pad as an interpositioning material in surgical management of oral sub mucous fibrosis. Materials and methods. A series of 8 cases with proven oral sub mucous fibrosis, with mouth opening less than 20 mm, involving the buccal mucosa were treated surgically in the Department of Oral and Maxillofacial Surgery, College of Dental Surgery, Saveetha University, Chennai. Pedicled buccal fat pad was used as an interpositioning material to cover the raw areas in the oral cavity after incision and release of fibrous bands. Results. In 8 patients, the range of pre operative mouth opening was 3–18 mm (mean 14 mm. As the result of the successful surgical procedure, the size of the intra operative mouth opening was ranged from 25–38 mm (mean 33.25 mm. The patients were discharged 5–7 days after the operation. The range of the mouth opening at this time was 25–36 mm (mean 30.63 mm. The results were evaluated using student’s t test and found to be statistically significant. The pedicled grafts took up uneventfull.

  7. Preparation of fluconazole buccal tablet and influence of formulation expedients on its properties

    Institute of Scientific and Technical Information of China (English)

    MOHAMED Saifulla P; MUZZAMMIL Shariff; PRAMOD Kumar TM


    The aim of present study was to prepare buccal tablets of fluconazole for oral candidiasis.The dosage forms were designed to release the drug above the minimum inhibitory concentration for prolonged period of time so as to reduce the frequency of administration and to overcome the side effects of systemic treatment.The buccal tablets were prepared by using Carbopol 71G and Noveon AA-1 by direct compression method.Microcrystalline cellulose was used as the filler and its effect was also studied.The prepared dosage forms were evaluated for physicochemical properties,in vitro release studies and mueoadhesive properties using sheep buccal mucosa as a model tissue.Tablets containing 50% of polymers(Carbopol & Noveon)were found to be the best with moderate swelling along with favorable bioadhesion force,residence time and in vitro drug release.The in vitro drug release studies revealed that drug released for 8 h,which in turn may reduce dosing frequency and improved patient compliance in oral candidiasis patients.

  8. Endoscopic, assisted, modified turbinoplasty with mucosal flap. (United States)

    Puterman, M M; Segal, N; Joshua, B-Z


    A variety of surgical methods have been developed to reduce the volume of the inferior turbinates, in order to create a more patent nasal airway. We describe a technique used in our department since February 2002 for all patients undergoing inferior turbinectomy. We resect with endoscopic assistance the lateral mucosa and bony inferior turbinate. This technique can reduce a large volume of the turbinate while preserving the mucosal continuity and the submucosa by covering the raw surface with a mucosal flap. We believe our method minimises post-operative side effects and complications such as dryness, infection, bleeding and pain.

  9. Use of periosteal membrane as a barrier membrane for the treatment of buccal Grade II furcation defects in lower molars: A novel technique

    Directory of Open Access Journals (Sweden)

    Vikas Verma


    Full Text Available Objective : To use the periosteum as a barrier in treatment of buccal Grade II furcation defects of lower molars. Materials and Methods : This technique was performed on 12 patients with bilateral buccal Grade II furcation defects of lower molars. On a random basis, one furcation defect of each pair was selected for the control group and other for the experimental group. Debridement was done in the defect area in both groups. In the control group, after debridement, mucoperiosteal flap was sutured back. In the experimental group, after reflection of the mucoperiosteal flap, a portion of the periosteum along with a layer of connective tissue (periosteal membrane was incised and mobilized in the defect area for defect coverage as a barrier, and then the periosteal membrane and mucoperiosteal flap were fixed with suture, respectively. Horizontal dimension of the furcation defect was the primary outcome measure. Gingival index, probing attachment level (PAL, and vertical dimension of furcation defect were the secondary outcome measures. Clinical parameters were registered at baseline and at 6 months. Results : Every clinical parameter was improved by surgery. Significant gain in PAL as well as horizontal and vertical dimensions of the furcation defects was found. Conclusion: This periosteum displacement technique is effective for the treatment of buccal Grade II furcation defects of lower molars.

  10. Versatility of free SCIA/SIEA flaps in head and neck defects. (United States)

    Nasir, Serdar; Aydin, Mustafa Asim


    Reconstruction of head and neck defects may require replacement of the bony structures, external soft tissue, and intraoral mucosa. Most cases, including maxillary defects, often require repair using only soft tissue flaps. Recently, the authors used free superficial circumflex iliac artery/superficial inferior epigastric (SCIA/SIEA) flaps for head and neck reconstruction. This was their first choice over other free flaps due to its versatile advantages. Fifteen patients underwent head and neck reconstruction with free SCIA/SIEA flaps (n = 16). No flap loss was observed; however, emergency vascular reanastomosis was performed in 3 cases to restore the blood supply in compromised flaps. Flap thinning and secondary debulking procedures were performed in 4 cases. The functional and aesthetic results were deemed as acceptable in all patients. Based on our results, we believe that the free SCIA/SIEA flap is useful for soft tissue defect reconstruction in the head and neck. It has the following advantages: (1) Large flap elevation is possible for reaching distant recipient vessels, (2) Two surgical teams may work at the same time preparing the donor and recipient regions, and (3) The flap design uses an abdominoplasty incision, which has minimal donor site morbidity.

  11. [Congenital penile curvature (chordee without hypospadias): surgical treatment for correction of penile curvature and/or buccal mucosal graft urethroplasty]. (United States)

    Kolar, Ivan


    Presented are the cases of 19 boys with ventral penile curvature without hypospadias. The cases were categorised into three groups according to the severity of the anomaly. In group I were 7 boys with ventral penile curvature affecting the shortening of the frenulum with skin tethering. The anomaly was corrected by fraenulotomy and, in 4 boys, by ventral "V" and "Y" penile skinplasty with excellent cosmetic results. In group II were 10 boys with an evident chordee. In 4 boys, the chordee was of type III according to Devin-Horton. A chordectomy was done with a "V" and "Y" skinplasty with very good result. The remaining 6 cases were chordee type II according to D-H. The same treatment was undertaken here, but with an additional Nesbit's dorsal tunica albuginea plication in 4 boys and a 50% success (3 of 6). In group III were 5 boys, 3 previously failed chordectomy from group II and 2 with "skin urethra" type chordee I according to D-H. All boys in this group were treated for urethroplasty with autologous buccal mucosal graft. Good results were obtained in 3 of 5 (60%). Successful outcome was achieved in both cases with "skin urethra" not previously treated. The results of our urethroplasty with buccal mucosa agree with those in literature. In the treatment of chordee without hypospadias, where it was necessary to reconstruct the urethra there was a constant problem of the shortage of local tissue, so we believe that buccal mucosa is a good choice.

  12. Development and in vitro evaluation of a buccal drug delivery system based on preactivated thiolated pectin. (United States)

    Hauptstein, Sabine; Hintzen, Fabian; Müller, Christiane; Ohm, Moritz; Bernkop-Schnürch, Andreas


    The aim of this study was to evaluate the potential of preactivated thiolated pectin (Pec-Cys-MNA) for buccal drug delivery. Therefore, a gel formulation containing this novel polymer and the model drug lidocaine was prepared and investigated in vitro in terms of rheology, mucoadhesion, swelling behavior and drug release in comparison to formulations based on pectin (Pec) and thiolated pectin (Pec-Cys). Both pectin derivatives showed gel formation without addition of any other excipient due to self-crosslinking thiol groups. Under same conditions, pectin did not show gel formation. Viscosity of Pec-Cys-based formulation increased 92-fold and viscosity of Pec-Cys-MNA-based formulations by 4958-fold compared to pectin-based formulation. Gels did not dissolve in aqueous environment during several hours and were able to take up water. Mucoadhesion of pectin on buccal tissue could be improved significantly, value of total work of adhesion increased in the following rank order: Pec-Cys-MNA > Pec-Cys > Pec. The retention time of a model drug incorporated in gel formulations on buccal mucosa under continuous rinsing with phosphate-buffered saline was prolonged, after 1.5 h 3-fold higher amount of a model drug was to be found on tissue after application of Pec-Cys-MNA-based formulation compared to pectin-based and 2-fold compared to Pec-Cys-based formulation. The Pec-Cys-MNA-based gel showed a more sustained release of lidocaine than Pec-Cys-based gel, whereas pectin solution revealed an immediate release. According to these results, the self-crosslinking pectin-derivative is a promising tool for buccal application.

  13. The submental island flap. (United States)

    Sterne, G D; Januszkiewicz, J S; Hall, P N; Bardsley, A F


    The submental island flap is a reliable source of skin of excellent colour, contour and texture match for facial resurfacing and leaves a well hidden donor site. The flap is safe, rapid and simple to raise. We report on its use in 12 cases of facial or intraoral reconstruction. Complications were few. However, there was one case of complete flap loss following its use in a reverse flow manner, due to the presence of an unreported, but constant, valve in the venous system of the face. We believe this flap to be a worthwhile addition to the existing surgical armamentarium.

  14. Propeller TAP flap

    DEFF Research Database (Denmark)

    Thomsen, Jørn Bo; Bille, Camilla; Wamberg, Peter;


    The aim of this study was to examine if a propeller thoracodorsal artery perforator (TAP) flap can be used for breast reconstruction. Fifteen women were reconstructed using a propeller TAP flap, an implant, and an ADM. Preoperative colour Doppler ultrasonography was used for patient selection...... major complications needing additional surgery. One flap was lost due to a vascular problem. Breast reconstruction can be performed by a propeller TAP flap without cutting the descending branch of the thoracodorsal vessels. However, the authors would recommend that a small cuff of muscle is left around...

  15. Mifepristone With Buccal Misoprostol for Medical Abortion



    © 2015 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved. Objective: To summarize clinical outcomes and adverse effects of medical abortion regimens consisting of mifepristone followed by buccal misoprostol in pregnancies through 70 days of gestation. Data Sources: We used PubMed,, and reference lists from published reports to identify relevant studies published between November 2005 and January 2015 usi...

  16. Cervicofacial flap revisited

    Directory of Open Access Journals (Sweden)

    Dhananjay V. Nakade


    Conclusions: Cervicofacial flap is simple, easy to operate, consume less operating time as compared to microvascular flap. It is less complicated and especially useful in diabetic, hypertensives and old debilitated patients with high risk of anaesthesia. [Int J Res Med Sci 2016; 4(11.000: 4669-4674

  17. Pedicled perforator flaps

    DEFF Research Database (Denmark)

    Demirtas, Yener; Ozturk, Nuray; Kelahmetoglu, Osman;


    Described in this study is a surgical concept that supports the "consider and use a pedicled perforator flap whenever possible and indicated" approach to reconstruct a particular skin defect. The operation is entirely free-style; the only principle is to obtain a pedicled perforator flap to recon......Described in this study is a surgical concept that supports the "consider and use a pedicled perforator flap whenever possible and indicated" approach to reconstruct a particular skin defect. The operation is entirely free-style; the only principle is to obtain a pedicled perforator flap...... more practical and creative to use a free-style manner during pedicled perforator flap surgery, instead of being obliged to predefined templates for this type of procedure....

  18. Vaginal-sparing ventral buccal mucosal graft urethroplasty for female urethral stricture: A novel modification of surgical technique (United States)

    Gani, Johan; Chee, Justin


    Purpose To present a novel modification of surgical technique to treat female urethral stricture (FUS) by a vaginal-sparing ventral buccal mucosal urethroplasty. Recurrent FUS represents an uncommon, though difficult clinical scenario to manage definitively. A variety of surgical techniques have been described to date, yet a lack of consensus on the optimal procedure persists. Materials and Methods We present a 51-year-old female with urethral stricture involving the entire urethra. Suspected etiology was iatrogenic from cystoscopy 17 years prior. Since then, the patient had undergone at least 25 formal urethral dilations and periods of self-dilation. In lithotomy position, the urethra was dilated to accommodate forceps, and ventral urethrotomy carried out sharply, exposing a bed of periurethral tissue. Buccal mucosa was harvested, and a ventral inlay technique facilitated by a nasal speculum, was used to place the graft from the proximal urethra/bladder neck to urethral meatus without a vaginal incision. Graft was sutured into place, and urethral Foley catheter inserted. Results The vaginal-sparing ventral buccal mucosal graft urethroplasty was deemed successful as of last follow-up. Flexible cystoscopy demonstrated patency of the repair at 6 months. At 10 months of follow-up, the patient was voiding well, with no urinary incontinence. No further interventions have been required. Conclusions This case describes a novel modification of surgical technique for performing buccal mucosal urethroplasty for FUS. By avoiding incision of the vaginal mucosa, benefits may include reduced: morbidity, urinary incontinence, and wound complications including urethro-vaginal fistula. PMID:27437540

  19. Role of tissue engineered buccal mucosa for treatment of urethral stricture


    Vaddi S; Godala C; Reddy V; Senthilkumar R; Reena H; Preethy S; Abraham S


    Cell based therapies in Urology: Cell based therapy for tissue engineering in urology, like in other branches of medicine uses the principles of cell transplantation, materials science, and biomedical engineering to develop biologic substitutes that can restore and maintain function of the damaged or lost genitourinary organs. Most current strategies for tissue engineering depend on a sample of autologous cells from the diseased organ of the host. However in cases where primary autologous...

  20. Mucormycosis at pectoralis major myocutaneous flap donor site

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    Saraiya Hemant


    Full Text Available Background: Advanced carcinomas involving the head and neck present a major therapeutic challenge because of their poor prognosis particularly in old age irrespective of the treatment modality used. Materials and Methods: A 71-year-old patient presented with right-sided buccal mucosal carcinoma involving the mandible. Composite resection with removal of mandible and radical neck dissection was done. Pectoralis major myocutaneous flap (PMMC with deltopectoral flap was done to cover the defect. On the 14th day mucormycosis was noted on pectoralis major myocutaneous flap donor site. Radical debridement and appropriate antibiotic and antifungal treatment was started. The patient was put on life support system. Results: Despite aggressive treatment the patient died. Conclusion: This case reaffirms the views that radical surgical procedure should be carried out with caution in old patients with preexisting diseases as the chances of life-threatening complications are very high in these patients. Mucormycosis at pectoralis major myocutaneous flap (PMMC donor site is probably being reported for the first time.

  1. Reduction of mandibular residual ridge after vestibuloplasty. A two-year follow-up study comparing the Edlan flap, mucosal and skin graft operations

    DEFF Research Database (Denmark)

    Hillerup, Søren; Eriksen, Erik; Solow, B


    Mandibular residual ridge reduction (RRR) after Edlan flap vestibuloplasty, buccal mucosal graft, and split skin graft vestibuloplasty was measured on lateral cephalometric radiographs obtained 1, 3, 6, 12 and 24 months postsurgery in 50 patients. The ridge reduction was most severe during the im...

  2. Free Gingival Graft to Increase Keratinized Mucosa after Placing of Mandibular Fixed Implant-Supported Prosthesis (United States)

    Marcantonio, Elcio


    Insufficiently keratinized tissue can be increased surgically by free gingival grafting. The presence or reconstruction of keratinized mucosa around the implant can facilitate restorative procedure and allow the maintenance of an oral hygiene routine without irritation or discomfort to the patient. The aim of this clinical case report is to describe an oral rehabilitation procedure of an edentulous patient with absence of keratinized mucosa in the interforaminal area, using a free gingival graft associated with a mandibular fixed implant-supported prosthesis. The treatment included the manufacturing of a maxillary complete denture and a mandibular fixed implant-supported prosthesis followed by a free gingival graft to increase the width of the mandibular keratinized mucosa. Free gingival graft was obtained from the palate and grafted on the buccal side of interforaminal area. The follow-up of 02 and 12 months after mucogingival surgery showed that the free gingival graft promoted peri-implant health, hygiene, and patient comfort. Clinical Significance. The free gingival graft is an effective treatment in increasing the width of mandibular keratinized mucosa on the buccal side of the interforaminal area and provided an improvement in maintaining the health of peri-implant tissues which allows for better oral hygiene. PMID:28293441

  3. Feasibility of Shape-Memory Ni/Ti Alloy Wire Containing Tube Elevators for Transcrestal Detaching Maxillary Sinus Mucosa: Ex Vivo Study

    Directory of Open Access Journals (Sweden)

    Yanfeng Li


    Full Text Available Background: Osteotome sinus floor elevation is a less invasive approach to augment an insufficient alveolar bone at the posterior maxilla for dental implantation. However, this approach has some limitations due to the lack of sinus lift tools available for clinical use and the small transcrestal access to the maxillary sinus floor. We recently invented shape-memory Ni/Ti alloy wire containing tube elevators for transcrestal detaching maxillary sinus mucosa, and developed goat ex vivo models for direct visualizing the effectiveness of detaching sinus mucosa in real time during transcrestal maxillary sinus floor elevation. Methods: We evaluated our invented elevators, namely elevator 012 and elevator 014, for their effectiveness for transcrestal detaching maxillary sinus mucosa using the goat ex vivo models. We measured the length of sinus mucosa detached in mesial and distal directions or buccal and palatal directions, and the space volume created by detaching maxillary sinus mucosa in mesial, distal, buccal and palatal directions using the invented elevators. Results: Elevator 012 had a shape-memory Ni/Ti alloy wire with a diameter of 0.012 inch, while elevator 014 had its shape-memory Ni/Ti alloy wire with a diameter of 0.014 inch. Elevator 012 could detach the goat maxillary sinus mucosa in the mesial or distal direction for 12.1±4.3 mm, while in the buccal or palatal direction for 12.5±6.7 mm. The elevator 014 could detach the goat maxillary sinus mucosa for 23.0±4.9 mm in the mesial or distal direction, and for 19.0±8.1 mm in the buccal or palatal direction. An average space volume of 1.7936±0.2079 ml was created after detaching the goat maxillay sinus mucosa in both mesial/distal direction and buccal/palatal direction using elevator 012; while the average space volume created using elevator 014 was 1.8764±0.2366 ml. Conclusion: Both two newly invented tube elevators could effectively detach the maxillary sinus mucosa on the goat ex

  4. Endoscopic closure of large septal perforations with bilateral Hadad-Bassagasteguy flaps. (United States)

    Morera Serna, Eduardo; Ferrán de la Cierva, Luis; Fernández, Meritxell Tomás; Canut, Santiago Quer; Mesquida, Jacoba Alba; Purriños, Francisco José García


    Surgical closure of nasal septal perforations is one of the most challenging procedures in nasal surgery. Defects greater than 2 cm are especially difficult to repair with the traditional approaches due to the challenges of mobilizing enough mucosa to close big gaps, and avoiding airway stenosis in the process. We present a new technique to endoscopically close major septal perforations using bilateral Hadad-Bassagasteguy flaps. Four consecutive patients with septal perforations greater than 2 cm were operated at our institution. Bilateral Hadad-Bassagasteguy flaps were endoscopically raised, one of them above the defect and the other one below it, and rotated to partially cover the defect on each side. A deep temporalis fascia graft was sandwiched between the two flaps to provide a scaffold for schneiderian mucosa growth. Both flaps were covered with a silicone sheet for 3 weeks. A complete closure of the defect was accomplished in three of the four patients; partial closure was achieved in the other. Nasal crusting, epistaxis, and nasal breathing improved in all patients. Large defects of the nasal septum may be closed in selected cases by rotation of bilateral pedicled septal mucosal flaps partially covering the defect area, followed by secondary healing of the nasal mucosa over an autologous graft acting as an epithelial scaffold.

  5. The prefabricated scapula flap consists of syngeneic bone, connective tissue, and a self-assembled epithelial coating. (United States)

    Kunstfeld, R; Petzelbauer, P; Wickenhauser, G; Schlenz, I; Korak, K; Vinzenz, K; Holle, J


    The reconstruction of maxillary defects is a challenge in plastic surgery. The so-called prefabricated scapula flap consists of syngeneic bone covered with syngeneic dermis and is used to reconstruct maxillary defects. After placing these flaps into the oral cavity, they are reepithelialized within a short time period, raising the question of the cellular origin of the "neomucosa." We therefore obtained sequential biopsy samples of the prefabricated flap and of the flap after being placed into the oral cavity and analyzed the keratin expression profile of epithelial cells. We expected that after placing the prefabricated flap into the oral cavity, keratinocytes from adnexal structures of the dermal component of the graft would migrate onto the surface and reepithelialize the flap. Unexpectedly, reepithelialization occurred earlier. The flap had acquired a mucosa-like epithelium at the interface between the Gore-Tex coating and the dermis while still being positioned within the scapular region. The keratin expression profile of this epithelium was very similar to that of mucosal epithelium. Thus, the prefabricated scapula flap not only consisted of bone covered with connective tissue, but was also covered with epithelial cells derived from adnexal structures of the dermal graft. This seems to be the reason for the rapid restoration of an intact mucosa and the excellent outcome achieved with this surgical technique.

  6. Spontaneous Flapping Flight (United States)

    Vandenberghe, Nicolas; Zhang, Jun; Childress, Stephen


    As shown in an earlier work [Vandenberghe, et. al. JFM, Vol 506, 147, 2004], a vertically flapping wing can spontaneously move horizontally as a result of symmetry breaking. In the current experimental study, we investigate the dependence of resultant velocity on flapping amplitude. We also describe the forward thrust generation and how the system dynamically selects a Strouhal number by balancing fluid and body forces. We further compare our model system with examples of biological locomotion, such as bird flight and fish swimming.

  7. Clinical application of micronucleus test in exfoliated buccal cells: A systematic review and metanalysis. (United States)

    Bolognesi, Claudia; Bonassi, Stefano; Knasmueller, Siegfried; Fenech, Michael; Bruzzone, Marco; Lando, Cecilia; Ceppi, Marcello


    The micronucleus assay in uncultured exfoliated buccal mucosa cells, involving minimally invasive sampling, was successfully applied to evaluate inhalation and local exposure to genotoxic agents, impact of nutrition and lifestyle factors. The potential use of the assay in clinics to monitor the development of local oral lesions and as an early biomarker for tumors and different chronic disorders was also investigated. A systematic review of the literature was carried out focusing on the clinical application of the assay. The literature search updated to January 2015 allowed to retrieve 42 eligible articles. Fifty three percent of investigations are related to oral, head and neck cancer, and premalignant oral diseases. Our analysis evidences a potential usefulness of the MN assay applied in buccal exfoliated cells in the prescreening and in the follow up of precancerous oral lesions. A significant excess of MN, in patients compared with matched controls was observed for subgroups of oral and neck cancer (meta-MR of 2.40, 95% CI: 2.02-2.85) and leukoplakia (meta-MR 1.88, 95% CI: 1.51-2.35). The meta-analysis of studies available on other tumors (meta-MR 2.00; 95% CI:1.66-2.41) indicates that the MN frequency in buccal cells could reflect the chromosomal instability of other organs. Increased MN frequency was also observed in small size studies on patients with chronic diseases, with Alzheimer's disease and with Down syndrome. The application of the cytome approach providing information of genotoxic, cytotoxic and cytostatic effects is suggestive of the possibility of an improvement in the predictive value of the assay and this deserves further investigations.

  8. [Micronucleus test of human oral buccal epithelium: problems, progress and prospects]. (United States)

    Kalaev, V N; Artiukhov, V G; Nechaeva, M S


    The articles by russian and foreign authors for the period from 2000 to 2012, devoted to the problems of application, analysis and interpretation of the results of micronucleus test in human buccal epithelium has been analyzed in the review. Nuclear abnormality founding in the cells of the oral mucosa has been described. The paper summarizes works devoted to the analysis of the influence of the micronucleus test methods (painting, taking scrapings) to its results. Modern opinions about the factors of different etiology (sex, age, genotype, psycho-physiological characteristics, immune status, diseases of different etiology, man-made pollution, climatic and geographical conditions, ionizing and nonionizing radiation, chemical compounds (drugs, dietary supplements, androgenic steroids, etc.), dental fillings, occupational exposures, alcohol, using tobacco blends) inducing the estimation of nuclear aberration has been summarized as a scheme. The problems and unresolved issues related to the peculiarities of micronucleus test has been noted.

  9. Benzydamine hydrochloride buccal bioadhesive gels designed for oral ulcers: preparation, rheological, textural, mucoadhesive and release properties. (United States)

    Karavana, Sinem Yaprak; Güneri, Pelin; Ertan, Gökhan


    This study developed and examined the characterization of Benzidamine hydrochloride (BNZ) bioadhesive gels as platforms for oral ulcer treatments. Bioadhesive gels were prepared with four different hydroxypropylmethylcellulose (HPMC) types (E5, E15, E50 and K100M) with different ratios. Each formulation was characterized in terms of drug release, rheological, mechanical properties and adhesion to a buccal bovine mucosa. Drug release was significantly decreased as the concentration and individual viscosity of each polymeric component increased due to improved viscosity of the gel formulations. The amount of drug released for the formulations ranged from 0.76 +/- 0.07 and 1.14 +/- 0.01 (mg/cm2 +/- SD). Formulations exhibited pseudoplastic flow and all formulations, increasing the concentration of HPMC content significantly raised storage modulus (G'), loss modulus (G''), dynamic viscosity (eta') at 37 degrees C. Increasing concentration of each polymeric component also significantly improved the hardness, compressibility, adhesiveness, cohesiveness and mucoadhesion but decreased the elasticity of the gel formulations. All formulations showed non-Fickian diffusion due to the relaxation and swelling of the polymers with water. In conclusion, the formulations studied showed a wide range of mechanical and drug diffusion characteristics. On the basis of the obtained data, the bioadhesive gel formulation which was prepared with 2.5% HPMC K 100M was determined as the most appropriate formulation for buccal application in means of possessing suitable mechanical properties, exhibiting high cohesion and bioadhesion.

  10. Repair of a submucous cleft palate by W-pushback and levator repositioning without incision to the nasal mucosa. (United States)

    Hwang, Kun


    The author created an innovative method of W-pushback and levator repositioning without having to make an incision to the nasal mucosa for submucous cleft palate repair.The W-shaped mucoperiosteal flap is outlined where the 2 peaks of W are the alveolar processes of both canine teeth and the midpoint of W is the anterior limit of the cleft notch of the hard palate. A short incision, medial to and behind the maxillary tuberosity and curved forward onto the palate and extended forward just medial to the alveolar process, is joined by a second incision from the apex of the cleft to the region of the canine tooth. The W-shaped mucoperiosteal flap is raised until the midline notch of the hard palate is exposed. The nasal mucosa and abnormally inserted levator veli palatini muscle to the posterior border of the hard palate bone are detached. By leaving the nasal mucosa intact, the detached levator veli palatini muscle is approximated at the midline and so the zona pellucida is obliterated. The cleft uvulas are cut in half and closed. The approximated W-flap is joined to the small anterior flap by 1 or more sutures (the W-pushback).Three patients were operated on with this technique without serious complications.The author believes that this method can make the levator sling and increase the length of the soft palate without making an incision to the nasal mucosa.

  11. Correction of incomplete cleft palate by u-shaped flap palatoplasty

    Directory of Open Access Journals (Sweden)

    Saleh Amin


    Full Text Available Objectives: During cleft palate repair, velopharyngeal sphincter reconstruction is still a challenge to plastic surgeons. To improve results of surgical treatment of cleft palate and secondary velopharyngeal incompetence, a carefully designed modified procedure for palatoplasty is presented. Materials and Methods: Thirty patients with incomplete cleft palate corrected by this procedure from April 2003 to October 2007 were included. A u-shaped incision was made in the anterior palate to separate bipedicle flap based on the greater palatine arteries of both sides. After complete dissection of the nasal and palatal mucosa, palatal muscles were carefully dissected from the posterior edge of the bones of the hard palate, wherein the well-mobilised flap receded backward spontaneously and elongated the soft palate. After suturing the nasal mucosa in the midline, the dissected palatal muscles of both sides were sutured together in the anterior third of the soft palate. On suturing the nasal mucosa and the palatal muscles, the soft palate became elongated and the oral mucosa was seen receding backward spontaneously to cover the anterior part of the soft palate. Results: All corrected patients showed good results, with no recurrence, no post-operative fistulae, with accepted speech pattern and no need for further pharyngoplasty. The line of the sutured nasal mucosa and the palatal muscles became covered by the healthy non-sutured oral mucosa and the soft palate became elongated, with narrowing of the vellopharyngeal isthmus after this technique. Conclusion: The designed flap allows covering of sutured nasal mucosa and palatal muscles with a healthy unsutured oral mucosa and elongates the soft palate. Thus, there was no incidence of post-operative fistula and no need for further pharyngoplasties.

  12. Hyalinosis cutis et mucosae. (United States)

    Vago, Bernadette; Hausser, Ingrid; Hennies, Hans Christian; Enk, Alexander; Jappe, Uta


    Hyalinosis cutis et mucosae is a rare autosomal recessive disorder which is characterized by deposition of hyaline material around the basement membrane of the skin and mucous membranes. Typical clinical symptoms are hoarseness, infiltration of the mucous membranes and papular verrucous skin changes. Mutations within the extracellular matrix protein gene (ECM-1) are the underlying defect. We report on a 24-year-old man, who had first been seen in our department at the age of seven and had undergone the necessary diagnostic procedures and who revisited 17 years later with hoarseness and extensive verrucous skin changes at elbows and knees which were removed by excision. A new mutation of the ECM1 gene was identified.

  13. Management of a coronally advanced lingual flap in regenerative osseous surgery: a case series introducing a novel technique. (United States)

    Ronda, Marco; Stacchi, Claudio


    One of the crucial factors in the success of guided bone regeneration procedures is the correct management of the soft tissues. This allows for stable primary wound closure without tension, which can result in premature exposure of the augmentation area, jeopardizing the final outcome. The use of vertical and periosteal incisions to passivate buccal and lingual flaps in the posterior mandible is often limited by anatomical factors. This paper reports on a series of 69 consecutive cases introducing a novel surgical technique to release and advance the lingual flap coronally in a safe and predictable manner.

  14. Inhibitory activity of the isoflavone biochanin A on intracellular bacteria of genus Chlamydia and initial development of a buccal formulation.

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    Leena Hanski

    Full Text Available Given the established role of Chlamydia spp. as causative agents of both acute and chronic diseases, search for new antimicrobial agents against these intracellular bacteria is required to promote human health. Isoflavones are naturally occurring phytoestrogens, antioxidants and efflux pump inhibitors, but their therapeutic use is limited by poor water-solubility and intense first-pass metabolism. Here, we report on effects of isoflavones against C. pneumoniae and C. trachomatis and describe buccal permeability and initial formulation development for biochanin A. Biochanin A was the most potent Chlamydia growth inhibitor among the studied isoflavones, with an IC50 = 12 µM on C. pneumoniae inclusion counts and 6.5 µM on infectious progeny production, both determined by immunofluorescent staining of infected epithelial cell cultures. Encouraged by the permeation of biochanin A across porcine buccal mucosa without detectable metabolism, oromucosal film formulations were designed and prepared by a solvent casting method. The film formulations showed improved dissolution rate of biochanin A compared to powder or a physical mixture, presumably due to the solubilizing effect of hydrophilic additives and presence of biochanin A in amorphous state. In summary, biochanin A is a potent inhibitor of Chlamydia spp., and the in vitro dissolution results support the use of a buccal formulation to potentially improve its bioavailability in antichlamydial or other pharmaceutical applications.

  15. Buccal microbiology analyzed by infrared spectroscopy (United States)

    de Abreu, Geraldo Magno Alves; da Silva, Gislene Rodrigues; Khouri, Sônia; Favero, Priscila Pereira; Raniero, Leandro; Martin, Airton Abrahão


    Rapid microbiological identification and characterization are very important in dentistry and medicine. In addition to dental diseases, pathogens are directly linked to cases of endocarditis, premature delivery, low birth weight, and loss of organ transplants. Fourier Transform Infrared Spectroscopy (FTIR) was used to analyze oral pathogens Aggregatibacter actinomycetemcomitans ATCC 29523, Aggregatibacter actinomycetemcomitans-JP2, and Aggregatibacter actinomycetemcomitans which was clinically isolated from the human blood-CI. Significant spectra differences were found among each organism allowing the identification and characterization of each bacterial species. Vibrational modes in the regions of 3500-2800 cm-1, the 1484-1420 cm-1, and 1000-750 cm-1 were used in this differentiation. The identification and classification of each strain were performed by cluster analysis achieving 100% separation of strains. This study demonstrated that FTIR can be used to decrease the identification time, compared to the traditional methods, of fastidious buccal microorganisms associated with the etiology of the manifestation of periodontitis.

  16. Lugol's test reexamined again: buccal cells. (United States)

    Jones, Edwin L; Leon, Julie A


    Lugol's iodine staining technique was used to examine oral samples from 10 men and 10 women. Examination of saliva samples before and after extraction with water shows that the low levels (49 positive cells and 3,951 negative cells) of glycogen in buccal epithelial cells become even lower after water extraction (0 positive cells and 4,000 negative cells). In addition to the 20 samples used in this paper, 40 oral swabs extracted with water were examined under classroom conditions with much less than 1% of the epithelial cells being positive for glycogen. Furthermore, 119 saliva samples from chewed gauze in sexual assault kits were extracted with water and all of them yielded less than 1% glycogen positive cells. This paper proposes that when more than 1% of the nucleated squamous epithelial cells are glycogen positive with Lugol's test after extraction in water, it is reasonable to eliminate the mouth as a source of these glycogen positive cells.

  17. Towards a noninvasive approach to malaria diagnosis: detection of parasite DNA in body secretions and surface mucosa. (United States)

    A-Elgayoum, Salwa M E; El-Rayah, El-Amin; Giha, Hayder A


    Invasive procedures for diagnostic or therapeutic purposes bear a relative risk of transmission of serious blood-borne infectious disease. In this study, a noninvasive approach to malaria diagnosis using polymerase chain reaction (PCR) for the detection of parasite DNA in saliva, buccal mucosa and urine (alternative samples) was examined. Saliva, buccal mucosa and urine samples were collected simultaneously with blood samples from 93 patients with microscopically confirmed Plasmodium falciparum infection. Species-specific primers detected the parasite DNA only in blood samples. However, when the PCR analysis was repeated using MSP1 and MSP2 primers in a subgroup of 21 complete sets of samples, the parasite DNA was detected in all except 3 samples, which were found to be negative with the MSP2 primers. Parasite density, body temperature or patient age did not influence the PCR results. In conclusion, P. falciparum parasite DNA was detected equally in saliva, buccal mucosa and urine of malaria patients, regardless of their ages, body temperatures or parasite density. Surprisingly, the parasite DNA was not amplified by species-specific primers in the alternative samples whereas it was in the blood samples.

  18. Oral and maxillofacial-head and neck reconstruction with soft tissue free flaps of 41 cases:A single team's experience%Oral and maxillofacial-head and neck reconstruction with soft tissue free flaps of 41 cases: A single team's experience

    Institute of Scientific and Technical Information of China (English)

    白岫峰; 阿里木江·吾守; 郑军; 李刚


    Objective To retrospectively review the single team's experience of oral and maxillofacial-head and neck reconstruction involving 41 soft tissue free flap procedures.Methods From 1994 to 2012,41 patients who underwent oral and maxillofacial-head and neck soft tissue free flap reconstruction at the Department of Oral and Maxillofacial-Head and Neck Surgical Oncology,Hospital and College of Stomatology,Xi'an Jiaotong University,were reviewed with clinicopathologic data.Results The 41 patients included 24 men and 17 women with a mean age of 54 years.A total of 41 soft tissue free flaps were performed to reconstruct different anatomical structures in the head and neck region including oral mucosa,facial bone,head and neck skin.Two types of soft tissue free flaps were used to reconstruct surgical defects,including radial forearm flap and latissimus dorsimyocutaneous flap.Radial forearm flaps were used for 37cases and latissimus dorsi-myocutaneous flaps were 4 cases.Of 41 cases,39 were successful,with an overall success rate of 95.1%.There were 2 free flap failures,including one radial forearm flap and one latissimus dorsi-myocutaneous flap (partial flap necrosis); hence,the flap success rates for radial forearm flap and latissimus dorsimyocutaneous were,respectively,97.3% and 87.5%.Conclusions Radial forearm flap and latissimus dorsi-myocutaneous flap are reliable soft tissue free flaps to repair oral and maxillofacial-head and neck area with high success rate,which resulted in good functionally and cosmetically with fewer complications both donor and recipient sites.

  19. Elevated expression of NF-kappaB in oral submucous fibrosis--evidence for NF-kappaB induction by safrole in human buccal mucosal fibroblasts. (United States)

    Ni, Wei-Feng; Tsai, Chung-Hung; Yang, Shun-Fa; Chang, Yu-Chao


    Nuclear factor-kappa B (NF-kappaB) is considered to be important in many inflammatory and immune responses. The aim of this study was to compare NF-kappaB expression in normal human buccal mucosa and oral submucous fibrosis (OSF) specimens and further explore the potential mechanism that may lead to induction of NF-kappaB expression. Seventeen OSF and six normal buccal mucosa specimens were examined by immunohistochemistry. Primary human buccal mucosal fibroblasts (BMFs) were established and challenged with safrole, a major polyphenolic compound in the influorescence of Piper betel, by cytotoxicity and western blot assays. Furthermore, glutathione precursor N-acetyl-L-cysteine (NAC), extracellular signal-regulated protein kinase (ERK) inhibitor PD98059, cyclooxygenase-2 (COX-2) inhibitor NS-398, dexamethasone, and cyclosporin A were added to find the possible mechanism. NF-kappaB expression was significantly higher in OSF specimens and expressed mainly by fibroblasts, endothelial cells, and inflammatory cells. Safrole was cytotoxic to BMFs in a dose-dependent manner (psafrole (psafrole induced-NF-kappaB expression (psafrole in fibroblasts may be mediated by ERK activation and COX-2 signal transduction pathway.

  20. Pro-apoptotic and anti-inflammatory potential of andrographolide during 7,12-dimethylbenz[a]anthracene induced hamster buccal pouch carcinogenesis

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    Karthikeyan Sekar


    Full Text Available Objective: Aim of the present study was to investigate the modulating effect of andrographolide on apoptotic and inflammatory markers during 7,12-dimethyl-benz[a]anthracene (DMBA induced hamster buccal pouch carcinogenesis. Methods: Oral tumors were developed in the buccal pouch of golden Syrian hamsters by painting with 0.5% DMBA in liquid paraffin three times a week for 14 weeks. The expression pattern of molecular markers were assayed using immunohistochemistry (p53, Bcl-2 and Bax, ELISA (COX-2 and real-time PCR (NFκB. Results: We noticed 100% tumor formation accompanied by deregulation in the apoptotic and inflammatory markers in the buccal mucosa of hamsters treated with DMBA alone. Oral administration of andrographolide at a dose of 50 mg/kg b.w to hamsters treated with DMBA, not only completely prevented the tumor formation but also modulated the status of above mentioned molecular markers in favor of inhibiting cell proliferation as evidenced by no tumor formation. Conclusion: The present study suggests that the anti-tumor effect of andrographolide could partly be attributed to its apoptotic and anti-inflammatory potential during DMBA-induced hamster buccal pouch carcinogenesis. [J Exp Integr Med 2012; 2(4: 313-319

  1. Variation in buccal surface morphology of deciduous first molars

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    M Simratvir


    Full Text Available Background: The buccal bulge of the deciduous first molars has always been a restorative challenge to the pediatric dentist. Morphologically it may vary from a slight prominence to a well-developed cusp-like structure. Aim: This study was conducted to determine the variable buccal surface morphology of deciduous first molar and its clinical relevance. Materials and Methods: A prospective study was conducted whereby 2016 patients visiting the outpatient clinic of dental hospital over 1 year were evaluated. Any variation in buccal surface morphology of the deciduous first molars was recorded photographically or by replicating in dental stone. Results: Varied morphological patterns on buccal surface were observed for which a new classification scheme has been proposed. Conclusion: The surface morphology of deciduous teeth crowns must be studied carefully as it may be indicative of pulpal extensions and accessory roots, requiring consideration during restorative treatment planning.


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    Gururaj S.Kulkarni


    Full Text Available The main objective of developing any new dosage form is reduce the side effects and increase the therapeutic effect of drug in existing dose of dosage form. Mucoadhesive drug delivery system is oral dosage form, where the tablet, gel or patch is attached to the buccal region for direct absorption of drug into blood circulation. This route can prevent the metabolism of drug in G.I tract or liver and side effects of metabolites avoided. In this study, the attempt was made to prepare mucoadhesive buccal tablets of Terbutaline sulphate with natural polymer sodium alginate with one side absorption by backing layer with ethyl cellulose. The buccal tablets of Terbutaline sulphate studied in detail. I R Spectroscopy did the compatible study between polymers and Terbutaline sulphate and No interaction was found between drug and polymers. Different formulations of oral Mucoadhesive buccal tablets of Terbutaline Sulphate (TS were prepared using polymer sodium alginate, in different concentrations by direct compression. Post compressed evaluation studies, hardness, thickness, friability; weight variation and drug content, mucoadhesive strength of tablets were studied. The in-vitro release of TS was studied in buffer pH 6.8 at 370C. All parameters of TS buccal tablets are passed the standard of mucoadhesive buccal tablets. It was found that mucoadhesive natural polymers exhibited better adhesiveness and mucoadhesiveness. The in vitro study of TS exhibited greater drug release profile with release of in the range of 79.25 to 99.85%.

  3. Usefulness of a bioengineered oral mucosa model for preventing palate bone alterations in rabbits with a mucoperiostial defect. (United States)

    Fernández-Valadés-Gámez, Ricardo; Garzón, Ingrid; Liceras-Liceras, Esther; España-López, Antonio; Carriel, Víctor; Martin-Piedra, Miguel-Ángel; Muñoz-Miguelsanz, María-Ángeles; Sánchez-Quevedo, Maria-Carmen; Alaminos, Miguel; Fernández-Valadés, Ricardo


    The use of mucoperiostial flaps during cleft palate surgery is associated with altered palatal bone growth and development. We analyzed the potential usefulness of a bioengineered oral mucosa in an in vivo model of cleft palate. First, a 4 mm palate defect was created in one side of the palate oral mucosa of 3 week-old New Zealand rabbits, and a complete autologous bioengineered oral mucosa (BOM) or acellular fibrin-agarose scaffold (AS) was implanted. No material was implanted in the negative controls (NC), and positive controls were not subjected to palatal defect (PC). Animals were allowed to grow for 6 months and the results were analyzed morphologically (palate mucosa and bone size) and histologically. Results show that palatal mucosa and bone growth and development were significantly altered in NC and AS animals, whereas BOM animals had similar results to PC and the bioengineered oral mucosa was properly integrated in the host palate. The amount and compaction of collagen fibers was similar between BOM and PC, and both groups of animals had comparable contents of proteoglycans and glycoproteins at the palate bone. No differences were found for decorin, osteocalcin and BMP2. The use of bioengineered oral mucosa substitutes is able to improve palate growth and maturation by preventing the alterations found in animals with denuded palate bone. These results support the potential clinical usefulness of BOM substitutes for the treatment of patients with cleft palate and other conditions in which palate mucosa grafts are necessary with consequent bone denudation.

  4. Blood-group-related carbohydrates are expressed in organotypic cultures of human skin and oral mucosa

    DEFF Research Database (Denmark)

    Grøn, B; Andersson, A; Dabelsteen, Erik


    -group-related carbohydrate structures, including Lewis x, sialylated Lewis x, Lewis y, Lewis a, and Lewis b, on the surface of epithelial cells in the cultures. We compared the results with the expression of more well-established markers, including cytokeratins, integrins, bullous pemphigoid antigen and laminin, in the same...... cultures. The organotypic skin and oral mucosa cultures showed a histological differentiation pattern analogous to that of normal skin and buccal mucosa, and a tissue-specific expression of carbohydrate structures and cytokeratins. However, both types of organotypic cultures also expressed markers which......Cellular maturation and migration are usually associated with changes in cell-surface carbohydrates, but the relationship between these changes and cell behaviour is at present largely unknown. To investigate whether an organotypic culture system can be used as an in vitro model to study...

  5. Buccal Epithelium in treating Ocular Surface Disorders

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    Srinivas KR


    Full Text Available Background - Ocular surface disorders due to limbal stem cell deficiency are an important cause of ocular morbidity and visual loss. Although autologous limbal stem cell transplants have helped in the management of unilateral disease, allografts in those with bilateral disease often fail due to immunological reasons. The use of autologous buccal epithelium cultivated on amniotic membrane has been described as a useful approach in the management of this condition. It is the purpose of this study to explore the feasibility of using a novel thermo-gelatin polymer (TGP as a substrate to culture these cells, and to characterize them using RNA extraction and RT-PCR. Methods - Oral cheek mucosal biopsies were obtained from 5 adult patients undergoing Modified Osteo-Odonto Keratoprosthesis surgery. The specimens were transported to the laboratory in transport medium. The cells were released using enzymatic digestion and seeded in both convention culture medium and TGP. The resulting cellular growth was characterized using RNA extraction and RT-PCR. Results - Cells could be cultured from 4 of the 5 specimens. In one specimen, contamination occurred and this was discarded. In the other specimens, the cheek epithelial cells could be cultured in both the conventional culture medium and TGP, with equal ease. RT-PCR revealed the presence of K3, a marker for epithelial cells, and GAPDH indicating the presence of some adipose tissue as well. Conclusions - It is possible to culture autologous cheek mucosal epithelial cells using TGP, a synthetic scaffold, without the need for other biological substrates. Since the specimens are obtained from the oral cavity, stringent asepsis is required. Further studies are required for histopathological characterization of the cultured cells and to create a model for delivery onto the ocular surface of eyes with bilateral surface disease due to limbal stem cell deficiency.

  6. 颏下动脉岛状瓣在颜面部软组织缺损修复中的应用%Application of the Submental Artery Island Flap for Repairing Facial Soft Tissue Defect

    Institute of Scientific and Technical Information of China (English)

    王贺红; 汪春兰; 赵宇


    Objective To explore the application of the submental artery island flap in repairing facial soft tissue defect. Methods From July 2007 to 2014, 10 cases with facial soft tissue defect were admitted in this study. Primary lesions in-cluded trauma (2 cases), buccal mucosa squamous cell carcinoma (SCC, 4 cases), buccal basal cell carcinoma (BCC, 1 case), and scar hyperplasia caused by burning or scalding (3 cases). Flaps ranging from 3 cm ×6 cm to 4 cm×10 cm were designed according to the size and location of the facial defects to repair facial soft tissue defects. Results Pale, swell and/or conges-tion were observed in all flaps postoperative, but the situation improved 5 days later. Partial necrosis was observed in 1 case but healed by dressing. All the patients were followed up for 3-12 months, full thickness skin which was used to cover the donor-site in 3 cases shrank inordinately during followed-up. Appearance and functions of the recipient site were satisfacto-ry. The scar of the donor-sites was not conspicuous. Conclusion The submental artery island flap is similar with the facial soft tissue on color and texture, and it offers the advantages of simplicity, reliability and aesthetic result, so it is an excellent choice for repairing facial defects and deformity.%目的:探讨颏下动脉岛状瓣在修复颜面部软组织缺损中的应用。方法2007年7月至2014年3月,收治颜面部软组织缺损患者10例,其中外伤2例,面部鳞癌4例,面部基底细胞癌1例,烫伤或烧伤后瘢痕增生3例。根据缺损位置及大小设计颏下动脉岛状瓣进行修复,最小为3 cm×6 cm,最大为4 cm×10 cm。结果术后皮瓣存在不同程度的肿胀苍白及淤血,5 d后逐渐改善。1例皮瓣远端出现坏死,经换药处理愈合。术后随访3~12个月,3例供皮区采用全厚皮覆盖创面,随访期间发现皮片不同程度收缩。其余受区外观及功能均较满意,供区瘢痕隐蔽。结论颏下

  7. Intraoperative and early postoperative complications using the buccal fat pad during cleft palate surgery in East Indonesia

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    Eveline Vere Konijnendijk


    Full Text Available Six baby’s with cleft are born in Indonesia every hour. There is no standardized treatment of cleft in East Indonesia. Closure is an important aspect during cleft lip and palate surgery. Various techniques have been advocated to gain tissue for closure of cleft area. Mostly these techniques may only provide a small amount of additional length. For lager defects they may be use the local flaps or the buccal fat pad flap. The aim of this study is gain more information about intraoperative and early postoperative complications using the buccal fat pat during cleft palate surgery in East Indonesia. The mouth can be divided in six parts therefor the LAHSAL index will be used. This LAHSAL system is a diagrammatic classification of cleft lip and palate. The LAHSAL system is being used for this study as this system classifies the cleft primarily on location and also on the cleft being complete or incomplete, which can be significant for the research. After diagnosis and classification, the following patient data was obtained: patient age, weight, gender, type of surgery (primary or following, i.e. when the surgery is a correction of a previous treatment, if a bone graft is needed for closure, history of maxillofacial surgery or orthodontics, operation technique, operation duration, type of an aesthesia (local or general, radiographical records and light photos. These data were collected during the pre-operative consultation, about 24 hours before surgery. It was the policy of the team to admit and see all patients one day prior to surgery for counselling, postoperative instructions and evaluating the patient's facial defect.

