by Yeung Hiu Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1999. / Includes bibliographical references (leaves 158-171). / Abstracts in English and Chinese. / ACKNOWLEDGEMENT --- p.i / ABBREVIATIONS --- p.ii / ABSTRACT (English & Chinese) --- p.iii / TABLE OF CONTENT --- p.viii / INDEX FOR FIGURES --- p.xii / INDEX FOR TABLES --- p.xvi / Chapter 1. --- INTRODUCTION --- p.2 / Chapter 1.1. --- History of Distraction Osteogenesis --- p.3 / Chapter 1.2. --- Clinical Application of Distraction Osteogenesis --- p.5 / Chapter 1.2.1. --- Limb-Lengthening --- p.5 / Chapter 1.2.2. --- Correction of Deformities and Non-Unions --- p.5 / Chapter 1.2.3. --- Bone Transport --- p.6 / Chapter 1.2.4. --- Reconstruction of the mandible --- p.7 / Chapter 1.3. --- Bone-specific Alkaline Phosphatase (BALP) --- p.8 / Chapter 1.4. --- Osteocalcin --- p.9 / Chapter 1.5. --- Bone Growth Factors --- p.11 / Chapter 1.6. --- Fibroblast Growth Factors (FGFs) --- p.12 / Chapter 1.6.1. --- Acidic Fibroblast Growth Factor (aFGF) --- p.13 / Chapter 1.6.2. --- Basic Fibroblast Growth Factor (bFGF) --- p.14 / Chapter 1.7. --- Transforming Growth Factor-pi (TGF-β1) --- p.16 / Chapter 1.8. --- Fracture Healing --- p.18 / Chapter 1.8.1. --- Histology --- p.18 / Chapter 1.8.2. --- Growth Factor Expression --- p.18 / Chapter 1.9. --- Distraction Osteogenesis --- p.19 / Chapter 1.9.1. --- Histology --- p.19 / Chapter 1.9.2. --- Growth Factor Expression --- p.20 / Chapter 1.10. --- Aim of the Study --- p.21 / Chapter 2. --- METHODOLOGY --- p.23 / Chapter 2.1. --- Animal Model --- p.23 / Chapter 2.1.1. --- Source of Animal --- p.23 / Chapter 2.1.2. --- Animal Operation --- p.23 / Chapter 2.1.3. --- Fracture Healing Model --- p.24 / Chapter 2.1.4. --- Distraction Osteogenesis Model --- p.24 / Chapter 2.2. --- Sample Collection --- p.25 / Chapter 2.2.1. --- Tissue Sample Collection and Preparation --- p.25 / Chapter 2.2.1.1. --- Test for the Complete Decalcification of the Calluses --- p.26 / Chapter 2.2.2. --- Blood Sample Collection and Storage --- p.26 / Chapter 2.3. --- Bone Mineral Density Measurement of the Distracted Callus and the Fracture Callus --- p.27 / Chapter 2.3.1. --- Fracture Healing Group --- p.27 / Chapter 2.3.2. --- Distraction Osteogenesis Group --- p.28 / Chapter 2.4. --- Serum Bone Specific Alkaline Phosphatase (BALP) Activity --- p.28 / Chapter 2.4.1. --- Wheat Germ Lectin (WGL) Precipitation of BALP --- p.28 / Chapter 2.4.1.1. --- Reagent --- p.28 / Chapter 2.4.1.2. --- Preparation and Measurement of Samples --- p.29 / Chapter 2.4.1.3. --- Auto-analyzer Setup --- p.30 / Chapter 2.5. --- Quantification of the Osteocalcin in Serum --- p.30 / Chapter 2.5.1. --- Reagent and Sample Preparation --- p.31 / Chapter 2.5.2. --- Detection Procedures --- p.31 / Chapter 2.6. --- Localization of the Growth Factors in Distraction Osteogenesis and Fracture Healing --- p.32 / Chapter 2.6.1. --- Immunohistochemistry of the Growth Factors --- p.33 / Chapter 2.6.1.1. --- Reagents and Solution Preparation --- p.33 / Chapter 2.6.1.2. --- Experimental Procedure --- p.36 / Chapter 2.6.1.3. --- Evaluation of Immunohistochmical Staining Results --- p.37 / Chapter 2.6.2. --- Verification of the Primary Antibody Used in the Study --- p.37 / Chapter 2.6.2.1. --- Tissue Preparation --- p.37 / Chapter 2.6.2.2. --- Antibody to Acidic Fibroblast Growth Factor (aFGF) --- p.38 / Chapter 2.6.2.2.1. --- Immunohistochemistry of Goat Brain and Growth Plate --- p.38 / Chapter 2.6.2.2.2. --- Dot Blot --- p.38 / Chapter 2.6.2.2.2.1. --- Materials and Reagents --- p.38 / Chapter 