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Publications (254)
Intervertebral disc (IVD) degeneration (IVDD), primarily caused by nucleus pulposus (NP) dehydration, leads to low back pain. While current treatments focus on symptom management or surgical intervention, tissue engineering using IVD‐derived cells, biofactors, and scaffolds offers a promising regenerative approach. Here, human NP cells (NPCs) and a...
Spina bifida is a birth defect resulting from abnormal embryonic development of the neural tube. Though spina bifida is divided into several subtypes, myelomeningocele—the most severe form of spina bifida often associated with a markedly diminished quality of life—accounts for a significant portion of cases. A broad range of genetic and environment...
Skin serves as the first-order protective barrier against the environment and any significant disruptions in skin integrity must be promptly restored. Despite significant advances in therapeutic strategies, effective management of large chronic skin wounds remains a clinical challenge. Dermal fibroblasts are the primary cell type responsible for re...
Nuclear morphology, which modulates chromatin architecture, plays a critical role in regulating gene expression and cell functions. While most research has focused on the direct effects of nuclear morphology on cell fate, its impact on the cell secretome and surrounding cells remains largely unexplored, yet is especially crucial for cell-based ther...
Effective repair of large bone defects through bone tissue engineering (BTE) remains an unmet clinical challenge. Successful BTE requires optimal and synergistic interactions among biocompatible scaffolds, osteogenic factors, and osteoprogenitors to form a highly vascularized microenvironment for bone regeneration and osseointegration. We sought to...
The volume and complexity of clinical data are growing rapidly. The potential for artificial intelligence (AI) and machine learning (ML) to significantly impact plastic and craniofacial surgery is immense. This manuscript reviews the overall landscape of AI in craniofacial surgery, highlighting the scarcity of prospective and clinically translated...
Ballistic facial trauma can cause complex fractures and overlying soft tissue damage, with a zone of injury that extends beyond the bullet tract. Early skeletal fixation is indicated, and previous large case series describe the use of debrided bone fragments as ‘spare part’ grafts. This series presents the indications and techniques for simultaneou...
Approaches to regenerating bone often rely on integrating biomaterials and biological signals in the form of cells or cytokines. However, from a translational point of view, these approaches are challenging due to the sourcing and quality of the biologic, unpredictable immune responses, complex regulatory paths, and high costs. We describe a simple...
Composite cranial defects have individual functional and aesthetic ramifications, as well as societal burden, while posing significant challenges for reconstructive surgeons. Single-stage composite reconstruction of these deformities entail complex surgeries that bear many short- and long-term risks and complications. Current research on composite...
Robin Sequence (RS) is a collection of distinct morphologic features involving the face and upper airway that results from the abnormal development of the neonatal mandible. Typically described as the triad of micrognathia, glossoptosis, and upper airway obstruction, it is frequently associated with a cleft palate and can be found in isolation or a...
Hypertrophic scarring (HS) is a major source of morbidity after extensive cutaneous injury, and yet underlying mechanisms of hypertrophic scars and keloid lesions are not well understood. It has been shown that prevention of Engrailed-1 (EN-1) activation in fibroblasts was beneficial for wound healing without scarring. However, the role of EN-1 act...
Recombinant adenovirus (rAdV) is a commonly used vector system for gene transfer. Efficient initial packaging and subsequent production of rAdV remains time-consuming and labor-intensive, possibly attributable to rAdV infection-associated oxidative stress and reactive oxygen species (ROS) production. Here, we show that exogenous GAPDH expression mi...
Approaches to regenerating bone often rely on the integration of biomaterials and biological signals in the form of cells or cytokines. However, from a translational point of view, these approaches face challenges due to the sourcing and quality of the biologic, unpredictable immune responses, complex regulatory paths, and high costs. We describe a...
Effective bone regeneration through tissue engineering requires a combination of osteogenic progenitors, osteoinductive biofactors and biocompatible scaffold materials. Mesenchymal stem cells (MSCs) represent the most promising seed cells for bone tissue engineering. As multipotent stem cells that can self-renew and differentiate into multiple line...
Although diversity, equity, and inclusion (DEI) principles are increasingly recognized as a critical component of surgical education, most departments of surgery lack a structured DEI curriculum. The purpose of this paper is to describe how our institution’s Department of Surgery created an innovative curriculum that integrates the individual exper...
Unilateral condylar hyperplasia (UCH) results in facial asymmetry, malocclusion, and temporomandibular joint dysfunction. Treatment consists of both surgical and orthodontic intervention. A review was performed for 4 patients with UCH who underwent digital surgical planning (DSP)-assisted condylectomy. All patients were female, aged 14 to 35 years...
Glycogen storage disease type I (GSDI) is an inherited metabolic disorder characterized by a deficiency of enzymes or proteins involved in glycogenolysis and gluconeogenesis, resulting in excessive intracellular glycogen accumulation. While GSDI is classified into four different subtypes based on molecular genetic variants, GSDIa accounts for appro...
