Muscle Fiber Composition Changes after Selective Nerve Innervation

Facial nerve paralysis interferes with mimetic muscle function. To reconstruct natural facial movement, free muscle flaps are transplanted as new muscles. However, it is difficult to maintain resting tonus. A dual innervation technique in which other nerves such as the hypoglossal nerve or contralateral facial nerve are added is often applied. Using 10-week-old rats (n = 10), the masseteric and hypoglossal nerves were cut, and the distal stump of the masseteric nerve and the proximal stump of the hypoglossal nerve were then sutured (suture group). In the other group, the masseteric nerve was cut and cauterized (cut group). Immunohistochemistry and microarray were performed on the extracted masseter muscle. The immunohistochemistry results suggested that the muscles in the suture group obtained oxidative characteristics. The microarray showed the genes involved in mitochondrial function, including Perm1. In summary, our data support the validity of the dualinnervation technique for facial paralysis treatment

Usefulness of Choline-PET for the detection of residual hemangiopericytoma in the skull base: comparison with FDG-PET

<p>Abstract</p> <p>Background</p> <p>Choline is a new PET tracer that is useful for the detection of malignant tumor. Choline is a precursor of the biosynthesis of phosphatidylcholine, a major phospholipid in the cell membrane of eukaryotic cells. Malignant tumors have an elevated level of phosphatidylcholine in cell membrane. Thus, choline is a marker of tumor malignancy.</p> <p>Method</p> <p>The patient was a 51-year-old man with repeated recurrent hemangiopericytoma in the skull base. We performed Choline-PET in this patient after various treatments and compared findings with those of FDG-PET.</p> <p>Results</p> <p>Choline accumulated in this tumor, but FDG did not accumulate. We diagnosed this tumor as residual hemangiopericytoma and performed the resection of the residual tumor. FDG-PET is not appropriate for skull base tumor detection because uptake in the brain is very strong.</p> <p>Conclusion</p> <p>We emphasize the usefulness of Choline-PET for the detection of residual hemangiopericytoma in the skull base after various treatments, compared with FDG-PET.</p

Treatment of Congenital Absence of the Mammary Gland

Breast reconstruction for breast deformity is significant not only for esthetic purposes but also from a psychological perspective. There have been a few reports on treatment of congenital simple absence of the mammary gland. For patients in puberty, even if they are in the middle of the growth phase, breast reconstruction is very important for the mental quality of life. In our two cases of congenital absence of unilateral mammary gland, breast reconstruction with a tissue expander worked well in terms of esthetic results and the psychological condition of the young patients. In our institute, operative indications are as follows: (1) a girl over 15 years old (this age is selected as breast growth can be determined at this time), (2) no endocrine-related disorders, (3) preoperative examination of breast MRI or US showing the absence or significant hypoplasia of mammary gland, and (4) a wish for breast reconstruction by the patient herself. For patients in the middle of the growth phase, silicone breast implant does not require a donor site and is easily adjustable in terms of volume to match the growth of the breast on the unaffected side by exchanging the silicone breast implant. Therefore, silicone breast implant is a better procedure than skin flaps with their accompanying large donor sites

Successful Function-Preserving Therapy for Chondroblastoma of the Temporal Bone Involving the Temporomandibular Joint

We present a case involving a late diagnosis of chondroblastoma of the temporal skull base involving the temporomandibular joint (TMJ). Following an initial misdiagnosis and unsuccessful treatment over a period of 5 years, the patient was referred to our department for further evaluation and possible surgical intervention for occlusal abnormalities, trismus, clicking of the TMJ, and hearing impairment. Based on preoperative immunochemical studies showing positive reaction of multinucleated giant cells for S-100 protein, the final diagnosis was chondroblastoma. The surgical approach – postauricular incision and total parotidectomy, with complete removal of the temporal bone, including the TMJ via the extended middle fossa – was successful in preserving facial nerves and diminishing clinical manifestations. This study highlights a misdiagnosed case in an effort to underline the importance of medical examinations and accurate differential diagnosis in cases involving any tumor mass in the temporal bone