2.6.2.2.2.2. --- Procedures --- p.39 / Chapter 2.6.2.2.3. --- Sodium Dodecylsulphate Polyacrylamide Gel Electrophoresis (SDS-PAGE) --- p.41 / Chapter 2.6.2.2.3.1. --- Materials and Reagents --- p.41 / Chapter 2.6.2.2.3.2. --- Procedures --- p.42 / Chapter 2.6.2.2.4. --- Western Blotting --- p.43 / Chapter 2.6.2.2.4.1. --- Materials and Reagents --- p.43 / Chapter 2.6.2.2.4.2. --- Procedures --- p.44 / Chapter 2.6.2.3. --- Antibody to Basic Fibroblast Growth Factor --- p.45 / Chapter 2.6.2.4. --- Antibody to Transforming Growth Factor-β1 --- p.45 / Chapter 3. --- RESULTS --- p.53 / Chapter 3.1. --- Animal Model --- p.53 / Chapter 3.1.1. --- Fracture Healing Animal Model --- p.53 / Chapter 3.1.1.1. --- Radiography of Fracture Healing --- p.53 / Chapter 3.1.2. --- Distraction Osteogenesis Animal Model --- p.54 / Chapter 3.1.2.1. --- Gross Morphology of Distraction Osteogenesis --- p.54 / Chapter 3.1.2.2. --- Radiography of Distraction Osteogenesis --- p.55 / Chapter 3.2. --- Bone Mineral Density (BMD) Measurement --- p.56 / Chapter 3.2.1. --- In Fracture Healing --- p.56 / Chapter 3.2.2. --- Distraction Osteogenesis --- p.57 / Chapter 3.3. --- Bone-specific Alkaline Phosphatase Activity in Goat Serum --- p.59 / Chapter 3.3.1 --- ", Fracture Healing" --- p.59 / Chapter 3.3.2. --- Distraction Osteogenesis --- p.59 / Chapter 3.4. --- Serum Osteocalcin Measurement --- p.60 / Chapter 3.4.1. --- Fracture Healing --- p.60 / Chapter 3.4.2. --- Distraction Osteogenesis --- p.60 / Chapter 3.5. --- Histology --- p.61 / Chapter 3.5.1. --- Fracture Healing --- p.61 / Chapter 3.5.2. --- Distraction Osteogenesis --- p.64 / Chapter 3.6. --- Verification of Primary Antibody Used in the Study --- p.67 / Chapter 3.6.1. --- Antibody to Acidic Fibroblast Growth Factor --- p.67 / Chapter 3.6.1.1. --- Dot Blot --- p.67 / Chapter 3.6.1.2. --- Western Blotting --- p.68 / Chapter 3.6.1.3. --- Immunohistochemistry of Goat Brain and Growth Plate --- p.68 / Chapter 3.6.2. --- Antibody to Basic Fibroblast Growth Factor --- p.69 / Chapter 3.6.2.1. --- Dot Blot --- p.69 / Chapter 3.6.2.2. --- Immunohistochemistry of Goat Brain and Growth Plate --- p.69 / Chapter 3.6.3. --- Antibody to Transforming Growth Factor-β1 --- p.70 / Chapter 3.6.3.1. --- Western Blotting --- p.70 / Chapter 3.6.3.2. --- Immunohistochemistry of Growth Plate --- p.70 / Chapter 3.7. --- Localization of Growth Factors in Fracture Healing and Distraction Osteogenesis --- p.70 / Chapter 3.7.1. --- Acidic Fibroblast Growth Factor --- p.71 / Chapter 3.7.1.1. --- Fracture Healing --- p.71 / Chapter 3.7.1.2. --- Distraction Osteogenesis --- p.72 / Chapter 3.7.2. --- Basic Fibroblast Growth Factor --- p.73 / Chapter 3.7.2.1. --- Fracture Healing --- p.73 / Chapter 3.7.2.2. --- Distraction Osteogenesis --- p.74 / Chapter 3.7.3. --- Transforming Growth Factor-β1 --- p.75 / Chapter 3.7.3.1. --- Fracture Healing --- p.75 / Chapter 3.7.3.2. --- Distraction Osteogenesis --- p.76 / Chapter 4. --- DISCUSSION --- p.142 / Chapter 4.1. --- The Biochemical Events in Fracture Healing --- p.142 / Chapter 4.2. --- The Biochemical Events in Distraction Osteogenesis --- p.147 / Chapter 4.3. --- Limitations of the present study --- p.153 / Chapter 4.4. --- Future Study --- p.154 / Chapter 5. --- CONCLUSION --- p.156 / BIBLIOGRAPHY --- p.158

Chan Chun Wai. / "August 2004." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2004. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. Ann Arbor, MI : ProQuest Information and Learning Company, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 184-204).