  8. The Gradual Expansion Muscle Flap (United States)


    defects can usu- ally be obtained with a rotational flap , larger size defects commonly require free tissue transfer. A number of techni- ques have...feasible.21,22 Because limb salvage situations occur in which rota- tional muscle coverage is inadequate and free flap coverage is less desirable, we...larger defects which previously would have required free tissue transfer. Surgical Technique The GEM flap for large soft tissue defects of the leg requires

  9. Sliding flap tracheoplasty. (United States)

    Gates, G A; Tucker, J A


    The optimal method for surgical management of subglottic stenosis is based upon careful assessment of the location, caliber, length, and maturity of the stenotic segment, as well as associated conditions. For patients with a mature stenosis of short length, excision of the anterior arch of the cricoid and first ring and immediate reconstruction by means of a sliding flap of the next two to three rings of trachea offer a one-stage definitive treatment without the need for grafting. We report four cases of subglottic stenosis and one case of cricoid chondroblastoma in which reconstruction of the airway was successful and prompt. For carefully selected cases, sliding flap tracheoplasty may be a useful alternative to procedures in which the airway is expanded by means of grafting.

  10. Cross finger flaps. (United States)

    Kisner, W H


    Proper fingertip reconstruction requires good skin and soft tissue coverage, preservation of function and as normal an appearance as possible. The cross finger flap results in negligible joint stiffness, minimal morbidity and little work-time loss. An important factor is the conservation of finger length permitted by this technique. This method of repair is underutilized. It is indicated in several types of fingertip amputations where bone shortening would be detrimental.

  11. The Simplified Posterior Interosseous Flap. (United States)

    Cavadas, Pedro C; Thione, Alessandro; Rubí, Carlos


    Several technical modifications have been described to avoid complications and simplify dissection. The authors describe some technical tips that make posterior interosseous flap dissection safer and more straightforward.

  12. The Versatile Modiolus Perforator Flap

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon Leifur; Thomsen, Jorn Bo


    BACKGROUND: Perforator flaps are well established, and their usefulness as freestyle island flaps is recognized. The whereabouts of vascular perforators and classification of perforator flaps in the face are a debated subject, despite several anatomical studies showing similar consistency. In our....... The color Doppler ultrasonography study detected a sizeable perforator at the level of the modiolus lateral to the angle of the mouth within a radius of 1 cm. This confirms the anatomical findings of previous authors and indicates that the modiolus perforator is a consistent anatomical finding, and flaps...

  13. Keystone flaps in coloured skin: Flap technology for the masses?

    Directory of Open Access Journals (Sweden)

    Satish P Bhat


    Full Text Available Introduction: Viscoelastic properties of skin in coloured ethnic groups are less favourable compared to Caucasians for executing Keystone flaps. Keystone flaps have so far been evaluated and reported only in Caucasians. The potential of Keystone flaps in a coloured ethnic group is yet unknown. Aim: This article reviews the experience to reconstruct skin defects presenting in a coloured ethnic group, by using Keystone flaps, with a review of existing literature. Design: Uncontrolled case series. Materials and Methods: This retrospective review involves 55 consecutive Keystone flaps used from 2009 to 2012, for skin defects in various locations. Patient demographic data, medical history, co-morbidity, surgical indication, defect features, complications, and clinical outcomes are evaluated and presented. Results: In this population group with Fitzpatrick type 4 and 5 skin, the average patient age was 35.73. Though 60% of flaps (33/55 in the series involved specific risk factors, only two flaps failed. Though seven flaps had complications, sound healing was achieved by suitable intervention giving a success rate of 96.36%. Skin grafts were needed in only four cases. Conclusions: Keystone flaps achieve primary wound healing for a wide spectrum of defects with an acceptable success rate in a coloured skin population with unfavorable biophysical properties. By avoiding conventional local flaps and at times even microsurgical flaps, good aesthetic outcome is achieved without additional skin grafts or extensive operative time. All advantages seen in previous studies were verified. These benefits can be most appreciated in coloured populations, with limited resources and higher proportion of younger patients and unfavorable defects.

  14. Úlcera eosinófila de la mucosa oral Eosinophilic ulcer of oral mucosa

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    A.C. Bencini


    Full Text Available La Úlcera Eosinófila de la Mucosa Oral, es una entidad poco frecuente, pobremente descrita en la literatura mundial. Se define como una lesión benigna autolimitada que si bien puede presentarse en distintas áreas de la cavidad bucal, presenta una marcada predilección por la mucosa ventral de la lengua. Clínicamente, se presenta como una lesión ulcerada de bordes indurados y sobreelevados. Los hallazgos histopatológicos son característicos y consisten en un infiltrado mixto rico en eosinófilos, acompañado de una población de grandes células mononucleadas. Recientes artículos basados en estudios inmunohistoquimicos, permiten afirmar la presencia de grandes linfocitos atípicos CD30+ y por lo tanto, incluir esta lesión en el espectro de las entidades simuladoras de desordenes linfoproliferativos. A pesar de esto, el mecanismo etiopatogenico permanece oscuro y el trauma local juega un rol todavía no dilucidado; aunque se halla presente en la mayoría de las publicaciones, explicando el fenómeno como un mecanismo reactivo. La importancia de esta lesión, radica en su diagnostico diferencial por su semejanza clínica al carcinoma espinocelular, histoplasmosis, chancro sifilítico, Úlcera tuberculosa, carcinoma epidermoide y otras. En nuestro trabajo se revisa la literatura y se discuten la características clínicas, histopatológicas y alternativas terapéuticas, a partir del artículo de un caso clínico en una paciente joven, que luego de la biopsia escisión como método para el diagnostico de certeza, se produce una recidiva de la lesión; lo que orientó el tratamiento hacia la cirugía combinada con corticoterapia local intralesional, logrando su remisión.Eosinophilic Ulcer of the Oral Mucosa, an entity, poorly deciphers in world-wide literature. It is defined as a self-limited, benign injury that although it can appear in different areas of the buccal cavity it presents a noticeable predilection via the ventral mucosa of the

  15. Fibrin glue application in conjunction with tetracycline hydrochloride root conditioning and semilunar coronally repositioned flap in the treatment of gingival recession. (United States)

    George, Joann Pauline; Prabhuji, M L V; Shaeesta, K B; Lazarus, Flemingson


    The purpose of this case report is to present the results of Fibrin Adhesive System (FAS) application, a topical biological tissue adhesive in the treatment of maxillary buccal recessions. A 40-year-old male patient presented with a pair of class I buccal recession defects on maxillary cuspids. Clinical parameters were recorded at baseline, 1 month, and 3 months. Semilunar coronally repositioned flap (Tarnow's technique), root debridement, root conditioning with tetracycline hydrochloride solution and one of the defect was treated with FAS application. Significant recession, height reduction, and attachment gain were observed with the FAS application defect site. About 50% of root coverage was noted in the FAS-treated defect and almost no root coverage in the defect site with no FAS application. Semilunar coronally repositioned flap with FAS application is an effective procedure for root coverage in anterior teeth. The addition of FAS improves the amount of root coverage, especially in relatively shallow defects.

  16. Papilla Preservation Flap as Aesthetic Consideration in Periodontal Flap Surgery

    Directory of Open Access Journals (Sweden)

    Sandra Olivia


    Full Text Available Flap surgery is treatment for periodontal disease with alveolar bone destruction. Surgical periodontal flap with conventional incision will result in gingival recession and loss of interdental papillae after treatment. Dilemma arises in areas required high aesthetic value or regions with a fixed denture. It is challenging to perform periodontal flap with good aesthetic results and minimal gingival recession. This case report aimed to inform and to explain the work procedures, clinical and radiographic outcomes of surgical papilla preservation flap in the area that requires aesthetic. Case 1 was a surgical incision flap with preservation of papillae on the anterior region of teeth 11 and 12, with a full veneer crown on tooth 12. Case 2 was a surgical incision flap with preservation of papillae on the posterior region of tooth 46 with inlay restoration. Evaluation for both cases were obtained by incision papilla preservation of primary closure was perfect, good aesthetic results, minimal gingival recession and the interdental papillae can be maintained properly. In conclusion, periodontal flap surgery on the anterior region or regions that require high aesthetic value could be addressed with papilla preservation incision. Incision papilla preservation should be the primary consideration in periodontal flap surgery if possible.DOI: 10.14693/jdi.v19i3.144

  17. Metastatic Uterine Leiomyosarcoma in the Upper Buccal Gingiva Misdiagnosed as an Epulis

    Directory of Open Access Journals (Sweden)

    Andrea Cassoni


    Full Text Available Uterine leiomyosarcoma (LMS is a rare tumor constituting 1% of all uterine malignancies. This sarcoma demonstrates an aggressive growth pattern with an high rate of recurrence with hematologic dissemination; the most common sites are lung, liver, and peritoneal cavity, head and neck district being rarely interested. Only other four cases of metastasis in the oral cavity have been previously described. The treatment of choice is surgery and the use of adjuvant chemotherapy and radiation has limited impact on clinical outcome. In case of metastases, surgical excision can be performed considering extent of disease, number and type of distant lesions, disease free interval from the initial diagnosis to the time of metastases, and expected life span. We illustrate a case of uterine LMS metastasis in the upper buccal gingiva that occurred during chemotherapy in a 63-year-old woman that underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy for a diagnosis of LMS staged as pT2bN0 and that developed lung metastases eight months after primary treatment. Surgical excision of the oral mass (previously misdiagnosed as epulis at a dental center and contemporary reconstruction with pedicled temporalis muscle flap was performed in order to improve quality of life. Even if resection was achieved in free margins, “local” relapse was observed 5 months after surgery.

  18. HGF is released from buccal fibroblasts after smokeless tobacco stimulation

    DEFF Research Database (Denmark)

    Dabelsteen, S; Christensen, S; Gron, B;


    To investigate the effect of smokeless tobacco (ST) on (1) HGF, KGF and GM-CSF expression by buccal fibroblasts and (2) on keratinocyte and fibroblast proliferation. Buccal fibroblasts were stimulated with different concentrations of ST extracts in a double dilution from 0.50% w/v to 0.03% w...... on exposure time and on concentration of the tobacco extract. High concentration increased production of HGF 4-fold. KGF production was doubled when high concentration of tobacco was used, low concentration did not stimulate cells. GM-CSF production was low in both stimulated and non-stimulated cells...

  19. Reconstruction of through-and-through oromandibular defects by the double-skin paddle fibula osteocutaneous flap: can the skin paddle always be divided? (United States)

    Kubo, Tateki; Osaki, Yoko; Hattori, Ryo; Kanazawa, Shigeyuki; Hosokawa, Ko


    Reconstruction of the through-and-through defects of the oral cavity, involving oral mucosa, bone, and external skin is a major challenge. A single fibula osteocutaneous flap providing two skin islands is an option for such composite reconstruction. The number, location, and size of skin perforators were studied in the distal two thirds of the lower legs in 22 cases of fibula osteocutaneous flap mandibular reconstruction, and whether the skin paddle of the fibula flap could always be divided completely based on two distal perforators was examined. In this study, only 50% of the flaps had two or more distal perforators; thus, it was concluded that the skin paddle of the fibula osteocutaneous flap could not always be divided based on two distal skin perforators.

  20. N-succinyl chitosan as buccal penetration enhancer for delivery of herbal agents in treatment of oral mucositis. (United States)

    Dhawan, Neha; Kumar, Krishan; Kalia, A N; Arora, Saahil


    Oral mucositis is one of the major side effects of cancer chemotherapy (30-76%) and radiotherapy (over 50%). Current palliative treatments of oral mucositis include specialized agents like pelifermin, platelet derived factors etc. or oral hygienic agents which suffered from various drawbacks like systemic side effect, least effect owing to fast wash out of buccal mucosa, patient unfriendly delivery systems, and mere symptomatic relief. In this research work, N-succinyl chitosan gel delivery system of microemulsified eugenol, honey and sodium hyaluronate was prepared to explore their multiple and synergistic effects on various pathological factors of oral mucositis. N-succinyl chitosan was synthesized in our laboratory and loaded with microemulsified eugenol (10% v/v), honey (10% v/v) and sodium hyaluronate (0.2% w/v) to prepare orogel with optimum pH, spreadability, mucoadhesion strength, and viscosity. In vitro eugenol release from N-succinyl chitosan gel after 8 hours in PBS (pH-6.4) was found to be 87.45±0.14%, which was better in comparison to that released from chitosan gel. Ex vivo penetration studies using rat buccal mucosal tissue also suggested better J-efflux of eugenol through N-succinyl chitosan in comparison to chitosan gel with enhancement ratio (ER) of 1.71. The antimicrobial effect of N-succinyl chitosan based orogel against S. aureus and C. albicans efficacy was found to be statistically high in comparison to chitosan based orogel as well as marketed formulation of chlorhexidine (pgel formulation within 15 days. The formulation was successful in elevating the survival and reducing the inflammation in the oral mucosa of animals compared to disease control (p<0.05) and hence suggesting the potential of N-succinyl chitosan orogel in the treatment of oral mucositis.

  1. 14 CFR 23.701 - Flap interconnection. (United States)


    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Flap interconnection. 23.701 Section 23.701... Systems § 23.701 Flap interconnection. (a) The main wing flaps and related movable surfaces as a system must— (1) Be synchronized by a mechanical interconnection between the movable flap surfaces that...

  2. Skin flaps and grafts - self-care (United States)

    ... Regional flaps - self-care; Distant flaps - self-care; Free flap - self-care; Skin autografting - self-care; Pressure ulcer ... your wound To care for the graft or flap site: You may need to rest ... around it clean and free from dirt or sweat. DO NOT let the ...

  3. Enhanced transbuccal salmon calcitonin (sCT) delivery: effect of chemical enhancers and electrical assistance on in vitro sCT buccal permeation. (United States)

    Oh, Dong-Ho; Chun, Kyeung-Hwa; Jeon, Sang-Ok; Kang, Jeong-Won; Lee, Sangkil


    This study investigates the combined effect of absorption enhancers and electrical assistance on transbuccal salmon calcitonin (sCT) delivery, using fresh swine buccal tissue. We placed 200 IU (40 μg/mL) of each sCT formulation--containing various concentrations of ethanol, N-acetyl-L-cysteine (NAC), and sodium deoxyglycocholate (SDGC)--onto the donor part of a Franz diffusion cell. Then, 0.5 mA/cm(2) of fixed anodal current was applied alone or combined with chemical enhancers. The amount of permeated sCT was analyzed using an ELISA kit, and biophysical changes of the buccal mucosa were investigated using FT-IR spectroscopy, and hematoxylin-eosin staining methods were used to evaluate histological alteration of the buccal tissues. The flux (J(s)) of sCT increased with the addition of absorption enhancer groups, but it was significantly enhanced by the application of anodal iontophoresis (ITP). FT-IR study revealed that all groups caused an increase in lipid fluidity but only the groups containing SDGC showed statistically significant difference. Although the histological data of SDGC groups showed a possibility for tissue damage, the present enhancing methods appear to be safe. In conclusion, the combination of absorption enhancers and electrical assistance is a potential strategy for the enhancement of transbuccal sCT delivery.

  4. In vivo bioavailability studies of sumatriptan succinate buccal tablets

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    B Jayakar


    Full Text Available    Back ground and the purpose of study: Sumatriptan succinate is a Serotonin 5- HT1 receptor agonist, used in treatment of migraine. It is absorbed rapidly but incompletely when given orally and undergoes first - pass metabolism, resulting in a low absolute bioavailability of about 15%. The aim of this work was to design mucoadhesive bilayered buccal tablets of sumatriptan succinate to improve its bioavailability. Methods:Mucoadhesive polymers carbopol 934 (Carbopol, HPMC K4M, HPMC K15M along with ethyl cellulose as an impermeable backing layer were used for the preparation of mucoadhesive bilayered tablets . In vivo bioavailability studies was also conducted in rabbits for optimized formulation using oral solution of sumatriptan succinate as standard. Results:Bilayered buccal tablets (BBT containing the mixture of Carbopol and HPMC K4M in the ratio 1:1 (T1 had the maximum percentage of in vitro drug release within 6 hrs. The optimized formulation (T1 followed non-Fickian release mechanism. The percentage relative bioavailability of sumatriptan succinate from selected bilayered buccal tablets (T1 was found to be 140.78%. Conclusions: Bilayered buccal tablets of sumatriptan succinate was successfully prepared with improved bioavailability.

  5. [Enlargement of the buccal aperture via. Technical consideration (author's transl)]. (United States)

    Pons, J; Pasturel, A; Pochan, Y; Barbier, M


    For a long time we know that it is possible to take out from the mouth a part or all the mandibule which presents a local malignant tumour. When the tumour is too extensed, the buccal aperture can be enlarged. The authors describe a new surgical technique which resolves this problem with notable and faithful advantages.

  6. A mechanistic based approach for enhancing buccal mucoadhesion of chitosan

    DEFF Research Database (Denmark)

    Meng-Lund, Emil; Muff-Westergaard, Christian; Sander, Camilla


    Mucoadhesive buccal drug delivery systems can enhance rapid drug absorption by providing an increased retention time at the site of absorption and a steep concentration gradient. An understanding of the mechanisms behind mucoadhesion of polymers, e.g. chitosan, is necessary for improving the muco......Mucoadhesive buccal drug delivery systems can enhance rapid drug absorption by providing an increased retention time at the site of absorption and a steep concentration gradient. An understanding of the mechanisms behind mucoadhesion of polymers, e.g. chitosan, is necessary for improving...... the mucoadhesiveness of buccal formulations. The interaction between chitosan of different chain lengths and porcine gastric mucin (PGM) was studied using a complex coacervation model (CCM), isothermal titration calorimetry (ITC) and a tensile detachment model (TDM). The effect of pH was assessed in all three models...... and the approach to add a buffer to chitosan based drug delivery systems is a means to optimize and enhance buccal drug absorption. The CCM demonstrated optimal interactions between chitosan and PGM at pH 5.2. The ITC experiments showed a significantly increase in affinity between chitosan and PGM at pH 5...

  7. Buccal cortical bone thickness on CBCT for mini-implant

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Jong Gook; Lim, Sung Hoon; Lee, Byoung Jin; Kim, Jae Duk [School of Dentistry, Chosun University, Gwangju (Korea, Republic of)


    Cortical bone thickness is one of the important factor in mini-implant stability. This study was performed to investigate the buccal cortical bone thickness at every interdental area as an aid in planning mini-implant placement. Two-dimensional slices at every interdental area were selected from the cone-beam computed tomography scans of 20 patients in third decade. Buccal cortical bone thickness was measured at 2, 4, and 6 mm levels from the alveolar crest in the interdental bones of posterior regions of both jaws using the plot profile function of Ez3D2009TM (Vatech, Yongin, Korea). The results were analyzed using by Mann-Whitney test. Buccal cortical bone was thicker in the mandible than in the maxilla. The thickness increased with further distance from the alveolar crest in the maxilla and with coming from the posterior to anterior region in the mandible (p?0.01). The maximum CT value showed an increasing tendency with further distance from the alveolar crest and with coming from posterior to anterior region in both jaws. Interdental buccal cortical bone thickness varied in both jaws, however our study showed a distinct tendency. We expect that these results could be helpful for the selection and preparation of mini-implant sites.

  8. Effects of zinc deficiency on the distribution of membrane-coating granules in rat buccal epithelium. (United States)

    Ashrafi, S H; Meyer, J; Squier, C A


    Nutritional zinc deficiency causes consistent excessive cell proliferation in the epithelium of the buccal mucosa. The number per cell and the intracellular location of membrane-coating granules in this epithelium were investigated in male rats placed at weanling age for a 4-week period on a diet containing 1.2 ppm of Zn and in their pair fed controls. Membrane-coating granules were identified on electron micrographs following their demonstration in thin sections by the use of an alkaline bismuth technique. Counts of membrane-coating granules in the first 4 rows of spinous cells and the last 4 rows of granular cells showed that in the zinc-deficient group (1) the total number of granules per cell was increased; (2) the proportion of granules displaced to the cell periphery was decreased in favor of a higher proportion persisting in the center and (3) there was a marked reduction in number and proportion of granules positioned near the superficial cell membrane. The greater uniformity in the distribution of the granules in the hyperplastic-hypertrophic epithelium of the zinc deficient group suggests weakening of the surface-oriented polarity characteristic of the control tissue.

  9. Tensile bond strength of a polymeric intra-buccal bioadhesive: the mucin role. (United States)

    Pedrazzi, V; Lara, E H; Dal Ciampo, J O; Panzeri, H


    The intra-bucal polymeric bioadhesive systems that can stay adhered to the oral soft tissues for drug programmed release, with the preventive and/or therapeutic purpose have been employed for large clinical situations. A system based on hydroxypropyl methyl cellulose/Carbopol 934TM/magnesium stearate (HPMC/Cp/StMg), was developed with the sodium fluoride as an active principle. This kind of system was evaluated according to its resistance to the removal by means of physical test of tensile strength. Swine buccal mucosa extracted immediately after animals' sacrifice was employed as a substrate for the physical trials to obtain 16 test bodies. Artificial saliva with or without mucin was used to involve the substrate/bioadhesive system sets during the trials. Artificial salivas viscosity were determined by means of Brookfield viscometer, and they showed 10.0 cP artificial saliva with mucin, and 7.5 cP artificial saliva without mucin. The tensile strength assays showed the following averages: 12.89 Pa for the group "artificial saliva with mucin", and 12.35 Pa for the group "without mucin". Statistical analysis showed no significant difference between the assays for both artificial salivas, and we can conclude that the variable mucin did not interfere with the bioadhesion process for the polymeric devices.

  10. Buccal mucosal graft urethroplasty for proximal bulbar urethral stricture: A revisit of the surgical technique and analysis of eleven consecutive cases

    Directory of Open Access Journals (Sweden)

    Irekpita Eshiobo


    Full Text Available Background: Urethral stricture disease is prevalent, and many surgical techniques have been developed to treat it. Currently, urethroplasty for bulbar strictures implies ventral or dorsal stricturotomy and a buccal mucosa graft (BMG patch. Objective: To describe the surgical approach of the ventral patch BMG urethroplasty for proximal bulbar urethral stricture and to analyze 11 consecutive cases for whom the technique was used. Patients and Methods: The diagnosis of urethral stricture was confirmed with a combined retrograde urethrography and micturating cystourethrography. A single team exposed the urethra, harvested, and planted the BMG in the lithotomy position under general anesthesia. The oral preoperative preparation was done with oraldene (hexetidine mouth wash three times daily beginning from the 2nd preoperative day. The buccal mucosa was harvested from the left inner cheek in all the patients. The donor site was left unclosed but packed with wet gauze. Data related to age, preoperative adverse conditions, stricture length, urine culture result, perineal/oral wound complications, postoperative residual urine volume, and duration of hospital stay were recorded. Results: Eleven patients with proximal bulbar urethral stricture had BMG urethroplasty from August 2013 to October 2015. Stricture length ranged from 2 to 5 cm. In six (54% of the men, the stricture resulted from urethritis thereby constituting the most common etiology of urethral stricture in this study. The preoperative adverse conditions were age above 70 in three, diabetes mellitus in two, severe dental caries in one, and recurrent stricture in two. All of them were able to resume reasonable oral intake 72 h postoperatively. One (9.2% had perineal wound infection, while two (18.2% still had mild pain at donor site 4 weeks postoperatively. Ten (90.9% of the 11 patients had <30 ml residual urine volume at 2 months of follow-up. Conclusion: Urethritis is still a common cause of

  11. Biomonitoring with Micronuclei Test in Buccal Cells of Female Farmers and Children Exposed to Pesticides of Maneadero Agricultural Valley, Baja California, Mexico (United States)

    Castañeda-Yslas, Idalia Jazmin; Arellano-García, María Evarista; García-Zarate, Marco Antonio; Ruíz-Ruíz, Balam; Zavala-Cerna, María Guadalupe; Torres-Bugarín, Olivia


    Feminization of the agricultural labor is common in Mexico; these women and their families are vulnerable to several health risks including genotoxicity. Previous papers have presented contradictory information with respect to indirect exposure to pesticides and DNA damage. We aimed to evaluate the genotoxic effect in buccal mucosa from female farmers and children, working in the agricultural valley of Maneadero, Baja California. Frequencies of micronucleated cells (MNc) and nuclear abnormalities (NA) in 2000 cells were obtained from the buccal mucosa of the study population (n = 144), divided in four groups: (1) farmers (n = 37), (2) unexposed (n = 35), (3) farmers' children (n = 34), and (4) unexposed children (n = 38). We compared frequencies of MNc and NA and fitted generalized linear models to investigate the interaction between these variables and exposition to pesticides. Differences were found between farmers and unexposed women in MNc (p < 0.0001), CC (p = 0.3376), and PN (p < 0.0001). With respect to exposed children, we found higher significant frequencies in MNc (p < 0.0001), LN (p < 0.0001), CC (p < 0.0001), and PN (p < 0.004) when compared to unexposed children. Therefore working as a farmer is a risk for genotoxic damage; more importantly indirectly exposed children were found to have genotoxic damage, which is of concern, since it could aid in future disturbances of their health. PMID:26981119

  12. Flap Edge Noise Reduction Fins (United States)

    Khorrami, Mehdi R. (Inventor); Choudhan, Meelan M. (Inventor)


    A flap of the type that is movably connected to an aircraft wing to provide control of an aircraft in flight includes opposite ends, wherein at least a first opposite end includes a plurality of substantially rigid, laterally extending protrusions that are spaced apart to form a plurality of fluidly interconnected passageways. The passageways have openings adjacent to upper and lower sides of the flap, and the passageways include a plurality of bends such that high pressure fluid flows from a high pressure region to a low pressure region to provide a boundary condition that inhibits noise resulting from airflow around the end of the flap.

  13. Dancing girl flap: a new flap suitable for web release. (United States)

    Shinya, K


    To create a deep web, a flap must be designed to have a high elongation effect in one direction along the mid-lateral line of the finger and also to have a shortening effect in the other direction, crossing at a right angle to the mid-lateral line. The dancing girl flap is a modification of a four-flap Z-plasty with two additional Z-plasties. It has a high elongation effect in one direction (>550%) and a shortening effect in the other direction at a right angle (<33%), creating a deep, U-shaped surface. This new flap can be used to release severe scar contracture with a web, and is most suitable for incomplete syndactyly with webs as high as the proximal interphalangeal joint.

  14. [Treatment of severe scrotal hypospadias with onlay-type urethroplasty using mouth mucosa]. (United States)

    Castañón, M; Grande, C; Muñoz, M E; García, A; Morales, L


    Failure in repairing severe hypospadias complicated with fistula and cutaneous retraction is often associated with lack of subcutaneous tissue and skin providing protection to the neourethra. We report the results of treatment in 6 patients with scrotal hypospadias with severe deviation and scarce dorsal prepuce. A neourethra was created by the onlay technique applying an oral mucosa graft and preserving in all cases the dorsal preputial skin for the island cutaneous flap. All patients had hypospadias without previous repairs excepting one of them, who had had one first time hypospadias repair in other hospital. Patients age ranged between 2 years and 3 months, and 4 years (mean: 2 years and 9 months). In all cases, hypospadias was scrotal type with severe deviation and scarce dorsal prepuce. All patients had prior hormone stimulation with dehydrotestosterone 3%. Surgical repair was performed in one-stage. Urethroplasty included preservation of the urethral plate, oral mucosa graft to provide ventral coverage, and island cutaneous flap with the dorsal preputial skin. In all cases, the chord was dissected behind the urethral plate. In 3 patients a dorsal Nesbit plication was necessary to obtain a complete straighten penis. Results in all 6 cases were satisfactory. Only one patient had a small leakage at the previous neomeatus. The other five patients are asymptomatic. Follow-up ranges from 6 months to 2 years. We conclude that urethroplasty in association with a well vascularized island flap of dorsal preputial skin decrease the incidence of fistulae. In patients with severe hypospadias with scarce dorsal prepuce urethroplasty should be completed with oral mucosa grafts preserving dorsal preputial skin for the ventral cutaneous plasty.

  15. 改良腭弓矫治后牙锁节对后牙功能恢复的影响%Influence of promote palatine arch treating buccal teeth lock on occlusion function recovery of buccal teeth

    Institute of Scientific and Technical Information of China (English)

    马宁; 孙应明; 白槐延


    @@ Background: Buccal teeth occlusion lock is a kind of common malocclusion malformation in orthodonic clinic. Traditional treatment to buccal teeth occlusion lock is interactive traction of upper and lower buccal teeth.This treatment had shortcoming such as insufficient anchorage and elongation of buccal teeth.We adopted promote fix palatine arch therapy, which recovery patients' occlusion function by clinical observation.

  16. Regional quantitative histological variations in human oral mucosa. (United States)

    Ciano, Joseph; Beatty, Brian Lee


    Oral mucosa demonstrates regional variations that reflect contact with food during mastication. Though known qualitatively, our aim was to quantitatively assess regions to establish a measurable baseline from which one could compare in pathological and comparative studies, in which the abrasiveness of diets may differ. We assessed variations in the epithelial-connective tissue junction (rete ridges counts), collagen organization within the lamina propria, and elastin composition of the lamina propria of 15 regions of the labial (buccal) gingiva, lingual gingiva, vestibule, and palate. All characteristics varied more between regions within the same individual than between individuals. Lingual gingiva had high rete ridges counts, high level of collagen organization, and moderate elastin composition compared to other regions. The labial gingiva had few rete ridges, high collagen organization, and low elastin. The vestibule had the fewest average of rete ridges, least organized collagen, and high elastin. The hard palate had the highest average of rete ridges, high collagen organization, and the lowest elastin content. The soft palate conversely had the smallest average of rete ridges, moderate collagen organization, and the highest elastin composition. Our results indicate that comparison of these quantitative histological differences is warranted only for collagen organization and elastin composition. Differences in rete ridges counts were not statistically significant. Most histological characteristics observed were not significantly different between dentulous and edentulous cadavers, and the group containing all individuals. An exception was the level of collagen fiber organization within the lamina propria, which was higher in most regions when teeth were present.

  17. Epithelioid hemangioma in the oral mucosa: A case report

    Directory of Open Access Journals (Sweden)

    Henriques Aguida Cristina Gomes


    Full Text Available Introduction. Epithelioid hemangioma is an uncommon benign vasoproliferative neoplasm that usually manifests as multiple red nodules in middle-aged adults. Case Outline. A 52-year-old male patient presented with a one-year history of a nodular lesion in the left buccal mucosa measuring 3 cm. The clinical hypothesis was lipoma. An excisional biopsy revealed a circumscribed lesion composed of lobules of vessels with perceptible or poor lumina, associated with a prominent inflammatory infiltrate consisting of eosinophils, histiocytes and chronic inflammatory cells. The endothelial cells composing the lesion had an epithelioid morphology and contained abundant eosinophilic cytoplasm. Immunohistochemistry for CD34, factor VIII, collagen IV, alpha-smooth muscle actin, and mast cells, as well as histochemical staining with Weigert’s orcein were performed. Conclusion. Vascular proliferations of soft tissues are a diverse and morphologically complex group of lesions that are difficult to diagnose. This report presents a case of oral epithelioid hemangioma, highlighting relevant morphological and immunohistochemical features that could help distinguish this condition from other neoplasms.


    Directory of Open Access Journals (Sweden)

    Mohammed Jafar


    Full Text Available Arthritis is one of the most common chronic diseases in the world. Life style effects of arthritis includes; Depression, Anxiety, Feelings of helplessness, Limitations on daily activities, Job limitations etc. Meloxicam, a non-steroidal anti-inflammatory drug is widely used in the treatment of rheumatoid arthritis, ankylosing spondulytis and osteoarthritis. It is also indicated for the management of dental pain, Post-traumatic and post-operative pain, inflammation and swelling. Recently it is considered as a potential drug for prevention and treatment of colorectal polyps. One of the major problems with this drug is its low solubility in biological fluids, which results into poor bioavailability and GI-Side effects after oral administration. The present work was aimed at overcoming these limitations of the drug. The first problem i.e. Poor solubility of meloxicam was overcome by solid dispersion technique and the same work was than published in a reputed online journal. The present study was the continuation of the published work, in this study buccal patches were prepared using varying percentage of carbopol 934p, HPMC (muco adhesive polymers and 50% W/W of propylene glycol (Plasticizer by solvent casting technique, using 32 factorial design. Prepared blank buccal patches were evaluated for various physical and mechanical parameters, patches which comply with reported results were selected for meloxicam and its solid dispersion incorporation. Meloxicam solid dispersion incorporated buccal patches were prepared and evaluated for drug content, in-vitro diffusion, in-vivo release of meloxicam in rabbits and stability study. All solid dispersion incorporated patches showed increased in-vitro drug release (i.e. between 94% to 99.98% over an extended period of 8hrs as compared to plain drug incorporated buccal patch. Whereas plain drug incorporated buccal patch showed only 31.22% in-vitro drug release in 8hrs. Release of meloxicam was slightly

  19. Monolithically Integrated Micro Flapping Vehicles (United States)


    Mechanical Logic • Memory Mm-Scale Ground Mobility Actuation & Mechanisms Ultrasonic Motors Reversible Adhesion Platform Design...MEMS Mm-Scale Ground Mobility PiezoMEMS Haltere Actuation & Mechanisms Ultrasonic Motors Reversible Adhesion Platform Design Flapping

  20. Active Control of Long Bridges Using Flaps

    DEFF Research Database (Denmark)

    Hansen, H. I.; Thoft-Christensen, Palle

    The main problem in designing ultra-long span suspension bridges is flutter. A solution to this problem might be to introduce an active flap control system to increase the flutter wind velocity. The investigated flap control system consists of flaps integrated in the bridge girder so each flap...... is the streamlined part of the edge of the girder. Additional aerodynamic derivatives are shown for the flaps and it is shown how methods already developed can be used to estimate the flutter wind velocity for a bridge section with flaps. As an example, the flutter wind velocity is calculated for different flap...... configurations for a bridge section model by using aerodynamic derivatives for a flat plate. The example shows that different flap configurations can either increase or decrease the flutter wind velocity. for optimal flap configurations flutter will not occur....

  1. The rat saphenous flap: a fasciocutaneous free flap model without panniculus carnosus. (United States)

    Mutaf, M; Tasaki, Y; Tanaka, K; Fujii, T


    The rat saphenous flap is described as a new experimental model for free flap studies. This is a fasciocutaneous free flap based on the saphenofemoral vascular pedicle. The flap may include the entire medial aspect of the lower leg between the knee and ankle. Thirty flaps were harvested from 15 inbred rats. Each flap was transferred to the anterior neck of a recipient rat of the same inbred strain so that 15 flaps were vascularized free flaps using the standard end-to-end microvascular technique and the other 15 flaps were nonvascularized free grafts. All but two (technical failure) of the vascularized flaps showed complete survival, whereas all nonvascularized flaps completely necrosed 2 weeks after transfer. It was concluded that the rat saphenous flap has several advantages such as a long and consistent vascular pedicle, ease of harvest, and an all-or-none survival pattern. Furthermore, as a unique feature of this flap, histological analysis revealed that the rat saphenous flap is composed of the skin and underlying fascia without panniculus carnosus. We therefore suggest that the rat saphenous flap is the first true fasciocutaneous free flap model in the rat. In this paper, in addition to illustrating the anatomy of the saphenous vessels and describing a new fasciocutaneous free flap model based on these vessels, we have documented some anatomical details of the rat leg that have never been described in the literature related to the rat anatomy.

  2. Buried free flaps in head and neck reconstruction: higher risk of free flap failure? (United States)

    Reiter, M; Harréus, U; Kisser, U; Betz, C S; Baumeister, Ph


    Thrombosis of the pedicle is central to free flap failure, and early revision of a compromised flap is the key to successfully salvage a flap. Therefore, the majority of free flaps in reconstructive head and neck surgery are used with the ability to visually examine the flap. Sometimes, due to intra-operative circumstances, it is necessary to use a flap that cannot be monitored externally. These flaps are called buried flaps and have the reputation of being put at risk. The current literature provides only limited data to support or disprove this position. A single institution retrospective review of patient charts between 2007 and 2015 was performed. Flap monitoring was carried out with hand-held Doppler of the pedicle hourly for the first 72 h in all cases. Additional duplex ultrasound was performed in the majority of buried flaps. A total of 437 flaps were included into the study. 37 flaps (7.8 %) were identified to fulfill the criteria of a buried free flap. In total, four patients had complications, three of which required operative reexploration. All interventions were successful, resulting in no flap loss in our series. An accurate operation technique combined with meticulous monitoring protocols supported by duplex ultrasound can result in satisfactory outcome of buried flaps. No enhanced risk of flap loss of buried flaps was found in our cohort.

  3. Evaluation of micronucleus frequency in oral exfoliated buccal mucosa cells of smokers and tobacco chewers: a comparative study

    Directory of Open Access Journals (Sweden)

    Vandana Agrawal


    Results: The mean number of micronuclei was 18.5+/-9.5 in tobacco chewers, 19.1+/-9.2 in chewers with smoking habit and 8.2+/-5.6 in controls. Bonferroni multiple comparisons amongst these three groups showed the mean difference of micronuclei to be highly significant when chewers and chewers with smoking habit were compared to controls. Similarly based on the duration of addiction, a highly significant difference was noted in no. of micronucleated cells in subjects addicted to tobacco for more than 15 years. Conclusions: Tobacco can cause and increase the rate of nuclear anomalies in both smoking and smokeless forms. Thus oral mucosal micronuclei frequency can be used as a marker of epithelial carcinogenic progression. [Int J Res Med Sci 2016; 4(8.000: 3130-3133

  4. DNA damage in oral mucosa cells of patients with fixed orthodontic appliances.

    Directory of Open Access Journals (Sweden)

    Farzin Heravi


    Full Text Available The release of toxic metal ions from orthodontic alloys has induced concerns regarding the biocompatibility of fixed appliances. This study investigated the genotoxic effect of metal appliances in a sample of patients undergoing fixed orthodontic treatment.The study included twenty-five healthy individuals requiring orthodontic therapy in both jaws. The patients were treated by stainless steel orthodontic brackets and nickel-titanium or stainless steel arch wires. The oral mucosa cells were gathered just before the appliance placement and 9 months later. The cells were centrifuged, fixed and dropped onto slides. After staining, the micronucleus (MN assay was used to determine genome alteration. The data were analyzed by paired sample t-test.The mean micronuclei frequency in the buccal mucosa was 10.6 ± 5.7 per 1000 cells before the appliance placement and 9.2 ± 6.37 per 1000 cells 9 months later. No significant difference was found in the MN count before and 9 months after therapy (p=0.336.Under the conditions used in this study, application of fixed orthodontic appliances did not expose healthy individuals to increased risk of DNA damage in oral mucosa cells.

  5. Detection of Identical Isolates of Enterococcus faecalis from the Blood and Oral Mucosa in a Patient with Infective Endocarditis. (United States)

    Okui, Akemi; Soga, Yoshihiko; Kokeguchi, Susumu; Nose, Motoko; Yamanaka, Reiko; Kusano, Nobuchika; Morita, Manabu


    The detection of infective endocarditis (IE) of oral origin has been previously discussed. However, there are few reports confirming this infection using molecular biological techniques. We herein describe the case of a 67-year-old man who developed IE. Blood culture samples and strains obtained from the gingival and buccal mucosa showed 100% identity to Enterococcus faecalis JCM 5803 on sequencing of 16S rRNA gene fragments. A random amplification of polymorphic DNA (RAPD) analysis showed the same pattern for these samples, thus confirming the identity of E. faecalis isolates in the blood and oral mucosa. Our observations provide novel information regarding the level of identity between IE pathogens and oral bacteria.

  6. DNA damage and cellular death in oral mucosa cells of children who have undergone panoramic dental radiography

    Energy Technology Data Exchange (ETDEWEB)

    Angelieri, Fernanda; Oliveira, Gabriela R. de [Sao Paulo Metodista University (UMESP), Department of Orthodontics, Sao Bernardo do Campo, Sao Paulo (Brazil); Sannomiya, Eduardo K. [Sao Paulo Metodista University (UMESP), Department of Dento-Maxillofacial Radiology, Sao Bernardo do Campo, Sao Paulo (Brazil); Ribeiro, Daniel A. [Federal University of Sao Paulo (UNIFESP), Department of Health Sciences, Santos, Sao Paulo (Brazil); Universidade Federal de Sao Paulo (UNIFESP), Departamento de Ciencias da Saude, Santos, Sao Paulo (Brazil)


    Despite wide use as a diagnostic tool in medical and dental practice, radiography can induce cytotoxic effects and genetic damage. To evaluate DNA damage (micronucleus) and cellular death (pyknosis, karyolysis and karyorrhexis) in exfoliated buccal mucosa cells taken from healthy children following exposure to radiation during dental radiography. A total of 17 children who had undergone panoramic dental radiography were included. We found no statistically significant differences (P > 0.05) between micronucleated oral mucosa cells in children before and after exposure to radiation. On the other hand, radiation did cause other nuclear alterations closely related to cytotoxicity including karyorrhexis, pyknosis and karyolysis. Taken together, these results indicate that panoramic dental radiography might not induce chromosomal damage, but may be cytotoxic. Overall, the results reinforce the importance of evaluating the health side effects of radiography and contribute to the micronucleus database, which will improve our understanding and practice of this methodology in children. (orig.)

  7. [Buccal bony exostoses induced by free gingival grafts]. (United States)

    Tal, H; Slutzkey, S


    Buccal Bony Exostoses (BBE) is a local benign osseous overgrowth continuous with the facial aspect of the jaw. Post operative BBE may be the result of dermal grafts used to restore the buccal vestibulum, of connective tissue graft placement, and of Free Gingival Grafts (FGG) procedures. In 46 patients in whom 72 FGG procedures were performed by the senior author (HT) over the past 12 years, BBE was clinically and radiographically diagnosed. In one case the tumor was surgically removed. The etiology, pathogenesis and frequency of BBE following FGG procedures was reviewed and discussed. We suggest that the BBE may develop owing to periosteal surgical trauma during FGG procedures, and suggest that this phenomenon receives further attention.

  8. Nasal and buccal drug delivery: management forum conference. (United States)

    Smart, John D


    The scope of the conference (Nasal and Buccal Drug Delivery Conference, Management Forum; Chairs Franz Merkus and Julie Suman) was to consider innovations in drug delivery via the nose and oral cavity, notably for the delivery of vaccines, antimalarials and rapidly acting sedatives. Presentations from experts from academia, government agencies and commercial organisations were made over the 2 days. The advantages of both routes were ease of application, patient acceptability and no requirement to produce sterile products. These routes worked best for drugs that are water soluble--but with some lipophilicity--only require low doses, are acceptable to the patient and have low irritancy (particulary for the nasal route). Challenges relate to the effectiveness of deposition from the delivery systems and the efficient clearance mechanisms. It was concluded that for many drugs, buccal and nasal delivery could become the route of choice for their application; vaccines, in particular, appear to show promise for nasal delivery.

  9. Formulation and characterization of mucoadhesive buccal films of glipizide

    Directory of Open Access Journals (Sweden)

    Semalty Mona


    Full Text Available Mucoadhesive buccal films of glipizide were prepared by solvent casting technique using hydroxypropylmethylcellulose, sodium carboxymethylcellulose, carbopol-934P and Eudragit RL-100. Prepared films were evaluated for weight, thickness, surface pH, swelling index, in vitro residence time, folding endurance, in vitro release, permeation studies and drug content uniformity. The films exhibited controlled release over more than 6 h. From the study it was concluded that the films containing 5 mg glipizide in 4.9% w/v hydroxypropylmethylcellulose and 1.5% w/v sodium carboxymethylcellulose exhibited satisfactory swelling, an optimum residence time and promising drug release. The formulation was found to be suitable candidate for the development of buccal films for therapeutic use.

  10. Formulation and characterization of mucoadhesive buccal films of glipizide



    Mucoadhesive buccal films of glipizide were prepared by solvent casting technique using hydroxypropylmethylcellulose, sodium carboxymethylcellulose, carbopol-934P and Eudragit RL-100. Prepared films were evaluated for weight, thickness, surface pH, swelling index, in vitro residence time, folding endurance, in vitro release, permeation studies and drug content uniformity. The films exhibited controlled release over more than 6 h. From the study it was concluded that the films containing 5...

  11. PIV Measurements on a Blowing Flap (United States)

    Hutcheson, Florence V.; Stead, Daniel J.


    PIV measurements of the flow in the region of a flap side edge are presented for several blowing flap configurations. The test model is a NACA 63(sub 2)-215 Hicks Mod-B main-element airfoil with a half-span Fowler flap. Air is blown from small slots located along the flap side edge on either the top, bottom or side surfaces. The test set up is described and flow measurements for a baseline and three blowing flap configurations are presented. The effects that the flap tip jets have on the structure of the flap side edge flow are discussed for each of the flap configurations tested. The results indicate that blowing air from a slot located along the top surface of the flap greatly weakened the top vortex system and pushed it further off the top surface. Blowing from the bottom flap surface kept the strong side vortex further outboard while blowing from the side surface only strengthened the vortex system or accelerated the merging of the side vortex to the flap top surface. It is concluded that blowing from the top or bottom surfaces of the flap may lead to a reduction of flap side edge noise.

  12. Free digital artery flap: an ideal flap for large finger defects in situations where local flaps are precluded. (United States)

    Wong, Chin-Ho; Teoh, Lam-Chuan; Lee, Jonathan Y-L; Yam, Andrew K-T; Khoo, David B-A; Yong, Fok-Chuan


    The heterodigital arterialized flap is increasingly accepted as a flap of choice for reconstruction of large finger wounds. However, in situations where the adjacent fingers sustained concomitant injuries, the use of this flap as a local flap is precluded. This paper describes our experience with the free digital artery flap as an evolution of the heterodigital arterialized flap. Four patients with large finger wounds were reconstructed with free digital artery flap. Our indications for digital artery free flap were concomitant injuries to adjacent fingers that precluded their use as donor sites. The arterial supply of the flap was from the digital artery and the venous drainage was from the dominant dorsal vein of the finger. The flap was harvested from the ulnar side of the finger. The digital nerve was left in situ to minimize donor morbidity. The donor site was covered with a full-thickness skin graft and secured with bolster dressings. Early intensive mobilization was implemented for all patients. All flaps survived. No venous congestion was noted and primary healing was achieved in all flaps. In addition to providing well-vascularized tissue for coverage of vital structures, the digital artery was also used as a flow-through flap for finger revascularization in one patient. Donor-site morbidity was minimal, with all fingers retaining protective pulp sensation and the distal and proximal interphalangeal joints retaining full ranges of motion. In conclusion, the free digital artery flap is a versatile flap that is ideal for coverage of large-sized finger defects in situations where local flaps are unavailable. Donor-site morbidity can be minimized by preservation of the digital nerve, firmly securing the skin graft with bolster dressings, and early mobilization of the donor finger.

