No Evidence for Maternal–Fetal Microchimerism in Infantile Hemangioma: A Molecular Genetic Investigation

In this study, using the placental origin theory as a basis, we set out to explore whether hemangioma endothelial cells (HEC) were maternal in origin. We rigorously addressed this hypothesis using several molecular genetic techniques. Fluorescent in situ hybridization on surgical specimens of proliferating hemangiomas (n=8) demonstrated no XX-labeled HEC from resected tumors of male infants. This analysis was followed by PCR genotyping of HEC (n=11) using microsatellite markers where cellular components were genotyped and compared to genomic DNA of corresponding mother-child pairs. In the seven informative mother-child pairs, HEC matched the genotype of the child and not the maternal genotype. Concerned that HEC represented a mixed population of cells, we subsequently enriched for cells using the placental-specific endothelial cell (EC) marker, Fc gammaRII. Three informative mother-child pairs exhibited only the genotype of the child in our enriched cell population. Using sequence analysis, we identified an informative single nucleotide polymorphism in an exon of the placental-EC-specific protein, GLUT1. When comparing GLUT1 complementary DNA (cDNA) with mother-child DNA, the genotype of the cDNA matched the constitutional DNA of the child. Our results indicate that hemangiomas are not microchimeric in origin. This study provides further insight into the origin of a tumor whose pathogenesis remains elusive

Functional Outcomes of Cleft Lip Surgery. Part II: Quantification of Nasolabial Movement

To explore nasolabial movements in participants with repaired cleft lip and palate

Functional Outcomes of Cleft Lip Surgery. Part I: Study Design and Surgeon Ratings of Lip Disability and Need for Lip Revision

Objective—Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed. To establish more reliable, functionally relevant outcome criteria for evaluation and treatment planning, a clinical trial currently is in progress. In this article, the design of the clinical trial is described and results of a study on subjective evaluations of facial form by surgeons for or against the need for lip revision surgery are presented. Design—Parallel, three-group, nonrandomized clinical trial and subjective evaluations/ratings of facial views by surgeons. Subjects—For the clinical trial, children with repaired cleft lip and palate scheduled for a secondary lip revision, children with repaired cleft lip and palate who did not have lip revision, and noncleft children. For the subjective evaluations, surgeons’ facial ratings of 21 children with repaired cleft lip. Analysis—Descriptive and Kappa statistics assessing the concordance of surgeons’ ratings of (a) repeated facial views and (b) a recommendation of revision on viewing the prerevision and postrevision views. Results—The surgeons’ consistency in rating repeated views was moderate to excellent; however, agreement among the surgeons when rating individual participants was low to moderate. Conclusions—The findings suggest that the agreement among surgeons was poor and support the need for more objective measures to assess the need for revision surgery

Functional Outcomes of Cleft Lip Surgery. Part I: Study Design and Surgeon Ratings of Lip Disability and Need for Lip Revision

Objective—Children with a cleft of the upper lip exhibit obvious facial disfigurement. Many require multiple lip surgeries for an optimal esthetic result. However, because the decision for lip revision is based on subjective clinical criteria, clinicians may disagree on whether these surgeries should be performed. To establish more reliable, functionally relevant outcome criteria for evaluation and treatment planning, a clinical trial currently is in progress. In this article, the design of the clinical trial is described and results of a study on subjective evaluations of facial form by surgeons for or against the need for lip revision surgery are presented. Design—Parallel, three-group, nonrandomized clinical trial and subjective evaluations/ratings of facial views by surgeons. Subjects—For the clinical trial, children with repaired cleft lip and palate scheduled for a secondary lip revision, children with repaired cleft lip and palate who did not have lip revision, and noncleft children. For the subjective evaluations, surgeons’ facial ratings of 21 children with repaired cleft lip. Analysis—Descriptive and Kappa statistics assessing the concordance of surgeons’ ratings of (a) repeated facial views and (b) a recommendation of revision on viewing the prerevision and postrevision views. Results—The surgeons’ consistency in rating repeated views was moderate to excellent; however, agreement among the surgeons when rating individual participants was low to moderate. Conclusions—The findings suggest that the agreement among surgeons was poor and support the need for more objective measures to assess the need for revision surgery

Comparison of Craniofacial Phenotype in Craniosynostotic Rabbits Treated With Anti–Tgf-β2 at Suturectomy Site

Overexpression of transforming growth factor-beta 2 has been associated with craniosynostosis and resynostosis following surgery. We examined the effects of localized transforming growth factor-beta 2 inhibition on craniofacial phenotype in rabbits with craniosynostosis