We introduce the expanded polytetrafluoroethylene (ePTFE) superficial musculoaponeurotic system extension graft (SEG) as an effective method of lower face-lift and an alternative to the minimally invasive lower face-lift and thread-lift. During a 4.5-year period, 450 lower face-lifts with ePTFE SEG were performed. The procedure consisted of a primary ePTFE grafting operation followed by a secondary ePTFE SEG traction operation 3 to 4 weeks later; the skin flap was then excised and redraped to adjust the postauricular sulcus. No major complications resulted from surgery, but minor complications included wound infection (2.7%), insufficient traction (1.8%), slipped ePTFE graft (1.3%), temporary earlobe numbness (1.1%), asymmetric traction (0.9%), occipital pain (0.7%), and hematoma below the earlobe (0.2%). Lower face-lift with ePTFE SEG produces satisfactory results for both patients and surgeons in view of the short recovery time, less minimal invasion, simple techniques, and long-lasting outcome when compared with other minimally invasive methods of lower face-lift.
We investigated how a new type of synthetic porous hydroxyapatite ceramic (HAP-TCP) acts when it is implanted in growing membranous bone. Seventy-six New Zealand White infant male rabbits (4-week-olds) were used. Rabbits received HAP-TCP block or silicone block implantation in their right nasal bone. The left nasal bone was used for a sham. Serial or cross-sectional examinations by morphometry, radiology, blood biochemistry, and histology were carried out. Both the HAP-TCP and silicone groups exhibited no systemic growth disturbance in terms of morphometry and blood biochemistry. Dual energy x-ray absorptiometry (DEXA) revealed, however, a decrease in the bone mineral content (BMC) of the right nasal bone in the silicone group. Histology revealed a superior affinity of HAP-TCP to bone tissue than that of silicone. When a HAP-TCP block was implanted under the periosteum it bonded directly to bone tissue. However, sinking of the implants into the bone tissue were noted both in the HAP-TCP and the silicone groups in longitudinal observation. These results suggest that although HAP-TCP has superior affinity to bone tissue, this by itself is not enough sufficient reason to believe that HAP-TCP can be effectively applied during the growth period.
To determine the effects of local bone turnover on the migration of macroporous hydroxyapatite onlays in the nasal bone and mandibular ramus, we performed histomorphometric analyses of the underlying bone area in 41 New Zealand White rabbits from the age of 4 weeks. The hydroxyapatite implants were placed under the periosteum of the right nasal bone (a depository bone onto its periosteal surface and endosteal resorptive) and the mandibular ramus (resorptive onto its outer surface). The corresponding left sides were sham operated. Following fluorescence bone labeling, composite specimens of the hydroxyapatite block including both sides of the nasal bone and mandible were removed at 0 (n = 1), 3, 6, 9, 12, and 16 weeks postoperatively (n = 8, respectively) and processed to yield undecalcified sections. Bone-bone marrow interfaces in the entire area within 200 microns beneath the base of the hydroxyapatite and in the counter-area on the sham-operated side were measured under a light microscope. In all grafted specimens, the hydroxyapatite matrix was directly united with the underlying tissue by bone ingrowth. However, the sinking of the hydroxyapatite graft in the nasal bone was significant at 3 weeks postoperatively and gradually increased thereafter. In the mandible, the sinking became significant at 6 weeks. In the nasal bone, the bone area density beneath the graft showed a time-dependent decrease during the experimental period, but in the mandibular bone, the value was initially decreased at 3 weeks and then recovered to baseline level. In both bones, parameters of bone resorption, such as osteoclast number and osteoclast surface, were significantly increased from 3 weeks. While the parameters of bone formation, such as osteoblast surface and mineralizing surface, were significantly decreased from 3 weeks in the nasal bone, they were significantly increased in the mandible. Mineral apposition rate showed a significant decrease in both bones. Our data indicate that while the bone area density beneath the hydroxyapatite seemed to depend on bone formation, increased bone resorption would be more critical for the remodeling of underlying bony architecture in the migration of the hydroxyapatite graft.
As medical doctors, we routinely check patient blood chemistry and CBC data to diagnose disease. However, these data and methods of analysis are very rarely used to find pre-disease conditions or treat undiagnosed malaise. Masatoshi Kaneko Ph.D. found that many pre-disease conditions and types of malaise could be detected using his unique method of blood data analysis, and could also be treated using personalized nutritional therapy as an alternative to using drugs. The authors of this article introduce personalized nutritional therapy based on blood data analysis (Kaneko’s method), and present and discuss some clinical cases. In total, 253 pre-disease or undiagnosed patients were treated using this nutritional therapy approach, and most of them recovered from their chronic symptoms and pre-disease conditions. This novel nutritional therapy has the potential to help many presymptomatic and undiagnosed patients suffering from malaise.
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