  13. Traumatic Forefoot Reconstructions With Free Perforator Flaps. (United States)

    Zhu, Yue-Liang; He, Xiao-Qing; Wang, Yi; Lv, Qian; Fan, Xin-Yv; Xu, Yong-Qing


    The forefoot is critical to normal walking; thus, any reconstruction of forefoot defects, including the soft tissues, must be carefully done. The free perforator flap, with its physiologic circulation, lower donor site morbidity, and minimal thickness is the most popular technique in plastic and microsurgery, and is theoretically the most suitable for such forefoot reconstruction. However, these flaps are generally recognized as more difficult and time-consuming to create than other flaps. In 41 patients with traumatic forefoot defects, we reconstructed the forefoot integument using 5 types of free perforator flaps. The overall functional and cosmetic outcomes were excellent. Three flaps required repeat exploration; one survived. The most common complications were insufficient perfusion and the need for second debulking. The key to our success was thoroughly debriding devitalized bone and soft tissue before attaching the flap. Forefoot reconstruction with a free perforator flap provides better function, better cosmesis, better weightbearing, and better gait than the other flaps we have used.

  14. Fibular flap for mandible reconstruction in osteoradionecrosis of the jaw: selection criteria of fibula flap


    Kim, Ji-Wan; Hwang, Jong-Hyun; Ahn, Kang-Min


    Background Osteoradionecrosis is the most dreadful complication after head and neck irradiation. Orocutaneous fistula makes patients difficult to eat food. Fibular free flap is the choice of the flap for mandibular reconstruction. Osteocutaneous flap can reconstruct both hard and soft tissues simultaneously. This study was to investigate the success rate and results of the free fibular flap for osteoradionecrosis of the mandible and which side of the flap should be harvested for better recons...



    Monica Kinra; Karthikeyan Ramalingam; Amitabha sarkar; Farzan Rehman; Girish KL


    The present study was carried out for quantitative analysis of the mean MCC/optical field and also MCD/sq. mm in oral submucous fibrosis (OSMF), oral lichen planus (OLP), oral leukoplakia (OL), oral squamous cell carcinoma (OSCC) and normal buccal mucosa which constituted control group. This study was carried out in the Department of Oral Pathology and Microbiology, Jaipur Dental College, Jaipur. Histologically confirmed 10 cases each of OSMF, OL, OLP and OSCC were selected. The sections were...

  16. Communication—Microelectrode Detection of Cholesterol Efflux from the Human Buccel Mucosa (United States)

    Yu, Xiaochun; Kelley, Thomas J.; Chiel, Hillel J.; Burgess, James D.


    It has previously demonstrated that cholesterol efflux from the cell plasma membrane is increased in a mouse model of cystic fibrosis (CF) compared to a wild-type control. A noninvasive means of characterizing plasma membrane cholesterol efflux at the surface of airway tissue of CF patients is needed to extend the trends found in animal models of CF to the human disease state. Microelectrode-induced cholesterol efflux from the plasma membrane of cells at the surface of tissue is proposed as a strategy to demonstrate increased cholesterol efflux for CF in human subjects. Data demonstrating detection of cholesterol efflux from the human buccal mucosa is reported as proof-of-concept for an in vivo diagnostic assay. PMID:27546897

  17. Blood flow and epithelial thickness in different regions of feline oral mucosa and skin. (United States)

    Johnson, G K; Squier, C A; Johnson, W T; Todd, G L


    The relationship between epithelial thickness and blood flow was examined in 6 mucosal and 3 skin regions of the cat. Blood flow to these tissues was determined using the radiolabelled microsphere method. From histologic sections the proportion of the tissue biopsy occupied by epithelium and the average epithelial thickness were calculated. The oral tissues had a significantly higher blood flow than the skin regions (p less than 0.05). In terms of epithelial thickness, the tissues could be divided into 4 groups (p less than 0.05). These were: a) palate; b) gingival regions and dorsum of the tongue; c) lip and buccal mucosa; d) all skin regions. When epithelial thickness was related to blood flow there was a significant positive correlation (p less than 0.005) indicating that a thicker epithelium is associated with a higher blood flow. This finding may reflect the greater metabolic demands of the thicker epithelia.

  18. Characteristics of benign lymphoadenosis of oral mucosa

    Institute of Scientific and Technical Information of China (English)

    Shu-Xia Li; Shi-Feng Yu; Kai-Hua Sun


    AIM: To investigate the pathological characteristics and carcinogenesis mechanism of benign lymphoadenosis of oral mucosa (BLOM).METHODS: The expressions of Ki-67, CD34 and apoptosis were evaluated by immunohistochemical SP staining in 64 paraffin-embedded tissue samples. Of them, 9 were from BLOM with dysplasia, 15 from BLOM without dysplasia,15 from oral squamous cell carcinoma (OSCC), 15 from oral precancerosis, and 10 from normal tissues. Cell proliferation, apoptosis and angiogenesis of tissue samples were also analyzed.RESULTS: The expression of Ki-67 in BLOM with dysplasia,oral precancerosis and OSCC was significantly higher than in BLOM without dysplasia and normal mucosa. The microvascular density (MVD) in BLOM with and without dysplasia, oral precancerosis, and OSCC was significantly higher than in normal mucosa. Apoptosis in BLOM and oral precancerosis was significantly higher than in OSCC and normal mucosa.CONCLUSION: Benign lymphoadenosis of oral mucosa has potentialities of cancerization.

  19. Lyophilized sponges loaded with curcumin solid lipid nanoparticles for buccal delivery: Development and characterization. (United States)

    Hazzah, Heba A; Farid, Ragwa M; Nasra, Maha M A; El-Massik, Magda A; Abdallah, Ossama Y


    This study aimed to prepare and evaluate mucoadhesive sponges as dosage forms for delivering solid lipid nanoparticles. For this purpose curcumin (Cur) was formulated as solid nanoparticles (SLN) using Gelucire 50/13, and polaxomer 407. The prepared CurSLN dispersion was thickened with different mucoadhesive polymers. Different concentrations of glycerol, and mannitol of range (0.25-20%), and (0-1%), respectively were also examined. The formed gel was poured into oblong molds and freeze dried to form mucoadhesive sponge to be applied to the buccal mucosa. The prepared sponges were evaluated for their, in-vivo residence time, in-vitro and in-vivo drug release, and hydration capacity. Surface morphology for the different sponges were examined using SEM. TEM was also carried out for sponge fragments previously dispersed into water. Infrared spectroscopy was conducted to investigate interaction between used ingredients. The results showed that the CurSLN loaded HPMC, and Polycarbophil sponges showed 4, and 15 h in-vivo residence time, respectively, providing a considerable amount of curcumin into saliva. The incorporation of glycerol and mannitol at concentration of 1% provided elegant and flexible sponges. The SEM showed that the deposition of CurSLN differed according to the type of polymer used. TEM confirmed the integrity of liberated CurSLN from sponges. IR spectra showed an interaction between HPMC and poloxamer 407, which affected its behavior as a gelling agent. The obtained results provide an efficient approach for delivering solid lipid nanoparticles in a solid dosage form keeping the nanoparticle characters and integrity.

  20. Success of dental implants in vascularised fibular osteoseptocutaneous flaps used as onlay grafts after marginal mandibulectomy. (United States)

    Chang, Y-M; Pan, Y-H; Shen, Y-F; Chen, J-K; ALDeek, N F; Wei, F-C


    We have evaluated the survival of dental implants placed in vascularised fibular flap onlay grafts placed over marginal mandibulectomies and the effects on marginal bone loss of different types of soft tissue around implants under functional loading. From 2001-2009 we studied a total of 11 patients (1 woman and10 men), three of whom had had ameloblastoma and eight who had had squamous cell carcinomas resected. A total of 38 dental implants were placed either at the time of transfer of the vascularised fibular ostoseptocutaneous flaps (nine patients with 30 implants) or secondarily (two patients with eight implants). Four patients were given palatal mucosal grafts to replace intraoral skin flaps around the dental implants (n=13), and the other seven had the skin flaps around the dental implants thinned (n=25) at the second stage of implantation of the osteointegrated teeth. All vascularised fibular osteoseptocutaneous flaps were successfully transferred, and all implants survived a mean (range) of 73 (33-113) months after occlusal functional loading. The mean (SD) marginal bone loss was 0.5 (0.3) mm on both mesial and distal sides in patients who had palatal mucosal grafts, but 1.8 (1.6) mm, and 1.7 (1.5) mm, respectively, on the mesial and distal sides in the patients who had had thinning of their skin flaps. This difference is significant (p=0.008) with less resorption of bone in the group who had palatal mucosal grafts. Palatal mucosa around the implants helps to reduce resorption of bone after functional loading of implants.

  1. Retrospective study of reverse dorsal metacarpal flap and compound flap: a review of 122 cases

    Institute of Scientific and Technical Information of China (English)

    LU Lai-jin; GONG Xu; LIU Zhi-gang; ZHANG Zhi-xin


    Objective:To evaluate the clinical application and discuss the operative indication of the reverse dorsal metacarpal flap and its compound flap on the skin defects of hand.Methods: From 1990 to 2003, we applied the reverse dorsal metacarpal flap and its compound flap to repair soft tissue defects of fingers in 122 cases, which included 90cases of the reverse metacarpal flap and 32 cases of its compound flaps with tendon grafts, nerve grafts or bone grafts. Based on the follow-up observations, we analyzed the indications of the reverse metacarpal flap and its compound flaps, the postoperative contours, flap colors and textures in comparison to contralateral fingers retrospectively.Results: In the series of 122 cases, flaps survived and the donor site defects were closed directly. The follow-up period ranged from 1-12 years. The postoperative contours,colors and textures of the flaps and its compound flaps were similar to those of normal fingers, although linear scar remained. According to standards of sense recovery(British Medical Research Council, BMRC ), the sense function of the flaps resumed S3 after operation for 1 year.In 10 cases with the tendon defects treated by the flap with tendon grafts, function of flexion-extension of fingers resumed 50%-75% in comparison to the contralateral fingers using the method of measurement of total active motion. In 7 cases with the phalangeal nonunion or bone defects treated by the flap with bone grafts, union occurred after operation for 3 months.Conclusions: To soft tissue defects on fingers with bone or tendon exposure, the reverse metacarpal flap and its compound flap are a better choice for repairing. The range of repairing is up to the distal interphalangeal joint of fingers. The second dorsal metacarpal artery is more consistent and larger as the choice of vascular pedicle, in comparison with other dorsal metacarpal arteries.Postoperative flap color and texture are similar to normal fingers.

  2. The freestyle pedicle perforator flap

    DEFF Research Database (Denmark)

    Gunnarsson, Gudjon Leifur; Jackson, Ian T; Westvik, Tormod S;


    not widely performed by the general plastic surgeons. The aim of this paper is to present the simplicity of pedicled perforator flap reconstruction of moderate-sized defects of the extremities and torso. METHODS: We retrospectively reviewed the charts of 34 patients reconstructed using 34 freestyle pedicled...

  3. Sternocleidomastoid Muscle Flap after Parotidectomy. (United States)

    Nofal, Ahmad Abdel-Fattah; Mohamed, Morsi


    Introduction Most patients after either superficial or total parotidectomy develop facial deformity and Frey syndrome, which leads to a significant degree of patient dissatisfaction. Objective Assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle (SCM) flap after superficial or total parotidectomy. Methods A prospective cohort study for 11 patients subjected to parotidectomy using a partial-thickness superiorly based SCM flap. The functional outcome (Frey syndrome, facial nerve involvement, and ear lobule sensation) and the esthetic results were evaluated subjectively and objectively. Results Facial nerve palsy occurred in 5 cases (45%), and all of them recovered completely within 6 months. The Minor starch iodine test was positive in 3 patients (27%), although only 1 (9%) subjectively complained of gustatory sweating. The designed visual analog score completed by the patients themselves ranged from 0 to 3 with a mean of 1.55 ± 0.93; the scores from the blinded evaluators ranged from 1 to 3 with a mean 1.64 ± 0.67. Conclusion The partial-thickness superiorly based SCM flap offers a reasonable cosmetic option for reconstruction following either superficial or total parotidectomy by improving the facial deformity. The flap also lowers the incidence of Frey syndrome objectively and subjectively with no reported hazard of the spinal accessory nerve.

  4. Sternocleidomastoid Muscle Flap after Parotidectomy

    Directory of Open Access Journals (Sweden)

    Nofal, Ahmad Abdel-Fattah


    Full Text Available Introduction Most patients after either superficial or total parotidectomy develop facial deformity and Frey syndrome, which leads to a significant degree of patient dissatisfaction. Objective Assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle (SCM flap after superficial or total parotidectomy. Methods A prospective cohort study for 11 patients subjected to parotidectomy using a partial-thickness superiorly based SCM flap. The functional outcome (Frey syndrome, facial nerve involvement, and ear lobule sensation and the esthetic results were evaluated subjectively and objectively. Results Facial nerve palsy occurred in 5 cases (45%, and all of them recovered completely within 6 months. The Minor starch iodine test was positive in 3 patients (27%, although only 1 (9% subjectively complained of gustatory sweating. The designed visual analog score completed by the patients themselves ranged from 0 to 3 with a mean of 1.55 ± 0.93; the scores from the blinded evaluators ranged from 1 to 3 with a mean 1.64 ± 0.67. Conclusion The partial-thickness superiorly based SCM flap offers a reasonable cosmetic option for reconstruction following either superficial or total parotidectomy by improving the facial deformity. The flap also lowers the incidence of Frey syndrome objectively and subjectively with no reported hazard of the spinal accessory nerve.

  5. Absorption and tolerability of fentanyl buccal soluble film (FBSF in patients with cancer in the presence of oral mucositis

    Directory of Open Access Journals (Sweden)

    Finn AL


    Full Text Available Andrew L Finn1, WD Charlie Hill2, Ignacio Tagarro3, Larry N Gever41Product Development, BioDelivery Sciences International, Inc, Raleigh, NC, USA; 2Co-founding partner, InVisions Consultants, LLC, San Antonio, TX, USA; 3Marketing Centre CIP CNS, Meda Pharma S.A.U., Madrid, Spain; 4Medical Affairs, Meda Pharmaceuticals, Inc, Somerset, NJ, USAPurpose: Fentanyl buccal soluble film (FBSF consists of a small, bilayered, water-soluble polymer film that adheres to the buccal mucosa and rapidly delivers fentanyl into the systemic circulation. The purpose of this study was to evaluate the absorption of fentanyl from FBSF in patients with cancer, with and without grade 1 oral mucositis, and to assess the tolerability of FBSF in this patient population.Patients and methods: In an open-label, single-dose study, two groups of opioid-naive patients (ie, not receiving opioids on a regular basis with cancer received a 200 µg dose of FBSF. Patients in cohort I (n = 7 had grade 1 mucositis, and patients in cohort II (n = 7 were age- and gender-matched controls without mucositis. The FBSF dose was placed on the area of mucositis in cohort I and on a matching location in cohort II. Blood samples were collected up to 4 hours after administration, and safety assessments were made throughout the study.Results: Peak plasma concentration and area under the concentration–time curve from time 0 to 4 hours post-dose values of patients in the grade 1 mucositis cohort were lower than those observed in patients without mucositis. There was no application site irritation reported in any patient, regardless of mucositis status. Mild somnolence was reported by two patients with mucositis. There were no deaths or serious adverse events reported in this study.Conclusion: The results of this study indicate that application of FBSF to an area of grade 1 mucositis does not result in increased fentanyl exposure or irritation of the mucosa. The 200 µg dose of FBSF was well

  6. The possibility for use of venous flaps in plastic surgery

    Energy Technology Data Exchange (ETDEWEB)

    Baytinger, V. F., E-mail:; Kurochkina, O. S., E-mail:; Selianinov, K. V.; Baytinger, A. V. [Research Institute of Microsurgery, Tomsk (Russian Federation); Dzyuman, A. N. [Siberian State Medical University, Tomsk (Russian Federation)


    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.

  7. The possibility for use of venous flaps in plastic surgery (United States)

    Baytinger, V. F.; Kurochkina, O. S.; Selianinov, K. V.; Baytinger, A. V.; Dzyuman, A. N.


    The use of venous flaps is controversial. The mechanism of perfusion of venous flaps is still not fully understood. The research was conducted on 56 white rats. In our experimental work we studied two different models of venous flaps: pedicled venous flap (PVF) and pedicled arterialized venous flap (PAVF). Our results showed that postoperative congestion was present in all flaps. However 66.7% of all pedicled venous flaps and 100% of all pedicled arterialized venous flaps eventually survived. Histological examination revealed that postoperatively the blood flow in the skin of the pedicled arterialized venous flap became «re-reversed» again; there were no differences between mechanism of survival of venous flaps and other flaps. On the 7-14th day in the skin of all flaps were processes of neoangiogenesis and proliferation. Hence the best scenario for the clinical use of venous flaps unfolds when both revascularization and skin coverage are required.


    Directory of Open Access Journals (Sweden)



    Full Text Available For systemic drug delivery, the buccal region offers an attractive route of drug administration. The main objective of the study is to formulate buccal patches of salbutamol sulphate. Salbutamol sulfate is a short-acting β2-adrenergic receptor agonist used for the relief of bronchospasm in conditions such as asthma and chronic obstructive pulmonary disease. It’s oral bioavailability is 40% due to extensive first pass metabolism. Salbutamol sulfate patches were prepared using HPMC, SCMC and Carbopol 934 in various proportions and combinations using Glycerol and tween-80 as plasticizers. Patches were laminated on one side with a water impermeable backing layer using ethyl cellulose for unidirectional drug release. The thickness of medicated patches were ranged between 0.402 and 0.431 mm and mass varied between 0.0312 and 0.0352 g. The surface-pH of patches ranged between 6 and 7. All formulations showed good folding endurance. Formulations F9 showed good drug content and Residence time of the tested patches ranged between 108 and 174 min. The maximum in vitro release was found to be 93.89% over a period of 150 min for formulation F9. Data of in vitro release from patches were fitted to different kinetic models such as Higuchi and Korsmeyer–Peppas models to explain the release profile. Formulations F9 were best fitted to the non-Fickian kinetics and zero order release was observed.

  9. Influence of buccal corridor dimension on smile esthetics

    Directory of Open Access Journals (Sweden)

    Diana Cunha Nascimento


    Full Text Available OBJECTIVE: To assess the influence of buccal corridor width on smile esthetics of male and female, Caucasian and Afro-descendant subjects by means of digitally manipulated photographs, as well as compare assessments of full-face view (FFV and close-up view of the mouth (CUVM images. METHODS: Facial photographs were taken of four adults' smile, two Caucasians and two Afro-descendants of both genders. The resulting images were digitally manipulated with the aim of rendering - from each original smile - three other smiles simulating three different buccal corridor widths, namely, narrow, medium width and wide. The rendered images, 12 of which portraying FFVs and 12 providing CUVMs, were assessed by 60 examiners who rated the attractiveness of each smile by means of a visual analog scale (VAS. The data were treated with ANOVA and Tukey's post test to compare the different buccal corridors, and Student's t test to compare the two image views (FFV and CUVM. RESULTS: Medium width buccal corridors were considered the most attractive in the four individuals investigated, both in the assessment of FFVs and CUVMs (p 0.05. Furthermore, no statistically significant difference was found between the analyses of FFVs and CUVMs (p > 0.05. CONCLUSION: The buccal corridor exercised a remarkable influence on smile esthetics, with the medium width group being rated as the most attractive. No influence was exerted by the individuals' face, ethnicity or gender.OBJETIVO: avaliar a influência do corredor bucal na estética de sorrisos femininos e masculinos, de leucodermas e melanodermas, por meio de fotografias manipuladas, bem como comparar essa avaliação numa vista facial completa e numa vista aproximada da boca. MÉTODOS: foram realizadas fotografias faciais do sorriso de quatro indivíduos adultos, sendo dois leucodermas e dois melanodermas, de ambos os sexos. As imagens geradas foram manipuladas a fim de produzir, a partir de cada sorriso original, três outros

  10. In vitro systems toxicology approach to investigate the effects of repeated cigarette smoke exposure on human buccal and gingival organotypic epithelial tissue cultures. (United States)

    Schlage, Walter K; Iskandar, Anita R; Kostadinova, Radina; Xiang, Yang; Sewer, Alain; Majeed, Shoaib; Kuehn, Diana; Frentzel, Stefan; Talikka, Marja; Geertz, Marcel; Mathis, Carole; Ivanov, Nikolai; Hoeng, Julia; Peitsch, Manuel C


    Smoking has been associated with diseases of the lung, pulmonary airways and oral cavity. Cytologic, genomic and transcriptomic changes in oral mucosa correlate with oral pre-neoplasia, cancer and inflammation (e.g. periodontitis). Alteration of smoking-related gene expression changes in oral epithelial cells is similar to that in bronchial and nasal epithelial cells. Using a systems toxicology approach, we have previously assessed the impact of cigarette smoke (CS) seen as perturbations of biological processes in human nasal and bronchial organotypic epithelial culture models. Here, we report our further assessment using in vitro human oral organotypic epithelium models. We exposed the buccal and gingival organotypic epithelial tissue cultures to CS at the air-liquid interface. CS exposure was associated with increased secretion of inflammatory mediators, induction of cytochrome P450s activity and overall weak toxicity in both tissues. Using microarray technology, gene-set analysis and a novel computational modeling approach leveraging causal biological network models, we identified CS impact on xenobiotic metabolism-related pathways accompanied by a more subtle alteration in inflammatory processes. Gene-set analysis further indicated that the CS-induced pathways in the in vitro buccal tissue models resembled those in the in vivo buccal biopsies of smokers from a published dataset. These findings support the translatability of systems responses from in vitro to in vivo and demonstrate the applicability of oral organotypical tissue models for an impact assessment of CS on various tissues exposed during smoking, as well as for impact assessment of reduced-risk products.

  11. Fungal infections of the oral mucosa

    Directory of Open Access Journals (Sweden)

    P Anitha Krishnan


    This review discusses the various predisposing factors, clinical presentations, clinical differential diagnosis, diagnosis and management of oral candidiasis, as well as briefly highlights upon a few of the more exotic non-Candidal fungi that infect the oral mucosa.

  12. [Regeneration of the gastric and intestinal mucosas]. (United States)

    Castrup, H J


    The physiological cell renewal of gastrointestinal mucosa is regulated in man as in animal through certain mechanisms with measurable kinetic data. Pathologic mucosal alterations, metabolic disorders, pharmacological agents etc. clearly affect the regenerative processes of the gastrointestinal epithelium. Gastrin and pentagastrin stimulate the growth not only of the parietal cells, but also of the superficial epithelium of the gastric mucosa, whereas secretin does not change cell growth. Glucocorticoid steroids inhibit epithelial regeneration in all parts of the gastrointestinal tract. 5-fluorouracil has a similar effect but acts at a different site in the regeneration cycle. Epithelial cell proliferation of the gastric and intestinal mucosa is likewise inhibited in an uremic condition. In inflammatory changes in the human gastric mucosa epithelial cell hyperproliferation relative to the severity of gastritis and anomalous proliferation within regions of dysplasia can be demonstrated. Foveolary hyperplasia in Ménétrier's disease occurs on the basis of excessive hyperproliferation with displacement of regeneration zones.

  13. Glans reconstruction with the use of an inverted urethral flap after distal penile amputation for carcinoma

    Directory of Open Access Journals (Sweden)

    Salvatore Sansalone


    Full Text Available Restoration of adequate cosmesis and preservation of sexual and urinary function are the main goals of penile reconstructive surgery following amputation for carcinoma. Split thickness skin grafts and oral mucosa grafts have been widely used for the creation of a pseudoglans with excellent cosmetic and functional results. The main drawbacks associated with the use of grafts are donor site morbidity, the lack of engorgement of the pseudoglans and the risk of poor graft take, which may lead to contracture and poor cosmetic results. In the present series the long term cosmetic and functional outcomes of glans reconstruction with an inverted distal urethral flap are described.


    Institute of Scientific and Technical Information of China (English)


    Objective: To investigate the roles of telomerase activity (TA) in relation to hamster buccal pouch tumor progression. Methods: male hamster were treated three times weekly with 0.5% of 7, 12-dimethyl- benzanthracene (DMBA) over a 15 weeks experimental period. Hamsters were sacrificed at 3, 6, 9, 12 and 15 weeks after treatment. Telomerase activity of hamster buccal pouch tissue were measured along with the analyses of the formation of DMBA-induced hamster buccal pouch tumors. Results: DMBA-induced squamous cell carcinomas were found at the 6th week after dosing. Telomerase activity elevation began at the 3rd week and was increasing to a plateau at the 12th week. Conclusion: Our results show that telomerase activity in the target tissue may be detected at the early stage of the DMBA-induced hamster buccal pouch tumor formation and suggests that telomerase activity may be used as a biomarker for an early clinical detection of buccal pouch cancer.

  15. Adjoint-based optimization of flapping plates hinged with a trailing-edge flap

    Directory of Open Access Journals (Sweden)

    Min Xu


    Full Text Available It is important to understand the impact of wing-morphing on aerodynamic performance in the study of flapping-wing flight of birds and insects. We use a flapping plate hinged with a trailing-edge flap as a simplified model for flexible/morphing wings in hovering. The trailing-edge flapping motion is optimized by an adjoint-based approach. The optimized configuration suggests that the trailing-edge flap can substantially enhance the overall lift. Further analysis indicates that the lift enhancement by the trailing-edge flapping is from the change of circulation in two ways: the local circulation change by the rotational motion of the flap, and the modification of vortex shedding process by the relative location between the trailing-edge flap and leading-edge main plate.


    Directory of Open Access Journals (Sweden)

    Elitsa Deliverska


    Full Text Available Background Hypochlorite solution is widely used in dental practice during root canal treatment. Although it is generally regarded as being very safe, potentially severe complications can occur when it comes into contact with soft tissue especially due to its cytotoxic features. Objective The aim of our paper is to present a case of damage of oral mucosa because of leakage of 3% hypochlorite through rubber dam during endodontic treatment. Material and methods We present a 31 years old female with necrosis of buccal mucosa during the endodontic treatment of 46. Results Three days after the procedure the patient was referred to our department for consultation and treatment. Antiseptic lavage was performed and oral antibiotic was administrated. After 5 days intraoral examination showed signs of almost full recovery. Conclusion The need for proper tooth isolation during restorative procedures is obvious. Anything that obscures the operative field negatively impacts operator efficiency and effectiveness. Visibility, patient/operator safety, infection control and the physical properties of dental materials are all compromised when proper isolation is lacking.

  17. Reconstruction of the tongue and mouth floor with the myofascial vastus lateralis free flap after cancer ablation. (United States)

    Wang, L; Liu, K; Shao, Z; Shang, Z-J


    The current study was undertaken to evaluate a novel approach to tongue and mouth floor reconstruction using the myofascial vastus lateralis free flap (MVLF). The surgical techniques, benefits, complication rate, and the aesthetic and functional results are described. A series of six patients underwent functional tongue reconstruction between July 2013 and November 2014. The myofascial vastus lateralis flap was obtained as follows: the vastus lateralis muscle was exposed, the neurovascular pedicle was identified, and the myofascial flap was raised. Postoperatively, the neotongue appeared plump and was able to maintain palatal contact. Moreover, no obvious decrease in flap volume was observed during the follow-up period. Most patients experienced good tongue mobility. Further use of the MVLF should confirm whether the mucous membrane on the surface of the flap becomes part of the tongue mucosa in the true sense, whether and how well the patients will recover their sense of taste, and the degree to which quality of life is improved after nerve anastomosis. So far, it appears to be a suitable approach to tongue and mouth floor reconstruction.

  18. Significance of buccopalatal implant position, biotype, platform switching, and pre-implant bone augmentation on the level of the midbuccal mucosa. (United States)

    Zuiderveld, Elise G; den Hartog, Laurens; Vissink, Arjan; Raghoebar, Gerry M; Meijer, Henny J A


    This study assessed whether buccopalatal implant position, biotype, platform switching, and pre-implant bone augmentation affects the level of the midbuccal mucosa (MBM). Ninety patients with a single-tooth implant in the esthetic zone were included. The level of the MBM was measured on photographs taken 1 year after crown placement. The factors analyzed only explained 22% of the level of the MBM. The more an implant was placed to the buccal, the more the MBM was positioned apically. A comparable phenomenon was observed in cases with a thick biotype and cases that underwent pre-implant bone augmentation. Platform switching did not affect the level of the MBM.

  19. The place of nasolabial flap in orofacial reconstruction: A review

    Directory of Open Access Journals (Sweden)

    Amin Rahpeyma


    Conclusion: Nasolabial flap is an old flap for reconstructive purposes. Over time different modifications have been introduced to expand its usage. Clear definition of the terms used with this flap is given.

  20. Freestyle Local Perforator Flaps for Facial Reconstruction

    Directory of Open Access Journals (Sweden)

    Jun Yong Lee


    Full Text Available For the successful reconstruction of facial defects, various perforator flaps have been used in single-stage surgery, where tissues are moved to adjacent defect sites. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Of four complicated cases, three developed venous congestion, which resolved in the subacute postoperative period, and one patient with partial necrosis underwent minor revision. We reviewed the literature on freestyle perforator flaps for facial defect reconstruction and focused on English articles published in the last five years. With the advance of knowledge regarding the vascular anatomy of pedicled perforator flaps in the face, we found that some perforator flaps can improve functional and aesthetic reconstruction for the facial defects. We suggest that freestyle facial perforator flaps can serve as alternative, safe, and versatile treatment modalities for covering small to moderate facial defects.

  1. Freestyle Local Perforator Flaps for Facial Reconstruction. (United States)

    Lee, Jun Yong; Kim, Ji Min; Kwon, Ho; Jung, Sung-No; Shim, Hyung Sup; Kim, Sang Wha


    For the successful reconstruction of facial defects, various perforator flaps have been used in single-stage surgery, where tissues are moved to adjacent defect sites. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Of four complicated cases, three developed venous congestion, which resolved in the subacute postoperative period, and one patient with partial necrosis underwent minor revision. We reviewed the literature on freestyle perforator flaps for facial defect reconstruction and focused on English articles published in the last five years. With the advance of knowledge regarding the vascular anatomy of pedicled perforator flaps in the face, we found that some perforator flaps can improve functional and aesthetic reconstruction for the facial defects. We suggest that freestyle facial perforator flaps can serve as alternative, safe, and versatile treatment modalities for covering small to moderate facial defects.

  2. Comparison of buccal infiltration of 4% articaine with 1 : 100,000 and 1 : 200,000 epinephrine for extraction of maxillary third molars with pericoronitis: a pilot study. (United States)

    Lima, José Lacet; Dias-Ribeiro, Eduardo; Ferreira-Rocha, Julierme; Soares, Ramon; Costa, Fábio Wildson Gurgel; Fan, Song; Sant'ana, Eduardo


    We compared the buccal infiltration of 4% articaine with 1 : 100,000 or 1 : 200,000 epinephrine without a palatal injection for the extraction of impacted maxillary third molars with chronic pericoronitis. This prospective, double-blind, controlled clinical trial involved 30 patients between the ages of 15 and 46 years who desired extraction of a partially impacted upper third molar with pericoronitis. Group 1 (15 patients) received 4% articaine with 1 : 100,000 epinephrine and group 2 (15 patients) received 4% articaine with 1 : 200,000 epinephrine by buccal infiltration. None of the patients in group 1 reported pain, but 3 patients in group 2 reported pain, which indicated a need for a supplementary palatal injection. The palatal injections were all successful in eliminating the pain. Two additional patients in group 2 experienced pain when the suture needle penetrated their palatal mucosa. Based on these results, 4% articaine with 1 : 100,000 epinephrine was found to be more effective for the removal of upper third molars in the presence of pericoronitis than 4% articaine hydrochloride with 1 : 200,000 epinephrine when only a buccal infiltration was used.

  3. Head and neck reconstruction with pedicled flaps in the free flap era

    NARCIS (Netherlands)

    Mahieu, R.; Colletti, G.; Bonomo, P.; Parrinello, G.; Iavarone, A.; Dolivet, G.; Livi, L.; Deganello, A.


    Nowadays, the transposition of microvascular free flaps is the most popular method for management of head and neck defects. However, not all patients are suitable candidates for free flap reconstruction. In addition, not every defect requires a free flap transfer to achieve good functional results.

  4. Pectoralis major flap for head and neck reconstruction in era of free flaps. (United States)

    Kekatpure, V D; Trivedi, N P; Manjula, B V; Mathan Mohan, A; Shetkar, G; Kuriakose, M A


    The aim of this study was to evaluate factors affecting the selection of pectoralis major flap in the era of free tissue reconstruction for post ablative head and neck defects and flap associated complications. The records of patients who underwent various reconstructive procedures between July 2009 and December 2010 were retrospectively analysed. 147 reconstructive procedures including 79 free flaps and 58 pectoralis major flaps were performed. Pectoralis major flap was selected for reconstruction in 21 patients (36%) due to resource constrains, in 12 (20%) patients for associated medical comorbidities, in 11 (19%) undergoing extended/salvage neck dissections, and in 5 patients with vessel depleted neck and free flap failure salvage surgery. None of the flaps was lost, 41% of patients had flap related complications. Most complications were self-limiting and were managed conservatively. Data from this study suggest that pectoralis major flap is a reliable option for head and neck reconstruction and has a major role even in this era of free flaps. The selection of pectoralis major flap over free flap was influenced by patient factors in most cases. Resource constraints remain a major deciding factor in a developing country setting.

  5. Resternal closure versus pectoral muscle flap following omental flap in treatment of deep sternal wound infection

    Directory of Open Access Journals (Sweden)

    Fouad Rassekh


    Conclusion: Omental flap is safe, easy and effective technique in management of mediastinitis with DSWI following open heart surgery in CABG patients either this procedure was followed by reclosure of the sternum or bilateral pectoral flap. However, reclosure of the sternum is more physiological and less invasive than doing bilateral pectoral flap leaving the sternum unclosed.

  6. Posterior interosseous free flap: various types. (United States)

    Park, J J; Kim, J S; Chung, J I


    The posterior interosseous artery is located in the intermuscular septum between the extensor carpi ulnaris and extensor digiti minimi muscles. The posterior interosseous artery is anatomically united through two main anastomoses: one proximal (at the level of the distal border of the supinator muscle) and one distal (at the most distal part of the interosseous space). In the distal part, the posterior interosseous artery joins the anterior interosseous artery to form the distal anastomosis between them. The posterior interosseous flap can be widely used as a reverse flow island flap because it is perfused by anastomoses between the anterior and the posterior interosseous arteries at the level of the wrist. The flap is not reliable whenever there is injury to the distal forearm or the wrist. To circumvent this limitation and to increase the versatility of this flap, we have refined its use as a direct flow free flap. The three types of free flaps used were (1) fasciocutaneous, (2) fasciocutaneous-fascia, and (3) fascia only. Described are 23 posterior interosseous free flaps: 13 fasciocutaneous flaps, 6 fasciocutaneous-fascial flaps, and 4 fascial flaps. There were 13 sensory flaps using the posterior antebrachial cutaneous nerve. The length and external diameter of the pedicle were measured in 35 cases. The length of the pedicle was on average 3.5 cm (range, 3.0 to 4.0 cm) and the external diameter of the artery averaged 2.2 mm (range, 2.0 to 2.5 mm). The hand was the recipient in 21 patients, and the foot in 2. All 23 flaps covered the defect successfully.

  7. Free flap pulse oximetry utilizing reflectance photoplethysmography


    Zaman, T.; Kyriacou, P. A.; Pal, S.


    The successful salvage of a free flap is dependent on the continuous monitoring of perfusion. To date there is no widely accepted and readily available post-operative monitoring technique to reliably assess the viability of free flaps by continuously monitoring free flap blood oxygen saturation. In an attempt to overcome the limitations of the current techniques a reflectance photoplethysmographic (PPG) processing system has been developed with the capability of real-time estimation of arteri...

  8. Dynamic stall in flapping flight (United States)

    Hubel, Tatjana; Tropea, Cameron


    We report on experiments concerning unsteady effects in flapping flight, conducted in the low-speed wind tunnel of the TU Darmstadt using a mechanical flapping-wing model. Particle Image Velocimetry (PIV) was used for qualitative and quantitative analysis parallel and perpendicular to the flow field. A sensitivity analysis of the main flight parameters has been performed, with specific attention to the flight envelope of 26,500 dynamic stall effect could be verified by the direct force measurement as well as the flow visualization. The observation of the leading-edge vortex for typical bird flight reduced frequencies shows that this flow cannot be approximated as being quasi- steady. This in effect proves that adaptive wings are necessary to fully control these unsteady flow features, such as dynamic stall.

  9. Flapping Wing Flight Dynamic Modeling (United States)


    von Karman, T. and Burgers, J. M., Gerneral Aerodynamic Theory - Perfect Fluids , Vol. II, Julius Springer , Berlin, 1935. [24] Pesavento, U. and Wang...L., Methods of Analytical Dynamics , McGraw-Hill Book Company, New York, 1970. [34] Deng, X., Schenato, L., Wu, W. C., and Sastry, S. S., Flapping...Micro air vehicle- motivated computational biomechanics in bio ights: aerodynamics, ight dynamics and maneuvering stability, Acta Mechanica

  10. Optimal propulsive flapping in Stokes flows

    CERN Document Server

    Was, Loic


    Swimming fish and flying insects use the flapping of fins and wings to generate thrust. In contrast, microscopic organisms typically deform their appendages in a wavelike fashion. Since a flapping motion with two degrees of freedom is able, in theory, to produce net forces from a time-periodic actuation at all Reynolds number, we compute in this paper the optimal flapping kinematics of a rigid spheroid in a Stokes flow. The hydrodynamics for the force generation and energetics of the flapping motion is solved exactly. We then compute analytically the gradient of a flapping efficiency in the space of all flapping gaits and employ it to derive numerically the optimal flapping kinematics as a function of the shape of the flapper and the amplitude of the motion. The kinematics of optimal flapping are observed to depend weakly on the flapper shape and are very similar to the figure-eight motion observed in the motion of insect wings. Our results suggest that flapping could be a exploited experimentally as a propul...

  11. A novel dosage form for buccal administration of bupropion

    Directory of Open Access Journals (Sweden)

    Nilsa Maria Galvão Almeida


    Full Text Available Bupropion is an antidepressant used in the treatment of smoking. The purpose of this study was to prepare controlled-release hydrogel films for buccal administration of bupropion and investigate its physicochemical and cytotoxic properties. The films were prepared from ultrapure sodium carboxymethylcellulose, hydroxypropylmethylcellulose K4M, and medium-viscosity chitosan. Evaluation of film physicochemical characteristics was based on scanning electron microscopy, bupropion content, mechanical strength (burst strength, relaxation, resilience, and traction, and cytotoxicity. Bupropion content in bilayer films was 121 mg per 9 cm2. The presence of bupropion modified film mechanical strength, but did not compromise the use of this pharmaceutical form. As shown by the cytotoxicity results, films containing bupropion did not cause cellular damage. Bupropion administration in the form of hydrogel films is a potentially useful alternative in the treatment of smoking.


    Directory of Open Access Journals (Sweden)

    Yu. G. KOLENKO


    Full Text Available In recent years, substantial changes have occurred in the structure of oral mucosa diseases, in particular an increased ratio of precancerous diseases, so that an effective non-invasive detection of any sign of malignancy appears as an urgent and most actual task of dentistry. Aim: To study the proliferative activity of epithelial cells in Ki-67 antigenin patients with leukoplakia of the oral mucosa. Materials and method: A complex clinical and laboratory examination was performed on 155 patients with oral leukoplakia, who addressed the Operative Dentistry Department of the “A.A.Bogomolets” National Medical University of Kiev between 2010 and 2014. All patients have been subjected to a careful clinical examination, which included: dental anamnesis, visual inspection, oral examination and digital palpation of oral mucosa and tongue mucosa, biopsy of leukoplakia lesions for cytological and histological examination. Results: Histological evaluation of the material has been performed according to the WHO (2005 classification of leukoplakia. 10 (14% sites of unaltered mucosa, 10 (14% samples of hyperkeratosis without atypia, 14 (19% biopsy specimens of hyperkeratosis SIN1, 15 (21% – hyperkeratosis SIN2, 10 (14% - SIN3 and 13 (18% cases of squamous cell carcinoma were evidenced. Immunohistochemical investigation evidenced the presence of protein Ki-67 in the nuclei of epithelial cells. In the unmodified epithelium of the oral mucosa, all epithelial cells with stained nuclei are virtually located in the basal layer. Conclusion: Against the general increase of the proliferative activity of epithelial cells with increasing SIN, a characteristic distribution of proliferating cells in the thickness of the epithelium was revealed for each studied group, as follows: in the control group and in leukoplakia without atypia, immunopositive cells are located in the basal layer, in leukoplakia (SIN1, SIN2 and SIN3 – in parabasal position while, in squamous

  13. The potential of chitosan in enhancing peptide and protein absorption across the TR146 cell culture model-an in vitro model of the buccal epithelium

    DEFF Research Database (Denmark)

    Portero, Ana; Remuñán-López, Carmen; Nielsen, Hanne Mørck


    To investigate the potential of chitosan (CS) to enhance buccal peptide and protein absorption, the TR146 cell culture model, a model of the buccal epithelium, was used.......To investigate the potential of chitosan (CS) to enhance buccal peptide and protein absorption, the TR146 cell culture model, a model of the buccal epithelium, was used....

  14. Analysis of biplane flapping flight with tail

    NARCIS (Netherlands)

    Tay, W.B.; Bijl, H.; Van Oudheusden, B.W.


    Numerical simulations have been performed to examine the interference effects between an upstream flapping biplane airfoil arrangement and a downstream stationary tail at a Reynolds number of 1000, which is around the regime of small flapping micro aerial vehicles. The objective is to investigate th

  15. Energy management - The delayed flap approach (United States)

    Bull, J. S.


    Flight test evaluation of a Delayed Flap approach procedure intended to provide reductions in noise and fuel consumption is underway using the NASA CV-990 test aircraft. Approach is initiated at a high airspeed (240 kt) and in a drag configuration that allows for low thrust. The aircraft is flown along the conventional ILS glide slope. A Fast/Slow message display signals the pilot when to extend approach flaps, landing gear, and land flaps. Implementation of the procedure in commercial service may require the addition of a DME navigation aid co-located with the ILS glide slope transmitter. The Delayed Flap approach saves 250 lb of fuel over the Reduced Flap approach, with a 95 EPNdB noise contour only 43% as large.

  16. Piezoelectrically actuated insect scale flapping wing (United States)

    Mukherjee, Sujoy; Ganguli, Ranjan


    An energy method is used in order to derive the non-linear equations of motion of a smart flapping wing. Flapping wing is actuated from the root by a PZT unimorph in the piezofan configuration. Dynamic characteristics of the wing, having the same size as dragonfly Aeshna Multicolor, are analyzed using numerical simulations. It is shown that flapping angle variations of the smart flapping wing are similar to the actual dragonfly wing for a specific feasible voltage. An unsteady aerodynamic model based on modified strip theory is used to obtain the aerodynamic forces. It is found that the smart wing generates sufficient lift to support its own weight and carry a small payload. It is therefore a potential candidate for flapping wing of micro air vehicles.

  17. Blood flow autoregulation in pedicled flaps

    DEFF Research Database (Denmark)

    Bonde, Christian T; Holstein-Rathlou, Niels-Henrik; Elberg, Jens J


    INTRODUCTION: Clinical work on the blood perfusion in skin and muscle flaps has suggested that some degree of blood flow autoregulation exists in such flaps. An autoregulatory mechanism would enable the flap to protect itself from changes in the perfusion pressure. The purpose of the present study...... was to evaluate if, and to what extent, a tissue flap could compensate a reduction in blood flow due to an acute constriction of the feed artery. Further, we wanted to examine the possible role of smooth muscle L-type calcium channels in the autoregulatory mechanism by pharmacological intervention with the L......-type calcium channel blocker nimodipine and the vasodilator papaverine. MATERIAL AND METHODS: Pedicled flaps were raised in pigs. Flow in the pedicle was reduced by constriction of the feed artery (n=34). A transit time flow probe measured the effect on blood flow continuously. Following this, three different...

  18. White light spectroscopy for free flap monitoring. (United States)

    Fox, Paige M; Zeidler, Kamakshi; Carey, Joseph; Lee, Gordon K


    White light spectroscopy non-invasively measures hemoglobin saturation at the capillary level rendering an end-organ measurement of perfusion. We hypothesized this technology could be used after microvascular surgery to allow for early detection of ischemia and thrombosis. The Spectros T-Stat monitoring device, which utilizes white light spectroscopy, was compared with traditional flap monitoring techniques including pencil Doppler and clinical exam. Data were prospectively collected and analyzed. Results from 31 flaps revealed a normal capillary hemoglobin saturation of 40-75% with increase in saturation during the early postoperative period. One flap required return to the operating room 12 hours after microvascular anastomosis. The T-stat system recorded an acute decrease in saturation from ~50% to less than 30% 50 min prior to identification by clinical exam. Prompt treatment resulted in flap salvage. The Spectros T-Stat monitor may be a useful adjunct for free flap monitoring providing continuous, accurate perfusion assessment postoperatively.

