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At least 19 recordsLinked to original sources

[Reconstruction of tracheal defect using the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum].

OBJECTIVE: To reconstruct tracheal defect after tumor excision, we used the contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum. METHODS: The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum was used to reconstruct the tracheal defect when the blood supply to the ipsilateral sternocleidomastoideus was destroyed because of lymphonode clearing or radiotherapy. The pedicle of the musculo-periosteum flap was dissected adequately and the blood supply was protected carefully. RESULTS: All flaps survived with epithelization and osteogenesis. The endotracheal tubes were pulled out safely without trachea stenosis in all the patients. CONCLUSIONS: The contralateral musculo-periosteum flap of the sternocleidomastoideus with clavicular periosteum could reconstruct the tracheal defect when the ipsilateral blood supply was damaged. This method extends the application of the musculo-periosteum flap.

Adult↗

Bio-artificial periosteum for severe open fracture--an experimental study of osteogenic cell/collagen sponge composite as a bio-artificial periosteum.

In an attempt to reduce complications in cases of severe open fracture, we developed a bio-artificial periosteum composed of osteogenic cells and collagen sponge. In the present study, we evaluated the osteogenic potential of the bio-artificial periosteum in vivo and in vitro. After 4-week incubation in vitro, the bio-artificial periosteum had high alkaline phosphatase activity and osteocalcin content. Moreover, energy dispersive X-ray analysis revealed numerous crystal structures consisting of P and Ca on the surface of the bio-artificial periosteum. Using a rat model for severe bone injury, we examined the bone formation process in defect sites covered with the bio-artificial periosteum. New bone formation occurred in the central part of the bone defect as well as at the bone edge. We conclude that by using the bio-artificial periosteum, the fracture site benefited from an improved osteogenic environment. These results indicate that a clinical trial to further evaluate this technique should be conducted.

Alkaline Phosphatase↗

1,25-Dihydroxyvitamin D3 effects on collagen and DNA synthesis in periosteum and periosteum-free calvaria.

1,25-dihydroxyvitamin D3 [1,25(OH)2D3] is essential for normal growth and mineralization, but its direct effects on various aspects of bone formation remain controversial. 1,25(OH)2D3 was studied for its effects on DNA, collagen and noncollagen protein synthesis, and alkaline phosphatase activity (APA) in the periosteum and periosteum-free bone from 21-day fetal rat calvariae. 1,25(OH)2D3 (0.01 to 10 nM) inhibited the incorporation of 3H-proline into collagenase-digestible protein (CDP) and the percent of collagen synthesized, and, at 10 nM, APA in the periosteum-free bone. 1,25(OH)2D3 inhibited type I collagen without affecting other collagen types. In contrast, 1,25(OH)2D3 at 10 nM caused a small but significant stimulation of the incorporation of 3H-thymidine into acid-insoluble residues (DNA) and on DNA content; both effects were exclusively observed in the periosteum. Hydroxyurea did not modify the inhibitory effect of 1,25(OH)2D3 on 3H-proline incorporation into CDP. These studies indicate that 1,25(OH)2D3 stimulates periosteal DNA synthesis but inhibits type I collagen synthesis and APA in the periosteum-free bone.

Alkaline Phosphatase↗

Immunohistochemical analysis of Sox9 expression in periosteum of tibia and calvaria after surgical release of the periosteum.

Sox9 is a transcription factor belonging to the SRY family of high-mobility box proteins, and plays a major role in endochondral ossification. Sox9 is a potent activator of the type-2 collagen pheno-type marker of articular cartilage. Regulation of osteogenic molecular signals in periosteal bone formation has not yet been elucidated yet. The purpose of the present study was to analyze histologically the bone formation in surgically released and repositioned periosteum, and to determine expression of Sox9 and type-2 collagen in periosteal bone formation of tibia and calvaria. After surgery, the released tibial periosteum formed ectopic cartilage. At 7 days, a combination of endochondral and intramembranous ossification was apparent. Some fibroblasts derived from the released periosteum showed Sox9 expression. Chondrocytes and cartilage matrix both displayed type-2 collagen expression. At 7 days, an additional new bone was formed on the calvaria. Osteoblasts and fibroblasts derived from released calvarial periosteum did not express Sox9 or type-2 collagen. Sox9 was not expressed throughout the process periosteal bone formation on the calvaria. It is concluded that we revealed Sox9 and type-2 collagen expression in periosteal cells after periosteum release and that the generative potential of periosteal cells of calvaria is different from that of tibia.