Thesis--University of Turku, Finland, 2002. / Includes bibliographical references.

Thesis (M.S.)--University of Michigan, 2002. / Includes bibliographical references.

Distraction Osteogenesis (DO) is a technique for bone lengthening and filling of bone defects following trauma, infection or resection of tumors. DO consists of an osteotomy of the bone to be lengthened, followed by controlled distraction of the bone segments with an external fixator until the desired lengthening is obtained (distraction phase). This is followed by the consolidation phase, during which the external fixator is kept in place until the newly formed bone in the distracted zone consolidates. This phase is long and may cause numerous problems. Ongoing research aims at finding a method to accelerate the consolidation of the newly formed bone. / Fibroblast Growth Factors (FGF) play a significant role in bone development and repair. FGF 18 has been shown to be the only FGF member to be expressed throughout both the distraction and the consolidation phases of DO. It was also reported that FGF18 is the physiological ligand of FGFR3. Therefore, we hypothesized that FGF18 and FGFR3 may have an important role in DO. / To test this hypothesis, we investigated DO in FGFR3 deficient mice (FGFR3-/-). (FGF18 deficient mice are not viable). A miniaturized DO apparatus was applied to the tibia followed by an osteotomy. Distraction began after a 5-day latency period at a rate of 0.2 mm/12 hours for 12 days. / Samples were collected at 3 time points comparing the mutants (FGFR3-/-) to their wild type litter' sates: end of distraction (17 days post-surgery), mid-consolidation (34 days post-surgery), and end of consolidation (51 days post surgery). The samples were analyzed using X-ray, DEXA, microCT, histology, biomechanical testing and Real-Time PCR. / Our results revealed that FGFR3 deficient mice showed accelerated bone formation compared to the W.T. littermates at mid-consolidation where the parameters measured revealed increased bone mineral density, bone mineral content and trabecular number in the mutant tibial samples. The newly regenerated bone consolidated faster in the FGFR3 knock-out mice and the bone was of better quality as revealed by biomechanical tests in which more force was needed to break the mutant bone because it exhibited higher resistance than the age matched wild-type sample. The marker gene expression patterns revealed an up-regulation of chondrogenic markers that suggest that the knock-out mice follow the endochondral ossification pathway during DO. All results were statistically significant. / These results show that signaling through FGFR3 acts to decrease bone formation during DO. Consequently, blocking FGFR3 may lead to accelerated bone formation in DO. This may have important clinical implications in attempts to improve the functional outcome of DO by decreasing the long duration that the external fixator has to be kept on.

Thesis (M.S.)--University of Alabama at Birmingham, 2007. / Title from first page of PDF file (viewed Oct. 31, 2007). Includes bibliographical references (p. 42-45).

No description available.

A distração osteogênica tem sido extensamente empregada na correção da grave hipoplasia do terço médio da face de portadores de craniossinostose sindrômica. Contudo, poucos estudos têm apresentado os resultados da distração do terço médio da face através de avaliação cefalométrica. O objetivo do presente estudo foi o de avaliar os resultados obtidos com o avanço ósseo do terço médio da face após osteotomia tipo Le Fort III ou frontofacial em monobloco seguida da utilização de dispositivo rígido externo de distração (RED), em portadores de craniossinostose sindrômica, em termos de quantidade de alongamento ósseo, estabilidade esquelética e crescimento facial. Onze pacientes submetidos aos procedimentos de distração, de fevereiro de 2002 a janeiro de 2006, na unidade de cirurgia plástica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, foram avaliados retrospectivamente. Seis pacientes eram portadores da síndrome de Crouzon, quatro da síndrome de Apert, e um da síndrome de Saethre-Chotzen. Onze pacientes foram submetidos ao procedimento de alongamento ósseo do terço médio da face através do uso de dispositivo externo rígido (RED), após osteotomias tipo Le Fort III (N = 4) ou frontofacial monobloco (N = 7). Foram avaliadas retrospectivamente três telerradiografias de face em norma lateral de cada paciente (T1- préoperatório; T2 - pós-operatório recente, logo após a remoção do distrator; T3 - pós-operatório tardio, obtida com um intervalo mínimo de 12 meses