  19. Bacterial-killing effect of atmospheric pressure non-equilibrium plasma jet and oral mucosa response. (United States)

    Liu, Dexi; Xiong, Zilan; Du, Tianfeng; Zhou, Xincai; Cao, Yingguang; Lu, Xinpei


    Recently, plasma sterilization has attracted increasing attention in dental community for the atmospheric pressure non-equilibrium plasma jet (APNPs), which is driven by a kilohertz pulsed DC power, may be applied to the dental and oral diseases. However, it is still in doubt whether APNPs can effectively kill pathogenic bacteria in the oral cavity and produce no harmful effects on normal oral tissues, especially on normal mucosa. The aim of this study was to evaluate the bacterial-killing effect of APNPs in the biofilms containing a single breed of bacteria (Porphyromonas gingivalis, P.g.), and the pathological changes of the oral mucosa after treatment by APNPs. P.g. was incubated to form the biofilms in vitro, and the samples were divided into three groups randomly: group A (blank control); group B in which the biofilms were treated by APNPs (the setting of the equipment: 10 kHz, 1600 ns and 8 kV); group C in which the biofilms were exposed only to a gas jet without ignition of the plasma. Each group had three samples and each sample was processed for up to 5 min. The biofilms were then fluorescently stained, observed and photographed under a laser scanning confocal microscope. In the animal experiment, six male Japanese white rabbits were divided into two groups randomly (n=3 in each group) in terms of the different post-treatment time (1-day group and 5-day group). The buccal mucosa of the left side and the mucosa of the ventral surface of the tongue were treated by APNPs for 10 min in the same way as the bacterial biofilm experiment in each rabbit, and the corresponding mucosa of the other sides served as normal control. The clinical manifestations of the oral mucosa were observed and recorded every day. The rabbits were sacrificed one or five day(s) after APNPs treatment. The oral mucosa were harvested and prepared to haematoxylin and eosin-stained sections. Clinical observation and histopathological scores were used to assess mucosal changes. The results


    Directory of Open Access Journals (Sweden)



    Full Text Available The determination of sex of an individual is an important subject in Forensic Medicine and Criminology and in Civil Law. The determination of sex is necessary in both living and the dead bodies. The expert opinion of the medico legal specialist regarding positive identification of an individual will be required for the following reasons. For the identification of the sex of individual whether living or dead , For deciding cases relating to legitimacy, divorce, paternity, affiliation, marriage, education, im potence, right to disposal of property, and in intersex condition & in cases of concealed sex. Determination of sex will be done by presumptive, probable and certain signs of sex. Sex chromatin is a planoconvex mass of about 1 micron in diameter lying near nuclear membrane - Barr body. In the buccal smear the percentage of the nuclei containing chromatin body ranges from 0 to 4 in males & 20n to 80 in females . In females neutrophil leucocytes contain a small nuclear attachment of drum stick form - David son bo dy in up to 6% of cell . This is absent in males . Exact sex determination can be made by using a single specimen of buccal smear , saliva or hair follicle, by the combined treatment of quinacrinedi hydrochloride staining for Y chromosome which is seen as bright florescent body in the nuclei of male cell & florescent feulgen reaction using acriflavin Schiff reagent for X chromosomes , which is seen as bright yellow spot in the nuclei . The percentage of quanacrine positive bodies ranges from 45 to 80% in male s , and 0 to 4% in females . With feulgen reaction technique florescent bodies are found in 50 to 70 % of cell in females, and 0 to 2% in males. Determination of sex chromatin pattern was done by examination of oral smears technique on 50 males and 50 female s who have attended the Casualty of Government General Hospital, Ananthapuramu., A. P . , in the Dept . of forensic Medicine from 17 - 06 - 2012 to 30 - 12 - 2014. Slides were

  1. DIEP flap sentinel skin paddle positioning algorithm. (United States)

    Laporta, Rosaria; Longo, Benedetto; Sorotos, Michail; Pagnoni, Marco; Santanelli Di Pompeo, Fabio


    Although clinical examination alone or in combination with other techniques is the only ubiquitous method for flap monitoring, it becomes problematic with buried free-tissue transfer. We present a DIEP flap sentinel skin paddle (SSP) positioning algorithm and its reliability is also investigated using a standardized monitoring protocol. All DIEP flaps were monitored with hand-held Doppler examination and clinical observation beginning immediately after surgery in recovery room and continued postoperatively at the ward. Skin paddle (SP) position was preoperatively drawn following mastectomy type incisions; in skin-sparing mastectomies types I-III a small SP (sSP) replaces nipple-areola complex; in skin-sparing mastectomy type IV, SSP is positioned between wise-pattern branches while in type V between medial/lateral branches. In case of nipple-sparing mastectomy SSP is positioned at inframammary fold or in lateral/medial branches of omega/inverted omega incision if used. Three hundred forty-seven DIEP flap breast reconstructions were reviewed and stratified according to SP type into group A including 216 flaps with large SP and group B including 131 flaps with SSP and sSP. Sixteen flaps (4.6%) were taken back for pedicle compromise, 13 of which were salvaged (81.25%), 11 among 13 from group A and 2 among 3 from group B. There was no statistical difference between the groups concerning microvascular complication rate (P = 0.108), and time until take-back (P = 0.521) and flap salvage rate (P = 0.473) resulted independent of SP type. Our results suggest that early detection of perfusion impairment and successful flaps salvage could be achieved using SSP for buried DIEP flap monitoring, without adjunctive expensive monitoring tests.

  2. Exotic wakes of flapping fins

    DEFF Research Database (Denmark)

    Schnipper, Teis

    We present, in 8 chapters, experiments on and numerical simulations of bodies flapping in a fluid. Focus is predominantly on a rigid foil, a model fish, that performs prescribed pitching oscillations where the foil rotates around its leading edge. In a flowing soap film is measured, with unpreced...... of frequencies. Drag reductions up to a factor 3 are measured. Many results presented are obtained through flow visualisations. A great effort is made to produce visualisations of primarily high scientific quality, but often also with a certain aesthetic appeal....

  3. Evaluation of resorbable membrane in treatment of human gingival isolated buccal recession

    Directory of Open Access Journals (Sweden)

    Sumit Narang


    Conclusion: Resorbable membrane is a versatile treatment modality for coverage of isolated buccal gingival recession. Although membrane exposure occurred in four patients, it did not interfere with post operative healing.

  4. Buccal absorption of ketobemidone and various ester prodrugs in the rat

    DEFF Research Database (Denmark)

    Hansen, L.B.; Jorgensen, A.; Rasmussen, S.N.


    The buccal absorption of ketobemidone, a strong narcotic analgesic, and various carboxylate and carbonate ester prodrugs was studied in rats. The compounds were administered in the form of aqueous solutions of pH 7.4. The absolute bioavailability of ketobemidone following buccal dosing was 26......% whereas the bioavailability of ketobemidone following buccal administration of the prodrugs ranged from 37 to 98%. The highest bioavailability was obtained with the ethyl carbonate ester. An apparent parabolic correlation between bioavailability and lipophilicity of the compounds was seen. All esters were...... rapidly hydrolyzed to ketobemidone after both buccal and intravenous administration. The acute toxicity of the esters after i.v. administration to mice and rats was similar to that of the parent drug. It is concluded that esterification of the phenolic hydroxyl group in ketobemidone to give a more...

  5. Buccal vs. nasogastric tube administration of tacrolimus after pediatric liver transplantation

    NARCIS (Netherlands)

    Goorhuis, JF; Scheenstra, R; Peeters, PMJG; Albers, MJIJ


    Tacrolimus is an important drug for immunosuppression after liver transplantation. Bioavailability of enterally administered tacrolimus is poor, and further reduced by gastric residuals or by enteral nutrition. Buccal administration might be an alternative route especially in children. Tacrolimus tr

  6. Use of rotation scalp flaps for treatment of occipital baldness. (United States)

    Juri, J; Juri, C; Arufe, H N


    We have used 25 rotation scalp flaps to treat occipital baldness associated with fronto-parietal baldness (the third flap), and 35 such flaps for the correction of isolated occipital baldness. We have not had any flap necrosis, and our patients have been well satisfied with the results of this surgery.

  7. The Change of the Oral Membrana Mucosa after A Course of Chemotherapy%一次化疗对口腔黏膜脱落细胞的影响

    Institute of Scientific and Technical Information of China (English)

    范亚峰; 郭琴琴


      Objective:To observe the influence of a course of chemotherapy to the oral membrana mucosa of patients with gastrointestinal surgery. Method:Select thirty-six patients with gastrointestinal surgery as research object.Wipe the buccal mucosa and rhizine of tongue with sterile cotton autograph early in the morning after gargle with Physiological saline for twice,once before chemotreatment,once after chemotreatment.After HE dyeing, Observing through the microscope.Count off the keratinocyte and the nonkeratinocyte of buccal mucosa epithelial ecclasis.Analyse the difference of the results.Result:After a course of chemotherapy,the count of the oral mucosa epithelial ecclasis of the patients was markedly higher than the count before chemotreatment except the right buccal mucosa keratinocyte(P<0.01). Conclusion:The count of the oral mucosa epithelial ecclasis of the patients was markedly higher than the count before chemotreatment.A course of chemotherapy may promote the growth and renewal of the oral membrana mucosa.%  目的:观察一次化疗对胃肠道癌根治术后患者的口腔黏膜脱落细胞的影响.方法:选取36例胃肠道癌根治术后接受化疗的患者.分别在患者一次化疗前后,于清晨生理盐水漱口后用无菌棉签擦取双颊黏膜和舌根部脱落细胞,HE染色,光镜下观察,并计数口腔黏膜脱落的角化细胞和非角化细胞.通过统计学分析化疗前后患者口腔黏膜脱落细胞的变化情况.结果:除右侧颊黏膜角化细胞外,化疗后口腔粘膜其余各部位脱落细胞数目较化疗前显著增高(P<0.01).结论:胃肠道癌根治术后化疗后患者口腔黏膜脱落的角化与非角化细胞数量均较化疗前增多.一次化疗对口腔黏膜细胞的更新有促进作用.

  8. Relative Telomere Repeat Mass in Buccal and Leukocyte-Derived DNA (United States)

    Finnicum, Casey T.; Dolan, Conor V.; Willemsen, Gonneke; Weber, Zachary M.; Petersen, Jason L.; Beck, Jeffrey J.; Codd, Veryan; Boomsma, Dorret I.; Davies, Gareth E.; Ehli, Erik A.


    Telomere length has garnered interest due to the potential role it may play as a biomarker for the cellular aging process. Telomere measurements obtained from blood-derived DNA are often used in epidemiological studies. However, the invasive nature of blood draws severely limits sample collection, particularly with children. Buccal cells are commonly sampled for DNA isolation and thus may present a non-invasive alternative for telomere measurement. Buccal and leukocyte derived DNA obtained from samples collected at the same time period were analyzed for telomere repeat mass (TRM). TRM was measured in buccal-derived DNA samples from individuals for whom previous TRM data from blood samples existed. TRM measurement was performed by qPCR and was normalized to the single copy 36B4 gene relative to a reference DNA sample (K562). Correlations between TRM from blood and buccal DNA were obtained and also between the same blood DNA samples measured in separate laboratories. Using the classical twin design, TRM heritability was estimated (N = 1892, MZ = 1044, DZ = 775). Buccal samples measured for TRM showed a significant correlation with the blood-1 (R = 0.39, p < 0.01) and blood-2 (R = 0.36, p < 0.01) samples. Sex and age effects were observed within the buccal samples as is the norm within blood-derived DNA. The buccal, blood-1, and blood-2 measurements generated heritability estimates of 23.3%, 47.6% and 22.2%, respectively. Buccal derived DNA provides a valid source for the determination of TRM, paving the way for non-invasive projects, such as longitudinal studies in children. PMID:28125671

  9. Total endoscopic free flap harvest of a serratus anterior fascia flap for microsurgical lower leg reconstruction

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    Erdmann, Alfons


    Full Text Available [english] Background: A tremendous number of free flaps have been developed in the past. As the surgical result depends not only on a successful flap transfer but also on the harvest, this paper details the procedures for undertaking the first total endoscopic harvest of a serratus fascia flap for free flap transplantation to the lower leg. Patient and methods: In September 2012 we performed the first total endoscopic serratus anterior fascia free flap harvest. The incision of 2.5 cm length was made 10 cm in front of anterior muscle border of the latissimus dorsi at level with the midthorax. After insertion of a flexible laparoscopic single port system we started CO gas insufflation. We used this setting to meticulously prepare a neo cavity between atissimus dorsi and M. serratus anterior. The vessels were dissected and the thoraco-dorsal nerve was separated. With a second auxiliary incision we used a clamp to support the raising of the fascia flap from the underlying muscle. Finally we clipped the vessels to the latissimus dorsi muscle and the flap vessels at the Arteria and Vena axillaris. The flap was extracted via the 2.5 cm incision.Results: We were able to perform a total endoscopic harvest of a serratus fascia flap for free flap reconstruction of soft tissues. With this new operative technique we were able to avoid a long skin incision, which in our view lowers the morbidity at the harvest area.Conclusion: We describe a new method for the total endoscopic harvest of the serratus fascia flap for free flap transfer. The flap was harvested within reasonable time and following surgery leaves the patient with minimal donor site morbidity compared to the open technique.

  10. Histopathology of mucosa-associated lymphoid tissue

    NARCIS (Netherlands)

    Kuper, C.F.


    Mucosa-associated lymphoid tissue (MALT) is a generalized term incorporating a disseminated collection of lymphoid tissues in multiple sites throughout the body. MALT sites that have been/are primarily studied include bronchus-associated lymphoid tissue (BALT), gut-associated lymphoid tissue (GALT),

  11. Mucocele of the lower lip mucosa

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    Tais Frenzel da Rosa


    Full Text Available Mucocele, also known as mucous extravasation phenomenon, is a pseudocyst of traumatic etiology, in which a minor salivary gland ductruptures. Clinically it can be observed as a tumefaction or bubble; it is flaccid on palpation, asymptomatic, with a smooth surface andvariable size, and with coloring equal to that of the adjacent mucosa, or bluish, depending on its depth in the tissue. The patient generally reports a bubble that has burst and fills up again, releasing a salty tasting liquid. There is greater incidence in women (25.4%, between the ages of 8 and 14 years, the commonest site being the mucosa of the lower lip. In the present study, the authors will present a clinical case of mucocele seen at the School of Dentistry at the Federal University of Pelotas, in the State of Rio Grande do Sul, Brazil, in a patient, a 23-year-old leukoderma man, who presented a lesion situated in the mucosa of the lower lip on the right side, close to the bottom of the fold, measuring approximately 0.6 cm, with coloring similar to the adjacent normal mucosa. The treatment performed was surgical excision of the mucocele and the accessory glands involved in the region of the lesion. The histopathologic report confirmed the clinical diagnosis of mucocele.

  12. Educative intervention for knowledge development on buccal health in elementary school.

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    Olga Lidia García Álvarez


    Full Text Available Background: There is high prevalence of buccal diseases which could be avoided with appropriate hygienic and alimentary habits that are supposed to be learned since the first stages of life. Objective: To verify the efficacy of an educative strategy on buccal health to develop buccal self-care through its application in girls and boys. Methods: An intervention study was developed with before and after design in 80 children of 5th grade and teachers of the primary school “Armando Mestre Martínez” in Cienfuegos, from September 2005 to March 2006. Initially, learning necessities and buccal hygiene were determined in both groups and later we verified the strategy efficiency. Initial information was obtained through surveys, focal groups, experts’ opinions and observation. Wilcoxon rank test was used for matched samples and Mc Nemar test for variables verification. Findings: Significant differences were obtained between the initial and final knowledge on buccal health and buccal hygiene coefficient. Qualitative methods showed audience approval of this strategy. Conclusions: Educative strategy applications allowed children learning actions of self-care as correct teeth brushing, use of dental floss, appropriate dietary selection and identification of prejudicial habits.

  13. Factors affecting buccal corridor space in Angle′s Class II Division 1 malocclusion

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    Rashmi Bhat


    Full Text Available Background and Objectives: Buccal corridor space has been thought of primarily in terms of maxillary width, but there is also evidence that they are heavily influenced by the antero-posterior position of maxilla. The present study was undertaken with an aim of evaluating and comparing the dental and skeletal factors related to buccal corridor space in individuals having Class I and Class II Division 1 malocclusions. Materials and Methods: A total of 80 subjects of which 40 were males and 40 were females in the age group of 20-30 years were selected as per inclusion criteria and were grouped as Group I having Class I malocclusion and as Group II having Class II malocclusions based on angle ANB. 12 linear and 2 angular cephalometric measurements and 4 study cast measurements were used to correlate with the buccal corridor linear ratio (BCLR, calculated on smile photograph using the Adobe Photoshop 7.0 software (Adobe Systems Inc., San Jose, California, USA. The data obtained was statistically evaluated using independent t-test and multiple linear regression analysis. Result: Buccal corridor space is larger in individuals with Class II Division 1 malocclusion when compared with individuals with Class I malocclusions. There exists a significant difference in buccal corridor space between males and females. Conclusion: The present study helps in establishing the correlation between certain factors and the amount of buccal corridor space in individuals having skeletal Class II pattern.

  14. Onset of buccal pumping in catshark embryos: how breathing develops in the egg capsule.

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    Taketeru Tomita

    Full Text Available Respiration in fishes involves buccal pumping, which is characterized by the generation of nearly continuous water flow over the gills because of the rhythmic expansion/compression of the pharyngeal cavity. This mechanism is achieved by the functions of the vascular, skeletal, and muscular systems. However, the process by which the embryo establishes the mechanism remains a mystery. Morphological and kinematical observations on captive cloudy catsharks, Scyliorhinus torazame, have suggested that the embryo starts buccal pumping just before the respiratory slits open on the egg capsule. During the pre-opening period, the embryo acquires oxygen mainly via the external gill filaments. After slit opening, respiration of the embryo involves buccal pumping to pass water over the "internal gills." The onset of buccal pumping accompanies four morphological changes: (1 regression of the external gill filaments, (2 development of blood vessels within the "internal gills," (3 completion of the development of hyoid skeletal and muscular elements, and (4 development of the oral valve. A previous study showed that buccal pumping allows the embryo to actively regulate oxygen intake by changing the pumping frequency. Thus, establishment of buccal pumping in the egg capsule is probably important for embryo survival in the unstable oxygen environment of the egg capsule after slit opening.

  15. Anatomic basis for an algorithmic approach for free fibula flap donor side selection in composite oro-mandibular defects

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    Mohit Sharma


    Full Text Available Introduction: Head and neck oncological resections may result in composite oro-mandibular defects involving the oral mucosa (lining, mandibular bone and the skin (cover. Reconstructive options for such defects have evolved over a period. Free fibula flap reconstruction is currently accepted the world over as the gold standard for oro-mandibular defect reconstruction. Existing literature provides conflicting views about the use of a particular side and orientation of the fibula flap for achieving the optimal outcome. The purpose of this study is to confirm anatomically the effect of bone, soft tissue and vessel orientation on the ease of doing reconstruction. Materials and Methods: This is a cadaveric study. A mandibular model with a defect was used. This was pre plated to maintain continuity. Composite fibula flaps of the same dimension were harvested from both legs of a fresh cadaver. The harvested flaps were used to reconstruct the mandibular defect in different orientations and the best configuration for each reconstructive requirement was assessed. Results: Keeping the peroneal surface for plating, that is, facing outwards, four different configurations of the fibula flap are possible for a given mandibular defect. With a posterior vascular pedicle ipsilateral fibula is suitable for skin cover and contralateral for mucosal lining and the reverse for an anteriorly placed pedicle. Conclusion: The algorithm based selection of appropriate sided fibula flap facilitates complex mandibular reconstruction by placing the right kind of tissue at the right place and helps in reducing the donor site morbidity by allowing the surgeon to harvest only the required amount of skin.

  16. Aerodynamic characteristics of a wing with Fowler flaps including flap loads, downwash, and calculated effect on take-off (United States)

    Platt, Robert C


    This report presents the results of wind tunnel tests of a wing in combination with each of three sizes of Fowler flap. The purpose of the investigation was to determine the aerodynamic characteristics as affected by flap chord and position, the air loads on the flaps, and the effect of flaps on the downwash.

  17. Treatment of inadequate lactation with oral sulpiride and buccal oxytocin. (United States)

    Ylikorkala, O; Kauppila, A; Kivinen, S; Viinikka, L


    Thirty-six puerperal women with inadequate lactation were treated with 50 mg sulpiride (N = 24) or placebo (N = 12) three times a day for two weeks. These treatments were supplemented with buccal oxytocin (100 IU, 300 IU, or 400 IU) or placebo preceding each breast-feeding on the sixth and 14th and on the seventh and 13th days of oral treatment, respectively. One woman treated with sulpiride and three women treated with placebo discontinued the trial because of the lack of the effect of treatment. The concentration of prolactin in maternal serum was higher (P less than .001) during sulpiride than placebo treatment at one week (380 +/- 43 ng/ml vs 23 +/- 7 ng/ml, mean +/- SE) and two weeks of treatment (381 +/- 38 ng/ml vs 34 +/- 10 ng/ml). Also, the daily breast milk yield, as measured objectively, was greater (P less than .05) during sulpiride than placebo treatment both at one week (628 +/- 51 ml vs 440 +/- 68 ml) and two weeks of treatment (684 +/- 67 ml vs 423 +/- 60 ml). Various doses of oxytocin failed to stimulate the milk secretion in the presence or absence of sulpiride-induced hyperprolactinemia. Thus, sulpiride improved inadequate lactation, whereas exogenous oxytocin alone or together with sulpiride had no effect on lactation in these mothers whose infants were able to suckle normally.

  18. Small Buccal Fat Pad Cells Have High Osteogenic Differentiation Potential. (United States)

    Tsurumachi, Niina; Akita, Daisuke; Kano, Koichiro; Matsumoto, Taro; Toriumi, Taku; Kazama, Tomohiko; Oki, Yoshinao; Tamura, Yoko; Tonogi, Morio; Isokawa, Keitaro; Shimizu, Noriyoshi; Honda, Masaki


    Dedifferentiated fat (DFAT) cells derived from mature adipocytes have mesenchymal stem cells' (MSCs) characteristics. Generally, mature adipocytes are 60-110 μm in diameter; however, association between adipocyte size and dedifferentiation efficiency is still unknown. This study, therefore, investigated the dedifferentiation efficiency of adipocytes based on cell diameter. Buccal fat pad was harvested from five human donors and dissociated by collagenase digestion. After exclusion of unwanted stromal cells by centrifugation, floating adipocytes were collected and their size distribution was analyzed. The floating adipocytes were then separated into two groups depending on cell size using 40- and 100-μm nylon mesh filters: cell diameters less than 40 μm (small adipocytes: S-adipocytes) and cell diameters of 40-100 μm (large adipocytes: L-adipocytes). Finally, we evaluated the efficiency of adipocyte dedifferentiation and then characterized the resultant DFAT cells. The S-adipocytes showed a higher capacity to dedifferentiate into DFAT cells (S-DFAT cells) compared to the L-adipocytes (L-DFAT cells). The S-DFAT cells also showed a relatively higher proportion of CD146-positive cells than L-DFAT cells, and exhibited more osteogenic differentiation ability based on the alkaline phosphatase activity and amount of calcium deposition. These results suggested that the S- and L-DFAT cells had distinct characteristics, and that the higher dedifferentiation potential of S-adipocytes compared to L-adipocytes gives the former group an advantage in yielding DFAT cells.

  19. Photodynamic therapy for the treatment of buccal candidiasis in rats. (United States)

    Junqueira, Juliana Campos; Martins, Joyce da Silva; Faria, Raquel Lourdes; Colombo, Carlos Eduardo Dias; Jorge, Antonio Olavo Cardoso


    The study objective was to evaluate the effects of photodynamic therapy on buccal candidiasis in rats. After experimental candidiasis had been induced on the tongue dorsum, 72 rats were distributed into four groups according to treatment: treated with laser and methylene blue photosensitizer (L+P+); treated only with laser (L+P-); treated only with photosensitizer (L--P+); not treated with laser or photosensitizer (L-P-). The rats were killed immediately, 1 day, or 5 days after treatment, for microscopic analysis of the tongue dorsum. Observation verified that the photodynamic therapy group (L+P+) exhibited fewer epithelial alterations and a lower chronic inflammatory response than the L-P- group. The group L+P- presented more intense epithelial alterations and chronic inflammatory response than the remaining groups. The L-P+ group showed tissue lesions similar to those of the L-P- group. In conclusion, rats treated with photodynamic therapy developed more discrete candidiasis lesions than did the remaining groups.

  20. Hydrodynamic schooling of flapping swimmers (United States)

    Becker, Alexander D.; Masoud, Hassan; Newbolt, Joel W.; Shelley, Michael; Ristroph, Leif


    Fish schools and bird flocks are fascinating examples of collective behaviours in which many individuals generate and interact with complex flows. Motivated by animal groups on the move, here we explore how the locomotion of many bodies emerges from their flow-mediated interactions. Through experiments and simulations of arrays of flapping wings that propel within a collective wake, we discover distinct modes characterized by the group swimming speed and the spatial phase shift between trajectories of neighbouring wings. For identical flapping motions, slow and fast modes coexist and correspond to constructive and destructive wing-wake interactions. Simulations show that swimming in a group can enhance speed and save power, and we capture the key phenomena in a mathematical model based on memory or the storage and recollection of information in the flow field. These results also show that fluid dynamic interactions alone are sufficient to generate coherent collective locomotion, and thus might suggest new ways to characterize the role of flows in animal groups.

  1. Reconstruction of lateral forefoot using reversed medial plantar flap with free anterolateral thigh flap. (United States)

    Fujioka, Masaki; Hayashida, Kenji; Senju, Chikako


    Skin defects of the heel have frequently been reconstructed using the medial plantar flap; however, forefoot coverage has remained a challenge, because the alternatives for flap coverage have been very limited. We describe a case of malignant melanoma on the lateral forefoot that was radically removed and reconstructed successfully with a distally based medial plantar flap, together with a free anterolateral thigh flap. The advantages of this flap include that it does not reduce the vascular supply to the foot owing to reconstruction of the medial plantar vascular systems, reduces the risk of flap congestion, minimizes donor site morbidity, and enables the transport of structurally similar tissues to the plantar forefoot. We believe this technique is a reasonable reconstructive option for large lateral plantar forefoot defects.

  2. Pedicled Supraclavicular Artery Island Flap Versus Free Radial Forearm Flap for Tongue Reconstruction Following Hemiglossectomy. (United States)

    Zhang, Senlin; Chen, Wei; Cao, Gang; Dong, Zhen


    This study investigated the tongue function and donor-site morbidity of patients with malignant tumors who had undergone immediate flap reconstruction surgery. Twenty-seven patients who had undergone immediate reconstruction after hemiglossectomy were observed. Twelve patients were reconstructed using the pedicled supraclavicular artery island flap (PSAIF) and 15 patients using the free radial forearm flap (FRFF). Flap survival, speech and swallowing function, and donor-site morbidity at the 6-month follow-up were evaluated. All the flaps were successfully transferred. No obvious complications were found in either the transferred flaps or donor regions. Age, sex, defect extent, speech and swallowing function were comparable between the 2 groups. Donor-site complications were less frequent with PSAIF reconstruction than FRFF reconstruction. The PSAIF is reliable and well suited for hemiglossectomy defect. It has few significant complications, and allows preservation of oral function.

  3. Monitoring of free TRAM flaps with microdialysis. (United States)

    Udesen, A; Løntoft, E; Kristensen, S R


    The aim of this investigation was to follow the metabolism of free TRAM flaps using microdialysis. Microdialysis is a new sampling technique that provide opportunities to follow the biochemistry in specific organs or tissues. A double-lumen microdialysis catheter or probe, with a dialysis membrane at the end, is introduced into the specific tissue. Perfusion fluid is slowly pumped through the catheter and equilibrates across the membrane with surrounding extracellular concentrations of low molecular weight substances. The dialysate is collected in microvials and analyzed by an instrument using very small volumes. Glucose, glycerol, and lactate concentrations were measured in the flaps and compared with those in a reference catheter that was placed subcutaneously in the femur. The investigation continued 72 hr postoperatively. The study group consisted of 14 women who underwent reconstruction with a free TRAM flap, and one woman with a double TRAM flap. During flap ischemia, the concentration of glucose was reduced, while the lactate and glycerol levels increased. The differences between the flaps and controls were statistically highly significant. After reperfusion of the flaps, the concentrations of glucose, lactate, and glycerol approached normal. One flap failed because of an arterial anastomosis thrombosis. This was clearly demonstrated by the samples from the microdialysis: the concentration of glucose fell to an unmeasurable level; the concentration of lactate increased for a period before it stopped due to lack of glucose; and the concentration of glycerol increased to a very high level, probably because ischemia caused damage to the cell membranes of which glycerol is an important part. The authors concluded that microdialysis can detect ischemia in free flaps at an early stage, making early surgical intervention possible.

  4. Zygomatico-maxillary Reconstruction with Computer-aided Manufacturing of a Free DCIA Osseous Flap and Intraoral Anastomoses (United States)

    Roy, Andrée-Anne; Efanov, Johnny I.; Mercier-Couture, Geneviève; Chollet, André


    Summary: Craniomaxillofacial reconstruction using virtual surgical planning, computer-aided manufacturing, and new microsurgical techniques optimizes patient-specific and defect-directed reconstruction. A 3D customized free deep circumflex iliac artery (DCIA) flap with intraoral anastomoses was performed on a 23-year-old man with a posttraumatic right zygomatico-maxillary defect with failure of alloplastic implant reconstruction. An osseous iliac crest flap was sculpted based on a customized 3D model of the mirror image of the patient’s unaffected side to allow for perfect fit to the zygomatico-maxillary defect. An intraoral dissection of the facial artery and vein was performed within the right cheek mucosa and allowed for end-to-end microvascular anastomoses. 3D preoperative planning and customized free DCIA osseous flap combined with an intraoral microsurgical technique provided restoration of facial esthetics and function without visible scars. In cases where zygomatico-malar reconstruction by alloplastic material fails, a customized free DCIA osseous flap can be designed by virtual surgical planning to restore facial appearance and function.

  5. New drag laws for flapping flight (United States)

    Agre, Natalie; Zhang, Jun; Ristroph, Leif


    Classical aerodynamic theory predicts that a steadily-moving wing experiences fluid forces proportional to the square of its speed. For bird and insect flight, however, there is currently no model for how drag is affected by flapping motions of the wings. By considering simple wings driven to oscillate while progressing through the air, we discover that flapping significantly changes the magnitude of drag and fundamentally alters its scaling with speed. These measurements motivate a new aerodynamic force law that could help to understand the free-flight dynamics, control, and stability of insects and flapping-wing robots.

  6. The Clinical Application of Anterolateral Thigh Flap

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    Yao-Chou Lee


    Furthermore, several modifications widen its clinical applications: the fascia lata can be included for sling or tendon reconstruction, the bulkiness could be created by including vastus lateralis muscle or deepithelization of skin flap, the pliability could be increased by suprafascial dissection or primary thinning, the pedicle length could be lengthening by proximally eccentric placement of the perforator, and so forth. Combined with these technical and conceptual advancements, the anterolateral thigh flap has become the workhorse flap for soft-tissue reconstructions from head to toe.

  7. Foot and ankle reconstruction: an experience on the use of 14 different flaps in 226 cases. (United States)

    Zhu, Yue-Liang; Wang, Yi; He, Xiao-Qing; Zhu, Min; Li, Fu-Bin; Xu, Yong-Qing


    The aim of this report was to present our experience on the use of different flaps for soft tissue reconstruction of the foot and ankle. From 2007 to 2012, the soft tissue defects of traumatic injuries of the foot and ankle were reconstructed using 14 different flaps in 226 cases (162 male and 64 female). There were 62 pedicled flaps and 164 free flaps used in reconstruction. The pedicled flaps included sural flap, saphenous flap, dorsal pedal neurocutaneous flap, pedicled peroneal artery perforator flap, pedicled tibial artery perforator flap, and medial plantar flap. The free flaps were latissimus musculocutaneous flap, anterolateral thigh musculocutaneous flap, groin flap, lateral arm flap, anterolateral thigh perforator flap, peroneal artery perforator flap, thoracdorsal artery perforator flap, medial arm perforator flap. The sensory nerve coaptation was not performed for all of flaps. One hundred and ninety-four cases were combined with open fractures. One hundred and sixty-two cases had tendon. Among 164 free flaps, 8 flaps were completely lost, in which the defects were managed by the secondary procedures. Among the 57 flaps for plantar foot coverage (25 pedicled flaps and 32 free flaps), ulcers were developed in 5 pedicled flaps and 6 free flaps after weight bearing, and infection was found in 14 flaps. The donor site complications were seen in 3 cases with the free anterolateral thigh perforator flap transfer. All of limbs were preserved and the patients regained walking and daily activities. All of patients except for one regained protective sensation from 3 to 12 months postoperatively. Our experience showed that the sural flap and saphenous flap could be good options for the coverage of the defects at malleolus, dorsal hindfoot and midfoot. Plantar foot, forefoot and large size defects could be reconstructed with free anterolateral thigh perforator flap. For the infected wounds with dead spce, the free latissimus dorsi musculocutaneous flap remained to

  8. Paramedian forehead flap combined with hinge flap for nasal tip reconstruction* (United States)

    Cerci, Felipe Bochnia; Dellatorre, Gerson


    The paramedian forehead flap is a great option for restoration of complex nasal defects. For full-thickness defects, it may be used alone or in combination with other methods. We present a patient with a basal cell carcinoma on the distal nose treated by Mohs micrographic surgery, and a resulting full-thickness defect repaired with paramedian forehead flap combined with a hinge flap. For optimal results with the paramedian forehead flap, adequate surgical planning, patient orientation and meticulous surgical technique are imperative.

  9. Correlation analysis of alveolar bone loss in buccal/palatal and proximal surfaces in rats

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    Carolina Barrera de Azambuja


    Full Text Available The aim was to correlate alveolar bone loss in the buccal/palatal and the mesial/distal surfaces of upper molars in rats. Thirty-three, 60-day-old, male Wistar rats were divided in two groups, one treated with alcohol and the other not treated with alcohol. All rats received silk ligatures on the right upper second molars for 4 weeks. The rats were then euthanized and their maxillae were split and defleshed with sodium hypochlorite (9%. The cemento-enamel junction (CEJ was stained with 1% methylene blue and the alveolar bone loss in the buccal/palatal surfaces was measured linearly in 5 points on standardized digital photographs. Measurement of the proximal sites was performed by sectioning the hemimaxillae, restaining the CEJ and measuring the alveolar bone loss linearly in 3 points. A calibrated and blinded examiner performed all the measurements. Intraclass Correlation Coefficient revealed values of 0.96 and 0.89 for buccal/lingual and proximal surfaces, respectively. The Pearson Correlation Coefficient (r between measurements in buccal/palatal and proximal surfaces was 0.35 and 0.05 for the group treated with alcohol, with and without ligatures, respectively. The best correlations between buccal/palatal and proximal surfaces were observed in animals not treated with alcohol, in sites both with and without ligatures (r = 0.59 and 0.65, respectively. A positive correlation was found between alveolar bone loss in buccal/palatal and proximal surfaces. The correlation is stronger in animals that were not treated with alcohol, in sites without ligatures. Areas with and without ligature-induced periodontal destruction allow detection of alveolar bone loss in buccal/palatal and proximal surfaces.

  10. Estimating Fatty Acid Composition of Infant Buccal Mucosal Cells by Capillary Gas Chromatography

    Institute of Scientific and Technical Information of China (English)

    CHEN Fei; ZHANG Wei-li; LI Fang; ZHU Xiao-dong; ZHU Jian-xing


    Long chain polyunsaturated fatty adds, i. e., docosahexaenoic acid (DHA or C22 : 6n -3), arachidonic acid (AA or C20 : 4n - 6) have been identified as essential fatty acids and play an important role in growth and development of infants. Mensurement of fatty acid composition is usually by collection of blood, but to obtain blood in infants is difficult. Nowadays, the fatty acid composition can be estimated by collecting buccal mucosal cells, which can avoid repeated blood sampling. The purpose of this paper is to compare the fatty acid composition of cheek calls with that of plasma and red blood cells (RBCs). In this study, twenty-seven infants were enrolled, and buccal mucosal cells and blood samples were obtained from these infants of the same time. Fatty acid composition of buccal mucesal cells, plasma and RBCs were measured by capillary gas chromatography. The results show that the contents of AA and DHA in the buccal mucosal cells are correlated well with that in the plasma [r=0.36 (P=0.042) and r=0.38 (P=0.033), respectively]. The ratio of AA to DHA is 1.32% in buccal mucosal cells, 1.60% in plasma and 1.55% in RBCs and there are no significant differences among groups (P = 0.134). It shows that the fatty acid composition in buccal mucosal cells can reflect the fat nutrition status in infants and can be detected by capillary gas chromatography. Estimating fatty acid composition of buccal mucosal cells in infants by capillary gas chromatography is feasible, and because of its noninvasiveness, it can be suitable for nutrition research in infants.

  11. Azithromycin buccal patch in treatment of chronic periodontitis (United States)

    Latif, Sajith Abdul; Vandana, K. L.; Thimmashetty, J.; Dalvi, Priyanka Jairaj


    Aim: This study aims to explore the clinical, microbiological, and biochemical impact of azithromycin (AZM) buccal patch in chronic generalized patients as a monotherapy as well as an adjunct to nonsurgical therapy. Materials and Methods: A parallel design was used forty periodontitis patients were randomly allocated into five groups, namely Group 1 scaling root planing (SRP) alone, Group 2 (SRP + AZM patch group), Group 3 (SRP + AZM tablet group), Group 4 (AZM patch monotherapy), and Group 5 (AZM tablet as monotherapy). Plaque index, gingival bleeding index, modified gingival index, probing pocket depth (PPD), and clinical attachment level (CAL) were assessed at baseline and 21 and 90 days. Subgingival pooled plaque sample was collected to assess periodontopathogens like Porphyromonas gingivalis and Prevotella intermedia (Pi) by anaerobic culture method. Tumor necrosis factor alpha (TNF-α) was also evaluated at baseline and 21 days. Periodontal maintenance was performed in Group 1 until 90th day, and clinical parameter was assessed at the end of 90th day. Results: SRP + AZM tablets showed greater reduction in clinical parameters (P < 0.05) AZM as monotherapy did not offer clinical benefits over SRP. Baseline data were compared at the end, i.e., 90th day a significant reduction in plaque scores, gingival bleeding, and PPD was observed however no significant gain in the clinical attachment was observed. Conclusion: The monotherapy resulted in no improvement of periodontal parameters, microbial parameters, and TNF-α level. It is safe to use AZM + SRP as a mode of nonsurgical treatment in periodontitis patients. PMID:27127325

  12. A comparative study on EDTA and coronaliy advanced flap technique in the treatment of human gingival recessions

    Directory of Open Access Journals (Sweden)

    Khoshkhoo Nejad AA


    Full Text Available Statement of Problem: Treatment of gingival recession defect and covering denuded root surfaces is one of the goals in periodontal therapy and several surgical techniques have been suggested in this field."nPurpose: The aim of this study was to perform a comparison on coronaliy repositioned flap procedure with and without the use of ethylenediaminoteraacetic acid (EDTA. 24%, pH=7 in the treatment of"nrecession defects."nMaterial and Methods: In this randomized clinical trial study, 16 patients, aged 17-60 years, with a total of 27 miller class 1 isolated buccal gingival recession type defects of at least 2mm depth, and based"non special criteria were investigated. After initial therapy, surgical recession coverage was performed as coronaliy advanced flap technique and EDTA gel conditioning (test or coronaliy advanced flap alone"n(control. Clinical examination including assessments of oral hygiene, recession depth (RD, recession width (RW, width of keratinized tissue (KT, probing depth (PD and probing attachment level (PAL"nwere performed before and 1, 2, 3 months after surgical treatment."nResults: The mean of initial RD, RW, KT, PT and PAL in the test group was 2.73, 3.17, 3.13, 1.1 and 3.83mm respectively and in the control group was 2.56, 3.03, 3.67, 1.25, 3.92mm respectively. The mean of these parameters 3 months after treatment in the test group were changed to 0.46, 1.97, 2.65, 0.67, 1.1 mm, corresponding figures for control teeth were 0.85, 2.98, 2.75, 1, 1.94, respectively. At 3 months after treatment the mean root coverage amounted to 83% (test and 67% (control which was a statistically significant difference (P=0.0067. Although a significant clinical difference was observed regarinding root coverage level, all other clinical variables were not statistically different, with the exception of probing attachment level (P=0.005."nConclusion: It was suggested that EDTA gel (24%, PLT=7 for 3 minutes as root conditioner and the coronaliy

  13. Periodic and Chaotic Flapping of Insectile Wings

    CERN Document Server

    Huang, Yangyang


    Insects use flight muscles attached at the base of the wings to produce impressive wing flapping frequencies. The maximum power output of these flight muscles is insufficient to maintain such wing oscillations unless there is good elastic storage of energy in the insect flight system. Here, we explore the intrinsic self-oscillatory behavior of an insectile wing model, consisting of two rigid wings connected at their base by an elastic torsional spring. We study the wings behavior as a function of the total energy and spring stiffness. Three types of behavior are identified: end-over-end rotation, chaotic motion, and periodic flapping. Interestingly, the region of periodic flapping decreases as energy increases but is favored as stiffness increases. These findings are consistent with the fact that insect wings and flight muscles are stiff. They further imply that, by adjusting their muscle stiffness to the desired energy level, insects can maintain periodic flapping mechanically for a range of operating condit...

  14. A dynamical system for interacting flapping swimmers (United States)

    Oza, Anand; Ramananarivo, Sophie; Ristroph, Leif; Shelley, Michael


    We present the results of a theoretical investigation into the dynamics of interacting flapping swimmers. Our study is motivated by the recent experiments of Becker et al., who studied a one-dimensional array of self-propelled flapping wings that swim within each other's wakes in a water tank. They discovered that the system adopts certain ``schooling modes'' characterized by specific spatial phase relationships between swimmers. To rationalize these phenomena, we develop a discrete dynamical system in which the swimmers are modeled as heaving airfoils that shed point vortices during each flapping cycle. We then apply our model to recent experiments in the Applied Math Lab, in which two tandem flapping airfoils are free to choose both their speed and relative positions. We expect that our model may be used to understand how schooling behavior is influenced by hydrodynamics in more general contexts. Thanks to the NSF for its support.

  15. Behind the performance of flapping flyers

    CERN Document Server

    Ramananarivo, Sophie; Thiria, Benjamin


    Saving energy and enhancing performance are secular preoccupations shared by both nature and human beings. In animal locomotion, flapping flyers or swimmers rely on the flexibility of their wings or body to passively increase their efficiency using an appropriate cycle of storing and releasing elastic energy. Despite the convergence of many observations pointing out this feature, the underlying mechanisms explaining how the elastic nature of the wings is related to propulsive efficiency remain unclear. Here we use an experiment with a self-propelled simplified insect model allowing to show how wing compliance governs the performance of flapping flyers. Reducing the description of the flapping wing to a forced oscillator model, we pinpoint different nonlinear effects that can account for the observed behavior ---in particular a set of cubic nonlinearities coming from the clamped-free beam equation used to model the wing and a quadratic damping term representing the fluid drag associated to the fast flapping mo...

  16. The flow around a flapping foil (United States)

    Mandujano, Francisco; Malaga, Carlos


    The flow around a two-dimensional flapping foil immersed in a uniform stream is studied numerically using a Lattice-Boltzmann model, for Reynolds numbers between 100 and 250, and flapping Strouhal numbers between 0 . 01 and 0 . 6 . The computation of the hydrodynamic force on the foil is related to the wake structure. When the foil's is fixed in space, numerical results suggest a relation between drag coefficient behaviour and the flapping frequency which determines the transition from the von Kármán to the inverted von Kármán wake. When the foil is free of translational motion up-stream swimming at constant speed is observed at certain values of the flapping Strouhal. This work was partially supported by UNAM-DGAPA-PAPIIT Grant Number IN115316.

  17. Benign Papules and Nodules of Oral Mucosa

    Directory of Open Access Journals (Sweden)

    Mehmet Salih Gürel


    Full Text Available This article reviews some of the more common benign oral papules and nodules of oral mucosa with emphasis on their etiology, epidemiology, clinical presentation, histopathology, and treatment. These lesions include mucocele, traumatic fibroma, epulis, pyogenic granuloma, oral papilloma, oral warts, lymphangioma, hemangioma, lipoma, oral nevi and some soft tissue benign tumors. These benign lesions must be separated clinically and histologically from precancerous and malign neoplastic lesions. Accurate clinico-pathological diagnosis is mandatory to insure appropriate therapy.

  18. Freestyle Local Perforator Flaps for Facial Reconstruction


    Jun Yong Lee; Ji Min Kim; Ho Kwon; Sung-No Jung; Hyung Sup Shim; Sang Wha Kim


    For the successful reconstruction of facial defects, various perforator flaps have been used in single-stage surgery, where tissues are moved to adjacent defect sites. Our group successfully performed perforator flap surgery on 17 patients with small to moderate facial defects that affected the functional and aesthetic features of their faces. Of four complicated cases, three developed venous congestion, which resolved in the subacute postoperative period, and one patient with partial necrosi...

  19. Interpreting laser Doppler recordings from free flaps. (United States)

    Svensson, H; Holmberg, J; Svedman, P


    Although the transfer of free flaps is nowadays accomplished with an increasing degree of safety, thrombosis of the microvascular anastomoses is still a problem. In order to avoid delay in re-operating, various methods for objective blood flow monitoring have been tried, among them Laser Doppler Flowmetry (LDF). When one reviews the literature, it is apparent that opinions differ about whether or not LDF is a reliable technique for this purpose. To focus on the need to interpret continuous recordings, this paper reports our findings in six latissimus dorsi free flaps chosen from our series of LDF monitoring procedures. One uneventful flap, no. 1, had an immediate postoperative LDF value of 4.5 perfusion units (PU). LDF values improved during the recovery period and the graphic recording showed fluctuations due to normal physiological variations of the blood flow in the flap. Another uneventful flap, no. 4, showed the same pattern, though at an appreciably lower level, 2 PU, on average. Flap no. 2 had an acceptably high value of 3.5 PU despite suffering a venous thrombosis. However, the LDF recording showed no fluctuations and the value declined gradually. Another flap, no. 3, showed fluctuations and blood flow was normal although the value decreased to 2.5 PU. In flap no. 5, any value between 2 and 3.5 PU could be obtained merely by adjusting the position of the probe in the holder. In no. 6, the LDF value suddenly dropped, accompanied by a decrease in the total amount of backscattered light, indicating venous obstruction which was confirmed at re-operation.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Morphology of the Lingual and Buccal Papillae in Alpaca (Vicugna pacos) - Light and Scanning Electron Microscopy. (United States)

    Goździewska-Harłajczuk, K; Klećkowska-Nawrot, J; Janeczek, M; Zawadzki, M


    The aim of this study was the description of the lingual and buccal papillae in adult alpaca (Vicugna pacos) by light and scanning electron microscopy (SEM). The tongue consisted of apex, body and root. Four types of lingual papillae (filiform, fungiform, conical and circumvallate) in addition to two types of buccal papillae were observed. The filiform papillae, some with secondary papillae, were distributed on both the corpus and apex of the tongue, with stratified epithelium, and layer of keratin coat were recognized. The short (small) cone papillae had pointed top, while bunoform papillae were wide with smooth apex. The much less numerous circumvallate papillae with pseudopapillae on the each rim of the caudal lingual body were present with weak layer of keratin and intra-epithelial taste buds. The small fungiform papillae were found on the dorsal lingual surface, while the large fungiform papillae were situated on the ventral surface of the tongue, especially, in rostral part and were round in shape with numerous gustatory pores and very thin keratin coat. Pseudopapillae were present on the buccal conical 'bunoform' papillae surface, while 'elongate' buccal papillae surface was rather softly folded with thin coat of keratin. Microridges were observed in the less keratinized parts of each type of papillae. The orientation of either lingual or buccal papillae into the throat side facilitates the emptying of oral cavity from nutrient and swallowing of food. In conclusion, the anatomical features of the alpaca tongue are an adaptation to the feeding habits.

  1. Influence of Smile Arc and Buccal Corridors on Facial Attractiveness: A Cross-sectional Study (United States)

    Gaikwad, Shashank; Vaz, Anna C; Singh, Baldeep; Taneja, Lavina; Vinod, KS; Verma, Prateek


    Introduction Two aspects of the smile: the Smile Arc (SA) and Buccal Corridors (BC) have been the interest of the orthodontist in recent years. Aim The present study was undertaken to evaluate the influence of the smile arc and buccal corridors on facial attractiveness as evaluated by orthodontists, general dentists and laymen. Materials and Methods Two subjects (one male & one female) were selected from the regional population fulfilling the criteria of an ideal smile arc and ideal buccal corridors. Frontal smile view photographs of these subjects were taken and modified by using adobe photoshop 7.0 to create combination of three smile arc variance and three buccal corridors variations respectively which were shown to 25 orthodontists, 25 general dentists & 25 laymen, to rate the facial attractiveness of each image on a rating scale. Results All the three groups (laypersons, dentists and orthodontists) showed significant difference in ratings, indicating that they had different perceptions on the facial attractiveness. Conclusion Orthodontists were more precise in discerning the smile arc and buccal corridors compared to dentists and laypersons. PMID:27790573

  2. Influence of anatomic reference on the buccal contour of prosthetic crowns

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    Flávia Sabrina Queirós Vasconcelos


    Full Text Available During clinical practice, when performing prosthetic rehabilitation with single crowns, improper reproduction of the dental contour by the dental laboratory is a common occurrence. Therefore, the present study evaluated the fidelity of the reproduction of the buccal contour in an upper left canine performed by three Dental Prosthesis Technicians (DPT using the indirect laminate veneer technique. First, the DPTs confected the veneers based on a model obtained from the upper arch of a dental dummy, containing a replica of an upper left canine with a prosthetic preparation for a laminate veneer. Then, the same DPTs received other identical models, now with the replica of the upper left canine with no preparation, to be used as an anatomical reference for confecting the laminate veneers. The laminate veneers were then bonded to the plaster models and had their buccal contour individually measured. Measurements were also made of the buccal contour of the reference canine. The data were analyzed by ANOVA and the t-test (p = 0.05. Results showed 100% of buccal overcontour when the laminate veneers were compared to the reference canine, regardless of which DPT confected the veneer and regardless of using or not the anatomical reference. The DPTs who participated in the present study were unable to acomplish a faithful anatomical reproduction of the buccal contour, creating an overcontour in all samples. This situation may be responsible for increasing the probability of periodontal and esthetic harm in clinical practice.