Animals↗

Human femoral neck has less cellular periosteum, and more mineralized periosteum, than femoral diaphyseal bone.

Periosteal expansion enhances bone strength and is controlled by osteogenic cells of the periosteum. The extent of cellular periosteum at the human femoral neck, a clinically relevant site, is unclear. This study was designed to histologically evaluate the human femoral neck periosteal surface. Femoral neck samples from 11 male and female cadavers (ages 34-88) were histologically assessed and four periosteal surface classifications (cellular periosteum, mineralizing periosteum, cartilage, and mineralizing cartilage) were quantified. Femoral mid-diaphysis samples from the same cadavers were used as within-specimen controls. The femoral neck surface had significantly less (P<0.05) cellular periosteum (18.4+/-9.7%) compared to the femoral diaphysis (59.2+/-13.8%). A significant amount of the femoral neck surface was covered by mineralizing periosteal tissue (20-70%). These data may provide an alternate explanation for the apparent femoral neck periosteal expansion with age and suggest the efficiency of interventions that stimulate periosteal expansion may be reduced, albeit still possible, at the femoral neck of humans.

Adult↗

Immunohistochemical observations of cellular differentiation and proliferation in endochondral bone formation from grafted periosteum: expression and localization of BMP-2 and -4 in the grafted periosteum.

PURPOSE: To clarify the involvement of bone morphogenetic proteins (BMPs) in the proliferation and differentiation of osteo/chondrogenic cells during the process of bone formation from grafted periosteum. MATERIAL AND METHODS: Tibial periosteum of young Japanese white rabbits was grafted into suprahyoid muscles and removed after 7, 9, 14 or 21 days. BMP-2, -4, proliferative cell nucleus antigen (PCNA) immunoreaction and Alcian blue staining in grafted periosteum was then sought microscopically. RESULTS: PCNA positive cells in the grafted periosteum expressed BMP-2 at 7 days. These cells differentiated into chondroblasts that expressed BMP-2 and Alcian blue at 9 days. After 14 days, cartilage formation was seen, and BMP-2 and -4 expressions were observed in mature and hypertrophic chondrocytes. Endochondral ossification was observed at 21 days and osteoblasts showed both BMP-2 and -4 expression. CONCLUSION: Both BMP-2 and -4 appear to play regulatory roles in the process of endochondral ossification from grafted periosteum, due to their involvement in the proliferation and differentiation into chondrogenic and osteogenic cells.

Alcian Blue↗

Role of fracture hematoma and periosteum during fracture healing in rats: interaction of fracture hematoma and the periosteum in the initial step of the healing process.

To study the mechanisms of fracture healing, we investigated the interaction between fracture hematoma and periosteum during the early phase of fracture healing in rats. Experimentally induced fractures of the tibia in untreated rats were compared histologically with such fractures in rats in which either the bone marrow or the periosteum had been removed. The extent of periosteal cell proliferation and chondrogenesis in the fracture hematoma was evaluated on experimental days 3, 6, 10, and 14. On day 3, periosteal cell proliferation at the tibial fracture site was decreased in the bone marrow-removed rats compared with the proliferation in untreated rats. Little chondrogenesis in the fracture hematoma was seen through day 6 in the periosteum-removed rats. These results suggest that the periosteum is important for mediating the primary steps of chondrogenesis and enchondral ossification in the fracture hematoma and that the fracture hematoma may be essential for periosteal cell proliferation during fracture healing.

