A rapid in vitro assay of cellular chemomigration in an epithelial carcinoma cell line.

We have studied the chemomigration activity of an epithelial carcinoma cell line using a modified 96-well Boyden chamber apparatus consisting of upper and lower wells separated by an 8-microns pore polycarbonate filter. Cells from the malignant squamous carcinoma cell line A-431 were plated in the upper wells over a collagen IV-coated filter. In chemokinesis assays, the cells were allowed to migrate toward NIH 3T3 fibroblast-conditioned medium or control media in the lower wells for 6 hours at 37 degrees C with 10% CO2.

Repair of critical size rat calvarial defects using extracellular matrix protein gels.

In this study the authors examined the capacity of gels of reconstituted basement membrane, laminin, and type I collagen to mediate repair of critical size defects in rat calvaria. Although autografts are widely used to repair bone defects caused by trauma or surgical treatment of congenital malformations, neoplasms, and infections, an adequate quantity of graft is not always available. Allogenic bone is readily available, but its use is associated with an increased incidence of nonunion, fatigue fracture, and rejection.

Squamous cell carcinoma growth in irradiated tissue: a murine model for quantitative assessment of treatment.

Locoregional recurrent and distant metastases from squamous cell carcinomas, despite multimodality therapy, remain troublesome clinical realities. Discrepancies in success rates of various surgery and radiation treatment regimens dealing with these problems are confusing to the clinician attempting to recommend the most beneficial treatments. There is a need for an experimental model to assess therapeutic effectiveness quantitatively from which guidelines for developing clinical trials may be suggested.

Reconstruction of the cranial base.

The cranial base is a complex boundary between intracranial and extracranial anatomic structures. Adequate reconstruction of the basicranium depends on the location, size, and nature of the defect. A reconstructive ladder can be built on a few basic principles: coverage of vital structures, separation of the intra- and extradural spaces, procedural simplicity, and aesthetics.

Vascular lesions of the cranial base.

Vascular lesions can be classified broadly into two groups on the basis of cellular proliferation characteristics: hemangiomas and vascular malformations. Additional lesions include a heterogeneous group of vascular tumors such as those represented by hemangiopericytoma and those with a frankly malignant course. Those lesions located around the cranial base remain challenging and difficult clinical problems.

Multiple recurrent benign schwannomas of deep and superficial nerves of the upper extremity: a new variant of segmental neurofibromatosis.

Benign schwannomas of the brachial plexus are uncommon tumors, first described in the late 19th century. These lesions, which are histologically benign, can generally be excised without sacrifice of neural elements. We present the first known case of multiple concurrent and recurrent benign schwannomas of the upper extremity in an individual who demonstrated no other evidence of neurofibromatosis, and we suggest that this case may represent a new subtype of type V neurofibromatosis.

In the absence of periosteum, transplanted fetal and neonatal rat coronal sutures resist osseous obliteration.

Normal craniofacial development depends on expansion of the cranial vault by growth at the sutures. Inappropriate development of the sutures leads to global disruption of patterns of craniofacial growth. Tissue interactions between dura mater and suture matrix play a critical role in the phenotypic maintenance of cranial sutures.

Sagittal synostosis.

Sagittal synostosis comprises a spectrum of deformities caused by premature fusion of the sagittal suture. The treatment of sagittal synostosis is dependent on the age of the patient and the characteristics of the presenting deformity. Immediate correction of the scaphocephalic deformity is the goal of operative treatment.

Prevention of "temporal hollowing" after fronto-orbital advancement for craniosynostosis.

Depression of profile in the temporal region is commonly seen after orbital rim advancement procedures. A newly developed temporalis musculoosseous flap has been designed with the intent to prevent this postoperative occurrence.

Computer-generated slide graphics on a shoestring budget.

The use of computer-generated slides in weekly didactic conferences and at regional and national meetings is commonplace. Though adding a professional look, the expense of computer-generated slides can be prohibitive. We herein present a simple technique for generating color slides that captures the professional look of computer-generated slides at a fraction of the cost.

Neuroleptic malignant syndrome: an overview.

Neuroleptic Malignant Syndrome (NMS) is a specific, potentially lethal disorder related to the usage of dopamine antagonists. The four clinical hallmarks associated with this syndrome are 1) hyperthermia, 2) muscle rigidity, 3) mental status changes, and 4) autonomic instability. NMS has been estimated to occur in 0.

Experimental expansion of the maxillary sinus.