  3. Dorsal hand coverage with free serratus fascia flap

    DEFF Research Database (Denmark)

    Fotopoulos, Peter; Holmer, Per; Leicht, Pernille


    serratus fascia flap, the connective tissue over the serratus muscle, for dorsal hand coverage. The flap consists of thin and well-vascularized pliable tissue, with gliding properties excellent for covering exposed tendons. It is based on the branches of the thoracodorsal artery, which are raised...... in the flap, leaving the long thoracic nerve intact on the serratus muscle. Coverage of the flap with split-thickness skin graft is done immediately. The free serratus fascia flap is an ideal flap for dorsal hand coverage when the extensor tendons are exposed, especially because of low donor-site morbidity....

  4. The prepuce free flap in 10 patients : modifications in flap design and surgical technique

    NARCIS (Netherlands)

    Werker, Paul M N


    The prepuce free flap was used in 10 oral and oropharyngeal reconstructions. During the course of this study, various modifications took place. Residual penile skin necrosis and skin island necrosis early in the series led to modification of flap design. This solved the donor-site problem by placing

  5. Potential applications of oral brush cytology with liquid-based technology: results from a cohort of normal oral mucosa. (United States)

    Kujan, Omar; Desai, Mina; Sargent, Alexandra; Bailey, Andrew; Turner, Andrew; Sloan, Philip


    Fifty healthy volunteers were studied to assess the potential applications of oral brush sampling using liquid-based cytology. Three specimens from the buccal mucosa and lateral border of tongue were collected from each subject by using cervical brushes and brooms. The brush was immersed in a preservative fluid. The sample in the preservative fluid was processed according to the manufacturer's directions (SurePath, UK). Slides were stained by the Papanicolaou method and assessed for squamous cell adequacy by the same criteria used for cervical cytology screening. Immunocytochemical staining for FHIT (Fragile Histidine Triad) was applied in liquid-based preparations following the streptavidin-biotin-peroxidase method. Human papillomavirus (HPV) detection was performed using the Hybrid Capture 2 assay (Digene) and the PCR-based Roche AMPLICOR HPV Test. LBC preparation slides showed good sample preservation, specimen adequacy and visualization of cell morphology. Interestingly, nine cases showed borderline cytological abnormalities from apparently normal oral mucosa. All cases showed good quality positive FHIT immunoreactivity staining. All studied cases were high-risk HPV negative using HC2 assay method. However, the AMPLICOR Roche Test detected four samples with positive results for high-risk HPVs. Liquid-based cytology has potential as a screening tool for oral cancer and precancer. The method may also have applications for research and practice in the field of oral cancer and precancer. However a special custom-designed oral cytobrush is required.

  6. Versatility of the Anterolateral Thigh Free Flap: The Four Seasons Flap (United States)

    Di Candia, Michele; Lie, Kwok; Kumiponjera, Devor; Simcock, Jeremy; Cormack, George C.; Malata, Charles M.


    Presented at the following academic meetings: ○ 56th Meeting of the Italian Society of Plastic, Reconstructive and Aesthetic Surgery (SICPRE) Fasano (Brindisi), Italy, September 26-29, 2007 ○ 42nd Meeting of the European Society for Surgical Research (ESSR), Warsaw, Poland, May 21-24, 2008 ○ Winter Meeting, British Association of Plastic, Reconstructive and Aesthetic Surgeons, (BAPRAS) London, December 1-3, 2009 Background: The anterolateral free flap has become increasingly popular at our institution year on year. We decided to review our experience with this flap and study the reasons for this trend. Methods: A retrospective review of all anterolateral thigh free flaps performed at Addenbrooke's University Hospital from the available charts was carried out. This chart review included patients' demographics, indications, flap size, recipient vessels used, ischemia time, flap, and donor site outcomes. All flap perforator vessels were located preoperatively using a handheld Doppler ultrasound probe. Results: From October 1999 to December 2008, 55 anterolateral thigh flaps were performed in 55 patients to reconstruct a variety of soft-tissue defects (upper and lower limbs, chest wall, skull base, head and neck). Flap size ranged 12 to 35 cm in length and 4 to 11 cm in width. During flap elevation, the main supply to the flap was found to be a direct septocutaneous perforator in 41% (n = 23) of the cases as opposed to a musculocutaneous perforator, which was found in 59% (n = 32). The mean ischemia time was 82 minutes (range, 62-103). The overall flap success rate was 100%. Two flaps were successfully salvaged after reexploration for venous congestion. The donor site morbidity was minimal. The mean follow-up time was 18 months (range, 2-48). Discussion and Conclusion: The anterolateral thigh free flap was found to be a very reliable flap (100% success) across a wide range of clinical indications. It facilitates microvascular anastomoses as evidenced by the short

  7. Quantitative electron microscopic analysis of the epithelium of normal human alveolar mucosa. (United States)

    Bernimoulin, J P; Schroeder, H E


    The epithelium of normal human alveolar mucosa originating from the anterior vestibulum was subjected to stereologic analysis. Eight biopsies were collected half-way between the muco gingival junction and the vestibular fornix from 20 to 50 year-old females, and processed for light and electron microscopy. At two levels of magnification, electron micrographs were sampled from four artificially selected strata in regions of epithelial ridges. Stereologic point counting based on a computer-aided system for analyzing stratified epithelia served for examining a total of about 860 electron micrographs. The alveolar epithelium was 0.26 mm thick, occasionally interdigitated by short, slender connective tissue papillae, and consisted of (1) a narrow basal and suprabasal, and (2) a broad spinous and surface compartment. It displayed a differentiation pattern which, in most subjects studied, was similar to that of normal human buccal epithelium, however, on the average, produced less mature surface cells. This pattern was expressed mainly by a density increase of cytoplasmic filaments (98 A in diameter), a concomitant decrease of the cytoplasmic ground substance, the formation of dark-cored membrane coating granules, and invividually variable amounts of glycogen deposition. In some subjects, a mixed differentiation pattern was found. The structural organization of alveolar epithelium, in analogy to cheek epithelium, was compatible with the function of distensibility.

  8. Evaluation of oral mucosa epithelium in type II diabetic patients by an exfoliative cytology method. (United States)

    Jajarm, Hassan Hosseinpour; Mohtasham, Nooshin; Moshaverinia, Maryam; Rangiani, Afsaneh


    Diabetes mellitus is a common metabolic disease that causes chronic hyperglycemia and disturbances in carbohydrate, lipid, and protein metabolism. Although diabetes can cause considerable cellular changes, this field has attracted little research. We therefore decided to evaluate the quantitative and qualitative changes in oral epithelial cells using an exfoliative cytology method. In 30 control individuals and 30 patients with type II diabetes, smears were obtained from two distinct oral sites: the buccal mucosa and tongue dorsum. The oral smears were stained using Papanicolaou solution. Quantitative and qualitative changes were evaluated in each slide. For this purpose, 50 clearly defined cells in each slide were microscopically evaluated, and photographs were subjected to computerized morphometric analysis. Cytoplasmic and nuclear areas in the diabetic group were significantly higher than in the control group. The cytoplasmic/nuclear ratio was lower in the control group. At both smear sites, the proportion of cells with nuclear changes was higher in the diabetic group. Diabetes mellitus can cause alterations in the oral epithelium that are detectable with this exfoliative cytology method. The method may be viable in evaluating this disease.

  9. Aerodynamic flight performance in flap-gliding birds and bats. (United States)

    Muijres, Florian T; Henningsson, Per; Stuiver, Melanie; Hedenström, Anders


    Many birds use a flight mode called undulating or flap-gliding flight, where they alternate between flapping and gliding phases, while only a few bats make use of such a flight mode. Among birds, flap-gliding is commonly used by medium to large species, where it is regarded to have a lower energetic cost than continuously flapping flight. Here, we introduce a novel model for estimating the energetic flight economy of flap-gliding animals, by determining the lift-to-drag ratio for flap-gliding based on empirical lift-to-drag ratio estimates for continuous flapping flight and for continuous gliding flight, respectively. We apply the model to flight performance data of the common swift (Apus apus) and of the lesser long-nosed bat (Leptonycteris yerbabuenae). The common swift is a typical flap-glider while-to the best of our knowledge-the lesser long-nosed bat does not use flap-gliding. The results show that, according to the model, the flap-gliding common swift saves up to 15% energy compared to a continuous flapping swift, and that this is primarily due to the exceptionally high lift-to-drag ratio in gliding flight relative to that in flapping flight for common swifts. The lesser long-nosed bat, on the other hand, seems not to be able to reduce energetic costs by flap-gliding. The difference in relative costs of flap-gliding flight between the common swift and the lesser long-nosed bat can be explained by differences in morphology, flight style and wake dynamics. The model presented here proves to be a valuable tool for estimating energetic flight economy in flap-gliding animals. The results show that flap-gliding flight that is naturally used by common swifts is indeed the most economic one of the two flight modes, while this is not the case for the non-flap-gliding lesser long-nosed bat.

  10. Differences in motility pattern between human buccal fibroblasts and periodontal and skin fibroblasts

    DEFF Research Database (Denmark)

    Lepekhin, Eugene; Grøn, Birgitte; Berezin, Vladimir


    Migration of fibroblasts from surrounding normal tissue into the wound bed is an important requirement for successful wound healing. This study investigated the motility pattern of buccal, periodontal and skin fibroblasts to determine whether differences in the wound healing efficiency...... at these sites can be explained by differences in the motile behavior of their respective fibroblast populations. The migratory characteristics were studied in a two-dimensional culture system. The migration of single cells was time-lapse video recorded at intervals of 15 min for a period of 6 h using a computer...... displacement of periodontal and skin fibroblasts. The decreased cellular displacement of the buccal fibroblasts was found to be due to both lower cellular speed and less persistence in direction. The buccal fibroblasts also displayed smaller areas and longer processes. The differences in cellular morphology...

  11. DNA breakage detection-fluorescence in situ hybridization (DBD-FISH in buccal cells

    Directory of Open Access Journals (Sweden)

    E. I. Cortés-Gutiérrez


    Full Text Available DNA breakage detection-fluorescence in situ hybridization (DBD-FISH is a recently developed technique that allows cell-by-cell detection and quantification of DNA breakage in the whole genome or within specific DNA sequences. The present investigation was conducted to adapt the methodology of DBD-FISH to the visualization and evaluation of DNA damage in buccal epithelial cells. DBD-FISH revealed that DNA damage increased significantly according to H2O2 concentration (r2=0.91. In conclusion, the DBD-FISH technique is easy to apply in buccal cells and provides prompt results that are easy to interpret. Future studies are needed to investigate the potential applicability of a buccal cell DBD-FISH model to human biomonitoring and nutritional work.

  12. DNA breakage detection-fluorescence in situ hybridization (DBD-FISH) in buccal cells. (United States)

    Cortés-Gutiérrez, E I; Dávila-Rodríguez, M I; Fernández, J L; López-Fernández, C; Gosálvez, J


    DNA breakage detection-fluorescence in situ hybridization (DBD-FISH) is a recently developed technique that allows cell-by-cell detection and quantification of DNA breakage in the whole genome or within specific DNA sequences. The present investigation was conducted to adapt the methodology of DBD-FISH to the visualization and evaluation of DNA damage in buccal epithelial cells. DBD-FISH revealed that DNA damage increased significantly according to H2O2 concentration (r2=0.91). In conclusion, the DBD-FISH technique is easy to apply in buccal cells and provides prompt results that are easy to interpret. Future studies are needed to investigate the potential applicability of a buccal cell DBD-FISH model to human biomonitoring and nutritional work.

  13. Prosthetic improvement of pronounced buccally positioned zygomatic implants: a clinical report. (United States)

    Bacchi, Ataís; Santos, Mateus Bertolini Fernandes dos; Pimentel, Marcele Jardim; Nóbilo, Mauro Antonio de Arruda; Consani, Rafael Leonardo Xediek


    This report presents a prosthetic technique for the improvement of surgically positioned, buccally placed zygomatic implants with the use of custom abutments for improved retention screw position and an esthetic implant reconstruction. The patient presented four zygomatic implants with pronounced buccal inclination. The anterior implants were inclined toward the location where the anterior artificial teeth should be placed during rehabilitation. As the manufacturer does not provide angulated abutments, we attempted the waxing and overcasting of a prosthetic abutment, repositioning the access holes of the prosthetic screws to a more palatal position. This clinical report demonstrates that abutment customization could be an interesting way to relocate the access holes of the prosthetic screws in cases of zygomatic implants with pronounced buccal inclination.

  14. A Cadaveric Study of the Communication Patterns Between the Buccal Trunks of the Facial Nerve and the Infraorbital Nerve in the Midface. (United States)

    Tansatit, Tanvaa; Phanchart, Piyaporn; Chinnawong, Dawinee; Apinuntrum, Prawit; Phetudom, Thavorn; Sahraoui, Yasmina M E


    Most nerve communications reported in the literature were found between the terminal branches. This study aimed to clarify and classify patterns of proximal communications between the buccal branches (BN) of the facial nerve and the infraorbital nerve (ION).The superficial musculoaponeurotic system protects any communication sites from conventional dissections. Based on this limitation, the soft tissues of each face were peeled off the facial skull and the facial turn-down flap specimens were dissected from the periosteal view. Dissection was performed in 40 hemifaces to classify the communications in the sublevator space. Communication site was measured from the ala of nose.A double communication was the most common type found in 62.5% of hemifaces. Triple and single communications existed in 25% and 10% of 40 hemiface specimens, respectively. One hemiface had no communication. The most common type of communication occurred between the lower trunk of the BN of the facial nerve and the lateral labial (fourth) branch of the ION (70% in 40 hemifaces). Communication site was deep to the levator labii superioris muscle at 16.2 mm from the nasal ala. Communications between the motor and the sensory nerves in the midface may be important to increase nerve endurance and to compensate functional loss from injury.Proximal communications between the main trunks of the facial nerve and the ION in the midface exist in every face. This implies some specific functions in normal individuals. Awareness of these nerves is essential in surgical procedure in the midface.

  15. Cytologic alterations in the oral mucosa after chronic exposure to ethanol Alterações citológicas na mucosa bucal após exposição crônica ao etanol

    Directory of Open Access Journals (Sweden)

    Sílvia Regina de Almeida Reis


    Full Text Available The effects of ethanol alone on the oral mucosa are still poorly understood, especially because there are few non-smoking chronic consumers of alcoholic beverages. The aim of this study was to evaluate the frequency of micronucleus, abnormal nucleus/cytoplasm ratio, pyknosis, karyorrhexis and karyolysis in exfoliated cells from the buccal mucosa and from the lateral border of the tongue in 36 non-smoker alcoholics (ethanol group and 18 non-smokers and non-drinkers (control group. The Papanicolaou method was used. Since alcoholics generally have hepatobiliary involvement, the association between serum gamma-glutamyl transpeptidase (GGT and some of the analyzed oral mucosa alterations was also investigated. The ethanol group showed a significant increase in the frequency of all alterations analyzed in the tongue cells when compared with the control group (p 0.05; Mann-Whitney. In the ethanol group, the correlation between serum GGT and the frequency of micronucleus and abnormal nucleus/cytoplasm ratio in oral mucosa cells was not significant (p > 0.05; Spearman. In conclusion, chronic exposure to ethanol may be associated with carcinogenic cytologic changes in the oral mucosa, even in the absence of tobacco smoking. These alterations were not correlated with hepatobiliary injury.Os efeitos do etanol isoladamente sobre a mucosa bucal permanecem pouco esclarecidos, sobretudo devido ao baixo número de não-fumantes consumidores crônicos de bebidas alcoólicas. O objetivo deste estudo foi avaliar as freqüências de micronúcleo, relação núcleo/citoplasma anormal, picnose, cariorrexe e cariólise em células esfoliadas da mucosa jugal e do bordo lateral da língua de 36 alcoólatras não-fumantes (grupo etanol e 18 abstêmios de álcool e fumo (grupo controle. O método de Papanicolaou foi utilizado. Uma vez que indivíduos alcoólatras geralmente apresentam comprometimento hepatobiliar, a associação entre gama-glutamil transpeptidase (GGT s

  16. A cone-beam computed tomography evaluation of buccal bone thickness following maxillary expansion

    Energy Technology Data Exchange (ETDEWEB)

    Akyalcin, Sercan; Englih, Jeryl D.; Stephens, Claude R.; Winkelmann, Sam [Dept. of Orthodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston (United States); Schaefer, Jeffrey S. [Todd Hughes Orthodontics, Houston (United States)


    This study was performed to determine the buccal alveolar bone thickness following rapid maxillary expansion (RME) using cone-beam computed tomography (CBCT). Twenty-four individuals (15 females, 9 males; 13.9 years) that underwent RME therapy were included. Each patient had CBCT images available before (T1), after (T2), and 2 to 3 years after (T3) maxillary expansion therapy. Coronal multiplanar reconstruction images were used to measure the linear transverse dimensions, inclinations of teeth, and thickness of the buccal alveolar bone. One-way ANOVA analysis was used to compare the changes between the three times of imaging. Pairwise comparisons were made with the Bonferroni method. The level of significance was established at p<0.05. The mean changes between the points in time yielded significant differences for both molar and premolar transverse measurements between T1 and T2 (p<0.05) and between T1 and T3 (p<0.05). When evaluating the effect of maxillary expansion on the amount of buccal alveolar bone, a decrease between T1 and T2 and an increase between T2 and T3 were found in the buccal bone thickness of both the maxillary first premolars and maxillary first molars. However, these changes were not significant. Similar changes were observed for the angular measurements. RME resulted in non-significant reduction of buccal bone between T1 and T2. These changes were reversible in the long-term with no evident deleterious effects on the alveolar buccal bone.

  17. Pharmacokinetics of buprenorphine following intravenous and buccal administration in cats, and effects on thermal threshold. (United States)

    Hedges, A R; Pypendop, B H; Shilo-Benjamini, Y; Stanley, S D; Ilkiw, J E


    This study reports the pharmacokinetics of buprenorphine, following i.v. and buccal administration, and the relationship between buprenorphine concentration and its effect on thermal threshold. Buprenorphine (20 μg/kg) was administered intravenously or buccally to six cats. Thermal threshold was determined, and arterial blood sampled prior to, and at various times up to 24 h following drug administration. Plasma buprenorphine concentration was determined using liquid chromatography/mass spectrometry. Compartment models were fitted to the time-concentration data. Pharmacokinetic/pharmacodynamic models were fitted to the concentration-thermal threshold data. Thermal threshold was significantly higher than baseline 44 min after buccal administration, and 7, 24, and 104 min after i.v. administration. A two- and three-compartment model best fitted the data following buccal and i.v. administration, respectively. Following i.v. administration, mean ± SD volume of distribution at steady-state (L/kg), clearance (mL·min/kg), and terminal half-life (h) were 11.6 ± 8.5, 23.8 ± 3.5, and 9.8 ± 3.5. Following buccal administration, absorption half-life was 23.7 ± 9.1 min, and terminal half-life was 8.9 ± 4.9 h. An effect-compartment model with a simple effect maximum model best predicted the time-course of the effect of buprenorphine on thermal threshold. Median (range) ke0 and EC50 were 0.003 (0.002-0.018)/min and 0.599 (0.073-1.628) ng/mL (i.v.), and 0.017 (0.002-0.023)/min and 0.429 (0.144-0.556) ng/mL (buccal).

  18. Microsurgical free flap reconstructions of the head and neck region: Shanghai experience of 34 years and 4640 flaps. (United States)

    Zhang, C; Sun, J; Zhu, H; Xu, L; Ji, T; He, Y; Yang, W; Hu, Y; Yang, X; Zhang, Z


    This study represents the surgical experience of 4481 microvascular free flap cases performed at the authors' institution in China, between 1979 and 2013. Four thousand four hundred and eighty-one patients underwent reconstruction with 4640 flaps: 56% radial forearm flaps, 8% iliac crest flaps, 13% fibula flaps, 10% anterolateral thigh flaps, and other flaps. In the overwhelming majority of cases, the flap transfer was required following tumour resection (97.5%). Three hundred and twenty minor complications (6.9%) occurred. One hundred and eighteen major complications (2.5%) were encountered: 114 cases of failure (2.4%) and four deaths. Among the 118 cases with major complications, 26 - 22.0% - had received radiotherapy; this proportion was higher than the 6.9% in the minor complications group and 8.1% in the non-intervention group. Venous thrombosis was the most common complication at the recipient site and was the main cause of flap failure. When a compromised flap is identified, surgical re-exploration should not be delayed. This study confirms that free flaps are reliable in achieving successful reconstruction in the head and neck region; however this technique requires extensive clinical experience. Owing to the large number of flap options, microsurgeons should always pay attention to the details of the different surgical defects and choose the most appropriate flap.

  19. High-throughput sequencing of forensic genetic samples using punches of FTA cards with buccal swabs

    DEFF Research Database (Denmark)

    Kampmann, Marie-Louise; Buchard, Anders; Børsting, Claus;


    with buccal swabs and compared the results with those obtained with DNA extracted using the EZ1 DNA Investigator Kit. Concordant profiles were obtained for all samples. Our protocol includes simple punch, wash, and PCR steps, reducing cost and hands-on time in the laboratory. Furthermore, it facilitates......Here, we demonstrate that punches from buccal swab samples preserved on FTA cards can be used for high-throughput DNA sequencing, also known as massively parallel sequencing (MPS). We typed 44 reference samples with the HID-Ion AmpliSeq Identity Panel using washed 1.2 mm punches from FTA cards...

  20. Modified cup flap for volar oblique fingertip amputations

    Directory of Open Access Journals (Sweden)

    Ahmadli, A.


    Full Text Available We describe a modified volar “V-Y cup” flap for volar fingertip defects that do not exceed more than half of the distal phalanx for better aesthetic and functional outcome. In seven cases out of eight, the flap was elevated with a subdermal pedicle, whereas in one case, the flap was elevated as an island on the bilateral neurovascular bundle. The fingertips have been evaluated for sensibility using standard tests, hook nail deformity and patient satisfaction. Seven flaps have survived completely. The flap with skeletonized bilateral digital neurovascular bundle has shown signs of venous insufficiency on the 5 postoperative day with consecutive necrosis. Suturing the distal edges of the flap in a “cupping” fashion provided a normal pulp contour. The modified flap can be used for defects as mentioned above. Subdermally dissected pedicle-based flap is safe and easy to elevate. The aesthetic and functional outcomes have been reported to be satisfactory.

  1. Intraoperative flap complications in lasik surgery performed by ophthalmology residents

    Directory of Open Access Journals (Sweden)

    Lorena Romero-Diaz-de-Leon


    Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye.

  2. "Comparison of AgNORs count in exfoliative cytology of normal oral mucosa in smokers and non- smokers"

    Directory of Open Access Journals (Sweden)

    Shahrabi Sh.


    Full Text Available Background and Aim: A strong causal relationship exists between cigarette smoking and development of oral squamous cell carcinoma, so oral screening using exfoliative cytology has been recommended to facilitate the early diagnosis of cellular alterations in oral mucosa and silver staining (AgNOR technique has been proven to be of value in the detection of incipient cellular alterations. The purpose of this study was to compare the argyrophilic nucleolar regions (AgNORs count of cells collected from normal mucosa of cigarette smokers with that obtained from non- smokers. Materials and Methods: In this cross-sectional study, cytologic smears of normal tongue, buccal mucosa and floor of the mouth from 19 smokers and 19 non- smokers were stained for AgNORs. The AgNORs count was established on 100 cells. The count value of groups were compared and analyzed using the Levens, Paired T, Student and Factorial tests. Using P<0.05 as the limit of significance. Results: The AgNORs were round and had a clustered distribution in both groups. The mean AgNORs count was statistically higher in cells of smokers than non- smokers (P<0.05. There was a significant difference between smears from the floor of the mouth and other anatomical sites in both groups. In this study, no correlation was found between AgNORs count and gender. Conclusion: Analysis of AgNORs suggests that there might be a correlation between the smoking habit and an increased rate of cellular proliferation in the oral mucosal cells.


    Directory of Open Access Journals (Sweden)

    L. V. Matveeva


    Full Text Available Ulcerogenesis in gastroduodenal mucosa area is a complex multistep process. Its, phases arecontrolled by interaction and activation of pro­ and antiinflammatory cytokine cascade. Present review article summarizes scientific data on impact of cytokines upon ulcerative and reparatory processes, a variety of their diagnostic and therapeutic options is defined. Evaluation of cytokine status, or, in some cases, cytokine genotyping in patients with stomach and duodenal ulcers, may predict clinical course of the disease, as well as efficiency of basic and eradication therapy, correction of the treatment.

  4. Upregulated Expression of Transient Receptor Potential Cation Channel Subfamily V Receptors in Mucosae of Patients with Oral Squamous Cell Carcinoma and Patients with a History of Alcohol Consumption or Smoking (United States)

    Sakakibara, Akiko; Sakakibara, Shunsuke; Kusumoto, Junya; Takeda, Daisuke; Hasegawa, Takumi; Akashi, Masaya; Minamikawa, Tsutomu; Hashikawa, Kazunobu; Terashi, Hiroto; Komori, Takahide


    Objectives Transient receptor potential cation channel (subfamily V, members 1–4) (TRPV1–4) are expressed in skin and neurons and activated by external stimuli in normal mucosae of all oral cavity sites. The oral cavity is exposed to various stimuli, including temperature, mechanical stimuli, chemical substances, and changes in pH, and, notably, the risk factors for oncogenic transformation in oral squamous epithelium are the same as the external stimuli received by TRPV1–4 receptors. Hence, we examined the relationship between oral squamous cell carcinoma (SCC) and TRPV1–4 expression. Materials and Methods Oral SCC patients (n = 37) who underwent surgical resection were included in this study. We investigated the expression of TRPV1–4 by immunohistochemical staining and quantification of TRPV1–4 mRNA in human oral mucosa. In addition, we compared the TRPV1–4 levels in mucosa from patients with SCC to those in normal oral mucosa. Results The receptors were expressed in oral mucosa at all sites (tongue, buccal mucosa, gingiva, and oral floor) and the expression was stronger in epithelia from patients with SCC than in normal epithelia. Furthermore, alcohol consumption and tobacco use were strongly associated with the occurrence of oral cancer and were found to have a remarkable influence on TRPV1–4 receptor expression in normal oral mucosa. In particular, patients with a history of alcohol consumption demonstrated significantly higher expression levels. Conclusion Various external stimuli may influence the behavior of cancer cells. Overexpression of TRPV1-4 is likely to be a factor in enhanced sensitivity to external stimuli. These findings could contribute to the establishment of novel strategies for cancer therapy or prevention. PMID:28081185

  5. Flow field of flexible flapping wings (United States)

    Sallstrom, Erik

    The agility and maneuverability of natural fliers would be desirable to incorporate into engineered micro air vehicles (MAVs). However, there is still much for engineers to learn about flapping flight in order to understand how such vehicles can be built for efficient flying. The goal of this study is to develop a methodology for capturing high quality flow field data around flexible flapping wings in a hover environment and to interpret it to gain a better understanding of how aerodynamic forces are generated. The flow field data was captured using particle image velocimetry (PIV) and required that measurements be taken around a repeatable flapping motion to obtain phase-averaged data that could be studied throughout the flapping cycle. Therefore, the study includes the development of flapping devices with a simple repeatable single degree of freedom flapping motion. The acquired flow field data has been examined qualitatively and quantitatively to investigate the mechanisms behind force production in hovering flight and to relate it to observations in previous research. Specifically, the flow fields have been investigated around a rigid wing and several carbon fiber reinforced flexible membrane wings. Throughout the whole study the wings were actuated with either a sinusoidal or a semi-linear flapping motion. The semi-linear flapping motion holds the commanded angular velocity nearly constant through half of each half-stroke while the sinusoidal motion is always either accelerating or decelerating. The flow fields were investigated by examining vorticity and vortex structures, using the Q criterion as the definition for the latter, in two and three dimensions. The measurements were combined with wing deflection measurements to demonstrate some of the key links in how the fluid-structure interactions generated aerodynamic forces. The flow fields were also used to calculate the forces generated by the flapping wings using momentum balance methods which yielded

  6. The aerodynamic and structural study of flapping wing vehicles



    This thesis reports on the aerodynamic and structural study carried out on flapping wings and flapping vehicles. Theoretical and experimental investigation of aerodynamic forces acting on flapping wings in simple harmonic oscillations is undertaken in order to help conduct and optimize the aerodynamic and structural design of flapping wing vehicles. The research is focused on the large scale ornithopter design of similar size and configuration to a hang glider. By means of Theodorsen’s th...

  7. 14 CFR 25.1511 - Flap extended speed. (United States)


    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Flap extended speed. 25.1511 Section 25... Limitations § 25.1511 Flap extended speed. The established flap extended speed V FE must be established so that it does not exceed the design flap speed V F chosen under §§ 25.335(e) and 25.345, for...

  8. Paramedian forehead flap thinning using a flexible razor blade. (United States)

    Justiniano, Hilda; Edwards, Julia; Eisen, Daniel B


    Paramedian forehead flaps are sometimes required to resurface large or deep nasal defects. The flap often needs to be thinned to match the contour of the surrounding skin at the recipient site. We describe a technique to thin the distal potion of the paramedian forehead flap using a flexible razor blade, the Dermablade. Once familiar with it, this same technique may be applied to thin other interpolation flaps.

  9. "A Free thenar flap – A case report"


    Chow Shew; Fung Boris KK; Garg Rajesh; Ip Wing


    Abstract We present a case report of a free thenar flap surgery done for a volar right hand middle finger, distal and middle phalanx degloving injury. A free thenar flap is a fasciocutaneous sensate flap supplied by a constant branch of the superficial radial artery and its variable nerve supply. It has a distinct advantage of low donor site morbidity, better cosmesis and texture of the flap. No immobilization is required postop. The donor site can be closed primiarily.

  10. The forked flap repair for hypospadias

    Directory of Open Access Journals (Sweden)

    Anil Chadha


    Full Text Available Context: Despite the abundance of techniques for the repair of Hypospadias, its problems still persist and a satisfactory design to correct the penile curvature with the formation of neourethra from the native urethral tissue or genital or extragenital tissues, with minimal postoperative complications has yet to evolve. Aim: Persisting with such an endeavor, a new technique for the repair of distal and midpenile hypospadias is described. Materials and Methods: The study has been done in 70 cases over the past 11 years. The "Forked-Flap" repair is a single stage method for the repair of such Hypospadias with chordee. It takes advantage of the rich vascular communication at the corona and capitalizes on the established reliability of the meatal based flip-flap. The repair achieves straightening of the curvature of the penis by complete excision of chordee tissue from the ventral surface of the penis beneath the urethral plate. The urethra is reconstructed using the native plate with forked flap extensions and genital tissue relying on the concept of meatal based flaps. Water proofing by dartos tissue and reinforcement by Nesbit′s prepucial tissue transfer completes the one stage procedure. Statistical Analysis: An analysis of 70 cases of this single stage technique of repair of penile hypospadias with chordee, operated at 3 to 5 years of age over the past 11 years is presented. Results and Conclusion: The Forked Flap gives comparable and replicable results; except for a urethrocutaneous fistula rate of 4% no other complications were observed.

  11. Mast cell density in cardio-esophageal mucosa. (United States)

    Mahjoub, Fatemeh E; Asefi, Hoda; Farahmand, Fatemeh; Pourpak, Zahra; Amini, Zahra


    Mast cells are related to certain gastrointestinal complaints. Mast cell density has not been studied in cardio-esophageal region to the best of our knowledge. In this study we wanted to obtain an estimate of mast cell density in this region and compare it with mast cell density in antrum. From April 2007 till March 2010, we chose children (mast cell density in the cardiac mucosa was 33.41 ± 32.75 in 0.25 mm2 (range: 0-155), which was two times of that in antral mucosa. We found a significant but weak positive correlation at the 0.05 level between mast cell density of cardiac mucosa and the antrum. Higher mast cell counts were seen in cardiac mucosa in this study. Significant positive correlation between mast cell density of cardiac mucosa and the antrum could hint to a single underlying etiology for the inflammatory process in gastro- esophageal junction and gastric mucosa.

  12. 14 CFR 23.1511 - Flap extended speed. (United States)


    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Flap extended speed. 23.1511 Section 23.1511 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Information § 23.1511 Flap extended speed. (a) The flap extended speed V FE must be established so that it...

  13. Prospective evaluation of outcome measures in free-flap surgery.

    LENUS (Irish Health Repository)

    Kelly, John L


    Free-flap failure is usually caused by venous or arterial thrombosis. In many cases, lack of experience and surgical delay also contribute to flap loss. The authors prospectively analyzed the outcome of 57 free flaps over a 28-month period (January, 1999 to April, 2001). The setting was a university hospital tertiary referral center. Anastomotic technique, ischemia time, choice of anticoagulant, and the grade of surgeon were recorded. The type of flap, medications, and co-morbidities, including preoperative radiotherapy, were also documented. Ten flaps were re-explored (17 percent). There were four cases of complete flap failure (6.7 percent) and five cases of partial failure (8.5 percent). In patients who received perioperative systemic heparin or dextran, there was no evidence of flap failure (p = .08). The mean ischemia time was similar in flaps that failed (95 +\\/- 29 min) and in those that survived (92 +\\/- 34 min). Also, the number of anastomoses performed by trainees in flaps that failed (22 percent), was similar to the number in flaps that survived (28 percent). Nine patients received preoperative radiotherapy, and there was complete flap survival in each case. This study reveals that closely supervised anastomoses performed by trainees may have a similar outcome to those performed by more senior surgeons. There was no adverse effect from radiotherapy or increased ischemia time on flap survival.

  14. Posttraumatic eyebrow reconstruction with hair-bearing temporoparietal fascia flap. (United States)

    Denadai, Rafael; Raposo-Amaral, Cassio Eduardo; Marques, Frederico Figueiredo; Raposo-Amaral, Cesar Augusto


    The temporoparietal fascia flap has been extensively used in craniofacial reconstructions. However, its use for eyebrow reconstruction has been sporadically reported. We describe a successfully repaired hair-bearing temporoparietal fascia flap after traumatic avulsion of eyebrow. Temporoparietal fascia flap is a versatile tool and should be considered as a therapeutic option by all plastic surgeons.

  15. Haemodynamics and viability of skin and muscle flaps

    Energy Technology Data Exchange (ETDEWEB)

    Clarke, H.M.


    In reconstructive surgery, occasional free flap failures occur despite the clinical and technical advances in microsurgery of the past few years. To minimize these losses a better understanding of basic flap physiology must be achieved. The objectives of this work were the investigation of the haemodynamic characteristics of skin and muscle flaps in normal and compromised circumstances, the viability of skin and muscle flaps after pedicle ligation or ischaemia, and the possible interrelationship of haemodynamics and viability. A Wistar rat groin island skin flap model was used to assess flap survival following vascular compromise produced by vessel ligation. Survival was seen earliest following loss of the artery and was not dependent on circulation through the vascular pedicle after 5 days. A study using free groin flaps in rats gave similar results. Normal free groin flaps were then transferred to irradiated Fischer F344 rats. Delayed neovascularization was shown at a time corresponding to the onset of the late phase of the response to skin radiation. A canine inferior epigastric free skin flap model was established to determine the normal haemodynamic parameters during free flap transfer. A canine gracilis free muscle flap model was developed. Normal haemodynamic parameters are given. These parameters were examined after ischaemia. Survival of the muscle followed ischaemia of 4 hours or less. Flap survival is not dependent solely on arterial input or venous drainage. More complex phenomena such as the reactive hyperaemia following ischaemia are implicated in survival.

  16. Proteome Analysis of Rheumatoid Arthritis Gut Mucosa. (United States)

    Bennike, Tue Bjerg; Ellingsen, Torkell; Glerup, Henning; Bonderup, Ole Kristian; Carlsen, Thomas Gelsing; Meyer, Michael Kruse; Bøgsted, Martin; Christiansen, Gunna; Birkelund, Svend; Andersen, Vibeke; Stensballe, Allan


    Rheumatoid arthritis (RA) is an inflammatory joint disease leading to cartilage damage and ultimately impaired joint function. To gain new insight into the systemic immune manifestations of RA, we characterized the colon mucosa proteome from 11 RA-patients and 10 healthy controls. The biopsies were extracted by colonoscopy and analyzed by label-free quantitative proteomics, enabling the quantitation of 5366 proteins. The abundance of dihydrofolate reductase (DHFR) was statistically significantly increased in RA-patient biopsies compared with controls and correlated with the administered dosage of methotrexate (MTX), the most frequently prescribed immunosuppressive drug for RA. Additionally, our data suggest that treatment with Leflunomide, a common alternative to MTX, increases DHFR. The findings were supported by immunohistochemistry with confocal microscopy, which furthermore demonstrated that DHFR was located in the cytosol of the intestinal epithelial and interstitial cells. Finally, we identified 223 citrullinated peptides from 121 proteins. Three of the peptides were unique to RA. The list of citrullinated proteins was enriched in extracellular and membrane proteins and included known targets of anticitrullinated protein antibodies (ACPAs). Our findings support that the colon mucosa could trigger the production of ACPAs, which could contribute to the onset of RA. The MS data have been deposited to ProteomeXchange with identifiers PXD001608 and PXD003082.

  17. Mucoadhesion dependence of pharmaceutical polymers on mucosa characteristics. (United States)

    Accili, Daniela; Menghi, Giovanna; Bonacucina, Giulia; Martino, Piera Di; Palmieri, Giovanni F


    Well known mucoadhesive polymers such as Carbopol 974P and Pharmacoat 606 and three different mucosas (sublingual, oesophageal and duodenal bovine) were used to verify how the mucoadhesive properties of materials may depend on the mucosa characteristics and if a polymer may reveal more mucoadhesive than another and vice versa by changing the type of interacting mucosa. So, tablets of Carbopol 974P and Pharmacoat 606 were prepared and their mucoadhesion on the three mucosas was set in terms of maximum load and work of detachment, using a texture analyzer. At the same time, mucosas were characterized by immunohistochemical techniques and lectin histochemistry. Results obtained from the Tensile test analyses show that the adhesive power of the two polymers is different in the three mucosas. Particularly, in the sublingual mucosa, Carbopol was more mucoadhesive than Pharmacoat. On the contrary, Pharmacoat was more mucoadhesive than Carbopol in duodenal mucosa. The significantly different behavior of polymers was correlated with the desquamation layer thickness and the differential sialic acid and fucose exposition in the targeted mucosas.

  18. Double papilla flap technique for dual purpose

    Directory of Open Access Journals (Sweden)

    P Mohan Kumar


    Full Text Available Marginal tissue recession exposes the anatomic root on the teeth, which gives rise to -common patient complaints. It is associated with sensitivity, tissue irritation, cervical abrasions, and esthetic concerns. Various types of soft tissue grafts may be performed when recession is deep and marginal tissue health cannot be maintained. Double papilla flap is an alternative technique to cover isolated recessions and correct gingival defects in areas of insufficient attached gingiva, not suitable for a lateral sliding flap. This technique offers the advantages of dual blood supply and denudation of interdental bone only, which is less susceptible to permanent damage after surgical exposure. It also offers the advantage of quicker healing in the donor site and reduces the risk of facial bone height loss. This case report presents the advantages of double papilla flap in enhancing esthetic and functional outcome of the patient.

  19. The angel flap for nipple reconstruction. (United States)

    Wong, Wendy W; Hiersche, Matthew A; Martin, Mark C


    Creation of an aesthetically pleasing nipple plays a significant role in breast reconstruction as a determining factor in patient satisfaction. The goals for nipple reconstruction include minimal donor site morbidity and appropriate, long-lasting projection. Currently, the most popular techniques used are associated with a significant loss of projection postoperatively. Accordingly, the authors introduce the angel flap, which is designed to achieve nipple projection with lasting results. The lateral edges of the flap and the area surrounding the top of the nipple are de-epithelialized and the flaps are wrapped to create a nipple mound composed primarily of dermis. Decreasing the amount of fat within core of the nipple and enhancing dermal content promotes long-lasting projection. Furthermore, the incision pattern fits within a desired areolar size, preventing unnecessary superfluous extension of the incisions. Thus, the technique described herein achieves the goals of nipple reconstruction, including adequate and long-lasting projection, without extension of the lateral limb scars.

  20. Perforator anatomy of the radial forearm free flap versus the ulnar forearm free flap for head and neck reconstruction

    NARCIS (Netherlands)

    Hekner, D.D.; Roeling, TAP; van Cann, EM


    The aim of this study was to investigate the vascular anatomy of the distal forearm in order to optimize the choice between the radial forearm free flap and the ulnar forearm free flap and to select the best site to harvest the flap. The radial and ulnar arteries of seven fresh cadavers were injecte

  1. Penetration effect of prostaglandin E2 gel on oral mucosa of rats

    Directory of Open Access Journals (Sweden)

    Rafinus Arifin


    Full Text Available Background: Several researches reported that Prostaglandin E2 (PGE2 injection on buccal mucosa combined with orthodontic pressure can faster tooth movement but has disadvantages such as high alveolar bone and root resorption furthermore pain from injection needle. PGE2 gel was made to better replace the lacks of injectable PGE2. Purpose: This research was aimed to prove that PGE 2 gel can penetrate rat’s oral mucosa effecting the appearance of PMN cells. Methods: This research was an in vivo laboratory experiment using 36 Sprague Dawley rats which were divided into 3 groups: normal group, topical PGE2 gel group after 1, 2, 4, 8 hours (4 subgroups, and topical gel without PGE2 group after 1, 2, 4, 8 hours (4 subgroups. Each group consists of 4 rats, therefore the total sample for all research groups were 36 rats. Gel with 25 µg/mL of PGE2 and gel without PGE2 were applied on oral mucosa for 2 minutes. Then, the rats were sacrificed after 1 hour, 2 hours, 4 hours, and 8 hours application. After that, the samples were prepared for histological examination with Hematoxyllin and Eosin. The picture were taken with OptiLab View and PMN cells amount were counted with light microscope, set 400 times of magnification. Results: Penetration effect of PGE2 gel on rat’s oral mucosa result in PMN inflammation cells distribution. One-way ANOVA showed no significant difference on PMN cells count in rats’ lower jaws between groups of normal and gel without PGE2. There was significant difference between groups of PGE2 gel and gel without PGE2 (p=0,001. PGE2 gel application showed PGE2 as inflammatory media, even though administered topically. Conclusion: PGE2 gel can penetrate rat’s oral mucosa, effecting PMN cells 1, 2, 4 and 8 hours after application of PGE2 gel.Latar belakang: Beberapa penelitian melaporkan bahwa injeksi (Prostaglandin E2 PGE2pada mukosa bukal yang dikombinasikan dengan tekanan ortodonti dapat mempercepat pergerakan gigi, tapi

  2. Rapidly-growing buccal mass in a 6-month-old infant. (United States)

    Kumar, A; Brierley, D; Hunter, K D; Lee, N


    Lipoblastoma and lipoblastomatosis are rare benign tumours of fetal-embryonal adipocytes that usually present in young children, which is why they are not often included in the differential diagnosis of soft tissue lesions in infants. We describe a case of a 6-month-old infant with an intraoral buccal lipoblastoma.

  3. A Comparison of Buccal Midazolam and Intravenous Diazepam for the Acute Treatment of Seizures in Children

    Directory of Open Access Journals (Sweden)

    Mohammad Ghofrani


    Full Text Available Objective: The purpose of the present study is to compare efficacy and safety of buccal midazolam with intravenous diazepam in control of seizures in Iranian children.Methods: This is a randomized clinical trial. 92 patients with acute seizures, ranging from 6 months to 14 years were randomly assigned to receive either buccal midazolam (32 cases or intravenous diazepam (60 cases at the emergency department of a children's hospital. The primary outcome of this study was cessation of visible seizure activity within 5 minutes from administration of the first dosage. The second dosage was used in case the seizure remained uncontrolled 5 minutes after the first one.Findings: In the midazolam group, 22 (68.8% patients were relieved from seizures in 10 minutes.Meanwhile, diazepam controlled the episodes of 42 (70% patients within 10 minutes. The difference was,however, not statistically significant (P=0.9. The mean time required to control the convulsive episodes after administration of medications was not statistically significant (P=0.09. No significant side effects were observed in either group. Nevertheless, the risk of respiratory failure in intravenous diazepam is greater than in buccal midazolam.Conclusion: Buccal midazolam is as effective as and safer than intravenous diazepam in control of seizures.

  4. Testing Dietary Hypotheses of East African Hominines Using Buccal Dental Microwear Data (United States)

    Martínez, Laura Mónica; Estebaranz-Sánchez, Ferran; Galbany, Jordi


    There is much debate on the dietary adaptations of the robust hominin lineages during the Pliocene-Pleistocene transition. It has been argued that the shift from C3 to C4 ecosystems in Africa was the main factor responsible for the robust dental and facial anatomical adaptations of Paranthropus taxa, which might be indicative of the consumption of fibrous, abrasive plant foods in open environments. However, occlusal dental microwear data fail to provide evidence of such dietary adaptations and are not consistent with isotopic evidence that supports greater C4 food intake for the robust clades than for the gracile australopithecines. We provide evidence from buccal dental microwear data that supports softer dietary habits than expected for P. aethiopicus and P. boisei based both on masticatory apomorphies and isotopic analyses. On one hand, striation densities on the buccal enamel surfaces of paranthropines teeth are low, resembling those of H. habilis and clearly differing from those observed on H. ergaster, which display higher scratch densities indicative of the consumption of a wide assortment of highly abrasive foodstuffs. Buccal dental microwear patterns are consistent with those previously described for occlusal enamel surfaces, suggesting that Paranthropus consumed much softer diets than previously presumed and thus calling into question a strict interpretation of isotopic evidence. On the other hand, the significantly high buccal scratch densities observed in the H. ergaster specimens are not consistent with a highly specialized, mostly carnivorous diet; instead, they support the consumption of a wide range of highly abrasive food items. PMID:27851745

  5. Formulation and evaluation of anti-asthmatic drug montelukast in mucoadhesive buccal patches

    Institute of Scientific and Technical Information of China (English)

    Magdy Ibrahim Mohamed; Mary Kamal Gad Mekhael


    Objective: To formulate and evaluate anti-asthmatic drug montelukast in mucoadhesive buccal patches. Methods:Buccal patches were formulated by using different hydrophilic polymers by solvent casting technique. Buccal patches were evaluated by seven physical appearances, in addition toin vitro drug release study. Results: All patches were uniform and translucent, and had smooth surface. In vitro release studies were conducted for montelukast buccal patches proved that release in the range of 75.26%-92.30% in 8 h. Emission of montelukast from all patches simulated zero order and diffusion mechanism. Finally it can be concluded that F3, F15 and F16 are the best formulation. Conclusions: The investigation concluded that patch of 5 mg of montelukast sodium were formulated by using sodium alginate with sodium carboxy methyl cellulose, hydroxy propyl methyl cellulose K100M with sodium carboxy methyl cellulose, and hydroxy propyl methyl cellulose K100M with sodium alginate (F3, F15 and F16 formulations) were the best formulations.