Animals↗

Osteogenic capacity of vascularised periosteum: experimental study using rib periosteum in rabbits.

The osteogenic capacity of vascularised periosteum was investigated in rabbits using island rib periosteum nourished by intercostal vessels as an experimental model. Twenty-three adult white female rabbits were used. Excellent bone formation was observed after 2 postoperative weeks in each case. In the early stages of bone formation, extensive chondral ossification was observed. Newly formed bone became mature after 4 to 8 postoperative weeks, on histological examination.

Animals↗

Influence of periosteum on donor healing after harvesting hard palate mucosa.

The authors report the influence of periosteum on healing of palatal defect based on more than 10 years of experience of harvesting hard palate mucosa. Between June of 1991 and May of 2001, the authors harvested 80 hard palate mucosae as graft material for skin and mucosa defects. All grafts were harvested from the center of the hard palate. Patients ranged in age from 10 to 82 years old. Of 80 mucosae, 54 were harvested with periosteum, and periosteum was not retained in the defect bed. The other 26 mucosae were harvested without periosteum, which was therefore retained in the defect bed. The healing time increased depending on the defect size in both groups of patients retaining and not retaining periosteum. There was a significant relationship between the defect size and healing time in both groups (Spearman's rank correlation test, p < 0.0001 in both groups). In the two groups, there was no significant relationship between patient age and healing time in the patients with defect smaller than 1.99 cm or larger than 2.00 cm2. There were no significant differences in the rate of patients with pain and bleeding between the groups retaining and not retaining periosteum. In the group not retaining the periosteum, all 54 patients showed a flat or atrophic smooth surface at more than 6 months after epithelization and had no discomfort. However, 17 patients showed flat or atrophic smooth surface in the group retaining the periosteum and the remaining 9 patients showed hypertrophy at more than 6 months after epithelization, with accompanying discomfort. The rate of the patients with hypertrophy in the group of patients retaining periosteum was significantly high as compared with that in the group of patients not retaining periosteum (p = 0.000013, Fisher's exact test). In 26 patients retaining periosteum, the age of the patients with hypertrophic surface was significantly younger than that of the patients with flat or atrophic surface (p = 0.0010, Welch's -test), and the defect size in the patient with hypertrophic surface was significantly smaller than that of the patients with flat or atrophic surface (p = 0.0028, Welch's t-test). In conclusion, our study demonstrated that the existence of periosteum in the palate donor bed does not contribute to reduced healing time or reduced pain. Rather, retaining the periosteum caused hypertrophy of the donor site, leading to discomfort, especially in young patients with a comparatively small defect.

Adolescent↗

Mechanical properties of the periosteum in the pig, Sus scrofa.

The fibrous periosteum forms an intermediary between muscle and ligament forces and the underlying osteoblastic tissue, thus the mechanical properties of the periosteum are critical to understanding osteogenic stimuli. Regional and directional variation in periosteal properties may contribute to the biomechanical regulation of growth in some bones. Periostea of the pig mandibular body, zygomatic arch and metacarpal were loaded to failure under continuous tension. Each tissue type was tested in both the long-axis and transverse orientation. Stiffness, peak stress and peak strain were compared between orientations and among regions. Within the zygomatic periosteum there was little indication of regional difference, and neither zygomatic nor mandibular periosteum showed directional differences. The metacarpal periosteum showed a directional effect only in peak strain, which was greater longitudinally than transversely. There were striking differences, however, among the periostea of the three bones. The zygomatic arch periosteum was the stiffest tissue (91.7+/-30.5 MPa) and showed the highest strength (12.3+/-4.6 MPa). The metacarpal periosteum demonstrated slightly lower stiffness and strength (84.7+/-35.1 and 11.3+/-5.3 MPa), and peak strains in zygomatic and metacarpal periostea were similarly high (17.7+/-3.7 and 17.9+/-3.7 MPa, respectively). The periosteum of the mandibular body was the most deformable tissue (63.0+/-25.4 MPa), with the lowest-peak strain (15.6+/-3.0 MPa) and the least strength (8.2+/-4.1 MPa). These results correspond with those of previous work in long bones, in that periosteum interfacing with ligament or muscle (e.g. zygomatic, metacarpal) demonstrates greater stiffness and strength than periosteum adjacent to loose connective tissue (e.g. mandibular body). Therefore, the degree to which the periosteal tissue serves as a functional interface between bone and muscle is reflected in the different failure properties of periostea from different bones. The structural fortification of the zygomatic arch periosteum relative to other periosteal tissues suggests a role for the periosteum in stabilizing the zygomatic arch-muscle functional complex. On the other hand, the similar failure properties of zygomatic and squamosal periostea from the zygomatic arch mean that the differential growth of these bones cannot be attributed to mechanical stimuli intrinsic to the periosteal tissue.

