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Motile cells inside living tissues often encounter junctions, where their path branches into several alternative directions of migration. We present a theoretical model of cellular polarization for cells migrating along one-dimensional lines, arriving at a symmetric Y-junction and extending protrusions along the different paths that emanate from the junction. The model predicts the spontaneous emergence of deterministic oscillations between competing protrusions, whereby the cellular polarization and growth alternates between the competing protrusions. The oscillations are modified by cellular noise, but remain as a dominant feature which affects the time it takes the cell to migrate across the junction. These predicted oscillations in the cellular polarization during the directional decision making process at the junction are found experimentally for two different cell types, noncancerous endothelial and cancerous glioma cells, migrating on patterned network of thin adhesive lanes with junctions.

Background: A longitudinal study design was conducted to assess the mandibular cortical shape index (CI) in panoramic radiographs retrospectively. An association between age and a deterioration of different radiological parameters on panoramic radiographs was stated in cross‑sectional studies. As longitudinal studies are rare, this one is designed to assess radiological changes over time. Materials and Methods: In this longitudinal study, The archive of the dentomaxillofacial radiology department was searched for panoramic radiographs of patients who have two radiographs with a time lapse of at least 15 years between both. The radiographs were then examined and the CI was categorized into three categories: normal, mild, and severely eroded. The following factors were examined to determine if they had an effect on possible changes of the CI using the Chi‑square test: The time period between both radiographs, the gender and the age of the subjects when both radiographs were made also compared using the Kolmogorov–Smirnov test. Results: Ninety radiographs met the inclusion criteria. The mean age, when the 1st radiograph and the 2nd radiograph were made, was 48.7 and 66.9 years, respectively. A deterioration of the CI over time was observed and only 31.1% of the radiographs remained in the same CI category while 57.8% dropped down by one category and 11.1% dropped down by two. The change of CI was significant (P < 0.001 using the McNemar’s test). Conclusion: In this longitudinally designed study, a deterioration of the CI over time when assessing the nonstandardized panoramic radiographs could be confirmed. This study shows that 68.9% of the patients had CI deterioration of at least one category over the average time of 17.96 years. This is the first study to quantify the CI deterioration over time to our knowledge. Key Words: Bone density, facial bones, mandible, osteoporosis, panoramic radiography

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

Introduction. Face transplantation (FT) is an innovative achievement of modern reconstructive surgery and is on the verge of becoming a common surgical opportunity. This review article was compiled to provide an update on this surgical field, especially regarding clinical outcomes, benefits, and complications implied.Methods. We performed an extensive research on all English-language Medline articles, case reports, and reviews published online until September 15, 2013. Used search terms were “face transplantation,” “face transplant,” “facial transplantation,” “facial transplant,” “face allograft,” and “facial allograft.”Results. To date 27 FTs have been performed worldwide. 19 of these cases have been published in the Medline database. Long-term follow-up reports of FT cases are rare. Three deaths associated with the procedure have occurred to date. The clinical outcomes of FT are satisfying. Reinnervation of sensation has been faster than motor recovery. Extensive functional improvements have been observed. Due to strict immunosuppression protocols, no case of hyperacute or chronic rejection and no graft-versus-host disease have occurred to date.Conclusions. As studies on long-term outcomes are missing, particularly regarding immunosuppression-related complications, FT will stay experimental for the next years. Nevertheless, for a small group of patients, FT already is a feasible reconstructive option.

The purpose of the present study was to find inexpensive and non-toxic additives enhancing and accelerating the osteogenesis of mesenchymal stem cells in vitro, which can be used for tissue engineering of bone material.Osteogenic differentiation of rat mesenchymal stem cells was carried-out using classic differentiation medium containing or lacking purmorphamine, statins or oxysterols, respectively. Cell proliferation, alkaline phosphatase activity, calcium sedimentation and expression of bone matrix protein genes were measured to monitor differentiation.Purmorphamine substantially suppressed proliferation, enhanced and accelerated alkaline phosphatase activity and calcium sedimentation and increased the expression of osteopontin and osteocalcin in rat mesenchymal stem cells in vitro. A similar osteogenesis-promoting effect was observed for oxysterols but not for the two statins.Purmorphamine and oxysterols promote and accelerate osteogenesis of mesenchymal stem cells in vitro suggesting their potential application for tissue engineering of bone material.