após cirurgia). Três cefalogramas foram obtidos de cada paciente, através da direta sobreposição das três telerradiografias, tomado como referência reparos anatômicos do crânio e da porção anterior da fossa craniana. Desta forma, os três traçados cefalométricos foram obtidos no mesmo papel acetato, o qual foi digitalizado. Utilizando o programa de computação gráfica de domínio público Image J, várias mensurações foram realizadas com a intenção de determinar a extensão do avanço sofrido pelos segmentos ósseos na direção do vetor do movimento esquelético, assim como de seus componentes horizontal e vertical, tomando como referência pontos A e orbitário. Pacientes foram ainda divididos em dois grupos (G 1 - pacientes submetidos à osteotomia tipo Le Fort III; G 2 - pacientes submetidos à osteotomia frontofacial em monobloco), e os dados obtidos a partir mensurações de ambos os grupos foram comparados. Avanço significativo do terço médio da face foi obtido com os procedimentos. O componente horizontal do movimento esquelético predominou ao componente vertical. A taxa de reposicionamento posterior horizontal tardio (perda de resultado) foi mínima. Quando comparados os dois procedimentos, foi observada uma diferença significativa entre os grupos Le Fort III e monobloco. A quantidade de avanço obtido foi maior no grupo monobloco que no grupo Le Fort III. Em termos perda de resultado, o grupo Le Fort III foi mais estável que o grupo monobloco. Foi observada uma evidente alteração vertical no posicionamento dos pontos de referência no pós-operatório tardio, se comparado ao pós-operatório recente, evidenciando crescimento na vertical da face, ao contrário do que ocorre na direção horizontal, onde existiu um pequeno reposicionamento posterior e nenhuma evidência de crescimento. / Distraction osteogenesis has been applied extensively to correct the severe midface hipoplasia in syndromic craniosynostosis patients. However few studies have reported midface distraction outcomes through cephalometric evaluation. The purpose of the present study was to evaluate outcomes with midface distraction after Le Fort III and frontofacial monobloc osteotomy using a rigid external device (RED) in patients with syndromic craniosynostosis, in terms of quantity of bone lengthening, skeletal stability and facial growth. Eleven patients underwent to midface distraction from February of 2002 to January of 2006 at the plastic surgery unit of The \'Hospital das Clínicas\' of the Medical School of The University of São Paulo were retrospectively evaluated. Six patients had Crouzon, four had Apert, and one had Saethre-Chotzen syndrome. The patients were submit to bone lengthening procedure of the midface using a rigid external device (RED) after osteotomy type Le Fort III (n=4) and frontofacial monobloc osteotomy (n=7). Three teleradiography were retrospectively evaluated of each patient (T1 - before surgery; T2- after surgery, rigth after distractor removal; T3 - after surgery, obtained with a minimal interval of 12 months after surgery). The three lateral cephalograms were obtained from each patient by direct teleradiography superimposition taken as references the anatomic repairs in the cranium and anterior skull base. This way the three cephalometric tracings were obtained in the same acetate paper which was digitalized. Utilizing a public domain program Image J, various mensurations were accomplished with intension of determine the extent of advancement suffered by the bone segments in the direction of vector skeletal movement and its horizontal and vertical components as well, as taken as references point A and orbitale. Patients still were divided between two groups (G 1- patients submitted to an osteotomy type Le Fort III; G 2- patients submitted to monobloc frontofacial osteotomy), and the data obtained from mensurations from both groups were compared. Significant midface advancement was achieved with the procedures. The horizontal component of the movement was predominant if compared to vertical. The rate of horizontal relapse was minimal. When compared the two procedures was noted a significant difference between Le Fort III and monobloc groups. The advancement rate was greater in monobloc than Le Fort III group. In terms of relapse Le Fort III group was more stable than monobloc group. In vertical direction was noted an evident altered position of the reference points at late postoperative period if compared with recent postoperative period given evidence of facial vertical direction growth, contrary from what occurred in horizontal direction where existed a small relapse and no growth.