Animals↗

The role of beta-tricalcium phosphate in vascularized periosteum.

To investigate the osteogenic capacity of vascularized periosteum in bore grafting, we prepared experimental groups by wrapping beta-tricalcium phosphate (beta-TCP) with vascularized periosteum of the femur of 12-week-old Japanese white rabbits, and evaluated osteogenesis histologically and biochemically. Bone formation was observed in the group with vascularized periosteum and in the group with bone marrow fluid added to the vascularized periosteum. In particular, woven bone was observed in the group that had added bone marrow. Osteogenesis appeared earlier in the group with bone marrow fluid added to the vascularized periosteum, but histologically, there was no significant difference between this group and the group with vascularized periosteum without bone marrow fluid added at week 24 after the operation. In the group with non-vascularized periosteum, slight osteogenesis was found at week 6 after the operation, but in the control group, with beta-TCP implanted in soft tissue, osteogenesis did not occur at all. Alkaline phosphatase (ALP) activity reached a peak at week 2 after the operation in the group with vascularized periosteum, but only half the peak value was then maintained until week 8. In the group with bone marrow fluid added to the vascularized periosteum, similar values were found from immediately after the operation until week 8. ALP activity did not show any significant difference between these two groups at week 8 postoperatively. In the group with beta-TCP implanted in the soft tissue, ALP activity was low at all times measured. These results suggested that the periosteum had osteoinduction capacity and beta-TCP had osteoconduction capacity; that better osteogenesis occurred with vascularized periosteum; and that bone marrow fluid was involved in the promotion of osteoblastic activity, but not in calcification.

Alkaline Phosphatase↗

Comparison of bone formation ingrafted periosteum harvested from tibia and calvaria.

Periosteum covers the bone surface and displays the potential to initiate bone formation, after injury to the bone. Numerous studies have demonstrated that the periosteum plays major roles in the healing process after bone fracture. Some reports have described that in the healing of long bone fractures, the periosteum forms new bone by intramembranous and endochondral ossification. Other researchers insist that healing of defects in membrane bone shows bone formation by intramembranous ossification. However, previous studies have not been able to clarify differences in bone formation patterns. We hypothesized that differences in bone formation pattern are associated with the periosteal potential for cell differentiation. The present study grafted periosteum, harvested from the tibia and calvaria, into the suprahyoid muscle, with the aim of interrupting release of factors from bone matrix. Bone formation, after grafting periosteum, harvested from the tibia and calvaria, was examined histologically and radiographically. Grafted tibial periosteum formed a large area of new bone by intramembranous and endochondral ossification, while grafted calvarial periosteum displayed intramembranous ossification. Grafted tibial periosteum formed a larger area of bone than grafted calvarial periosteum. Patterns of cell differentiation thus differ between grafted periosteum, harvested from the tibia and calvaria.

Animals↗

Relationship of donor site to chondrogenic potential of periosteum in vitro.