Object.To determine the incidence of postoperative bleeding for oral osteotomy carried out under continued monoantiplatelet therapy with clopidogrel and dual therapy with clopidogrel/aspirin.Design.Retrospective single center observatory study of two study groups and a control group.Methods.A total of 64 and 60 oral osteotomy procedures carried out under continued monoclopidogrel therapy and dual clopidogrel/aspirin therapy, respectively, were followed for two weeks for postoperative bleeding. Another 281 similar procedures were also followed as a control group. All oral osteotomy procedures were carried out on an outpatient basis.Results.We observed postoperative bleeding in 2/281 (0.7%) cases in the control group, in 1/64 (1.6%) cases in the clopidogrel group, and in 2/60 (3.3%) cases in the dual clopidogrel/aspirin group. The corresponding 95% confidence intervals are 0–1.7%, 0–4.7%, and 0–7.8%, respectively, and the incidences did not differ significantly among the three groups (P>0.09). Postoperative hemorrhage was treated successfully in all cases with local measures. No changes of antiplatelet medication, transfusion, nor hospitalisation were necessary. No major cardiovascular events were recorded.Conclusions.Our results indicate that minor oral surgery can be performed safely under continued monoantiplatelet medication with clopidogrel or dual antiplatelet medication with clopidogrel/aspirin.

The present study aimed to find bone substitutes to enhance osteogenic differentiation of mesenchymal stem cells in three-dimensional scaffolds in the absence of dexamethasone.Seven commercial bone substitutes were added to a three-dimensional fibrin-matrix containing rat mesenchymal stem cells in a biocompatible poly-L-lactic-acid mesh. Cell viability, cytotoxicity and alkaline phosphatase activity were followed for three weeks. Expression of bone markers was examined by qualitative evaluation of corresponding transcripts.Six out of the seven bone derivatives exhibited an osteogenic-enhancing effect.The osteogenic-enhancing effect of the evaluated bone substitutes suggests their potential clinical application for preparation of autologous bone replacement material in three-dimensional carriers.

Einleitung: Die Rekonstruktion von ausgedehnten knöchernen Defekten im Kopf- Halsbereich mittels mikrovaskulärer Transplantate ist aufwendig und langwierig um eine optimale dreidimensionale Situation wiederherzustellen. In den letzten Jahren wurde zur Unterstützung des Chirurgen die virtuelle[for full text, please go to the a.m. URL], 131. Kongress der Deutschen Gesellschaft für Chirurgie

Introduction. Face transplantation (FT) is an innovative achievement of modern reconstructive surgery and is on the verge of becoming a common surgical opportunity. This review article was compiled to provide an update on this surgical field, especially regarding clinical outcomes, benefits, and complications implied. Methods. We performed an extensive research on all English-language Medline articles, case reports, and reviews published online until September 15, 2013. Used search terms were “face transplantation,” “face transplant,” “facial transplantation,” “facial transplant,” “face allograft,” and “facial allograft.” Results. To date 27 FTs have been performed worldwide. 19 of these cases have been published in the Medline database. Long-term follow-up reports of FT cases are rare. Three deaths associated with the procedure have occurred to date. The clinical outcomes of FT are satisfying. Reinnervation of sensation has been faster than motor recovery. Extensive functional improvements have been observed. Due to strict immunosuppression protocols, no case of hyperacute or chronic rejection and no graft-versus-host disease have occurred to date. Conclusions. As studies on long-term outcomes are missing, particularly regarding immunosuppression-related complications, FT will stay experimental for the next years. Nevertheless, for a small group of patients, FT already is a feasible reconstructive option.