  6. Neuraminidase-enhanced attachment of Bacteroides intermedius to human erythrocytes and buccal epithelial cells.


    Okuda, K; Ono, M.; Kato, T.


    Bacteroides intermedius strains strongly agglutinated only neuraminidase-treated erythrocytes. The neuraminidase-dependent hemagglutinating activity of B. intermedius was abolished by heating or treating with protease. The adherence of these microorganisms to human buccal epithelial cells was enhanced by neuraminidase pretreatment of the cells (P less than 0.01).

  7. A Non-Invasive Strategy for Neonatal Alloimmune Thrombocytopenia Diagnosis: Newborn Platelet Genotyping with Buccal Swabs

    Directory of Open Access Journals (Sweden)

    Gérald Bertrand


    Full Text Available Neonatal alloimmune thrombocytopenia results from the maternal immune response against fetal-specific antigens inherited from the father. The diagnosis is ascertained only when the maternal alloantibody and the offending antigen present in the newborn are identified. Up until now most laboratories perform DNA extraction for neonatal genotyping from newborn blood samplings. In order to avoid such an invasive procedure, two protocols of DNA extraction from buccal swabs were developed: a manual protocol using the QIAamp mini blood kit (Qiagen, and an automated procedure with the MagNA Pure Compact instrument (Roche. Both EDTA-blood and buccal swabs from thrombocytopenic newborns were genotyped manually (14 samples, automatically (15 samples or both manually and automatically (two samples. Human Platelet Antigen (HPA genotyping was performed using the BeadChip assay (BioArray, Immucor. Concordant genotypings were obtained for all samples except for one swab with the manual method. The automated DNA extraction from newborn buccal swabs with the MagNA Pure Compact instrument was chosen as the first-line strategy, with a significant gain of time in processing buccal swabs.

  8. Reactivation of inactive X chromosome in buccal smear of carcinoma of breast

    Directory of Open Access Journals (Sweden)

    Natekar Prashant


    Full Text Available Buccal mucosal smears of 100 female patients of carcinoma of breast were compared with 100 controls matched accordingly. The frequency of Barr bodies was significantly lower in carcinoma of breast patients (menstruating and menopausal women P < 0.001 when compared with controls indicating reactivation of the inactive X chromosome.

  9. Characterization of chitosan-magnesium aluminum silicate nanocomposite films for buccal delivery of nicotine

    DEFF Research Database (Denmark)

    Pongjanyakul, Thaned; Khunawattanakul, Wanwisa; Strachan, Clare J


    The objective of this study was to prepare and characterize chitosan-magnesium aluminum silicate (CS-MAS) nanocomposite films as a buccal delivery system for nicotine (NCT). The effects of the CS-MAS ratio on the physicochemical properties, release and permeation, as well as on the mucoadhesive...

  10. The transversely split gracilis twin free flaps

    Directory of Open Access Journals (Sweden)

    Upadhyaya Divya


    Full Text Available The gracilis muscle is a Class II muscle that is often used in free tissue transfer. The muscle has multiple secondary pedicles, of which the first one is the most consistent in terms of position and calibre. Each pedicle can support a segment of the muscle thus yielding multiple small flaps from a single, long muscle. Although it has often been split longitudinally along the fascicles of its nerve for functional transfer, it has rarely been split transversely to yield multiple muscle flaps that can be used to cover multiple wounds in one patient without subjecting him/her to the morbidity of multiple donor areas .

  11. Immediate reconstruction following resection of oral cancer with free rectus abdominis myocutaneous flap

    Institute of Scientific and Technical Information of China (English)


    目的:研究游离腹直肌肌皮瓣即刻修复口腔颌面部恶性肿瘤切除术后缺损的方法并评价其作用.方法:6例患者在进行广泛的口腔癌切除术后,应用游离腹直肌肌皮瓣进行缺损即刻修复,3例颊癌患者分别切除唇,颊,下颌骨及上颌骨后造成大面积洞穿性缺损,2例舌癌及1例下颌骨恶性肿瘤患者在进行舌切除及下颌骨切除后造成大面积及复杂的缺损,缺损修复的转移皮瓣最大面积达110mm×230mm.结果:游离腹直肌肌皮瓣及供区无严重的手术并发症,6例游离腹直肌肌皮瓣有5例愈合无并发症,1例皮瓣出现部分坏死,供皮区腹壁无组织感染及裂开.结论:游离腹直肌肌皮瓣使口腔颌面部缺损修复在功能和美观上达到满意的效果,提高了口腔颌面部恶性肿瘤患者广泛切除术后的生存质量.%Objective:To study the method of rectus abdominis myocutaneous free flap for immediate reconstruction of defects resulting from orofacial cancer resections and evaluate the effect of the flap. Methods:There were six patients with oral cancer following extensive surgery received the rectus abdominis myocutaneous free flaps for immediate reconstruction of defects.In three patients with buccle mucosa carcinoma,extensive perforating defects had resulted from resection of large areas of the lip,cheek,mandible,and maxilla.In two patients with tongue cancer and one patient with mandibular carcinoma,extensive and complex defects had resulted from glossectomy and mandibulectomy.The maximal size of the skin peddle of the transferred flap was 110mm×230mm. Results:There were no serious complications of the transferred rectus abdominis myocutaneous free flaps and donor sites.Five of six rectus abdominis myocutaneous free flaps healed without immediate complications and one flap had partial necrosis.There were no infections and dehiscences of the abdominal wall. Conclusions:The rectus abdominis myocutaneous free flap provide

  12. Suspension Bridge Flutter for Girder with Separate Control Flaps

    DEFF Research Database (Denmark)

    Huynh, T.; Thoft-Christensen, Palle

    Active vibration control of long span suspension bridge flutter using separated control flaps (SFSC) has shown to increase effectively the critical wind speed of bridges. In this paper, an SFSC calculation based on modal equations of the vertical and torsional motions of the bridge girder including...... the flaps is presented. The length of the flaps attached to the girder, the flap configuration and the flap rotational angles are parameters used to increase the critical wind speed of the bridge. To illustrate the theory a numerical example is shown for a suspension bridge of 1000m+2500m+1000m span based...

  13. Circadian variations of clock gene Per2 and cell cycle genes in different stages of carcinogenesis in golden hamster buccal mucosa. (United States)

    Tan, Xue-Mei; Ye, Hua; Yang, Kai; Chen, Dan; Wang, Qing-Qing; Tang, Hong; Zhao, Ning-Bo


    Previous studies have suggested that the expression of clock genes have circadian rhythms, and many cell cycle genes are regulated by clock genes. The disruption of circadian rhythms appears to be associated with the acceleration of cancer development. To investigate the circadian patterns of the clock gene Per2 and of cell cycle genes p53, Cyclin D1, CDK1 and Cyclin B1 in different stages of carcinogenesis, the daily mRNA profiles of these genes were detected by real-time RT-PCR in dimethylbenzanthracene-induced cancer, in precancerous lesions and in normal tissues. Per2, p53, Cyclin D1 and CDK1 showed circadian rhythms in the 3 different stages of carcinogenesis, whereas the circadian rhythm of Cyclin B1 was absent in the precancerous lesions. The mesors and amplitudes of Per2 and p53 were decreased (P circadian pattern variations of these genes in different stages of carcinogenesis.

  14. Genotoxic Effects of Tobacco on Buccal Epithelium: Cell Nuclear Anomalies as Biomarker

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    Sohini Das Biswas


    Full Text Available Background: Tobacco use has toxic effects on different organs. This study was carried out to assess the effect of indigenous tobacco both in smoking (bidi and smokeless (gutkha, zarda and khaini forms on buccal cells at chromosomal level, through assessment of different nuclear anomalies as biomarker. Methods:This study was done on people living in Durgapur and its adjacent areas, West Bengal, India during January to July 2011. The samples were collected from 50 smokers (case group, 50 smokeless tobacco consumers or chewers (case group and 50 non-tobacco consumers (control group. Micronucleus assay was used to assess buccal cell nuclear changes. Buccal smears collected from study subjects were prepared on a grease free slide. Prepared slides were observed under light microscope and 2 to 5 fields were observed randomly for counting the different anomalies. In each field, the frequency of each anomaly was assessed in 100 cells and reported with percentage. Results:Chewers had significantly the highest frequency of all nuclear anomalies compared to smokers and healthy controls (HCs. Smokers also had significantly more anomalies compared to HCs. Condensed chromatin (CC, karyolysis (KL and bi-nucleation (BN in chewers and CC, pyknosis and BN in smokers were the most frequent anomalies. KL was significantly more frequent in chewers compared to smokers (59.8 ± 6.4 vs. 24.2 ± 12.4%, P < 0.001, however, the frequency of other nuclear anomalies were not significantly different in these two study groups. Presence of each nuclear anomaly was significantly greater in older ages in all study groups. Conclusion:Tobacco can cause and increase the rate of nuclear anomalies in both smoking and smokeless forms compared to HCs. The genotoxic effects of tobacco on buccal cells are partly age-related. Cell nuclear anomalies in buccal tissue can be used as biomarker indicating the detrimental effects of tobacco.

  15. Buccal Corridors: A Fact or a Myth in the Eyes of Laymen? (United States)

    Elhiny, Omnia A.; Harhash, Asmaa Y.


    AIM: This study aimed to investigate laymen knowledge of the existence of the buccal corridor and whether it was an important factor for them in judging smile attractiveness and the effect of introducing the knowledge to them on their further judgment. MATERIALS AND METHODS: Nine subjects were randomly selected with variable buccal corridor percentages. They were coached to smile in a posed fashion and full face smile photographs were taken from a standardised distance. The photographs were randomly arranged in a power point presentation and displayed to a panel of thirty-nine randomly selected laymen judges. The judges made their beauty judgment on a visual analogue scale (VAS) and filled a questionnaire. After their education about the buccal corridor, they were asked to make a second judgment on a second sheet with VAS and with a different random sequence of the photographs. RESULTS: Intra-class correlation agreement for all the judges between the first and second scores was 0.713. The Spearman’s rho Correlation coefficient indicated a positive correlation for all the photos. For the male judges, the agreement between the ratings was 0.839, and the correlation was positive for all the photos. For the female judges, the agreement between the ratings was 0.510, and the correlation was positive for all the photographs. Hundred percent of the judges were not familiar with the buccal corridor. Eighty percent of the female judges and 44.4% of the male judges mentioned that it would affect their further judgment. CONCLUSION: Laymen build their esthetic judgments on what we teach them, and modifying treatment plans to include corrections of buccal corridors for esthetic reasons only is a myth. PMID:28028418

  16. Single stage dorsal inlay buccal mucosal graft with tubularized incised urethral plate technique for hypospadias reoperations

    Institute of Scientific and Technical Information of China (English)

    Wei-Jing Ye; Ping Ping; Yi-Dong Liu; Zheng Li; Yi-Ran Huang


    Aim: To report the experience with single stage dorsal inlay buccal mucosal grafts using the Snodgrass technique for complex redo cases. Methods: From May 2004 to December 2005, a total of 53 patients aged from 3 to 34 years old(average 11.62 ± 7.18 years) with failed previous hypospadias surgery were included in the present study. Indica- tions included urethral strictures and repair breakdown. The unhealthy urethra was unroofed from the meatus in the ventral midline, a buccal mucosal graft was inlayed between the incised urethral plate and fixed to the corporacavemosa. The neourethra was tubularized, and covered with subcutaneous (dartos) tissue and penile skin. Glanuloplasty was also performed in all cases. Outcome analysis included clinical follow-up, and endoscopy in 2 selected cases. Results: The buccal mucosal graft was 3.0-7.5 cm in length and 0.7-2.0 cm in width. All patients required glanuloplasty, with buccal mucosal grafts extended to the tip of the glans. After a follow-up of 14-30 months (mean 22.6 months), the total complication rate was 15.1%, with five cases of fistula and three cases of stricture. Conclusion: Inlaying dorsal buccal mucosal grafts applying the Snodgrass technique is a reliable method for creating a substitute urethral plate for tubularization. The recurrent rate of urethral stricture and fistula is at an acceptable level for redo cases. This approach represents an effective, simple and safe option for reoperations. (Asain J Androl 2008 Jul; 10: 682- 686)

  17. Double-skin paddled superficial temporofascial flap for the reconstruction of full-thickness cheek defect. (United States)

    Kilinc, Hidir; Geyik, Yilmaz; Aytekin, Ahmet Hamdi


    The most common causes of cheek defects include trauma, burn, and tumor resections. In the reconstruction of the defects in this region, it is essential to use similar or adjacent tissue considering the aesthetic and functional properties. For this purpose, numerous local, regional, or distant free flaps were described. The local flaps harvested from the head and neck region are the most frequent methods because of the similar skin color, texture, and compatibility with cheek.In this study, the reconstruction in a 29-year-old male patient who had a full-thickness cheek defect due to tumor resection on the left side was performed, wherein a hairless skin island was carried through the frontal branch of superficial temporal artery for oral mucosa, and a hairy skin island through the parietal branch of the same pedicle was carried for the bearded skin defect. No complication occurred postoperatively and both aesthetic and functional satisfactory results were obtained, providing the oral mucosal and natural beard integrity. Donor-site scarring and temporal alopecia were recorded as the disadvantages of this method.This technique is a useful method for the reconstruction of full-thickness cheek defects because of its advantages including compatibility of color and texture, reliable blood supply, requiring single-session procedure, and being able to carry 2 different skin islands on the same pedicle.

  18. The study of expanded tri-lobed flap in a rabbit model: possible flap model in ear reconstruction?

    Directory of Open Access Journals (Sweden)

    Yüreklý Yakup


    Full Text Available Abstract Background Local flaps are widely used in reconstructive surgery. Tri-lobed skin flap is a relatively new flap and there has been no experimental model of this flap. This flap can be used for repair of full thickness defects in the face, ears and alar region. Based on the size of ears in a rabbit, we designed a model of ear reconstruction using expanded tri-lobed flap. Local flaps are more advantageous in that they provide excellent color and texture matching up with those of the face, adequately restore ear contour, place scars in a favorable location and ideally accomplish these goals in a single stage with minimal donor site morbidity. Methods Eight adult New Zealand rabbits were divided into two groups. 50 ml round tissue expander were implanted to four rabbits. After completion of the expansion, a superiorly based tri-lobed flap was elevated and a new ear was created from the superior dorsal skin of each rabbit. Scintigraphy with Technetium-99m pertecnetate was performed to evaluate flap viability. Results Subtotal flap necrosis was seen in all animals in non-expanded group. New ear in dimensions of the original ear was created in expanded group without complication. Perfusion and viability of the flaps were proved by Technetium-99m pertecnetate scintigraphy. Conclusion According to our knowledge this study is the first to demonstrate animal model in tri-lobed flap. Also, our technique is the first application of the trilobed flap to the possible ear reconstruction. We speculated that this flap may be used mastoid based without hair, in human. Also, tri-lobed flap may be an alternative in reconstruction of cylindrical organs such as penis or finger.

  19. The palatal island mucoperiosteal flap for primary intraoral reconstruction following tumor ablative surgery. (United States)

    Magdy, Emad A


    Reconstruction of intraoral mucosal defects following tumor ablative surgery can be a challenging problem. The objective of this study was to evaluate the use of the palatal island mucoperiosteal flap (PIMPF) in reconstructing intraoral defects resulting from ablative tumor resections. The study included eight consecutive patients who underwent primary reconstruction using the PIMPF following intraoral tumor resections in a 5-year period by a single surgeon at a tertiary referral institute. Patients included five men and three women ranging in age from 32 to 69 years. Four patients were smokers (averaging 40 pack-years). None had received prior irradiation therapy. Resultant surgical defects ranged in size from 6 to 16.5 cm(2) (mean 12.3 ± 3.9) and included areas of soft/hard palate, lateral pharyngeal wall, retromolar trigone and inner cheek. Final pathological findings revealed three benign and five malignant tumors, mostly from minor salivary gland origin. All patients began oral diet between postoperative days 1 and 4 (mean 2 days). All flaps survived well with good postoperative wound healing except one minor flap dehiscence that eventually healed by granulation tissue with no further surgery needed. All donor sites were completely healed by remucosalization within 5-13 weeks. No patients manifested permanent velopharyngeal insufficiency, speech impairment, or airway compromise after a follow-up period ranging from 13 to 56 months (mean 31.3 ± 15.9). The PIMPF was found to be an attractive single-staged versatile and reliable reconstructive option for postero-lateral oral cavity/oropharyngeal defects that provides well-vascularized, sensate mucosa with minimal morbidity.

  20. Effect of Systemic Antioxidant Allopurinol Therapy on Skin Flap Survival (United States)

    Rasti Ardakani, Mehdi; Al-Dam, Ahmed; Rashad, Ashkan; Shayesteh Moghadam, Ali


    BACKGROUND It has been reported that systemic administration of allopurinol improves cell survival. This study was aimed to evaluate effects of allopurinol on skin flaps in dogs. METHODS Twenty dogs underwent one skin flap surgery with a 2-week interval. The first procedure was performed according to the standard protocols. The second phase was started by a 1-week pretreatment with allopurinol. Length of the necrotic zone was measured and recorded daily. At each phase, flaps were removed and sent for histopathological study after 1 week observation. RESULTS Mean length of the necrotic zone in allopurinol treated skin flaps has been significantly less than normal flaps over all 7 days of observation (p<0.0001). Histopathology study showed less inflammation and more normal tissue structure in the allopurinol treated skin flaps. CONCLUSION It was demonstrated that systemic administration of allopurinol significantly improved skin flap survival. PMID:28289614

  1. Breast reconstruction by pedicled transverse rectus abdominis myocutaneous flap

    Directory of Open Access Journals (Sweden)

    Kozarski Jefta


    Full Text Available Reconstruction of the amputated breast in female patients after surgical management of breast carcinoma is possible with the use of autologous tissue, synthetic implants, or by combining autologous tissue and synthetic materials. Autologous tissue provides soft and sufficiently elastic tissue which is usable for breast reconstruction and eventually obtains original characteristics of the surrounding tissue on the chest wall. The use of the TRAM flap for breast reconstruction was introduced in 1982 by Hartrampf Scheflan, and Black. The amount of the TRAM flap tissue allows breast reconstruction in the shape most adequate to the remaining breast. The possibilities of using the TRAM flap as pedicled myocutaneous flap or as free TRAM flap make this flap a superior choice for breast reconstruction in comparison with other flaps.

  2. Perceptions of brachyfacial, mesofacial and dolichofacial individuals with regard to the buccal corridor in different facial types

    Directory of Open Access Journals (Sweden)

    Matheus Melo PITHON


    Full Text Available Objective: Evaluate the esthetic perception and attractiveness of the smile with regard to the buccal corridor in different facial types by brachyfacial, mesofacial and dolichofacial individuals. Material and Methods: The image of a smiling individual with a mesofacial type of face was changed to create three different facial types with five different buccal corridors (2%, 10%, 15%, 22% and 28%. To achieve this effect, a photo editing software was used (Adobe Photoshop, Adobe Systems Inc, San Francisco, CA, EUA. The images were submitted to evaluators with brachyfacial, mesofacial and dolichofacial types of faces, who evaluated the degree of esthetic perception and attractiveness by means of a visual analog scale measuring 70 mm. The differences between evaluators were verified by the Mann-Whitney test. All statistics were performed with a confidence level of 95%. Results: Brachyfacial individuals perceived mesofacial and dolichofacial types of faces with buccal corridor of 2% as more attractive. Mesofacial individuals perceived mesofacial and dolichofacial types of faces with buccal corridor of 2%, 10% and 15% as more attractive. Dolichofacial individuals perceived the mesofacial type of face with buccal corridor of 2% as more attractive. Evaluators of the female sex generally attributed higher scores than the male evaluators. Conclusion: To achieve an enhanced esthetic smile it is necessary to observe the patient’s facial type. The preference for narrow buccal corridors is an esthetic characteristic preferred by men and women, and wide buccal corridors are less attractive.

  3. Dorsalis Pedis Free Flap: The Salvage Option following Failure of the Radial Forearm Flap in Total Lower Lip Reconstruction


    Theodoros Stathas; Georgios Tsinias; Dimitra Tsiliboti; Aris Tsiros; Nicholas Mastronikolis; Panos Goumas


    Reconstruction after resection of large tumors of the lower lip requires the use of free flaps in order to restore the shape and the function of the lip, with the free radial forearm flap being the most popular. In this study we describe our experience in using the dorsalis pedis free flap as a salvage option in reconstruction of total lower lip defect in a patient with an extended lower lip carcinoma after failure of the radial forearm free flap, that was initially used. The flap was integra...

  4. Assessment of the mutagenic potential of Cr(VI) in the oral mucosa of Big Blue® transgenic F344 rats. (United States)

    Thompson, Chad M; Young, Robert R; Suh, Mina; Dinesdurage, Harshini R; Elbekai, Reem H; Harris, Mark A; Rohr, Annette C; Proctor, Deborah M


    Exposure to high concentrations of hexavalent chromium [Cr(VI)] in drinking water was associated with an increased incidence of oral tumors in F344 rats in a 2-year cancer bioassay conducted by the National Toxicology Program. These tumors primarily occurred at 180 ppm Cr(VI) and appeared to originate from the gingival mucosa surrounding the upper molar teeth. To investigate whether these tumors could have resulted from a mutagenic mode of action (MOA), a transgenic mutation assay based on OECD Test Guideline 488 was conducted in Big Blue(®) TgF344 rats. The mutagenic oral carcinogen 4-nitroquinoline-1-oxide (4-NQO) served as a positive control. Mutant frequency was measured in the inner gingiva with adjacent palate, and outer gingiva with adjacent buccal tissue. Exposure to 10 ppm 4-NQO in drinking water for 28 days increased mutant frequency in the cII transgene significantly, from 39.1 ± 7.5 × 10(-6) to 688 ± 250 × 10(-6) in the gingival/buccal region, and from 49.8 ± 17.8 × 10(-6) to 1818 ± 362 × 10(-6) in the gingival/palate region. Exposure to 180 ppm Cr(VI) in drinking water for 28 days did not significantly increase the mutant frequency in the gingival/buccal (44.4 ± 25.4 × 10(-6)) or the gingival/palate (57.8 ± 9.1 × 10(-6)) regions relative to controls. These data indicate that high (∼180,000 times expected human exposure), tumorigenic concentrations of Cr(VI) did not significantly increase mutations in the gingival epithelium, and suggest that Cr(VI) does not act by a mutagenic MOA in the rat oral cavity.

  5. To flap or not to flap: a discussion between a fish and a jellyfish (United States)

    Martin, Nathan; Roh, Chris; Idrees, Suhail; Gharib, Morteza


    Fish and jellyfish are known to swim by flapping and by periodically contracting respectively, but which is the more effective propulsion mechanism? In an attempt to answer this question, an experimental comparison is made between simplified versions of these motions to determine which generates the greatest thrust for the least power. The flapping motion is approximated by pitching plates while periodic contractions are approximated by clapping plates. A machine is constructed to operate in either a flapping or a clapping mode between Reynolds numbers 1,880 and 11,260 based on the average plate tip velocity and span. The effect of the total sweep angle, total sweep time, plate flexibility, and duty cycle are investigated. The average thrust generated and power required per cycle are compared between the two modes when their total sweep angle and total sweep time are identical. In general, operating in the clapping mode required significantly more power to generate a similar thrust compared to the flapping mode. However, modifying the duty cycle for clapping caused the effectiveness to approach that of flapping with an unmodified duty cycle. These results suggest that flapping is the more effective propulsion mechanism within the range of Reynolds numbers tested. This work was supported by the Charyk Bio-inspired Laboratory at the California Institute of Technology, the National Science Foundation Graduate Research Fellowship under Grant No. DGE-1144469, and the Summer Undergraduate Research Fellowships program.

  6. Enhanced Correlation of SMART Active Flap Rotor Loads (United States)

    Kottapalli, Sesi


    This is a follow-on study to a 2010 correlation effort. Measured data from the SMART rotor test in the NASA Ames 40- by 80- Foot Wind Tunnel are compared with CAMRAD II calculations. As background, during the wind tunnel test, unexpectedly high inboard loads were encountered, and it was hypothesized at that time that due to changes in the flexbeams over the years, the flexbeam properties used in the analysis needed updating. Boeing Mesa, recently updated these properties. This correlation study uses the updated flexbeam properties. Compared to earlier studies, the following two enhancements are implemented: i) the inboard loads (pitchcase and flexbeam loads) correlation is included for the first time (reliable prediction of the inboard loads is a prerequisite for any future anticipated flight-testing); ii) the number of blade modes is increased to better capture the flap dynamics and the pitchcase-flexbeam dynamics. Also, aerodynamically, both the rolled-up wake model and the more complex, multiple trailer wake model are used, with the latter slightly improving the blade chordwise moment correlation. This sensitivity to the wake model indicates that CFD is needed. Three high-speed experimental cases, one uncontrolled free flap case and two commanded flap cases, are considered. The two commanded flap cases include a 2o flap deflection at 5P case and a 0o flap deflection case. For the free flap case, selected modifications to the HH-06 section flap airfoil pitching moment table are implemented. For the commanded 2o flap case, the experimental flap variation is approximately matched by increasing the analytical flap hinge stiffness. This increased flap hinge stiffness is retained for the commanded 0o flap case also, which is treated as a free flap case, but with larger flap hinge stiffness. The change in the mid-span and outboard loads correlation due to the updating of the flexbeam properties is not significant. Increasing the number of blade modes results in an

  7. Flapping wing aerodynamics: from insects to vertebrates. (United States)

    Chin, Diana D; Lentink, David


    More than a million insects and approximately 11,000 vertebrates utilize flapping wings to fly. However, flapping flight has only been studied in a few of these species, so many challenges remain in understanding this form of locomotion. Five key aerodynamic mechanisms have been identified for insect flight. Among these is the leading edge vortex, which is a convergent solution to avoid stall for insects, bats and birds. The roles of the other mechanisms - added mass, clap and fling, rotational circulation and wing-wake interactions - have not yet been thoroughly studied in the context of vertebrate flight. Further challenges to understanding bat and bird flight are posed by the complex, dynamic wing morphologies of these species and the more turbulent airflow generated by their wings compared with that observed during insect flight. Nevertheless, three dimensionless numbers that combine key flow, morphological and kinematic parameters - the Reynolds number, Rossby number and advance ratio - govern flapping wing aerodynamics for both insects and vertebrates. These numbers can thus be used to organize an integrative framework for studying and comparing animal flapping flight. Here, we provide a roadmap for developing such a framework, highlighting the aerodynamic mechanisms that remain to be quantified and compared across species. Ultimately, incorporating complex flight maneuvers, environmental effects and developmental stages into this framework will also be essential to advancing our understanding of the biomechanics, movement ecology and evolution of animal flight.

  8. Pearls for perfecting the mastoid interpolation flap. (United States)

    Justiniano, Hilda; Eisen, Daniel B


    Helical rim ear defects can present a reconstructive challenge to the Mohs surgeon. Multiple options exist including wedge excision, helical rim advancement flaps, bilobed flap, and grafts, to name a few. Wedge excision of the ear may result in a noticeable anteverted, smaller ear, and disrupts auricular cartilage with the possibility of chondritis and excess pain. Helical rim advancements can result in anteversion of the ear and a smaller lobule. Mastoid interpolation flaps, which are also called retroauricular to auricular flaps, can be a useful alternative in patients who are willing to return for a second procedure. They are easy to perform and can result in a highly aesthetic reconstruction in which the ear size and form are maintained. The donor skin comes from an area that is hidden from view and heals with minimal complications. We present our suggestions for performing these reconstructions. Ways to optimize results, potential pitfalls, and postoperative care instructions are discussed. Step by step videos are included with this manuscript.

  9. Detection of Human Papilloma Virus (HPV in oral mucosa of women with cervical lesions and their relation to oral sex practices

    Directory of Open Access Journals (Sweden)

    Martinez-Martinez Alejandro


    Full Text Available Abstract Background Previous studies have either investigated the relationship of HPV with oral cancer or the prevalence of HPV on the oral cavity. The purpose of this investigation was to study the prevalence of HPV in oral cavity of women with oral sex practices and cervical lesions. Methods Forty six (46 non-smokers and non-alcoholic patients attended the "Clínica de Displasias" of "Ciudad Juarez" were sampled. This population had a CIN diagnosis sometime between the previous six months. On previous consent they filled out a questionnaire related to their oral sex practices. Afterwards one swab from cheeks and another from palate/gum were taken; PCR was used to determine generic HPV, HPV16 and HPV18. Results Seventy two percent (72% of the patients stated to have oral sex practices regularly which all of them were positive to HPV either in oral mucus, palate/gum or both. The total of the given results showed that 35% had HPV16; among those distributed in 26% with regular oral sex practices and 9% stated as never practiced oral sex. An association was found between oral HPV16 positivity and progression to cervical CIN advanced lesions. On the other hand HPV18 was not detected. The frequency of HPV16 was higher in buccal mucosa (23% versus palate/gum (16%. Conclusions This study suggests that buccal HPV16 infection is associated with CIN progression.

  10. [Vestibularly displaced flap with bone augmentation]. (United States)

    Bakalian, V L


    The aim of this study is to achieve esthetic gingival contours with the help of less traumatic mucogingival surgeries. 9 Patients were operated with horizontal deficiencies in 9 edentulous sites, planned to be restored with fixed partial dentures. In all cases there was lack of keratinized tissues. Temporary bridges were fabricated to all patients. Before surgery the bridges were removed and the abutment teeth were additionally cleaned with ultrasonic device. A horizontal incision was made from lingual (palatal) side between the abutment teeth, which was connected with two vertical releasing incisions to the mucogingival junction from the vestibular side. The horizontal incision was made on a distance 6-10 mm from the crest of the alveolar ridge. A partial thickness flap in the beginning 3-5 mm, then a full thickness flap up to the mucogingival junction, then a partial thickness flap was made. The flap was mobilized and displaced vestibularly. In the apical part the cortical bone was perforated, graft material was put and the flap was sutured. In all 9 cases the horizontal defect was partially or fully eliminated. The width of the keratinized tissues was also augmented in all cases. The postoperative healing was without complications, discomfort and painless. The donor sites also healed without complications. The application of Solcoseryl Dental Adhesive Paste 3 times a day for 7-10 days helped for painless healing of the donor site. The offered method of soft tissue and bone augmentation is effective in the treatment of horizontal defects of edentulous alveolar ridges of not big sizes. It makes possible to achieve esthetic results without traumatizing an additional donor-site.

  11. Recurrent squamous cell carcinoma of the scalp treated with serial free flaps

    DEFF Research Database (Denmark)

    Ikander, Peder; Sørensen, Jens Ahm


    dorsi flaps and one anterolateral thigh flap. No total flap loss was seen, but partial flap necrosis called for secondarily reconstruction. The final result was cosmetically acceptable and the patient is of good health. In conclusion, serial free microvascular flaps may be used with good results when...

  12. Reconstruction of the anterior floor of the mouth with the inferiorly based nasolabial flap

    NARCIS (Netherlands)

    van Wijk, MP; Damen, A; Nauta, JM; Lichtendahl, DHE; Dhar, BK


    The results of reconstruction of the anterior floor of the mouth, using 105 nasolabial flaps in 79 patients were reviewed in a retrospective study. Of those flaps, 82% healed uneventfully; flap survival was 95%. Considerable flap loss occurred in 5%. Primary dehiscence was observed in 5% of all flap

  13. Pedicle versus free flap reconstruction in patients receiving intraoperative brachytherapy. (United States)

    Geiger, Erik J; Basques, Bryce A; Chang, Christopher C; Son, Yung; Sasaki, Clarence T; McGregor, Andrew; Ariyan, Stephan; Narayan, Deepak


    Introduction This study compared complication rates between pedicle flaps and free flaps used for resurfacing of intraoperative brachytherapy (IOBT) implants placed following head and neck tumour extirpation to help clarify the ideal reconstructive procedure for this scenario. Patients and methods A retrospective review of reconstructions with IOBT at our institution was conducted. Patient and treatment details were recorded, as were the number and type of flap complications, including re-operations. Logistic regressions compared complications between flap groups. Results Fifty free flaps and 55 pedicle flaps were included. On multivariate analysis, free flap reconstruction with IOBT was significantly associated with both an increased risk of having any flap complication (OR = 2.9, p = 0.037) and with need for operative revision (OR = 3.5, p = 0.048) compared to pedicle flap reconstruction. Conclusions In the setting of IOBT, free flaps are associated with an increased risk of having complications and requiring operative revisions.

  14. Effect of flapping trajectories on the dragonfly aerodynamics

    Institute of Scientific and Technical Information of China (English)


    The effects of translational, figure-eight and double-figure-eight flapping trajectories on the dragonfly aerodynamics were numerically studied by solving the Navier-Stokes equations. There is a common characteristic regarding the lift/drag force coefficients that the downstroke flapping provides the lift forces while the upstroke flapping creates the thrust forces for different flapping trajectories. The maximum lift force coefficient exceeds five for the translational trajectory. It is greater than six for the figure-eight and double-figure-eight flapping trajectories, which is sufficiently larger than unity under the steady state flight condition. The ellipse and double-figure-eight flapping trajectories yield the decrease of the lift force, while the figure-eight flapping trajectory yields higher lift force as well as the thrust force than the translational flapping one. During the insect flight, the wing flapping status should be changed instantaneously to satisfy various requirements. Study of the flapping trajectories on the insect aerodynamics is helpful for the design of the Micro-air-vehicles (MAVs).

  15. Temporal-based pericranial flaps for orbitofrontal Dural repair: A technical note and Review of the literature

    Directory of Open Access Journals (Sweden)

    Esther Dupépé


    Conclusions: A temporal-based pericranial flap represents an alternative vascularized pedicle flap to the classic frontal-based pericranial flap used in orbitofrontal dural repair. In certain clinical settings, the temporal-based flap may be preferable.

  16. Feasibility of a porcine oral mucosa equivalent: a preclinical study. (United States)

    Kinikoglu, Beste; Hemar, Julie; Hasirci, Vasif; Breton, Pierre; Damour, Odile


    Oral tissue engineering aims to treat and fill tissue deficits caused by congenital defects, facial trauma, or malignant lesion surgery, as well as to study the biology of oral mucosa. The Food and Drug Administration (FDA) and the European Medicines Agency (EMA) require a large animal model to evaluate cell-based devices, including tissue-engineered oral mucosa, prior to initiating human clinical studies. Porcine oral mucosa is non-keratinized and resembles that of humans more closely than any other animal in terms of structure and composition; however, there have not been any reports on the reconstruction of a porcine oral mucosa equivalent, probably due to the difficulty to culture porcine fibroblasts. In this study, we demonstrate the feasibility of a 3D porcine oral mucosa equivalent based on a collagen-GAG-chitosan scaffold, as well as reconstructed porcine epithelium by using an amniotic membrane as support, or without any support in form of epithelial cell sheets by using thermoresponsive culture plates. Explants technique was used for the isolation of the porcine fibroblasts and a modified fibroblast medium containing 20% fetal calf serum was used for their culture. The histological and transmission electron microscopic analyses of the resulting porcine oral mucosa models showed the presence of non-keratinized epithelia expressing keratin 13, the major differentiation marker of non-keratinized oral mucosa, in all models, and the presence of newly synthesized collagen fibers in the lamina propria equivalent of the full-thickness model, indicating the functionality of porcine fibroblasts.

  17. Amalgam tattoo (amalgam pigmentation) of the oral mucosa: clinical manifestations, diagnosis and treatment. (United States)

    Buchner, A


    Amalgam tattoo is an iatrogenic lesion caused by traumatic implantation of dental amalgam into soft tissue. Amalgam tattoo is the most common localized pigmented lesion in the mouth. In a study of a mass screening oral examination in the United States, it was found in about 0.4-0.9% of the adult population and in Sweden in about 8%. Clinically, amalgam tattoo presents as a dark gray or blue, flat macule located adjacent to a restored tooth. Most are located on the gingiva and alveolar mucosa followed by the buccal mucosa and the floor of the mouth. Microscopic examination reveals that amalgam is present in the tissues in two forms: as irregular dark, solid fragments of metal or as numerous, discrete fine, brown or black granules dispersed along collagen bundles and around small blood vessels and nerves. In most lesions, it is presented in both forms. The biologic response to the amalgam is related to particle size, quantity and elemental composition of the amalgam. Large fragments often become surrounded by dense fibrous connective tissue. Smaller particles are associated with mild to moderate chronic inflammatory response with individual macrophages engulfing small amalgam particles. Occasionally, the reaction takes the form of foreign body granuloma in which macrophages and multinucleated giant cells are present. Some of the multinucleated giant cells also contain amalgam particles. Diagnosis of amalgam tattoo is usually obvious from the location and clinical appearance. A radiograph is recommended to confirm the presence of metallic particles, but absence of radiographic evidence does not rule out the possibility, since particles are often too fine or widely dispersed to be visible on radiographs. When there is no radiographic evidence or an adjacent restored tooth, biopsy is recommended to rule out an early melanoma. Once the diagnosis of amalgam tattoo has been established, no additional treatment is necessary except for cosmetic reasons. If the pigmentation

  18. Effect of zinc deficiency on keratins in buccal epithelium of rats. (United States)

    Hsu, D J; Daniel, J C; Gerson, S J


    Weanling rats fed a zinc-deficient diet (less than 1 part/10(6)) for 4 weeks develop parakeratotic and hyperplastic buccal epithelium with increased mitotic activity. Normal buccal epithelium contains major keratin polypeptides of 56, 46 and 43 kDa. Four-week zinc-deficient rats lacked the 43 kDa keratin. It appears that the 46 and 43 kDa keratins are related, differing as a result of some post-translation modification. A proteolytic cleavage of the 46 kDa keratin to the 43 kDa species is the most likely mechanism. The findings point to a decrease of keratinolytic enzyme activity in the zinc-deficient rats.

  19. Development of an ANN optimized mucoadhesive buccal tablet containing flurbiprofen and lidocaine for dental pain

    Directory of Open Access Journals (Sweden)

    Hussain Amjad


    Full Text Available A novel mucoadhesive buccal tablet containing flurbiprofen (FLB and lidocaine HCl (LID was prepared to relieve dental pain. Tablet formulations (F1-F9 were prepared using variable quantities of mucoadhesive agents, hydroxypropyl methyl cellulose (HPMC and sodium alginate (SA. The formulations were evaluated for their physicochemical properties, mucoadhesive strength and mucoadhesion time, swellability index and in vitro release of active agents. Release of both drugs depended on the relative ratio of HPMC:SA. However, mucoadhesive strength and mucoadhesion time were better in formulations, containing higher proportions of HPMC compared to SA. An artificial neural network (ANN approach was applied to optimise formulations based on known effective parameters (i.e., mucoadhesive strength, mucoadhesion time and drug release, which proved valuable. This study indicates that an effective buccal tablet formulation of flurbiprofen and lidocaine can be prepared via an optimized ANN approach.

  20. A buccal cell model comet assay: Development and evaluation for human biomonitoring and nutritional studies

    Energy Technology Data Exchange (ETDEWEB)

    Szeto, Y.T. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); School of Health Sciences, Macao Polytechnic Institute, Macao (China); Benzie, I.F.F. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China)]. E-mail:; Collins, A.R. [Department of Nutrition, University of Oslo, Oslo (Norway); Choi, S.W. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); Cheng, C.Y. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); Yow, C.M.N. [Department of Health Technology and Informatics, Hong Kong Polytechnic University, Kowloon, Hong Kong (China); Tse, M.M.Y. [School of Nursing, Hong Kong Polytechnic University, Kowloon, Hong Kong (China)


    The comet assay is a widely used biomonitoring tool for DNA damage. The most commonly used cells in human studies are lymphocytes. There is an urgent need to find an alternative target human cell that can be collected from normal subjects with minimal invasion. There are some reports of buccal cells, collected easily from the inside of the mouth, being used in studies of DNA damage and repair, and these were of interest. However, our preliminary studies following the published protocol showed that buccal cells sustained massive damage and disintegrated at the high pH [O. Ostling, K.J. Johanson. Microelectrophoretic study of radiation-induced DNA damages in individual mammalian cells. Biochem. Biophys. Res. Commun. 123 (1984) 291-298] used, but that at lower pH were extremely resistant to lysis, an essential step in the comet assay. Therefore, the aims of this study were to develop a protocol than enabled buccal cell lysis and DNA damage testing in the comet assay, and to use the model to evaluate the potential use of the buccal cell model in human biomonitoring and nutritional study. Specifically, we aimed to investigate intra- and inter-individual differences in buccal cell DNA damage (as strand breaks), the effect of in vitro exposure to both a standard oxidant challenge and antioxidant treatment, as well as in situ exposure to an antioxidant-rich beverage and supplementation-related effects using a carotenoid-rich food. Successful lysis was achieved using 0.25% trypsin for 30 min followed by proteinase K (1 mg/ml) treatment for 60 min. When this procedure was performed on cells pre-embedded in agarose on a microscope slide, followed by electrophoresis (in 0.01 M NaOH, 1 mM EDTA, pH 9.1, 18 min at 12 V), a satisfactory comet image was obtained, though inter-individual variation was quite wide. Pre-lysis exposure of cells to a standard oxidant challenge (induced by H{sub 2}O{sub 2}) increased DNA strand breaks in a dose related manner, and incubation of cells in

  1. Development of an ANN optimized mucoadhesive buccal tablet containing flurbiprofen and lidocaine for dental pain. (United States)

    Hussain, Amjad; Syed, Muhammad Ali; Abbas, Nasir; Hanif, Sana; Arshad, Muhammad Sohail; Bukhari, Nadeem Irfan; Hussain, Khalid; Akhlaq, Muhammad; Ahmad, Zeeshan


    A novel mucoadhesive buccal tablet containing flurbiprofen (FLB) and lidocaine HCl (LID) was prepared to relieve dental pain. Tablet formulations (F1-F9) were prepared using variable quantities of mucoadhesive agents, hydroxypropyl methyl cellulose (HPMC) and sodium alginate (SA). The formulations were evaluated for their physicochemical properties, mucoadhesive strength and mucoadhesion time, swellability index and in vitro release of active agents. Release of both drugs depended on the relative ratio of HPMC:SA. However, mucoadhesive strength and mucoadhesion time were better in formulations, containing higher proportions of HPMC compared to SA. An artificial neural network (ANN) approach was applied to optimise formulations based on known effective parameters (i.e., mucoadhesive strength, mucoadhesion time and drug release), which proved valuable. This study indicates that an effective buccal tablet formulation of flurbiprofen and lidocaine can be prepared via an optimized ANN approach.

  2. Comparison of outcome of microvascular bony head and neck reconstructions using the fibular free flap and the iliac crest flap. (United States)

    Mücke, Thomas; Loeffelbein, Denys J; Kolk, Andreas; Wagenpfeil, Stefan; Kanatas, Anastasios; Wolff, Klaus-Dietrich; Mitchell, David A; Kesting, Marco R


    Several microvascular free flaps are available for reconstruction of the osseous components after resections for head and neck cancer. We have prospectively evaluated patients treated by bony microsurgical reconstruction to identify predictors of adverse outcomes for delayed wound healing and failure of free flaps. All patients from July 2007 to June 2011 who had reconstructions with microvascular fibular or iliac crest flaps immediately after resection of the tumour were evaluated. There were a total of 156 bony free flaps: 120 (77%) fibular and 36 (23%) iliac crest flaps. A total of 133 (85%) were successful. Delayed wound healing was more common with the iliac crest flap (p=0.01) at the intraoral site (p=0.04). Significantly more iliac crest free flaps failed (p=0.02). Anastomosis to the facial artery (p=0.05) and facial vein (p=0.04), and duration of overall operating time were associated with a significantly higher risk of failure of the flap. Patients with cancer of the head and neck who require microsurgical bony reconstruction are at increased risk of postoperative complications. Significantly more complications were found with the iliac crest flap, whereas the fibular flap was associated with a significantly longer operating time.

  3. In vitro Fluoride Release and Tensile Bond Strength of a Polymeric Intra-Buccal Bioadhesive


    Vinicius PEDRAZZI; LARA, Elza Helena Guimaraes; PANZERI, Heitor; John H Collett; ISSA, Joao Paulo Mardegan


    The intra-buccal polymeric bioadhesive systems that can stay adhered to the oral soft tissues for drug programmed release, with the preventive and/or therapeutic purpose has been employed for large clinical situations. A system based on hydroxypropyl methyl cellulose/Carbopol 934`/magnesium stearate (HPMC/Cp/StMg) was developed having the sodium fluoride as active principle. This kind of system was evaluated according to its resistance to the removal by means of physical test of tensile stren...

  4. Procedures for risk-stratification of lung cancer using buccal nanocytology


    Subramanian, H; P. Viswanathan; Cherkezyan, L.; Iyengar, R; Rozhok, S.; Verleye, M.; Derbas, J.; Czarnecki, J.; Roy, H K; Backman, V


    Lung cancer is the leading cause of cancer deaths in the U.S. with survival dramatically depending on stage at diagnosis. We had earlier reported that nanocytology of buccal cells can accurately risk-stratify smokers for the presence of early and late-stage lung cancer. To translate the technique into clinical practice, standardization of operating procedures is necessary to consistently yield precise and repeatable results. Here, we develop and validate simple, robust, and easily implementab...

  5. Direct PCR amplification of the HVSI region in mitochondrial DNA from buccal cell swabs

    Directory of Open Access Journals (Sweden)

    Kovačević-Grujičić Nataša


    Full Text Available Amplification of human mitochondrial DNA (mtDNA has been widely used in population genetics, human evolutionary and molecular anthropology studies. mtDNA hypervariable segments I and II (HVSI and HVSII were shown to be a suitable tool in genetic analyses due to the unique properties of mtDNA, such as the lack of recombination, maternal mode of inheritance, rapid evolutionary rate and high population-specific polymorphisms. Here we present a rapid and low-cost method for direct PCR amplification of a 330 bp fragment of HVSI from buccal cell samples. Avoiding the DNA isolation step makes this method appropriate for the analysis of a large number of samples in a short period of time. Since the transportation of samples and fieldwork conditions can affect the quality of samples and subsequent DNA analysis, we tested the effects of long-term storage of buccal cell swabs on the suitability of such samples for direct PCR amplification. We efficiently amplified a 330 bp fragment of HVSI even after the long-term storage of buccal cells at room temperature, +4°C or at -20°C, for up to eight months. All examined PCR products were successfully sequenced, regardless of sample storage time and conditions. Our results suggest that the direct PCR amplification of the HVSI region from buccal cells is a method well suited for large-scale mtDNA population studies.[Acknowledgments. This work was supported by the Ministry of Education and Science of the Republic of Serbia (Grant no. III 47025.