To assess the feasibility of "tissue" expansion as a means of midface advancement for correction of hypoplasia, expanders were placed in the left maxillary sinuses of New Zealand White rabbits. Twenty-one animals were used for the study, all of whom underwent implantation of radiopaque dental amalgam markers adjacent to cranial sutures at 9 days of age. The nonoperative control group (n = 13) underwent no further surgery.

Tissue interactions with underlying dura mater inhibit osseous obliteration of developing cranial sutures.

Cranial sutures play a critical role in calvarial morphogenesis, serving as growth centers during skull development. Both biomechanical tensile forces originating in the cranial base and biochemical factors present in dura mater have been postulated as determinants of suture morphogenesis and patency. A rat transplant model free of the putative biomechanical influence of the dura and cranial base was used to investigate the role of the dura mater in both the initial morphogenesis and maintenance of sutures during skull growth.

The endogenous inhibitor of protein kinase-C in the rat ovary is a protein phosphatase.

Calcium- and lipid-dependent protein kinase (PKC) activity in the ovary of the pseudopregnant rat is masked by an endogenous inhibitor of PKC. These studies were undertaken to examine the mechanism of action of the endogenous inhibitor of PKC in the rat ovary. The addition of the phosphatase inhibitors calyculin-A (0.

Frontonasal dysplasia in two successive generations.

Frontonasal dysplasia is thought to be a sporadic condition limited to the face and head. We describe a family from the Bahamas in which a mother, 2 of her children, and the mother's brother have variable manifestations of frontonasal dysplasia. The mother has extremely mild expression, but her brother and 2 sons are more severely affected.

Calvarial deformity regeneration following subtotal craniectomy for craniosynostosis: a case report and theoretical implications.

We describe an infant with combined sagittal and unilateral coronal synostosis who underwent "total vault" craniectomy for skull reshaping. The operative procedure was interrupted without replacement of the calvarial bone grafts. Follow-up over the ensuing 2 months revealed regeneration of the entire cranium and supraorbital rims, as well as (in contrast to earlier reports) redevelopment of fusion within the suture at the same site noted in the initial operation, associated with similar skull deformity.

Malignant peripheral nerve sheath tumors. A clinicopathologic study of 28 cases.

Background: In order to improve management, the files and tissue sections of 28 cases of malignant peripheral nerve sheath tumors (MPNST) diagnosed at the University of Virginia Health Sciences Center between 1960 and 1990 were reviewed.

Methods: Clinical data tabulated included age, sex, race, the presence or absence of von Recklinghausen neurofibromatosis type 1 (NF-1), tumor size, tumor location, type of treatment, and status of surgical margins. Pathologic study included assessment of mitotic rate, divergent differentiation, cellular atypia, necrosis, and vascular reaction.

The serratus anterior free tissue transfer for craniofacial reconstruction.

The serratus anterior muscle was used as a free tissue transfer to reconstruct complex craniofacial defects in 5 patients. Serratus anterior muscle alone and serratus anterior muscle with rib were the transfers made. All flaps survived and scapular winging did not occur.

Neurological deterioration after lumbar cerebrospinal fluid drainage.

Large-bore lumbar spinal fluid drainage is used frequently as part of the preoperative and intraoperative management of patients undergoing cranial base tumor resection. Such drainage allows displacement of the brain with minimal force, thereby potentially decreasing retraction damage to it. We document 2 patients in whom serious complications resulted from lumbar drainage systems.

Surgeon's foot: a report of sural nerve palsy.

Although compression neuropathies are encountered frequently in neurosurgical practice, involvement of the sural nerve is described rarely. We report a case of bilateral compression neuropathy of the sural nerve with an unusual mechanism of injury. The case is discussed, and the pertinent literature is reviewed.

Duraplasty in cranial base resection.

Complications of cerebrospinal fluid leakage following cranial base surgery are a predominant source of morbidity and mortality. The physical properties of the dura in this region, advanced patient age, previous irradiation, and the extent of tumor resection often limit or complicate the reconstructive options available to cranial base surgeons. We describe a technique that delivers vascularized tissue to the dural wound by transposing a dural flap based on the axial pedicle blood supply from the middle meningeal artery.

Craniofacial suture stenosis: morphologic effects.

Craniofacial anomalies, such as Apert's and Crouzon's syndromes, are presumed to be related to premature growth arrest of cranial base growth sites. However, premature growth arrest at cranial vault sutures in animals appears to play a causative role in the development of cranial deformities characteristic of single-suture, or simple, craniosynostosis in humans. To study the possible causative role of cranial vault and other (interface) suture stenoses on the development of craniofacial deformity, a vault suture and an interface suture between the cranial vault and facial skeleton were simultaneously immobilized.