Periosteum has been shown in vitro and in vivo to have a chondrogenic potential that permits it to be used for cartilage regeneration. A useful donor site should have good chondrogenic potential, availability of a large quantity of periosteum, and relative ease of access, and it should be associated with a low rate of morbidity. We hypothesized that the chondrogenic potential of periosteum varies from one bone to another and among different regions of the periosteum from a single bone. A total of 370 periosteal and 37 fascia lata (control) explants were taken from the skull, the ilium, the scapula, the upper, middle, and lower medial proximal tibia, the posterior proximal tibia, and the distal tibia of 2-month-old New Zealand rabbits. The explants were cultured for 6 weeks in agarose/Dulbecco's modified Eagle medium to which 10 ng/ml of transforming growth factor-beta 1 was added during the first 2 weeks. Skeletal muscle and fascia lata were used as controls. In addition, the thickness, cell density, and total cell count of the cambium layer were measured in 24 explants from the donor sites on the ilium and the upper, middle, and lower proximal tibia. At 6 weeks, histomorphometry and quantitative collagen typing were performed. The periosteal donor sites could be grouped into three categories according to chondrogenic potential: ilium (best), scapula and tibia, and skull (no chondrogenesis). The scapular periosteum was slightly better than that from the tibia. Within the tibia, the upper and middle zones of the proximal region were similar and were slightly better than the lower proximal tibia or the distal tibia. The cellularity of the cambium layer correlated positively with the amount of cartilage as a percentage of the total area. The results of this study indicate that iliac periosteum exhibited the best overall chondrogenic potential in vitro but that periosteum from the traditionally used medial proximal tibia also was excellent. Periosteum from the skull was not chondrogenic. The chondrogenic potential of periosteum varies from bone to bone and within the periosteum from one bone. This variation in chondrogenic potential among donor sites may be due to a difference in the total cell count of the cambium layer.

Analysis of Variance↗

Distribution of CGRP-, VIP-, D beta H-, SP-, and NPY-immunoreactive nerves in the periosteum of the rat.

In light of the possible role peripheral nerves may play in bone metabolism, the morphology of calcitonin gene-related peptide (CGRP)-, vasoactive intestinal peptide (VIP)-, substance P (SP)-, neuropeptide Y (NPY)-, and dopamine-beta-hydroxylase (D beta H)-immunoreactive nerve fibers was examined in whole-mount preparations of periosteum of membranous bones (calvaria, mandible) and long bones (tibia) from the rat. Periosteum from animals treated to remove selectively either the sympathetic or fine-caliber primary afferent nerves was also examined to determine the origin of the nerve fibers. We found a consistent and often dense innervation of the periosteum. The innervation patterns of the calvaria and mandible were similar, with networks of nerves spread across the surface of the bone. Nerves in the tibial periosteum were oriented in the longitudinal axis and were more numerous at the epiphyses than in the mid-shaft region. CGRP-immunoreactive fibers were widely and densely distributed. The presence of populations of CGRP-immunoreactive fibers of differing calibers and perivascular arrangements suggests that such nerves in bone tissues may serve different functions. SP-immunoreactivity was present in a fine network of varicose fibers in the superficial layers of the periosteum. CGRP- and SP-immunoreactive nerve fibers were dramatically reduced in periosteum of capsaicin-treated animals as compared to controls, indicating the sensory origin of these nerves. VIP-immunoreactive nerve fibers were distributed in the periosteum of mandible and calvaria as small networks and individual fine varicose fibers. In tibial periosteum, larger networks of these fibers were visible. VIP-immunoreactive nerve fibers in the periosteum were associated with both vascular and nonvascular elements within the layers of cells closest to the bone, suggesting that VIP may serve more than one function in periosteal tissues. NPY-immunoreactive fibers were largely confined to vascular elements; occasional fibers were observed among the bone-lining cells. D beta H-immunoreactivity was associated only with blood vessels. VIP-, NPY-, and D beta H-immunoreactivities were dramatically reduced in the periosteum of guanethidine-treated animals, indicating the sympathetic origin of these nerves.

Animals↗