A distração osteogênica tem sido extensamente empregada na correção da grave hipoplasia do terço médio da face de portadores de craniossinostose sindrômica. Contudo, poucos estudos têm apresentado os resultados da distração do terço médio da face através de avaliação cefalométrica. O objetivo do presente estudo foi o de avaliar os resultados obtidos com o avanço ósseo do terço médio da face após osteotomia tipo Le Fort III ou frontofacial em monobloco seguida da utilização de dispositivo rígido externo de distração (RED), em portadores de craniossinostose sindrômica, em termos de quantidade de alongamento ósseo, estabilidade esquelética e crescimento facial. Onze pacientes submetidos aos procedimentos de distração, de fevereiro de 2002 a janeiro de 2006, na unidade de cirurgia plástica do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, foram avaliados retrospectivamente. Seis pacientes eram portadores da síndrome de Crouzon, quatro da síndrome de Apert, e um da síndrome de Saethre-Chotzen. Onze pacientes foram submetidos ao procedimento de alongamento ósseo do terço médio da face através do uso de dispositivo externo rígido (RED), após osteotomias tipo Le Fort III (N = 4) ou frontofacial monobloco (N = 7). Foram avaliadas retrospectivamente três telerradiografias de face em norma lateral de cada paciente (T1- préoperatório; T2 - pós-operatório recente, logo após a remoção do distrator; T3 - pós-operatório tardio, obtida com um intervalo mínimo de 12 meses após cirurgia). Três cefalogramas foram obtidos de cada paciente, através da direta sobreposição das três telerradiografias, tomado como referência reparos anatômicos do crânio e da porção anterior da fossa craniana. Desta forma, os três traçados cefalométricos foram obtidos no mesmo papel acetato, o qual foi digitalizado. Utilizando o programa de computação gráfica de domínio público Image J, várias mensurações foram realizadas com a intenção de determinar a extensão do avanço sofrido pelos segmentos ósseos na direção do vetor do movimento esquelético, assim como de seus componentes horizontal e vertical, tomando como referência pontos A e orbitário. Pacientes foram ainda divididos em dois grupos (G 1 - pacientes submetidos à osteotomia tipo Le Fort III; G 2 - pacientes submetidos à osteotomia frontofacial em monobloco), e os dados obtidos a partir mensurações de ambos os grupos foram comparados. Avanço significativo do terço médio da face foi obtido com os procedimentos. O componente horizontal do movimento esquelético predominou ao componente vertical. A taxa de reposicionamento posterior horizontal tardio (perda de resultado) foi mínima. Quando comparados os dois procedimentos, foi observada uma diferença significativa entre os grupos Le Fort III e monobloco. A quantidade de avanço obtido foi maior no grupo monobloco que no grupo Le Fort III. Em termos perda de resultado, o grupo Le Fort III foi mais estável que o grupo monobloco. Foi observada uma evidente alteração vertical no posicionamento dos pontos de referência no pós-operatório tardio, se comparado ao pós-operatório recente, evidenciando crescimento na vertical da face, ao contrário do que ocorre na direção horizontal, onde existiu um pequeno reposicionamento posterior e nenhuma evidência de crescimento. / Distraction osteogenesis has been applied extensively to correct the severe midface hipoplasia in syndromic craniosynostosis patients. However few studies have reported midface distraction outcomes through cephalometric evaluation. The purpose of the present study was to evaluate outcomes with midface distraction after Le Fort III and frontofacial monobloc osteotomy using a rigid external device (RED) in patients with syndromic craniosynostosis, in terms of quantity of bone lengthening, skeletal stability and facial growth. Eleven patients underwent to midface distraction from February of 2002 to January of 2006 at the plastic surgery unit of The \'Hospital das Clínicas\' of the Medical School of The University of São Paulo were retrospectively evaluated. Six patients had Crouzon, four had Apert, and one had Saethre-Chotzen syndrome. The patients were submit to bone lengthening procedure of the midface using a rigid external device (RED) after osteotomy type Le Fort III (n=4) and frontofacial monobloc osteotomy (n=7). Three teleradiography were retrospectively evaluated of each patient (T1 - before surgery; T2- after surgery, rigth after distractor removal; T3 - after surgery, obtained with a minimal interval of 12 months after surgery). The three lateral cephalograms were obtained from each patient by direct teleradiography superimposition taken as references the anatomic repairs in the cranium and anterior skull base. This way the three cephalometric tracings were obtained in the same acetate paper which was digitalized. Utilizing a public domain program Image J, various mensurations were accomplished with intension of determine the extent of advancement suffered by the bone segments in the direction of vector skeletal movement and its horizontal and vertical components as well, as taken as references point A and orbitale. Patients still were divided between two groups (G 1- patients submitted to an osteotomy type Le Fort III; G 2- patients submitted to monobloc frontofacial osteotomy), and the data obtained from mensurations from both groups were compared. Significant midface advancement was achieved with the procedures. The horizontal component of the movement was predominant if compared to vertical. The rate of horizontal relapse was minimal. When compared the two procedures was noted a significant difference between Le Fort III and monobloc groups. The advancement rate was greater in monobloc than Le Fort III group. In terms of relapse Le Fort III group was more stable than monobloc group. In vertical direction was noted an evident altered position of the reference points at late postoperative period if compared with recent postoperative period given evidence of facial vertical direction growth, contrary from what occurred in horizontal direction where existed a small relapse and no growth.