  6. Deep inferior epigastric perforator flap for breast reconstruction: experience with 43 flaps

    Institute of Scientific and Technical Information of China (English)

    YAN Xiao-qing; YANG Hong-yan; ZHAO Yu-ming; YOU Lei; XU Jun


    Background In the past decade, there has been increasing breast reconstructions after mastectomy. The ideal material for reconstruction of a breast is fat and skin. The transverse rectus abdominis myocutaneous (TRAM) flap has been the gold standard for breast reconstruction until recently. Abdominal wall function is a major concern for plastic surgeons in breast reconstruction with TRAM flaps. The deep inferior epigastric perforator (DIEP) free flap spares the whole rectus abdominis muscle, includes skin and fat only, and therefore preserves adequate abdominal wall competence. The aim of this study was to summarize our experience in breast reconstruction with DIEP flap.Methods Between March 2000 and August 2005, a total of 43 breast reconstructions were performed on 40 patients by our surgeons using DIEP flap (3 patients had bilateral procedures), 14 of them were immediate surgeries and 26 were delayed. Abdominal function, satisfaction with the donor site and reconstructed breast, and the sensation recovery was assessed respectively during follow-up.Results The mean age of the patients was 38.6 years (range, 28-50). The size of the flaps was 11 cm×26 cm in average (height 10-12 cm, width 15-33 cm). The mean length of the vascular pedicles was 9.3 cm (range, 7-12). The patients were followed up for a mean of 16 months (range, 6-30 months). During the follow-up, 2 (5%) patients had total flap loss, 2 (5%) had partial necrosis, 4 (9%) had wound edge necrosis in the abdomen, and 1 had axillary seroma. None of the patients had hernia, and all of them were able to resume their daily activities after the operation. Patient satisfaction with the reconstructed breast rated high, 95% of the patients achieved spontaneous return of sensation in the reconstructed breast, but none of them had a sensation equivalent or approximate to the normal.Conclusions The DIEP flap has the same benefits as the TRAM flap without destroying the continuity of the rectus muscle. It can reduce

  7. Fungal infections of the oral mucosa. (United States)

    Krishnan, P Anitha


    Fungal infections in humans occur as a result of defects in the immune system. An increasing emergence in oral Candidal and non-Candidal fungal infections is evident in the past decade owing to the rise in the immunodeficient and immunocompromised population globally. Oral Candidal infection usually involves a compromised host and the compromise may be local or systemic. Local compromising factors include decreased salivation, poor oral hygiene, wearing dentures among others while systemic factors include diabetes mellitus, nutritional deficiency, HIV infection/AIDS and others. Oral candidiasis is generally a localized infection and rarely appears as a systemic fungal disease whereas oral non-Candidal fungal infections are usually signs of disseminated disease. Some of the non-Candidal fungi that were once considered exotic and geographically restricted are now seen worldwide, beyond their natural habitat, probably attributed to globalization and travels. Currently infections from these fungi are more prevalent than before and they may present either as primary oral lesions or as oral manifestations of systemic mycoses. This review discusses the various predisposing factors, clinical presentations, clinical differential diagnosis, diagnosis and management of oral candidiasis, as well as briefly highlights upon a few of the more exotic non-Candidal fungi that infect the oral mucosa.

  8. [Acquired bullous diseases of the oral mucosa]. (United States)

    Vaillant, L; Hüttenberger, B


    Bullous diseases of the oral cavity cause painful erosion. They must be distinguished from aphthae and vesicles which may have a similar presentation. Acute, chronic and congenital conditions are recognized. Acute lesions may involve a polymorphous oral erhythema which has an polymorphous erythematous presentation or toxidermia (Stevens-Johnson syndrome, Lyell syndrome, fixed pigmented erythema). Examination of the skin and history taking are the keys to diagnosis. Patients with chronic bullous diseases may have a congenital condition (bullous epidermolysis or lymphangioma) suggested by the age at onset and the clinical presentation. Acquired chronic bullous diseases include lichen planus and autoimmune bullous diseases. Careful examination is essential to identify mucosal or cutaneous involvement and to obtain a biopsy for histological examination. Search for antibodies deposited in the perilesional mucosa is necessary. Chronic erosive gingivitis is a frequent presentation. Most of the patients have cicatricial pemphigoid, lichen planus, and more rarely pemphigus. The pinch sign is highly discriminative to differentiate the cause of this syndrome. Symptomatic treatment of bullous lesions of the oral cavity include adapted diet and correct and early use of antalgesics.

  9. Immune Homeostasis of Human Gastric Mucosa in Helicobacter pylori Infection. (United States)

    Reva, I V; Yamamoto, T; Vershinina, S S; Reva, G V


    We present the results of electron microscopic, microbiological, immunohistochemical, and molecular genetic studies of gastric biopsy specimens taken for diagnostic purposes according by clinical indications during examination of patients with gastrointestinal pathology. Immune homeostasis of the gastric mucosa against the background of infection with various pathogen strains of Helicobacter pylori was studied in patients of different age groups with peptic ulcer, gastritis, metaplasia, and cancer. Some peculiarities of Helicobacter pylori contamination in the gastric mucosa were demonstrated. Immune homeostasis of the gastric mucosa in different pathologies was analyzed depending on the Helicobacter pylori genotype.

  10. Power performance optimization and loads alleviation with active flaps using individual flap control (United States)

    Pettas, Vasilis; Barlas, Thanasis; Gertz, Drew; Madsen, Helge A.


    The present article investigates the potential of Active Trailing Edge Flaps (ATEF) in terms of increase in annual energy production (AEP) as well as reduction of fatigue loads. The basis for this study is the DTU 10 MW Reference Wind Turbine (RWT) simulated using the aeroelastic code HAWC2. In an industrial-oriented manner the baseline rotor is upscaled by 5% and the ATEFs are implemented in the outer 30% of the blades. The flap system is kept simple and robust with a single flap section and control with wind speed, rotor azimuth, root bending moments and angle of attack in flap's mid-section being the sensor inputs. The AEP is increased due to the upscaling but also further due to the flap system while the fatigue loads in components of interest (blade, tower, nacelle and main bearing) are reduced close to the level of the original turbine. The aim of this study is to demonstrate a simple and applicable method that can be a technology enabler for rotor upscaling and lowering cost of energy.

  11. Pedicled perforator flaps in the head and neck. (United States)

    Hofer, Stefan O P; Mureau, Marc A M


    Perforator flaps, since their first description in 1989, have in many ways revolutionized reconstructive surgery. Whereas little more than a decade ago many surgeons were still hesitant to fully trust perforator flaps to be a reliable option, nowadays these flaps are often first choice. Investigators have to remain critical, however, of their advances and realize that not every reconstruction will require or benefit from a perforator flap, as previously well-established, nonperforator flaps still have their indication and can give excellent results. The most important skill in reconstructive surgery of the head and neck is not cutting the flap but assessing the defect, planning the reconstruction, and choosing wisely from the ever-increasing options available.

  12. The "Gent" consensus on perforator flap terminology: preliminary definitions. (United States)

    Blondeel, Phillip N; Van Landuyt, Koen H I; Monstrey, Stan J M; Hamdi, Moustapha; Matton, Guido E; Allen, Robert J; Dupin, Charles; Feller, Axel-Mario; Koshima, Isao; Kostakoglu, Naci; Wei, Fu-Chan


    Due to its increasing popularity, more and more articles on the use of perforator flaps have been reported in the literature during the past few years. Because the area of perforator flaps is new and rapidly evolving, there are no definitions and standard rules on terminology and nomenclature, which creates confusion when surgeons try to communicate and compare surgical techniques. This article attempts to represent the opinion of a group of pioneers in the field of perforator flap surgery. This consensus was reached after a terminology consensus meeting held during the Fifth International Course on Perforator Flaps in Gent, Belgium, on September 29, 2001. It stipulates not only the definitions of perforator vessels and perforator flaps but also the correct nomenclature for different perforator flaps. The authors believe that this consensus is a foundation that will stimulate further discussion and encourage further refinements in the future.

  13. Incidence of flap procedures in the management of burn patients. (United States)

    Lineaweaver, William C; Craft-Coffman, Beretta; Oswald, Tanya M


    Increased survival of burn patients presents opportunities for reconstructive strategies to improve outcomes in management of acute and secondary burn injuries. To assess one such strategy, namely flap reconstruction, we reviewed cases performed during the first 4.5 years of the JMS Burn and Reconstruction Center. We found that flap procedures accounted for 0.8% of acute cases (23 of 2723 procedures) and 33% of secondary cases (260 of 790 procedures). This initial finding shows that in this practice flap procedures are applied to a small number of acute problems while flap procedures comprise 33% of secondary procedures. Reconstructive flap surgery plays a measurable role in burn treatment at this center. Further study of outcomes and timing could lead to better understanding of optimal strategies for flap reconstruction in burns.

  14. Development of polymer-bound fast-dissolving metformin buccal film with disintegrants (United States)

    Haque, Shaikh Ershadul; Sheela, Angappan


    Fast-dissolving drug-delivery systems are considered advantageous over the existing conventional oral dosage forms like tablets, capsules, and syrups for being patient friendly. Buccal films are one such system responsible for systemic drug delivery at the desired site of action by avoiding hepatic first-pass metabolism. Metformin hydrochloride (Met), an antidiabetic drug, has poor bioavailability due to its high solubility and low permeability. The purpose of the study reported here was to develop a polymer-bound fast-dissolving buccal film of metformin to exploit these unique properties. In the study, metformin fast-dissolving films were prepared by the solvent-casting method using chitosan, a bioadhesive polymer. Further, starch, sodium starch glycolate, and microcrystalline cellulose were the disintegrants added to different ratios, forming various formulations (F1 to F7). The buccal films were evaluated for various parameters like weight variation, thickness, folding endurance, surface pH, content uniformity, tensile strength, and percentage of elongation. The films were also subjected to in vitro dissolution study, and the disintegration time was found to be less than 30 minutes for all formulations, which was attributed to the effect of disintegrants. Formulation F6 showed 92.2% drug release within 6 minutes due to the combined effect of sodium starch glycolate and microcrystalline cellulose. PMID:26491321

  15. Development and in vitro evaluation of insulin-loaded buccal Pluronic F-127 gels. (United States)

    Das, Nilanjana; Madan, Parshotam; Lin, Senshang


    Insulin-loaded buccal Pluronic F-127 (PF-127) gel formulations were fabricated to study the effect of PF-127 concentration, insulin concentration, presence of salt, addition of polymer, and permeation enhancer on their gelation time, mucoadhesion force, release and permeation characteristics of insulin from the gels. Thereafter, the principle of statistical optimization to prepare a gel formulation having the potential for buccal delivery of basal insulin in diabetic patients was employed. The gelation time decreased as the concentration of PF-127 increased. Presence of salts as well as addition of polymer, such as methyl cellulose (MC) and hydroxypropylmethyl cellulose (HPMC) decreased the gelation time. An increase in PF-127 concentration and addition of MC and HPMC increased the mucoadhesion force of the gel formulations. Release and permeation of insulin from the gel formulations decreased with increased concentration of PF-127, presence of salts, and addition of MC and HPMC. Permeation of insulin from the optimized gel formulation was 93.17 (+/- 0.058, n = 3) microg/cm(2) which was not only found in close agreement with predicted results from the model equations used for the formulation optimization but also considered comparable to clinical setting. Therefore, the development of optimized buccal insulin-loaded Pluronic F-127 gels using a statistical experimental design is feasible.

  16. Particle size reduction to the nanometer range: a promising approach to improve buccal absorption of poorly water-soluble drugs

    Directory of Open Access Journals (Sweden)

    Rao S


    Full Text Available Shasha Rao, Yunmei Song, Frank Peddie, Allan M EvansSansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, South Australia, AustraliaAbstract: Poorly water-soluble drugs, such as phenylephrine, offer challenging problems for buccal drug delivery. In order to overcome these problems, particle size reduction (to the nanometer range and cyclodextrin complexation were investigated for permeability enhancement. The apparent solubility in water and the buccal permeation of the original phenylephrine coarse powder, a phenylephrine–cyclodextrin complex and phenylephrine nanosuspensions were ­characterized. The particle size and particle surface properties of phenylephrine nanosuspensions were used to optimize the size reduction process. The optimized phenylephrine nanosuspension was then freeze dried and incorporated into a multi-layered buccal patch, consisting of a small tablet adhered to a mucoadhesive film, yielding a phenylephrine buccal product with good dosage accuracy and improved mucosal permeability. The design of the buccal patch allows for drug incorporation without the need to change the mucoadhesive component, and is potentially suited to a range of poorly water-soluble compounds.Keywords: buccal drug delivery, nanosuspension, solubility, permeation enhancement, mucoadhesion

  17. [Pedicled versus free TRAM flap for breast reconstruction]. (United States)

    Galla, T J; Lukas, B; Feller, A M


    In breast reconstruction, the free TRAM-flap offers many advantages over the pedicled TRAM-flap. Due to its superior perfusion, the free flap rarely develops necrosis. Shaping of the flap is easier due to the lack of the thick muscle pedicle. Because the rectus muscle is spared, there is minimal donor site morbidity. However, the necessary microvascular anastomoses reduced the acceptance of the free TRAM-flap. During a 13-months period, 51 breast reconstructions were performed in 41 patients, 31 unilateral and ten bilateral. 45 flaps served for delayed reconstruction and six flaps for immediate reconstruction. The operations were performed by two teams working simultaneously. The average operating time was 3.9 hours for unilateral and 6.9 hours for bilateral delayed reconstruction. For immediate reconstruction, 6.2 and 6.3 hours were required for uni- and bilateral procedures, respectively. In 38 flaps, the thoracodorsal vessels served as recipient vessels; 13 flaps were anastomosed to the internal mammary artery and vein. Postoperative complications were observed in 13 patients. Three vessel anastomoses had to be revised. In one flap, a partial necrosis occurred; in two flaps hematoma evacuation was necessary. Two patients suffered from fat necroses at the abdomen and one umbilicus was lost. Skin irritations and seromas at the abdomen occurred in five patients. Pulmonary embolism was diagnosed in one patient three weeks postoperatively. Abdominal hernias or bulging in the epigastric area were not observed up to 15 months after reconstruction. These results reveal a low complication rate for breast reconstruction with the free TRAM-flap. The advantages of this technique as compared to the pedicled technique are discussed.

  18. Design, manufacturing and testing of Controllable Rubber Trailing Edge Flaps

    DEFF Research Database (Denmark)

    Løgstrup Andersen, Tom; Aagaard Madsen, Helge; Barlas, Thanasis K

    The overall goal for the INDUFLAP project was realization of a test facility for development and test of Controllable Rubber Trailing Edge Flaps (CRTEF) for wind turbines. This report covers experimental work at DTU Wind Energy including design, manufacture and test of different configurations...... of flaps with voids in chord- or spanwise direction. Development of rubber flaps has involved further design improvements. Non-metallic spring elements and solutions for sealing of continuous extruded rubber profiles have been investigated....

  19. Surgical Excision of Multiple Penile Syringomas With Scrotal Flap Reconstruction



    Objective: Penile syringomas are rare lesions usually occurring in isolation. We report the excision and reconstruction of multiple synchronous penile shaft syringomas with local scrotal flaps. Methods: We report a rare case of excision of multiple penile syringomas and reconstruction with scrotal flaps in a 29-year-old man. Results: Penile syringomas were excised and reconstructed with scrotal flaps in a single-stage procedure. Conclusions: In addition to providing wound coverage, this recon...

  20. Herpes Simplex Virus 1 Infection on a Reconstructive Free Flap


    Parys, Simon P.; Leman, Thea; Gurfinkel, Reuven


    Objective: Herpes simplex virus 1 (HSV1) is a widespread virus that primarily causes orofacial infection. Methods: We present a case of HSV1 infection on a free radial forearm flap used to reconstruct a palate defect. Initially, the free flap appeared healthy; however, after 48 hours the free flap appeared in distress, with dark red colour and fast capillary refill. Venous congestion was suspected, and the patient underwent a second operation where no vascular compromise was found. Vesicles w...

  1. Microdialysis in clinical practice: monitoring intraoral free flaps. (United States)

    Jyränki, Janne; Suominen, Sinikka; Vuola, Jyrki; Bäck, Leif


    Clinical examination is still the gold standard of postoperative free flap monitoring, but with intraorally situated and/or buried flaps, it can be difficult or impossible. Microdialysis is a sampling technique which offers the possibility to monitor the metabolism of a flap continuously. Ischemia can be detected by monitoring the changes in glucose, lactate, and pyruvate levels in interstitial fluid of the specific tissue. Our aim was to use microdialysis to monitor the metabolism of free flaps used for reconstructions inside the oral cavity/oropharynx and to evaluate the reliability and usefulness of this new monitoring method.Twenty-five consecutive patients who underwent oral cavity/oropharynx cancer resection and immediate reconstruction with free flap were included in the study. A microdialysis catheter was placed into the subcutaneous adipose tissue of the flap in the end of the surgical procedure. Dialysate samples were taken on an hourly basis for 72 hours postoperatively. Routine clinical monitoring was carried out by experienced nursing staff. Clinical findings were recorded and later compared with microdialysis values. Two flaps out of 25 failed in spite of reoperations. In both problem cases, microdialysis indicated ischemia 1 to 2 hours before it became clinically evident. During flap ischemia, the lactate/pyruvate ratio increased, glucose concentrations reduced, whereas lactate level increased when compared with normal values. Our results indicate that microdialysis is safe for the patient and the flap. It can reliably detect flap ischemia at an early stage. This is especially useful in buried flaps when clinical monitoring is difficult. Microdialysis may also reduce the patient discomfort caused by repeated clinical examination of the flap.

  2. [Osteomuscular serrato-costal free flap: application to mandibular reconstruction]. (United States)

    Breton, P; Henry, J F; Crezoit, E; Souchere, B; Freidel, M


    The serrato-costal free flap provides a large costal flap vascularized by a digitation of the serratus anterior muscle supplied by the dorsal thoracic artery. The flap is easy and rapid to raise with low morbidity. The repair obtained is functionally very satisfactory, but does not allow insertion of an implant. Six cases are reported. The indications of this technique of mandibular reconstruction are discussed.


    Directory of Open Access Journals (Sweden)

    Anand Narayan


    Full Text Available Development of electric lamp by Thomas Elva Edison had significant impact on human civilization. With increasing production of electrical energy to meet ongoing demands of increased frequency of electrical injuries. Despite increased awareness of potential dangers, elect ricity is responsible for many fatalities all over the world. Electrical burn accounts for ~3% of all burn related injuries. Estimated 3, 000 annual admittions to burn units. Electrical burn have bimodal distribution ~1/3 children <6 yrs ( E lectric cords & wall outlets ~2/3 miners, construction, & electrical workers. Our case is one that of a 12 year old male child having electrical injury over face and neck with exposed angle of mandible which was covered by Deltopectoral flap with caterpillar advancement of flap.

  4. A crosslinguistic lexicon of the labial flap

    Directory of Open Access Journals (Sweden)

    Kenneth S. Olson


    Full Text Available We provide a large sample of the occurrences of the labial flap in the world’s languages, including audio and video data from the Mono dialect of Mid-Southern Banda. This sample provides the evidence for Olson and Hajek’s (2003 crosslinguistic generalizations concerning the articulation, the geographic distribution, the genetic distribution, and the phonological status of the speech sound.

  5. Translational damping on high-frequency flapping wings (United States)

    Parks, Perry A.

    Flapping fliers such as insects and birds depend on passive translational and rotational damping to terminate quick maneuvers and to provide a source of partial stability in an otherwise unstable dynamic system. Additionally, passive translational and rotational damping reduce the amount of active kinematic changes that must be made to terminate maneuvers and maintain stability. The study of flapping-induced damping phenomena also improves the understanding of micro air vehicle (MAV) dynamics needed for the synthesis of effective flight control strategies. Aerodynamic processes which create passive translational and rotational damping as a direct result of symmetric flapping with no active changes in wing kinematics have been previously studied and were termed flapping counter-force (FCF) and flapping counter-torque (FCT), respectively. In this first study of FCF measurement in air, FCF generation is measured using a pendulum system designed to isolate and measure the relationship of translational flapping-induced damping with wingbeat frequency for a 2.86 gram mechanical flapper equipped with real cicada wings. Analysis reveals that FCF generation and wingbeat frequency are directly proportional, as expected from previous work. The quasi-steady FCF model using Blade-Element-Theory is used as an estimate for translational flapping-induced damping. In most cases, the model proves to be accurate in predicting the relationship between flapping-induced damping and wingbeat frequency. "Forward-backward" motion proves to have the strongest flapping-induced damping while "up-down" motion has the weakest.

  6. Design, Fabrication and Testing Of Flapping Wing Micro Air Vehicle

    Directory of Open Access Journals (Sweden)

    K. P. Preethi Manohari Sai


    Full Text Available Flapping flight has the potential to revolutionize micro air vehicles (MAVs due to increased aerodynamic performance, improved maneuverability and hover capabilities. The purpose of this project is to design and fabrication of flapping wing micro air vehicle. The designed MAV will have a wing span of 40cm. The drive mechanism will be a gear mechanism to drive the flapping wing MAV, along with one actuator. Initially, a preliminary design of flapping wing MAV is drawn and necessary calculation for the lift calculation has been done. Later a CAD model is drawn in CATIA V5 software. Finally we tested by Flying.

  7. Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery* (United States)

    Cerci, Felipe Bochnia


    Staged retroauricular flap is a great option for full-thickness defects along the helical rim and antihelix. Donor site consists of the posterior ear, postauricular sulcus and mastoid area. The advantages of this flap include hidden donor scar, donor tissue similarity and rich vascularity. We present a case of collision tumor on the left helix treated with Mohs micrographic surgery and the resulting full-thickness defect repaired with a staged retroauricular flap. This flap is an effective technique for full-thickness helical defect repair with relatively little operative morbidity. High esthetic and functional results may be obtained restoring the ear size and shape.

  8. A novel animal model for skin flap prelamination with biomaterials (United States)

    Zhou, Xianyu; Luo, Xusong; Liu, Fei; Gu, Chuan; Wang, Xi; Yang, Qun; Qian, Yunliang; Yang, Jun


    Several animal models of skin flap construction were reported using biomaterials in a way similar to prefabrication. However, there are few animal model using biomaterials similar to prelamination, another main way of clinical skin flap construction that has been proved to be reliable. Can biomaterials be added in skin flap prelamination to reduce the use of autogenous tissues? Beside individual clinical attempts, animal model is needed for randomized controlled trial to objectively evaluate the feasibility and further investigation. Combining human Acellular Dermal Matrix (hADM) and autologous skin graft, we prelaminated flaps based on inguinal fascia. One, two, three and four weeks later, hADM exhibited a sound revascularization and host cell infiltration. Prelaminated skin flaps were then raised and microsurgically transplanted back to groin region. Except for flaps after one week of prelamination, flaps from other subgroups successfully reconstructed defects. After six to sixteen weeks of transplantation, hADM was proved to being able to maintain its original structure, having a wealth of host tissue cells and achieving full revascularization.To our knowledge, this is the first animal model of prelaminating skin flap with biomaterials. Success of this animal model indicates that novel flap prelamination with biomaterials is feasible.

  9. Rotational flaps in oncologic breast surgery. Anatomical and technical considerations. (United States)

    Acea Nebril, Benigno; Builes Ramírez, Sergio; García Novoa, Alejandra; Varela Lamas, Cristina


    Local flaps are a group of surgical procedures that can solve the thoracic closure of large defects after breast cancer surgery with low morbidity. Its use in skin necrosis complications after conservative surgery or skin sparing mastectomies facilitates the initiation of adjuvant treatments and reduces delays in this patient group. This article describes the anatomical basis for the planning of thoracic and abdominal local flaps. Also, the application of these local flaps for closing large defects in the chest and selective flaps for skin coverage by necrosis in breast conserving surgery.

  10. [Expanded pedicled forearm flap for reconstruction of multiple finger amputations]. (United States)

    Alvarez Jorge, A; Martelo Villar, F


    Soft-tissue injuries of the hand frequently require flap coverage to preserve structures damaged at the time of injury or to facilitate later reconstruction. The radial forearm flap makes local tissue readily available and offers a simple method of reconstruction. Secondary augmentation of the skin flap by means of tissue expansion appears to be a useful alternative to improve the possibilities of reconstruction. This case report describes a primary reconstruction of a hand with multiple finger amputations using both techniques: Forearm flap and tissue expansion.

  11. Epiglottis reconstruction with free radial forearm flap after supraglottic laryngectomy. (United States)

    Hsiao, Hung-Tao; Leu, Yi-Shing; Tung, Kwang-Yi


    A bilobed free radial forearm flap was designed to reconstruct a defect in the epiglottis and tongue base in 2 patients who underwent supraglottic laryngectomy. The flap was initially sutured in the shape of the epiglottis to prevent aspiration during deglutition. Six months after surgery, after a full course of radiation therapy, the flap had flattened and underwent atrophy, but the patients still had good voice production and were able to swallow well without any aspiration. Regardless of the final shape of the reconstructed epiglottis, it will suffice to prevent aspiration if the flap is large enough to occlude the tracheal outlet.

  12. A novel animal model for skin flap prelamination with biomaterials (United States)

    Zhou, Xianyu; Luo, Xusong; Liu, Fei; Gu, Chuan; Wang, Xi; Yang, Qun; Qian, Yunliang; Yang, Jun


    Several animal models of skin flap construction were reported using biomaterials in a way similar to prefabrication. However, there are few animal model using biomaterials similar to prelamination, another main way of clinical skin flap construction that has been proved to be reliable. Can biomaterials be added in skin flap prelamination to reduce the use of autogenous tissues? Beside individual clinical attempts, animal model is needed for randomized controlled trial to objectively evaluate the feasibility and further investigation. Combining human Acellular Dermal Matrix (hADM) and autologous skin graft, we prelaminated flaps based on inguinal fascia. One, two, three and four weeks later, hADM exhibited a sound revascularization and host cell infiltration. Prelaminated skin flaps were then raised and microsurgically transplanted back to groin region. Except for flaps after one week of prelamination, flaps from other subgroups successfully reconstructed defects. After six to sixteen weeks of transplantation, hADM was proved to being able to maintain its original structure, having a wealth of host tissue cells and achieving full revascularization.To our knowledge, this is the first animal model of prelaminating skin flap with biomaterials. Success of this animal model indicates that novel flap prelamination with biomaterials is feasible. PMID:27659066

  13. Mastectomy skin flap necrosis: challenges and solutions (United States)

    Robertson, Stuart A; Jeevaratnam, Johann A; Agrawal, Avi; Cutress, Ramsey I


    Introduction Mastectomy skin flap necrosis (MSFN) has a reported incidence of 5%–30% in the literature. It is often a significant and underappreciated problem. The aim of this article was to review the associated challenges and possible solutions. Methods A MEDLINE search was performed using the search term “mastectomy skin flap necrosis”. Titles and abstracts from peer-reviewed publications were screened for relevance. Results MSFN is a common complication and may present as partial- or full-thickness necrosis. Predictive patient risk factors include smoking, diabetes, obesity, radiotherapy, previous scars and severe medical comorbidity. MSFN leads to a number of challenges, including wound management problems, delays to adjuvant therapy, esthetic compromise, implant extrusion, patient distress and financial loss. Careful preoperative planning and meticulous surgical technique may reduce the incidence of MSFN. A number of intraoperative techniques are available to try and predict skin flaps at risk of MSFN. MSFN may be managed operatively or nonoperatively. Early intervention may reduce the morbidity of MSFN in selected cases. Topical nitroglycerin ointment may be beneficial in reducing MSFN following immediate reconstruction, but the evidence base is still limited. Conclusion MSFN can result in considerable challenges for the patient and the health care service. This review discusses the management options for this problem. PMID:28331365

  14. Lichen sclerosus of the oral mucosa: a case report. (United States)

    Jiménez, Yolanda; Gavaldá, Carmen; Carbonell, Enrique; Margaix, María; Sarrión, Gracia


    Lichen sclerosus or lichen sclerosus et atrophicus is a chronic inflammatory disease predominantly affecting the genital mucosa and skin. Clinically, it is characterized by white atrophic plaques in the anogenital region. The lesions are generally asymptomatic, but may cause discomfort with itching and pain. Extragenital mucosal involvement is very unusual, and lesions limited to the oral mucosa are even less frequent. Knowledge of such lesions is important in order to establish a differential diagnosis with other white oral lesions, and histological confirmation is required. We present the case of a 31-year-old woman with a well delimited, pearly white lesion located in the upper gingival mucosa, lip mucosa and adjacent skin. The lesion had led to loss of periodontal attachment of the affected tooth, causing pain in response to tooth brushing. The biopsy confirmed lichen sclerosus, and treatment was provided in the form of intralesional corticoid injections, followed by improvement of the mucosal lesion, though without recovery of the periodontal loss.

  15. Roseomonas mucosa Isolated from Bloodstream of Pediatric Patient ▿


    Bard, J. Dien; Deville, J. G.; Summanen, P. H.; Lewinski, M. A.


    We report a case of catheter-related bacteremia associated with Roseomonas mucosa isolated from an immunocompromised pediatric patient with a history of multiple episodes of urinary tract infection and bacteremia.

  16. Roseomonas mucosa isolated from bloodstream of pediatric patient. (United States)

    Bard, J Dien; Deville, J G; Summanen, P H; Lewinski, M A


    We report a case of catheter-related bacteremia associated with Roseomonas mucosa isolated from an immunocompromised pediatric patient with a history of multiple episodes of urinary tract infection and bacteremia.

  17. 冠向复位瓣术治疗牙龈退缩的临床研究%Coronally positioned flap procedure in the treatment of human gingival recession

    Institute of Scientific and Technical Information of China (English)

    于春梅; 陈巨峰; 方溢云; 李嘉朋; 卢钰芬


    AIM:To compare the clinical outcome following treatment of local gingival recessions by coronal ly positioned flap with a bioabsorbable membrane or by a coronally positioned flap procedure alone. METHODS: Twenty patients with buccal bilateral Miller Class Ⅰ or Class Ⅱ gingival recession defects were treated randomly by coro nally positioned flap with a bioabsorbable membrane or a coronally positioned flap alone (20 sites). The treatment sites were selected randomly. Twenty sites in the membrane group and 20 sites in the non - membrane group were examinat ed at baseline, and at 3 and 6 months postoperatively. Clinical variables included the apical extent of the gingival re cession ( RD), the width of the gingival recession ( RW) at the cemento - enamel junction ( CEJ), the probing depth ( PD ) and the clinical attachment level ( CAL). RESULTS: Both treatments resulted in a significant gain of root cov erage(p 0.05). Statistical difference could be found in the results of PD, CAL but non in the results of RD and RW between two groups. CONCLUSION: Compared with coronally positioned flap combined with a bioabsorbable membrane , coronally positioned flap procedure alone can get more root coverage in vertical and horizontal direc tions. The coronally positioned flap operation offers a predictable and simple approach as a root coverage procedure for 2.5 mm~5mm recession defects .%目的:单纯冠向复位瓣技术(Coronally positioned flap,CPF)与冠向复位瓣技术联合引导组织再生技术(guided tissue regeneration,GTR)治疗牙龈退缩临床效果的比较.方法:选择牙弓两侧均有唇或颊侧牙龈退缩的病人20例(Miller分度Ⅰ或Ⅱ度,2.5 mm0.05);两组间的CAL、PD结果无统计学差异(P>0.05);RD、RW有统计学差异(P<0.05);结论:冠向复位瓣技术治疗2.5-5 mm的牙龈退缩可在垂直和水平方向获得更多的根面覆盖,与冠向复位瓣技术联合引导组织再生技术相比具有一定的临床优越性.

  18. Mast cell density in cardio-esophageal mucosa.

    Directory of Open Access Journals (Sweden)

    Fatemeh E Mahjoub


    Full Text Available Mast cells are related to certain gastrointestinal complaints. Mast cell density has not been studied in cardio-esophageal region to the best of our knowledge. In this study we wanted to obtain an estimate of mast cell density in this region and compare it with mast cell density in antrum. From April 2007 till March 2010, we chose children (<14 years old who underwent upper endoscopy and from whom the taken biopsy was stated to be from lower third of esophagus, but in microscopic examination either cardio- esophageal mucosa or only cardiac mucosa was seen. Mast cells were counted by Giemsa stain at × 1000 magnification in 10 fields. 71 children (<14 years old were included in this study of which, 63.4% (n=45 were female and 36.6% (n=26 were male. The mean age of patients was 7.20 ± 4.21 years (range: 0.2 -14 years. The most common clinical manifestations were recurrent abdominal pain (64.8% and vomiting (23.9% followed by symptoms of gastro-esophageal reflux disorder, poor weight gain, hematemesis and dysphagia. The mean mast cell density in the cardiac mucosa was 33.41 ± 32.75 in 0.25 mm2 (range: 0-155, which was two times of that in antral mucosa. We found a significant but weak positive correlation at the 0.05 level between mast cell density of cardiac mucosa and the antrum. Higher mast cell counts were seen in cardiac mucosa in this study. Significant positive correlation between mast cell density of cardiac mucosa and the antrum could hint to a single underlying etiology for the inflammatory process in gastro- esophageal junction and gastric mucosa.

  19. Habitual biting of oral mucosa: A conservative treatment approach

    Directory of Open Access Journals (Sweden)

    Sarabjot Kaur Bhatia


    Full Text Available Chronic biting of oral mucosa is an innocuous self inflicted injury, commonly seen in children suffering from developmental and psychological problems and has rarely been reported in normal unaffected individuals. The management strategies vary from counseling, prescription of sedatives to different prosthetic shields. The paper highlights the efficacy of a simple approach using soft mouth guard in the management of self inflicted lesions due to habitual biting of oral mucosa in two normal healthy children.

  20. Structural Features of the Lymphoid Tissue of Newborns’ Gastric Mucosa


    Kliuchko, S. S.


    72 Wistar rats’ stomachs were examined in order to study the features of the dynamics of the lymphoid cells content and distribution in the newborns rats’ gastric mucosa in normal. Morphometric, histological and statistical methods were used. The most significant changes in the composition of different populations of immune cells of the gastric mucosa lymphoid tissue was found to occur within the first three weeks after birth, when antigen load on the stomach increases in the form of new food...

  1. Power performance optimization and loads alleviation with active flaps using individual flap control

    DEFF Research Database (Denmark)

    Pettas, Vasilis; Barlas, Athanasios; Gertz, Drew Patrick;


    The present article investigates the potential of Active Trailing Edge Flaps (ATEF) in terms of increase in annual energy production (AEP) as well as reduction of fatigue loads. The basis for this study is the DTU 10 MW Reference Wind Turbine (RWT) simulated using the aeroelastic code HAWC2...... the sensor inputs. The AEP is increased due to the upscaling but also further due to the flap system while the fatigue loads in components of interest (blade, tower, nacelle and main bearing) are reduced close to the level of the original turbine. The aim of this study is to demonstrate a simple...

  2. Comparative study of visual acuity and aberrations after intralase femtosecond LASIK: small corneal flap versus big corneal flap

    Institute of Scientific and Technical Information of China (English)

    Ya-Li; Zhang; Lei; Liu; Chang-Xia; Cui; Ming; Hu; Zhao-Na; Li; Li-Jun; Cao; Xiu-Hua; Jing; Guo-Ying; Mu


    AIM:To study the effects of different flap sizes on visual acuity, refractive outcomes, and aberrations after femtosecond laser for laser keratomileusis (LASIK). ·METHODS: In each of the forty patients enrolled, 1 eye was randomly assigned to receive treatment with a 8.1mm diameter corneal flap, defined as the small flap, while the other eye was treated with a 8.6mm diameter corneal flap, defined as the big flap. Refractive errors, visual acuity, and higher -order aberrations were compared between the two groups at week 1, month 1 and 3 postoperatively. · RESULTS: The postoperative refractive errors and visual acuity all conformed to the intended goal. Postoperative higher -order aberrations were increased, especially in spherical aberration (Z12) and vertical coma (Z7). There were no statistically significant differences between the two groups in terms of postoperative refractive errors, visual acuity, root mean square of total HOAs (HO -RMS), trefoil 30° (Z6), vertical coma (Z7), horizontal coma (Z8), trefoil 0° (Z9), and spherical aberration (Z12) at any point during the postoperative follow-up. ·CONCLUSION: Both the small and big flaps are safe and effective procedures to correct myopia, provided the exposure stroma meets the excimer laser ablations. The personalized size corneal flap is feasible, as we can design the size of corneal flap based on the principle that the corneal flap diameter should be equal to or greater than the sum of the maximum ablation diameter and apparatus error.

  3. Comparison of a new flap design with the routinely used triangular flap design in third molar surgery. (United States)

    Yolcu, Ü; Acar, A H


    The aim of this study is to introduce a new flap design in the surgical removal of impacted mandibular third molars - a lingually based triangular flap - and to compare this flap design with the routinely used triangular flap. This randomized, prospective, split-mouth study involved 22 patients with impacted bilateral mandibular third molars that were symmetrically positioned, mesially angulated, and retained in bone. The impacted teeth were removed in two sessions, using two different flap designs: the new alternative flap and the traditional triangular flap. Postoperative complications (pain, swelling, trismus, alveolar osteitis, and wound dehiscence) were recorded on days 2, 7, 14, and 21. The data obtained were analysed using the χ(2) test, the Mann-Whitney U-test, and Pearson's correlation. In terms of the severity of postoperative facial swelling and trismus, there were no statistically significant differences between the flap designs (P>0.05). The alternative flap exhibited higher pain scores at 12h post-surgery (Pthird molar surgery.

  4. Identification of Flap Motion Parameters for Vibration Reduction in Helicopter Rotors with Multiple Active Trailing Edge Flaps

    Directory of Open Access Journals (Sweden)

    Uğbreve;ur Dalli


    Full Text Available An active control method utilizing the multiple trailing edge flap configuration for rotorcraft vibration suppression and blade loads control is presented. A comprehensive model for rotor blade with active trailing edge flaps is used to calculate the vibration characteristics, natural frequencies and mode shapes of any complex composite helicopter rotor blade. A computer program is developed to calculate the system response, rotor blade root forces and moments under aerodynamic forcing conditions. Rotor blade system response is calculated using the proposed solution method and the developed program depending on any structural and aerodynamic properties of rotor blades, structural properties of trailing edge flaps and properties of trailing edge flap actuator inputs. Rotor blade loads are determined first on a nominal rotor blade without multiple active trailing edge flaps and then the effects of the active flap motions on the existing rotor blade loads are investigated. Multiple active trailing edge flaps are controlled by using open loop controllers to identify the effects of the actuator signal output properties such as frequency, amplitude and phase on the system response. Effects of using multiple trailing edge flaps on controlling rotor blade vibrations are investigated and some design criteria are determined for the design of trailing edge flap controller that will provide actuator signal outputs to minimize the rotor blade root loads. It is calculated that using the developed active trailing edge rotor blade model, helicopter rotor blade vibrations can be reduced up to 36% of the nominal rotor blade vibrations.

  5. Complex lower face reconstruction using a combined technique of Estlander flap and subscapular artery system free flaps. (United States)

    Hamahata, Atsumori; Saitou, Takashi; Beppu, Takeshi; Shirakura, Satoshi; Hatanaka, Akio; Yamaki, Takashi; Sakurai, Hiroyuki


    When advanced mandibular carcinoma is resected, the defect may include lip and oral commissure. Free flap insertion is commonly used to reconstruct the lip defect. Although improvements in the oral reconstructive method via free flap use have been reported, functional and aesthetic results of the oral sphincter remain limited. This case report describes two individuals presenting with massive lower face defects, including a lower lip defect and a mandibular bone defect. Reconstruction was accomplished using the Estlander flap and free subscapular system of flaps. In both cases, the free subscapular artery system flap was elevated from the mandibular bone defect and other mucosal defect. The lower lip and oral commissure defect was reconstructed via Estlander flap. Free flaps survived 100% and both cases healed without complication. Patients regained good oral sphincter function with no reports of drooling. Thus, in cases involving massive lower face resection, including that of the lower lip and mandibular bone, this method of reconstruction when combined with lip-switch flap and subscapular artery system flap can prove to be useful.

  6. Effect of wing aspect ratio and flap span on aerodynamic characteristics of an externally blown jet-flap STOL model (United States)

    Smith, C. C., Jr.


    An investigation has been conducted to determine the effects of flap span and wing aspect ratio on the static longitudinal aerodynamic characteristics and chordwise and spanwise pressure distributions on the wing and trailing-edge flap of a straight-wing STOL model having an externally blown jet flap without vertical and horizontal tail surfaces. The force tests were made over an angle-of-attack range for several thrust coefficients and two flap deflections. The pressure data are presented as tabulated and plotted chordwise pressure-distribution coefficients for angles of attack of 1 and 16. Pressure-distribution measurements were made at several spanwise stations.

  7. Preliminary study of genotoxicity evaluation of orthodontic miniscrews on mucosa oral cells by the alkaline comet assay. (United States)

    Martín-Cameán, Ana; Puerto, María; Jos, Ángeles; Azqueta, Amaya; Iglesias-Linares, Alejandro; Solano, Enrique; Cameán, Ana M


    Miniscrew implants are widely used nowadays in orthodontic treatments due to their good results in clinical practice. However, data regarding the biocompatibility of commercially available orthodontic miniscrews and temporary devices are very scarce, and their role as genotoxicity inducers has been not previously evaluated with the alkaline comet assay. The aim of this study was to investigate the DNA damage in buccal cells of patients subjected to orthodontic treatments. The alkaline comet assay has been applied in oral mucosa cells from patients treated with conventional orthodontic treatment in comparison to patients treated additionally with miniscrews, non-treated volunteers (control) and smoking volunteers (positive control). The application of orthodontic appliances and miniscrews induced significant and similar (2-fold) increases of %DNA in tail in comparison to control group. Females experienced a significant increase in %DNA in all the treatments in comparison to the control group, whereas males showed significant damage only with the combined orthodontic and miniscrew treatment. In conclusion, conventional orthodontic appliances induced genotoxicity, and the incorporation of miniscrews assayed did not imply any additional increase of DNA damage.

  8. Quadrilobed superior gluteal artery perforator flap for sacrococcygeal defects

    Institute of Scientific and Technical Information of China (English)

    HAI Heng-lin; SHEN Chuan-an; CHAI Jia-ke; LI Hua-tao; YU Yong-ming; LI Da-wei


    Background Perforator flaps are used extensively in repairing soft tissue defects.Superior gluteal artery perforatorflaps are used for repairing sacral defects,but the tension required for direct closure of the donor area after harvesting ofrelatively large flaps carries a risk of postoperative dehiscence.This research was to investigate a modified superiorgluteal artery perforator flap for repairing sacrococcygeal soft tissue defects.Methods From June 2003 to April 2010,we used our newly designed superior gluteal artery perforator flap for repair of sacrococcygeal soft tissue defects in 10 patients (study group).The wound and donor areas were measured,and the flaps were designed accordingly.Wound healing was assessed over a follow-up period of 6-38 months.From January 1998 to February 2003,twelve patients with sacrococcygeal pressure sores were treated with traditional methods,VY advancement flaps or oblong flaps,as control group.Results After debridement,the soft tissue defects ranged from 12 cm × 10 cm to 26 cm × 22 cm (mean 16.3 cm x 13.5cm).Four patients were treated using right-sided flaps ranging from 15 cm × 11 cm to 25 cm × 20 cm (mean 18.2 cm × 14cm).Four patients were treated using left-sided flaps,and two were treated using both right-and left-sided flaps.Suction drains were removed on postoperative Days 3-21 (mean 5.9) and sutures were removed on postoperative Days 12-14.Each flap included 1-2 perforators for each of the donor and recipient sites.Donor sites were closed directly.All flaps survived.In eight patients,the wounds healed after single-stage surgery.After further debridement,the wounds of the remaining two patients were considered healed on postoperative Days 26 and 33,respectively.The rate of first intention in the study group (80%,8/10) significantly increased than that of control group ((25%,3/12),X2=4.583,P=-0.032).Follow-up examinations found that the flaps had a soft texture without ulceration.In the two patients without

  9. Folding in and out: passive morphing in flapping wings. (United States)

    Stowers, Amanda K; Lentink, David


    We present a new mechanism for passive wing morphing of flapping wings inspired by bat and bird wing morphology. The mechanism consists of an unactuated hand wing connected to the arm wing with a wrist joint. Flapping motion generates centrifugal accelerations in the hand wing, forcing it to unfold passively. Using a robotic model in hover, we made kinematic measurements of unfolding kinematics as functions of the non-dimensional wingspan fold ratio (2-2.5) and flapping frequency (5-17 Hz) using stereo high-speed cameras. We find that the wings unfold passively within one to two flaps and remain unfolded with only small amplitude oscillations. To better understand the passive dynamics, we constructed a computer model of the unfolding process based on rigid body dynamics, contact models, and aerodynamic correlations. This model predicts the measured passive unfolding within about one flap and shows that unfolding is driven by centrifugal acceleration induced by flapping. The simulations also predict that relative unfolding time only weakly depends on flapping frequency and can be reduced to less than half a wingbeat by increasing flapping amplitude. Subsequent dimensional analysis shows that the time required to unfold passively is of the same order of magnitude as the flapping period. This suggests that centrifugal acceleration can drive passive unfolding within approximately one wingbeat in small and large wings. Finally, we show experimentally that passive unfolding wings can withstand impact with a branch, by first folding and then unfolding passively. This mechanism enables flapping robots to squeeze through clutter without sophisticated control. Passive unfolding also provides a new avenue in morphing wing design that makes future flapping morphing wings possibly more energy efficient and light-weight. Simultaneously these results point to possible inertia driven, and therefore metabolically efficient, control strategies in bats and birds to morph or recover

  10. Intraoperative Flap Complications in LASIK Surgery Performed by Ophthalmology Residents (United States)

    Romero-Diaz-de-Leon, Lorena; Serna-Ojeda, Juan Carlos; Navas, Alejandro; Graue-Hernández, Enrique O.; Ramirez-Miranda, Arturo


    Purpose: To report the rate of flap-related complications in LASIK surgery performed by in-training ophthalmology residents and to analyze the risk factors for these complications. Methods: We analyzed 273 flap dissections in 145 patients from March 2013 to February 2014. We included all LASIK surgeries performed by 32 ophthalmology residents using a Moria M2 microkeratome. All the flap-related complications were noted. Comparison between both groups with and without complications was performed with an independent Student's t-test and relative risks were calculated. Results: There were 19 flap-related complications out of the 273 flap dissections (6.95%). The most common complication was incomplete flap dissection (n = 10; 3.66%), followed by free-cap (n = 5; 1.83%), and flap-buttonhole (n = 2; 0.73%). There was no significant difference between the complicated and uncomplicated cases in terms of the right versus the left eye, pachymetry results, white-to-white diameter, and spherical equivalent. But this difference was significant for mean keratometry (P = 0.008), K-min (P = 0.01), and K-max (P = 0.03) between these groups. Final visual acuity after rescheduling laser treatment was similar in both groups. Relative risks for flap-related complications were 2.03 for the first LASIK surgery (CI 95% 0.64 to 6.48; P = 0.22) and 1.26 (CI 95% 0.43 to 3.69; P = 0.66) for the surgeon's flap-related complications. Female gender presented an odds ratio of 2.48 (CI 95% 0.68 to 9.00; P = 0.16) for complications. Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye. PMID:27621782

  11. The application of island myocutaneous flap for challenging wounds on cervico-thoracic region

    Institute of Scientific and Technical Information of China (English)

    XING Xin; XUE Chun-yu; LI Li; HUAN Jing-ning; GUO En-tan


    Objective:To introduce the experiences in the application of island myocutaneous flap for challenging wound on cervico-thoracic region. Methods: Different myocutaneous flaps were selected according to the location, peculiarity and etiological factor of wound. There were 28 cases of island pectoralis major island myocutanuous flaps, 34 cases of latissimus dorsi island myocutaneous flaps, 19 cases of trapizius island myocutaneous flaps and 17 cases of rectus abdominis island myocutaneous flaps in this report. Results: All 98 patients with challenging wound on cervico-thoracic region were successfully treated with this method without complications, and obtained functional and cosmetic effectiveness. Conclusion:Challenging wounds in cervico-nuchal region can be repaired with pertoralis major island myocutaneous flap, latissimus dorsi island myocutaneous flap and trapizius island myocutaneous flap, while challenging wounds in thoracic region can be repaired with latissimus dorsi island myocutaneous flap and rectus abdominis island myocutaneous flap. Satisfactory functional and cosmetic results can be obtained.