Purpose: The reconstruction of large facial bony defects using microvascular transplants requires extensive surgery to achieve full rehabilitation of form and function. This retrospective study evaluates the virtual planning tool ProPlan CMF®in 30 consecutive cases to enhance precision and efficiency[for full text, please go to the a.m. URL], 51. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW)

Einleitung und Fragestellung: Nach vier bis sechs Stunden globaler Ischämie treten irreversible Schäden an den Strukturen Muskulatur, Subkutis, Dermis und Epidermis in unterschiedlicher Ausprägung auf. In der vorliegenden Studie soll lichtmikroskopisch untersucht werden, welche Strukturen[for full text, please go to the a.m. URL], 51. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW)

Einleitung: Mikrochirurgische Anastomosen sind technisch aufwändige Verfahren. Eine Verkürzung der Operationszeiten durch ein schnelleres, sicheres, aber qualitativ gleichwertiges Anastomosierungsverfahren wäre mit Vorteilen verbunden. N-Fibroin (Seide) ist biokompatibel, wird proteolytisch[for full text, please go to the a.m. URL], 50. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW)

Einleitung: Eine gerinnungsinhibierende Therapie mit ASS und Clopidogrel ist für Patienten, die beispielweise einen Myokardinfarkt erlitten haben oder an einer koronaren Herzkrankheit leiden, von essentieller Bedeutung. Die Frage, diese Therapie für eine operative Therapie von Hautläsionen[for full text, please go to the a.m. URL], 50. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW)

Keratocystic odontogenic tumors (KCOTs) arise from remnants of epithelial structures associated with the development of teeth and occur predominantly intraosseously. In rare occasions they can appear extraosseously in the gingiva as peripheral counterparts; only 15 cases have been reported to date. Evenmore rare are cases of KCOTs of the buccal soft tissues. The aim of this report is to present a rare case of KCOT affecting the buccal soft tissue as an original site and a review of the literature regarding diagnostic and therapeutic options.

Neurofibromatosis (NF1) is an autosomal dominant tumour predisposition syndrome. A plethora of tumours are described in the literature associated with NF1. These tumours usually develop earlier in life. Some tumours show a close association with NF1, e.g. malignant peripheral nerve sheath tumour and optic nerve glioma, others are only rarely diagnosed in the context of this disease. This report focuses on the diagnosis and therapy of a squamous cell carcinoma (SCC) of the sole of the foot arising in a 67-year-old male patient with NF1. The lesion was initially misdiagnosed as an abscess. Wide excision of the highly differentiated SCC was followed by conditioning of the deep wound by a vacuum dressing. After achievement of bulky granulation tissue covering the defect at the level of the adjacent skin, a full-thickness skin graft was obtained from the abdominal skin and fixed on the defect. Healing of the defect was almost achieved by primary intention; two small lesions healed within weeks. The patient was repeatedly investigated. Five years after primary surgery, the patient had developed a corn on the medial side of the former defect. This lesion was completely excised and the defect was closed by primary intention after creating a small rotation flap. The lesion proved to be inflamed skin of the sole of the foot with no dedifferentiation of the epithelia. NF1 is a complex hereditary disease that displays an abundance of signs and symptoms. SCC may affect individuals with NF1. However, SCC account only for a small number of malignancies in NF1 compared to malignancies arising in connective tissue and brain. To the best of our knowledge, this is the first report on an SCC of the sole diagnosed in NF1. Vacuum dressing as an adjunct to surgery allowed reduced reconstructive measures.

Einleitung: Die Rekonstruktion des Unterkiefers mit mikrovaskulären Fibulatransplantaten nach Resektion neoplastischer Raumforderungen erfordert einen umfangreichen Eingriff zur möglichst weitgehenden Wiederherstellung von Funktion und Ästhetik. Um diese hohen Anforderungen zu erfüllen[for full text, please go to the a.m. URL], 49. Jahrestagung der Deutschen Gesellschaft für Plastische und Wiederherstellungschirurgie (DGPW)