  12. Complex Technique of Large Sural Flap: An Alternative Option for Free Flap in Large Defect of the Traumatized Foot

    Directory of Open Access Journals (Sweden)

    Naser Mohammadkhah


    Full Text Available The distally based sural fasciocutaneous flap has become a main part of the reconstruction of the lower leg, heel and foot. However, perfusion problems and venous congestion have been reported. Over the past decade, several flap modifications have been reported to improve flap viability and to solve a myriad of reconstructive needs. The purpose of this paper is to describe our experience in harvesting the reversed large sural flap from the proximal and middle third of the leg for large defects on the foot. We applied the extended reversed sural flap from the proximal third of the leg in traumatized patients which had large defects on their foot. The technique was done in 3 parts: 1- the flaps were designed in the proximal third of the leg five centimeter lipofascial tissue was protected around the pedicle in distal part; 3- The pivot point was located in seven to eight cm proximal the lateral malleolus before the first fasciocutaneous perforators arising from the peroneal artery. Sural flaps from the proximal and middle third of the leg were designed in13 patients who had large defects on their foot. No flap necrosis or split thickness skin graft loss occurred. The flaps healed by the 3rd week excluding two patients. This study supports the application of our technique as a safe, easy and useable method in large defects of the foot. The results showed low rates of ischemia, venous congestion, dehiscence, infection and flap necrosis. Proximal extended and large distally based sural flap is an alternative to free tissue transfer for large defect reconstruction of the foot.

  13. Bifurcation to forward flapping flight at intermediate Reynolds number. (United States)

    Vandenberghe, Nicolas; Zhang, Jun; Childress, Stephen


    The locomotion of most fish and birds is realized by flapping wings or fins transverse to the direction of travel. According to early theoretical studies, a flapping wing translating at finite speed in an inviscid fluid experiences a propulsive force. In steady forward flight this thrust is balanced by drag. Such "lift-based mechanisms" of thrust production are characteristic of the Eulerian realm, where discrete vortical structures are shed. But, when the Reynolds number is small, viscous forces dominate and reciprocal flapping motions are ineffective. A flapping wing experiences a net drag and cannot be used to propel an organism. We have devised an experiment to bridge the two regimes, and to examine the transition to forward flight at intermediate Reynolds numbers. We study the dynamics of an horizontal wing that is flapped up and down and is free to move either forwards or backwards. This very simple kinematics emphasizes the demarcation between low and high Reynolds number because it is effective in the Eulerian realm but has no effect in the Stokesian realm. We show that flapping flight occurs abruptly as a symmetry breaking bifurcation at a critical flapping frequency. Beyond the bifurcation the forward speed increases linearly with the flapping frequency. The experiment establishes a clear demarcation between the different strategies of locomotion at large and small Reynolds number.

  14. Repair of large palatal fistula using tongue flap

    Directory of Open Access Journals (Sweden)

    Fejjal Nawfal


    Full Text Available Large palatal fistulas are a challenging problem in cleft surgery. Many techniques are used to close the defect. The tongue flap is an easy and reproductible procedure for managing this complication. The authors report a case of a large palatal fistula closure with anteriorly based tongue flap.

  15. 14 CFR 25.701 - Flap and slat interconnection. (United States)


    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Flap and slat interconnection. 25.701....701 Flap and slat interconnection. (a) Unless the airplane has safe flight characteristics with the... sides of the plane of symmetry must be synchronized by a mechanical interconnection or...

  16. Dorsalis pedis arterialized venous flap for hand and foot reconstruction

    Institute of Scientific and Technical Information of China (English)

    YU Guang; LEI Hong-yu; GUO Shuang; HUANG Jian-hua; YU Hao


    Objective:To report the results of repair of skin defects in the extremities with arterialized venous flap harvested from the lateral aspect of the dorsum of the foot.Methods:Six cases of skin and soft tissue defects over the foot and hands were resurfaced by free arterialized venous flaps,including five patients with skin defects of the hands,and one with defects at the dorsum of the foot.The flaps were harvested from the lateral aspect of the dorsum of the foot with the sizes ranging from 2 cm×5.5 cm to 6 cm×11 cm.Two veins at the proximal margin of the flap were retained,one of which was anastomosed to a recipient bed artery to provide arterial inflow and the other was anastomosed to a recipient bed vein for venous outflow.Results:All flaps demonstrated mild edema and survived completely.Blisters appeared on four flaps.Using this technique,we achieved good functional and cosmetic results in this series.Conclusions:Dorsalis pedis arterialized venous flap with rich vascular communications could enhance peripheral perfusion and decrease congestion of venous flaps,thereby improves reliability and utility for extremity reconstruction.

  17. Experimental and numerical study of an autonomous flap

    NARCIS (Netherlands)

    Bernhammer, L.O.; Navalkar, S.T.; Sodja, J.; De Breuker, R.; Karpel, M.


    This paper presents the experimental and numerical study of an autonomous load alleviation concept using trailing edge flaps. The flaps are autonomous units, which for instance can be used for gust load alleviation. The unit is self-powered and self-actuated through trailing edge tabs which are moun

  18. Coverage of soft tissue defect in palm with prefabricated flap

    Institute of Scientific and Technical Information of China (English)

    ZHANG Gong-lin; CAI Guo-rong; ZHANG Ming; ZHENG Liang-jun; ZHANG Yan


    @@ The coverage of large soft tissue defects in palm remains a challenge in the plastic recon-structive surgery. There are many local tissue transfers described for small-sized defects of hand, whereas large defect require regional flaps such as the radial forearm flap or free tissue transfer.1-5

  19. The versatility of the pectoralis major flap in reconstructive surgery

    NARCIS (Netherlands)

    Corten, E.M.L.


    Background The pectoralis major flap is frequently being applied as a pedicled flap for head and neck reconstruction. To reduce donor-site morbidity, muscle-preserving methods using only a segment of this muscle for transplantation, were described. The nerve supply to the clavicular part of the pect

  20. Monitoring microvascular free flaps with tissue oxygen measurement and PET. (United States)

    Schrey, Aleksi R; Kinnunen, Ilpo A J; Grénman, Reidar A; Minn, Heikki R I; Aitasalo, Kalle M J


    Tissue oxygen measurement and positron emission tomography (PET) were evaluated as methods for predicting ischemia in microvascular free flaps of the head and neck. Ten patients with head and neck squamous cell cancer underwent resection of the tumour followed by microvascular reconstruction with a free flap. Tissue oxygenation of the flap (P(ti)O(2)) was continuously monitored for three postoperative (POP) days and the blood flow of the flap was assessed using oxygen-15 labelled water and PET. In three free flaps a perfusion problem was suspected due to a remarkable drop in P(ti)O(2)-values, due to two anastomosis problems and due to POP turgor. No flap losses occurred. During the blood flow measurements with PET [mean 8.5 mL 100 g(-1) min(-1 )(SD 2.5)], the mean P(ti)O(2) of the flaps [46.8 mmHg (SD 17.0)] appeared to correlate with each other in each patient (pmonitoring system of free flaps. The perfusion-study with PET correlates with P(ti)O(2)-measurement.

  1. The use of free flaps in skull base reconstruction. (United States)

    Macía, G; Picón, M; Nuñez, J; Almeida, F; Alvarez, I; Acero, J


    Skull base tumours are rare, comprising less than 1% of all tumours of the head and neck. Surgical treatment of these tumours involves the approach, the resection, and the reconstruction of the defect, which present a challenge due to the technical difficulty and anatomical complexity. A retrospective study of 17 patients with tumours involving the skull base, treated by resection and immediate reconstruction using microsurgical free flaps, is presented; 11 were men and six were women. The following types of flap were used: osteocutaneous fibula flaps, fasciocutaneous anterolateral thigh flaps, and myocutaneous latissimus dorsi flaps. The most common histology of the tumours was squamous cell carcinoma. The most frequent point of origin was the paranasal sinuses (58.8%). All of the free flaps used for reconstruction were viable. A cerebrospinal fluid fistula occurred in two patients, and in one of these cases, meningoencephalitis led to death. In conclusion, the reconstruction of large defects of the skull base after ablation requires a viable tissue that in many cases can be obtained only through the use of microvascular free flaps. The type of flap to be selected depends on the anatomical structures and size of the defect to be restored.

  2. The effect of laterally positioned flap-revised technique and 24% ethylenediaminetetraacetic acid root conditioning on root coverage: A case report. (United States)

    Singh, Jagmohan; Bharti, Vipin


    Complete root coverage is considered the true goal of treatment of gingival recession defects because only complete coverage assures recovery from the hypersensitivity and esthetic defects associated with recession areas. Previous studies have shown that the laterally positioned flap (LPF) technique or root surface biomodification yields a higher percentage of complete root coverage upon gingival recession treatment. This article highlights the use of the laterally positioned pedicle flap-revised technique (LPFRT) as a modification of the LPF technique, along with 24% EDTA gel as a root surface biomodification agent, in the management of localized gingival recession defects. Clinical examination revealed a Miller class II recession defect on the buccal aspect of the lower right central incisor, as well as the presence of aberrant frenum pull adjacent to the recession defect. The LPFRT, together with 24% EDTA gel, was speculated to cover the gingival recession defect. The frenectomy, along with periosteal fenestration, was planned simultaneously with LPFRT. After 6 months of therapy, the clinical condition was stable with complete root coverage and satisfactory healing of the gingival tissues at both the donor and recipient sites with no signs of inflammation.

  3. The effect of laterally positioned flap-revised technique and 24% ethylenediaminetetraacetic acid root conditioning on root coverage: A case report

    Directory of Open Access Journals (Sweden)

    Jagmohan Singh


    Full Text Available Complete root coverage is considered the true goal of treatment of gingival recession defects because only complete coverage assures recovery from the hypersensitivity and esthetic defects associated with recession areas. Previous studies have shown that the laterally positioned flap (LPF technique or root surface biomodification yields a higher percentage of complete root coverage upon gingival recession treatment. This article highlights the use of the laterally positioned pedicle flap-revised technique (LPFRT as a modification of the LPF technique, along with 24% EDTA gel as a root surface biomodification agent, in the management of localized gingival recession defects. Clinical examination revealed a Miller class II recession defect on the buccal aspect of the lower right central incisor, as well as the presence of aberrant frenum pull adjacent to the recession defect. The LPFRT, together with 24% EDTA gel, was speculated to cover the gingival recession defect. The frenectomy, along with periosteal fenestration, was planned simultaneously with LPFRT. After 6 months of therapy, the clinical condition was stable with complete root coverage and satisfactory healing of the gingival tissues at both the donor and recipient sites with no signs of inflammation.

  4. Immediate placement and provisionalization of maxillary anterior single implant with guided bone regeneration, connective tissue graft, and coronally positioned flap procedures. (United States)

    Waki, Tomonori; Kan, Joseph Y K


    Immediate implant placement and provisionalization in the esthetic zone have been documented with success. The benefit of immediate implant placement and provisionalization is the preservation of papillary mucosa. However, in cases with osseous defects presenting on the facial bony plate, immediate implant placement procedures have resulted in facial gingival recession. Subepithelial connective tissue grafts for immediate implant placement and provisionalization procedures have been reported with a good esthetic outcome. Biotype conversion around implants with subepithelial connective tissue grafts have been advocated, and the resulting tissues appear to be more resistant to recession. The dimensions of peri-implant mucosa in a thick biotype were significantly greater than in a thin biotype. Connective tissue graft with coronally positioned flap procedures on natural teeth has also been documented with success. This article describes a technique combining immediate implant placement, provisionalization, guided bone regeneration (GBR), connective tissue graft, and a coronally positioned flap in order to achieve more stable peri-implant tissue in facial osseous defect situations.

  5. Coarse-grained models for interacting, flapping swimmers (United States)

    Oza, Anand; Ristroph, Leif; Shelley, Michael; Courant Institute Applied Math Lab Collaboration


    We present the results of a theoretical investigation into the dynamics of interacting flapping swimmers. Our study is motivated by ongoing experiments in the NYU Applied Math Lab, in which freely-translating, heaving airfoils interact hydrodynamically to choose their relative positions and velocities. We develop a discrete dynamical system in which flapping swimmers shed point vortices during each flapping cycle, which in turn exert forces on the swimmers. We present a framework for finding exact solutions to the evolution equations and for assessing their stability, giving physical insight into the preference for certain observed "schooling states". The model may be extended to arrays of flapping swimmers, and configurations in which the swimmers' flapping frequencies are incommensurate. Generally, our results indicate how hydrodynamics may mediate schooling and flocking behavior in biological contexts. A. Oza acknowledges the support of the NSF Mathematical Sciences Postdoctoral Fellowship.

  6. Reconstruction of weightbearing forefoot defects with digital artery flaps. (United States)

    Liu, Lifeng; Cao, Xuecheng; Cai, Jinfang


    Reconstruction of a defect of the weightbearing forefoot region remains a challenging problem owing to the limited alternatives available. The digital artery flap can be used for coverage of defects in the weightbearing forefoot. The present study reports our results using a digital artery flap for reconstruction of soft tissue defects of the weightbearing forefoot in 8 patients. The mean patient age was 35 ± 11.3 years. The etiology of the soft tissue defects included 4 (50%) traumatic events, 2 (25%) dysfunctional scars, and 2 (25%) neuropathic ulcerations. The mean postoperative follow-up duration was 22 ± 11.1 months (range 12 months to 4 years). All 8 flaps survived successfully. The complications included 1 case of delayed healing of a neuropathic ulceration. The digital artery flap is a good alternative for soft tissue defects of the weightbearing forefoot. The surgical techniques for harvesting the flaps are easy to manage.

  7. Distally Based Abductor Hallucis Adipomuscular Flap for Forefoot Plantar Reconstruction. (United States)

    Lee, Sanglim; Kim, Min Bom; Lee, Young Ho; Baek, Jeong Kook; Baek, Goo Hyun


    Soft tissue and bone defects of the lower leg, ankle, and heel region often require coverage by local or distant flaps. The authors successfully used the distally based adipomuscular abductor hallucis flap for the treatment of 7 patients with soft tissue defect on the plantar forefoot after diabetic ulcer (n = 2), excision of melanoma at the medial forefoot (n = 3), and posttraumatic defects of the plantar forefoot (n = 2). The size of the defects ranged from 6 to 36 cm. All defects were covered successfully without major complications. The distally based adipomuscular flap from the abductor hallucis muscle provides a reliable coverage for small and moderate defects of the plantar and medial forefoot. This flap is often preferable to the use of free flaps because the surgery is rapidly performed and does not require microsurgical expertise.

  8. Free Flap Procedures for Reconstruction After Head and Neck Cancer. (United States)

    Kini, Erin


    Patients with head and neck cancer are seeking improved surgical procedures to avoid severe defects that result from head and neck cancer resection. Free flap reconstruction provides vascularized tissue that has been transferred from a distant donor site on a patient's body to a recipient site, markedly improving wound closure and protecting structures of the head and neck. This article discusses free flap procedures for reconstruction after head and neck cancer resection, including the following procedure phases: airway protection and neck dissections, tumor resection, flap harvest, microvascular anastomosis of the flap, and reconstruction and closure. The article also explains specific risk factors for patients undergoing free flap procedures that have been identified in the literature and include procedure length, hypothermia, and pressure injuries. Each of these factors is discussed regarding its specific effect on this patient population, and the nursing interventions to reduce these risks are identified.

  9. Vaginal reconstruction using perineal-thigh flaps with subcutaneous pedicle. (United States)

    Chen, Z; Chen, C; Chen, M; Zhang, J; Wu, N; Wang, J


    A technique of vaginal reconstruction using bilateral, perineal-thigh flaps with subcutaneous pedicle is described. In this procedure, the flaps were raised bilaterally and introduced into an artificial space between the urinary bladder and rectum. The blood supply for the flaps flows from the perineal artery through anastomotic branches to the external pudendal artery. The authors used the technique on four patients, and all the flaps survived entirely. There was no complication. According to a more than two-year follow-up survey, the reconstructed vaginas are expansible and contract little. No stent is needed. There is good sensitivity in the wall of the artificial vagina because sensory nerves run through the flaps.

  10. Efficacy of buccal midazolam compared to intravenous diazepam in controlling convulsions in children: a randomized controlled trial. (United States)

    Talukdar, Bibek; Chakrabarty, Biswaroop


    A study was done to examine the efficacy of buccal midazolam in controlling convulsion in children by comparing it with intravenous diazepam, a standard mode of treating convulsions. One hundred and twenty cases presenting with convulsions to emergency were treated randomly with either buccal midazolam (in a dose of 0.2mg/kg) or intravenous diazepam (in a dose of 0.3mg/kg). Partial seizures, generalized tonic, clonic and tonic-clonic convulsions were included irrespective of duration or cause. One episode per child only was included. The frequency of overall control of convulsive episodes within 5 min were 85% and 93.3% in buccal midazolam and intravenous diazepam groups, respectively; the difference was, however, not statistically significant (p=0.142). The mean time needed for controlling the convulsive episodes after administration of the drugs was significantly less with intravenous diazepam (p=diazepam (p=0.004) that is likely to be due to longer time needed for initiating treatment with intravenous diazepam in preparing the injection and establishing an IV line. There was no significant side effect in both the groups. The findings suggest that buccal midazolam can be used as an alternative to intravenous diazepam especially when getting an IV line becomes difficult. In situations where establishing an IV line is a problem, buccal midazolam may be the first choice.

  11. Clinical utility of chromosomal microarray analysis of DNA from buccal cells: detection of mosaicism in three patients. (United States)

    Sdano, Mallory R; Vanzo, Rena J; Martin, Megan M; Baldwin, Erin E; South, Sarah T; Rope, Alan F; Allen, William P; Kearney, Hutton


    Mosaic chromosomal abnormalities are relatively common. However, mosaicism may be missed due to multiple factors including failure to recognize clinical indications and order appropriate testing, technical limitations of diagnostic assays, or sampling tissue (s) in which mosaicism is either not present, or present at very low levels. Blood leukocytes have long been the "gold standard" sample for cytogenetic analysis; however, the culturing process for routine chromosome analysis can complicate detection of mosaicism since the normal cell line may have a growth advantage in culture, or may not be present in the cells that produce metaphases (the lymphocytes). Buccal cells are becoming increasingly utilized for clinical analyses and are proving to have many advantages. Buccal swabs allow for simple and noninvasive DNA collection. When coupled with a chromosomal microarray that contains single nucleotide polymorphic probes, analysis of buccal cells can maximize a clinician's opportunity to detect cytogenetic mosaicism. We present three cases of improved diagnosis of mosaic aberrations using buccal specimens for chromosomal microarray analysis. In each case, the aberration was either undetectable in blood or present at such a low level it likely could have gone undetected. These cases highlight the limitations of certain laboratory methodologies for identifying mosaicism. We also present practice implications for genetic counselors, including clinic workflow changes and counseling approaches based on increasing use of buccal samples.

  12. Evaluation of Calendula mucilage as a mucoadhesive and controlled release component in buccal tablets. (United States)

    Sabale, V; Patel, V; Paranjape, A


    Mucoadhesive drug delivery systems were developed to sustain drug delivery via various mucus membranes for either local or systemic delivery of poorly absorbed drugs such as peptides and proteins as well as drugs that are subjected to high first-pass metabolism. The present study was undertaken to use isolated Calendula mucilage as a mucoadhesive agent and to formulate controlled release buccoadhesive tablets with an intention to avoid hepatic first-pass metabolism as well as to enhance residence time of drug in the buccal cavity. The mucilage was isolated from the Calendula petals by aqueous extraction method and characterized for various physiochemical parameters as well as for its adhesive properties. By using direct compression technique, tablets were prepared containing dried mucilage and chlorpheniramine maleate (CPM) as a model drug. Three batches of tablets were prepared and evaluated containing three mucoadhesive components namely Methocel K4M, Carbopol 974P and isolated Calendula mucilage in 16.66%, 33.33 % and 50 % (1:2:3 ratio) resulting in 9 different formulations. FTIR studies between mucilage and CPM suggested the absence of a chemical interaction between CPM and Calendula mucilage. The results of the study showed that the isolated mucilage had good physicochemical and morphological characteristics and tablets conformed to the pharmacopoeial specifications. Also in vitro release studies showed controlled action of drug with increasing the concentration of the isolated Calendula mucilage as a mucoadhesive agent in the formulations. Permeability studies indicated that permeability behavior was not statistically different (P>0.05) by changing the mucoadhesive component. The formulated mucoadhesive tablets for buccal administration containing 75 mg Calendula mucilage showed controlled drug release. Thus, mucoadhesive natural Calendula mucilage based buccal tablets for controlled release were successfully formulated.

  13. Formulation and evaluation of bioadhesive buccal drug delivery of repaglinide tablets

    Directory of Open Access Journals (Sweden)

    Dasharath M Patel


    Full Text Available The purpose of this research was to formulate and evaluate bioadhesive buccal tablets of repaglinide using HPMC K15M as a sustained release polymer, chitosan as a bioadhesive polymer and ethyl cellulose as an impermeable backing layer. The tablets were evaluated for weight variation, thickness, hardness, friability, surface pH, mucoadhesive strength, swelling index, in vitro drug release, ex vivo mucoadhesion time and ex vivo drug permeation. A 3 2 full factorial design was used in present study for optimization. Tablets containing HPMC K15M and chitosan in the ratio of 1:1 and lactose as a filler (F2 had the maximum percentage of in vitro drug release. The swelling index, friability and in vitro drug release was affected by type of filler as dicalcium phosphate (DCP had good binding ability compared to lactose. The surface pH of all tablets was found to be satisfactory (between 6.26 and 7.01, close to neutral pH; hence buccal cavity irritation should not occur with these tablets. F2 batch was considered optimum based on good bioadhesive strength (17.83±0.51 gm and maximum similarity factor (64.43. The drug release from optimum batch followed zero order kinetics with non-Fickian diffusion. Drug-excipients compatibility study showed no interaction between drug and excipients. Stability study of optimized formulation showed that tablets were stable at accelerated environment condition. Thus, buccal adhesive tablet of repaglinide could be an alternative route to bypass hepatic first pass metabolism and to improve bioavailability of repaglinide.

  14. Application of skin flaps transplantation in burn surgery in China%皮瓣移植在我国烧伤外科中的应用

    Institute of Scientific and Technical Information of China (English)



    The history and application of surgical flap transplantation in burn wound were briefly reviewed. We outlined skin flap, muscuiocutaneous flap, fascia flap and neurocutaneous vascular flap in this paper and recommended repair deep wounds with flap. All in all, in this review, we hope to provide a meaningful option for clinical application of surgical flap in the future.

  15. Infrahyoid myofascial flap for tongue reconstruction. (United States)

    Windfuhr, Jochen P; Remmert, Stephan


    For selected cases, reconstruction of the tongue may be required after tumor removal. This study was undertaken to demonstrate a simplified concept of tongue reconstruction with emphasis on infrahyoid myofascial flaps (IMF). The defects of the tongue were classified in 23 patients according to the extent of tumor growth, functional and surgical aspects. The oral tongue (OT; n = 1), base of tongue (BT; n = 12) or both areas (OT and BT; n = 10) were involved, with (n = 14) or without (n = 9) infiltration of adjacent tissues. Minor defects (extent (1/4) or less) required no reconstructive procedure at any area. Major defect closure (extent (1/2)-3/4) was accomplished with a combination of IMF covered by a radial forearm flap (RFF). A complete reconstruction of the OT was achieved with a combination of a bilateral IMF covered by a RFF. Whenever the complete BT has to be removed, interposition of a vein graft to establish a sufficient arterial blood supply to the remaining OT is mandatory. Moreover, a larynx lift to prevent aspiration is recommendable. Resection of adjacent soft tissues requires a larger RFF (OT; BT) or flaps from the shoulder-back region (BT and OT). Whenever the integrity of the mandible has to be sacrificed, a free fibula graft serves as an excellent tool for reconstruction. IMF serves as a reliable tool for minor or major reconstructive procedures of the tongue. Reliability and versatility of IMF may contribute to a reduced time required for surgery since harvesting is performed in the neck area immediately after neck dissection. Moreover, harvesting of the IMF does not result in an increased postoperative morbidity. Hence, functional restoration can be achieved with a more cost-effective procedure.

  16. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

    Directory of Open Access Journals (Sweden)

    N. Lumen


    Full Text Available Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF or the pedicled anterolateral thigh flap (ALTF has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months. Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula. Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps.

  17. Clark's rule vis à vis the buccal object rule: its evolution & application in endodontics. (United States)

    Gutmann, James L; Endo, Cert


    Originally, Clark's rule was used to identify the position of unerupted or supernumerary teeth (a concept known as oral localization) prior to orthodontic tooth movement or surgical removal. However, the versatility of this rule's principles and concepts are also highly applicable to endodontic diagnosis and treatment. While contemporarily known by many different names, such as the "buccal object rule" and the "cone beam-shift technique," the importance of this rule in endodontics was not recognized in the literature until late in the 20th century, despite historical evidence demonstrating its incorporation into root canal procedures almost 100 years ago.

  18. Design and evaluation of mucoadhesive buccal drug delivery systems containing metoprolol tartrate

    Directory of Open Access Journals (Sweden)

    Ramana M


    Full Text Available Mucoadhesive buccal tablets of metoprolol tartarate were fabricated with objective of avoiding first pass metabolism and prolonging duration of action. The mucoadhesive polymers used in formulation were Carbopol-934, hydroxypropylmethylcellulose, hydroxyethylcellulose and sodium carboxymethylcellulose. The formulations were characterized for physiochemical parameters, in vitro release studies and in vivo placebo studies. The best mucoadhesive performance and in vitro drug release profile were exhibited by the tablets containing hydroxyethylcellulose and Carbopol-934 in ratio 1:2. This product was more comfortable to the user due to absence of erosion, faster hydration rate and less viscosity of surrounding environment. In vivo placebo studies did not show any side effects.

  19. Procedures for risk-stratification of lung cancer using buccal nanocytology. (United States)

    Subramanian, H; Viswanathan, P; Cherkezyan, L; Iyengar, R; Rozhok, S; Verleye, M; Derbas, J; Czarnecki, J; Roy, H K; Backman, V


    Lung cancer is the leading cause of cancer deaths in the U.S. with survival dramatically depending on stage at diagnosis. We had earlier reported that nanocytology of buccal cells can accurately risk-stratify smokers for the presence of early and late-stage lung cancer. To translate the technique into clinical practice, standardization of operating procedures is necessary to consistently yield precise and repeatable results. Here, we develop and validate simple, robust, and easily implementable procedures for specimen collection, processing, etc. in addition to a commercially-viable instrument prototype. Results of this work enable translation of the technology from academic lab to physicians' office.

  20. L'écosystème buccal chez le patient âgé


    Lacoste-Ferré, Marie-Hélène; Hermabessière, Sophie; Jézéquel, Fabienne; Rolland, Yves


    International audience; La bouche est une cavité naturelle complexe qui forme le segment initial du tube digestif. Elle est un acteur essentiel des fonctions vitales que sont la nutrition, le langage et la communication. L'ensemble de la bouche (dents, parodonte, muqueuses, langue) est constamment hydraté et lubrifié par la salive. À tout âge, un équilibre s'établit entre la prolifération bactérienne, le flux salivaire et la réponse tissulaire : c'est l'écosystème buccal. La régulation de cet...

  1. Procedures for risk-stratification of lung cancer using buccal nanocytology (United States)

    Subramanian, H.; Viswanathan, P.; Cherkezyan, L.; Iyengar, R.; Rozhok, S.; Verleye, M.; Derbas, J.; Czarnecki, J.; Roy, H. K.; Backman, V.


    Lung cancer is the leading cause of cancer deaths in the U.S. with survival dramatically depending on stage at diagnosis. We had earlier reported that nanocytology of buccal cells can accurately risk-stratify smokers for the presence of early and late-stage lung cancer. To translate the technique into clinical practice, standardization of operating procedures is necessary to consistently yield precise and repeatable results. Here, we develop and validate simple, robust, and easily implementable procedures for specimen collection, processing, etc. in addition to a commercially-viable instrument prototype. Results of this work enable translation of the technology from academic lab to physicians’ office. PMID:27699138

  2. Radiographic monitoring of healing process of buccal bifurcation cysts after marsupialization: two cases

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Suk Ja; Kang, Byung Cheol [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)


    This report is to show healing process of two cases of buccal bifurcation cyst (BBC) developed from the mandibular deciduous second molars. Extracting the involved deciduous teeth led to marsupialization of the cysts and promoted eruption of the associated successors without orthodontic force. The cyst-associated premolars in the two cases erupted faster than the premolars on the contralateral noncyst side. The cysts were completely filled with normal bone. The monitoring radiographs showed bone healing, root formation, and path of eruption of the associated teeth after marsupialization of BBC.

  3. Effects of Electron-Beam Irradiation on Buccal-Cell DNA



    Buccal cells were collected from 29 participants, by use of mouthwash rinses, and were split into equal aliquots, with one aliquot irradiated by electron-beam (E-beam) irradiation equivalent to the sterilizing dosage used by the U.S. Postal Service and the other left untreated. Aliquots were extracted and tested for DNA yields (e.g., TaqMan assay for quantifying human genomic DNA), genomic integrity, and amplification-based analysis of genetic variants (e.g., single-nucleotide polymorphisms [...

  4. Increased Flap Weight and Decreased Perforator Number Predict Fat Necrosis in DIEP Breast Reconstruction

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    Carolyn L. Mulvey, BS


    Conclusions: Flaps with increasing weight have increased risk of fat necrosis. These data suggest that inclusion of more than 1 perforator may decrease odds of fat necrosis in large flaps. Perforator flap breast reconstruction can be performed safely; however, considerations concerning race, body mass index, staging with tissue expanders, perforator number, and flap weight may optimize outcomes.

  5. Flap prefabrication and stem cell-assisted tissue expansion: how we acquire a monoblock flap for full face resurfacing. (United States)

    Li, Qingfeng; Zan, Tao; Li, Haizhou; Zhou, Shuangbai; Gu, Bin; Liu, Kai; Xie, Feng; Xie, Yun


    Total face skin and soft-tissue defects remain one of the biggest challenges in reconstructive surgery. Reconstruction of the entire face with uniform coverage and delicate features is difficult to achieve. To avoid the patchwork result seen in multiple flaps and skin grafts, 1 monoblock flap that has similar color, texture, and thickness might be an ideal option to minimize the incisional scars and several surgical procedures but is unavailable with current approaches because of the lack of sufficient matched tissue and the unreliable blood supply for such a large flap. To acquire a monoblock flap for full face reconstruction, we combine the prefabricated flaps, skin overexpansion, and bone marrow mononuclear stem cell transplantation for total facial resurfacing. In this article, we present our experience from our case series that provides universally matched skin and near-normal facial contour. It is a reliable and an excellent reconstructive option for massive facial skin defect.

  6. Expanded retroauricular skin and fascial flap in congenital microtia reconstruction. (United States)

    Zhang, Qingguo; Quan, Yuzhu; Su, Yuanda; Shi, Lei; Xie, Yangchun; Liu, Xinhai


    The aim of this article is to report the application of expanding retroauricular skin fascia flap, and autogenous costal cartilage for congenital microtia reconstruction. Microtia reconstruction was generally completed in 3 surgical stages. In the first surgical stage, a 50 or 80 mL kidney-shaped tissue expander was inserted subcutaneously in the retroauricular mastoid region. Inflation of saline volume increased up to 60 to 80 mL, and skin flap was expanded for 2 to 3 months postoperatively. In the second surgical stage, removal of tissue expander, formation of retroauricular skin flap, elevation of retroauricular fascia flap, and pedicles of both flaps in remnant ear side were performed. Costal cartilage was harvested from ipsilateral side chest to the ear for reconstruction. The 3D ear framework was sculpted with stabilization of structure, contour and erection. Simultaneously, intermediate full thickness skin graft of 4 x 8 cm was obtained from previous incision site from where costal cartilage was harvested. Cartilage ear framework was anchored between skin flap and fascia flap, and fixed it symmetrically to the opposite normal ear, inferior portion of the ear framework was wrapped by remnant ear lobule, expanded skin flap covered the anterior portion of the framework, fascial flap was draped to the posterior side of framework and helical rim, then fascial flap was surfaced by intermediate full thickness skin graft. Suction drain was inserted and coated between skin flap and framework, drain was removed fifth postoperative day. Tragus construction and conchal excavation with skin graft was performed in the third stage of microtia reconstruction. Between October 2000 and October 2007, 426 cases were diagnosed as unilateral microtia patients and 22 cases were bilateral microtia patients. Therefore, 448 microtia ears were treated with tissue expander and autogenous costal cartilage. In 262 cases, structure of the helix, tragus, conchal excavation

  7. Free Medial Plantar Flap Connection with a Posterior Tibial Artery Flap in Reconstruction of Fore–Mid Foot Skin Defect (United States)

    Wu, Hao; Sheng, Jia-Gen


    Background: Although there are many surgical treatments for covering the skin defect of the fore–mid foot, how to reconstruct the weight-bearing region remains a challenge. The weight-bearing region of the sole needs to withstand the pressure and shearing stresses of walking, so the plantar skin is anatomically different from other skins in the areas of texture, thickness, subcutaneous tissue, etc. Medial plantar flaps that are harvested from the instep region are regarded as the first choice for weight-bearing region reconstruction because of their excellent functional and aesthetic long-term result. However, when facing an extensive skin defect on a weight-bearing area such as a fore–mid foot avulsion, the application of this flap is limited because if we put the flap in a weight-bearing area of the forefoot, the set of vessels will be exposed to outside. Methods: We suggest 2 connected free flaps (posterior tibial artery flap and medial plantar flap) pedicled with 1 set of vessels. The medial plantar flap was used to cover the skin defect of the weight-bearing area in the forefoot. The dorsal skin defect of the injured foot was covered with a posterior tibial artery flap and supplied the medial plantar flap with the posterior tibial vessel. The midfoot skin defect was repaired by a full-skin grafting. Results: Long-term follow-up results showed that the shape and function of the injured limbs recovered almost entirely. Conclusion: This method of connected flaps is suitable for repairing large skin defects of the fore–mid foot. PMID:27975013

  8. Development and Evaluation of Epichlorohydrin Cross-linked Mucoadhesive Patches of Tamarind Seed Polysaccharide for Buccal Application

    Directory of Open Access Journals (Sweden)

    Sougata Jana


    Full Text Available In this study, buccal patches of metronidazole were formulated by solvent casting method using tamarind seed polysaccharide (TSP. The patches were crosslinked with epichlorohydrin and different batches were prepared following 23 factorial design. The patches were evaluated with respect to their ex-vivo drug permeation characteristics, mucoadhesive strength, folding endurance, and buccal residence time. At lower level of cross linker and plasticizer, the drug permeation was the highest (72.72%. The drug release from the patches was dominated by a dissolution-controlled mechanism rather than diffusion. The folding endurance did not vary widely (201-254, however the mucoadhesive strength (6.1-36.5 g and the residence time (~2-6 h deviated widely depending upon the formulation variables. The FT-IR spectroscopy revealed no interaction between drug and polymer. Thus the TSP could be a promising vehicle for the fabrication of buccal patches.

  9. Harvesting oral mucosa for one-stage anterior urethroplasty

    Directory of Open Access Journals (Sweden)

    Sanjay Balwant Kulkarni


    Full Text Available Oral mucosa has been the most popular substitute material for urethral reconstructive surgery because it is easy to harvest, is easy to access, has a concealed donor site scar, and obviates most of the problems associated with other grafts. However, the success of using oral mucosa for urethral surgery is mainly attributed to the biological properties of this tissue. Herein, the surgical steps of harvesting oral mucosa from the inner cheek are presented with an emphasis on tips and tricks to render the process easier and more reproducible and to prevent intra and post-operative complications. The following steps are emphasized: Nasal intubation, ovoid shape graft, delicate harvesting leaving the muscle intact, donor site closure and removal of submucosal tissue.

  10. [Oral medicine 7: white lesions of the oral mucosa]. (United States)

    de Visscher, J G A M; van der Meij, E H; Schepman, K P


    White lesions of the oral mucosa may be due to highly diverse disorders. Most of these disorders are benign but some may be a malignant or premalignant condition. The disease is often confined to the oral mucosa. There are also disorders which are accompanied by skin disorders or systemic diseases. Many white oral mucosa disorders have such characteristic clinical aspects that a diagnosis can be made on clinical grounds only. When the clinical diagnosis is not clear, histopathological examination is carried out. Treatment depends on the histological diagnosis. In some cases, treatment is not necessary while in other cases, treatment is not possible since an effective treatment is not available. Potentially malignant disorders are treated.

  11. Testosterone Buccal (United States)

    ... and dependence of testosterone and other AAS.The Anabolic Steroids Control Act of 1990 placed AAS, including testosterone, ... insulin (Apridra, Humalog, Humulin, Lantus, Novolin, others), oral steroids ... doctor if you have breast cancer or have or may have prostate cancer. Your ...

  12. The effectiveness of different root debridement modalities in open flap surgery. (United States)

    Huerzeler, M B; Einsele, F T; Leupolz, M; Kerkhecker, U; Strub, J R


    It is unclear what degree of roughness or smoothness result from use of hand instruments alone in comparison to the use of hand instruments in combination with other aids and how it may effect the grade of cleanliness. The aim of this study was to determine in vivo whether the combination of hand instruments with other aids can increase the effectiveness of root debridement. 11 patients with holpless 4 mandibular incisors were involved in this study. After elevating a lingual and buccal mucoperiosteal flap, the 4 incisors were randomly treated with either: (1) no treatment (control); (2) 5-min scaling (method 1); (3) 4-min scaling and 1 min instrumentation with a perio-diamond bur (15 microm) (method 2); (4) 3-min scaling, 1-min instrumentation with a perio-diamond bur (15 microm) and 1 min with an air abrasive system (method 3). The cleanliness of the surface was determined using the method of Eschler and -Rapley. The degree of roughness (Ra and Rt) were measured with a laser beam (computer supported optical surface sensor system). In addition, an SEM analysis was performed. With regard to the remaining calculus (surface cleanliness), method 3 yielded significantly better results than the other 2 methods. The roughness analyses also exhibited that method 3 is superior to methods 1 and 2. The qualitative results of the SEM investigations demonstrated the most homogeneous and smooth surfaces with method 3. Root debridement in vivo was most significant using a combination of different treatment modalities (i. e., curettes, perio-diamond bur and air abrasive system).

  13. Hydrotalcite composites for an effective fluoride buccal administration: a new technological approach. (United States)

    Perioli, Luana; Nocchetti, Morena; Giannelli, Paola; Pagano, Cinzia; Bastianini, Maria


    The aim of this work was to develop new mucoadhesive buccal patches containing an inorganic fluorinated compound, MgAl-F, intended for decay prevention. Firstly MgAl-F was synthesized and characterized, then the patches were prepared starting from a physical blend of mucoadhesive polymers (NaCMC and polycarbophil) in which MgAl-F was dispersed in different amounts in order to obtain the films. The prepared mucoadhesive patches were characterized in terms of swelling capacity, mucoadhesion force and time, surface morphology and in vitro release studies. Moreover, the organoleptic properties and acceptability have been evaluated by in vivo application. The performed studies demonstrated that the proposed formulations are practical, manageable, flexible and adaptable to the biological substrate showing, at the same time, good organoleptic properties. Moreover, the presence of the MgAl-F is able to decrease the strong adhesion of the employed polymers, reducing pain and irritations resulting in a high patient acceptability. Data obtained from release studies revealed that the application of small patch portions is enough able to release, for a prolonged time, an amount of fluoride ions able to reach the efficacious dose. These observations suggest the applicability of such formulations for buccal administration of different active ingredients.

  14. Sunitinib Improves Some Clinical Aspects and Reverts DMBA-Induced Hyperplasic Lesions in Hamster Buccal Pouch (United States)

    de Souza, Fernanda Lopes; Oliveira, Mariana; Nunes, Marianne Brochado; Serafim, Lucas Horstmann; Azambuja, Alan Arrieira; Braga, Luisa Maria G. de M.; Saur, Lisiani; de Souza, Maria Antonieta Lopes; Xavier, Léder Leal


    Oral squamous cell carcinoma (OSCC) is a public health problem. The hamster buccal pouch model is ideal for analyzing the development of OSCC. This research analysed the effects of sunitinib (tyrosine kinase inhibitor) in precancerous lesions induced by 7,12-dimethylbenz(a)anthracene (DMBA) in this model. Thirty-four male hamsters, divided into six groups: control—C (n = 7), acetone—A (n = 12), carbamide peroxide—CP (n = 5 ), acetone and CP—A+CP (n = 8), 1% DMBA in acetone and CP—DA+CP (n = 6), and 1% DMBA in acetone and CP and 4-week treatment with sunitinib—DA+CP+S (n = 7). The aspects evaluated were anatomopathological features (peribuccal area, paws, nose, and fur), histological sections of the hamster buccal pouches (qualitatively analyzed), epithelium thickness, and the rete ridge density (estimated). Sunitinib was unable to attenuate the decrease in weight gain induced by DMBA; no increase in volume was detected in the pouch and/or ulceration, observed in 43% of the animals in the DA+CP group. DA+CP groups presented a significant increase in rete ridge density compared to the control groups (P < 0.01) which was reverted by sunitinib in the DA+CP+S group. Sunitinib seems to have important benefits in early stage carcinogenesis and may be useful in chemoprevention. PMID:24693453

  15. Buccal and lingual activity during mastication and swallowing in typical adults. (United States)

    Casas, M J; Kenny, D J; Macmillan, R E


    A non-invasive protocol was developed to assess tongue and cheek movements during mastication and to evaluate the temporal relationship between mastication and the initiation of pharyngeal swallowing. Typical adults (three males and three females) were monitored during chewing. Miniature pressure transducers were bonded unilaterally to the buccal and lingual surfaces of the first mandibular molar and the buccal surface of the first maxillary molar on each subject's preferred chewing side. Surface electromyography of the ipsilateral masseter muscle was recorded as an indicator of jaw-closing activity. Pressure and electromyography (EMG) recordings were time-linked to simultaneous B-mode ultrasound imaging of the oral cavity using a submental, coronal view aligned with the first mandibular molar. The intervals between peak pressure recorded at each pressure transducer and peak jaw-closing activity for each masticatory cycle were not statistically different [analysis of variance (anova), P=0.9856] and displayed large statistical variation. These intervals were not different at the beginning of the trials (hard biscuit) than they were at the completion of mastication when the cookie had been broken down to a paste/puree consistency bolus. The interval between the last chewing stroke and the initiation of swallowing was 0.92 +/- 0.34 s). No significant difference existed among subjects for this time interval (anova, P=0.382).

  16. Mucoadhesive buccal patches based on interpolymer complexes of chitosan–pectin for delivery of carvedilol (United States)

    Kaur, Amanpreet; Kaur, Gurpreet


    The study was designed to develop bioadhesive patches of carvedilol hydrochloride using chitosan (CH) and pectin (PE) interpolymer complexes and to systematically evaluate their in vitro and in vivo performances. Mucoadhesive buccal patches of carvedilol were prepared using solvent casting method. The physicochemical interaction between CH and PE was investigated by FTIR and DSC studies. The patches were evaluated for their physical characteristics like mass variation, content uniformity, folding endurance, ex vivo mucoadhesion strength, ex vivo mucoadhesion time, surface pH, in vitro drug release, in situ release study, and in vivo bioavailability study. The swelling index of the patches was found to be proportional to the PE concentration. The surface pH of all the formulated bioadhesive patches was found to lie between 6.2 and 7.2. The optimized bioadhesive patch (C1, CH:PE 20:80) showed bioadhesive strength of 22.10 ± 0.20 g, in vitro release of 98.73% and ex vivo mucoadhesion time of 451 min with in a period of 8 h. The optimized patch demonstrated good in vitro and in vivo results. The buccal delivery of carvedilol in rabbits showed a significant improvement in bioavailability of carvedilol from patches when compared to oral route. PMID:23960773

  17. Epigenetic Variation in Monozygotic Twins: A Genome-Wide Analysis of DNA Methylation in Buccal Cells

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    Jenny van Dongen


    Full Text Available DNA methylation is one of the most extensively studied epigenetic marks in humans. Yet, it is largely unknown what causes variation in DNA methylation between individuals. The comparison of DNA methylation profiles of monozygotic (MZ twins offers a unique experimental design to examine the extent to which such variation is related to individual-specific environmental influences and stochastic events or to familial factors (DNA sequence and shared environment. We measured genome-wide DNA methylation in buccal samples from ten MZ pairs (age 8–19 using the Illumina 450k array and examined twin correlations for methylation level at 420,921 CpGs after QC. After selecting CpGs showing the most variation in the methylation level between subjects, the mean genome-wide correlation (rho was 0.54. The correlation was higher, on average, for CpGs within CpG islands (CGIs, compared to CGI shores, shelves and non-CGI regions, particularly at hypomethylated CpGs. This finding suggests that individual-specific environmental and stochastic influences account for more variation in DNA methylation in CpG-poor regions. Our findings also indicate that it is worthwhile to examine heritable and shared environmental influences on buccal DNA methylation in larger studies that also include dizygotic twins.

  18. Rapid detection of chromosome 18 copy number in buccal smears using DNA probes and FISH

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    Harris, C.; Nunez, M. [Univ. of Wisconsin, WI (United States); Giraldez, R. [ONCOR, Inc., Gaithersburg, MD (United States)


    Rapid diagnosis of trisomy 18 in newborns is often critical to clinical management decisions that must be made in a minimum of time. DNA probes combined with FISH can be used to accurately to determine the copy number of chromosome 18 in interphase cells. We have used the D18Z1 alpha satellite DNA probe to determine signal frequency in normal, previously karyotyped subjects, 12 females and 6 males. We also present one clinical case of trisomy 18, confirmed by karyotype, for comparison to the results obtained from normal subjects. Buccal smears, unlike cytogenetic preparations from peripheral blood, are quite resistant to penetration of probes and detection reagents resulting in higher levels of false monosomy. We have studied 19 individuals and have obtained consistent FISH results, ranging from 64 to 90% disomy. False monosomy rates ranged from 10 to 36%, while false trisomy or tetrasomy was less than 1% in all samples. High rates of false monosomy make this test questionable for detection of low order mosaicism for monosomy, but the extremely low false hyperploidy rate suggests that this is a dependable procedure for detection of trisomy 18, enabling the use of buccal epithelium which can be collected easily from even premature and tiny infants.

  19. Microdialysis in reconstructive surgery : a clinical and experimental study focusing on monitoring flap metabolism and viability


    Röjdmark, Jonas


    When flap procedures are used to repair complex tissue wounds adequate flap circulation is of supreme importance. If the circulation is disturbed by either vascular occlusion, hemorrhage, or infection, delayed healing and flap necrosis may ensue. Early recognition of flap ischemia followed by appropriate surgical and/or pharmacotherapeutical measures may be crucial for flap survival. In the present thesis the microdialysis (MD) technique was used for the first time in recons...

  20. Goal-directed fluid therapy for microvascular free flap reconstruction following mastectomy: A pilot study


    Funk, Duane; Bohn, James; Mutch, WAC; Hayakawa, Tom; Buchel, Edward W


    Fluid replacement is an important aspect of surgery and is particularly challenging in patients undergoing microvascular free flap reconstruction. The use of vasopressors can compromise blood flow to the flap, a problem also encountered with inadequate volume replacement, which can lead to ischemia and flap loss. However, excessive perioperative fluid administration may lead to flap loss resulting from venous engorgement and flap edema. This uncertainty, in part, prompted the authors of this ...