The evolutionarily conserved Wnt signaling pathway plays a central role in development and adult tissue homeostasis across species. Wnt proteins are secreted, lipid-modified signaling molecules that activate the canonical (β-catenin dependent) and non-canonical (β-catenin independent) Wnt signaling pathways. Cellular behaviors such as proliferation...
Craniosynostosis is a condition with neurologic and aesthetic sequelae requiring invasive surgery. Understanding its pathobiology requires familiarity with the processes underlying physiologic suture closure. Animal studies have shown that cyclical strain from chewing and suckling influences the closure of cranial vault sutures, especially the meto...
Topographical cues on cells can, through contact guidance, alter cellular plasticity and accelerate the regeneration of cultured tissue. Here we show how changes in the nuclear and cellular morphologies of human mesenchymal stromal cells induced by micropillar patterns via contact guidance influence the conformation of the cells’ chromatin and thei...
Craniofrontonasal dysplasia (CFND) is a rare congenital malformation, which has a wide array of symptoms that can vary drastically between patients. These include coronal synostosis with associated brachycephaly, hypertelorism, cleft lip and palate, and limb malformations, among others. The pleomorphic nature of the disease and numerous clinical de...
Background:
Genetic research in nonsyndromic craniosynostosis remains limited compared to syndromic craniosynostosis. This systematic review aimed to comprehensively summarize the genetic literature of nonsyndromic craniosynostosis and highlight key signaling pathways.
Methods:
The authors performed a systematic literature search of PubMed, Ovid...
The use of high-fidelity stereolithographic models that accurately reflect patient-specific pathology has become commonplace in craniofacial surgery. Multiple studies have reported the use of commercially available 3D printers that allow limited-resource medical centers to reconstruct 3D models comparable to industry-made counterparts. However, mos...
Background
The objective of this study was to create normative growth curves for pediatric upper airway volume using 3D computed tomography with emphasis on the neonatal age group.
Methods
We completed a single-institution, retrospective review of all patients with available CT scans between the ages of 0 and 60 months. Patients were excluded if t...
[This corrects the article DOI: 10.1016/j.gendis.2018.04.006.].
Wnt signaling plays a major role in regulating cell proliferation and differentiation. The Wnt ligands are a family of 19 secreted glycoproteins that mediate their signaling effects via binding to Frizzled receptors and LRP5/6 coreceptors and transducing the signal either through β-catenin in the canonical pathway or through a series of other prote...
Recent advances in deep sequencing technologies have revealed that, while less than 2% of the human genome is transcribed into mRNA for protein synthesis, over 80% of the genome is transcribed, leading to the production of large amounts of noncoding RNAs (ncRNAs). It has been shown that ncRNAs, especially long non-coding RNAs (lncRNAs), may play cr...
We tested hypotheses about sagittal suture morphology, strain regime, feeding behavior, and muscle activity relationships in robust Sapajus and gracile Cebus capuchin primates. Morphometrics of sinuosity in three regions of the sagittal
suture were compared among museum specimens of Sapajus and Cebus, as well as in robust and gracile lab specimens....
[This corrects the article DOI: 10.1016/j.gendis.2018.02.001.].
[This corrects the article DOI: 10.1016/j.gendis.2021.01.004.].
Ovarian cancer (OC) is one of the most lethal malignancies of the female reproductive system. OC patients are usually diagnosed at advanced stages due to the lack of early diagnosis. The standard treatment for OC includes a combination of debulking surgery and platinum-taxane chemotherapy, while several targeted therapies have recently been approve...
Silk as a natural biomaterial is considered as a promising bone substitute in tissue regeneration. Sericin and fibroin are the main components of silk and display unique features for their programmable mechanical properties, biocompatibility, biodegradability and morphological plasticity. It has been reported that sericin recombinant growth factors...
Craniofacial development requires precise spatiotemporal regulation of multiple signaling pathways that crosstalk to coordinate the growth and patterning of the skull with surrounding tissues. Recent insights into these signaling pathways and previously uncharacterized progenitor cell populations have refined our understanding of skull patterning,...
Biomechanical and clinical studies have yet to converge on the optimal fixation technique for angle fractures, one of the most common and controversial fractures in terms of fixation approach. Prior pre-clinical studies have used a variety of animal models and shown abnormal strain environments exacerbated by less rigid (single-plate) Champy fixati...
The WNT/β-catenin signaling pathway has a major role in regulating cell proliferation and differentiation. Aberrant activation of the pathway contributes to various human cancer types. Because casein kinase CK1α-initiated phosphorylation of β-catenin is a key first step to restrain WNT signaling, effective restoration of CK1α activity represents an...
Background
A healthy alveolar epithelium is critical to the gas exchange function of the lungs. As the major cell type of alveolar epithelium, alveolar type 2 (AT2) cells play a critical role in maintaining pulmonary homeostasis by serving as alveolar progenitors during lung injury, inflammation, and repair. Dysregulation of AT2 cells may lead to t...
Background
Although the technology has been available and several pilot studies have shown success, use of telemedicine has previously been limited in the United States, especially among surgeons. This study aimed to investigate the benefits and obstacles for successful implementation of telemedicine visits in paediatric surgical subspecialties ami...
Background
The purpose of this study was to review the published literature in an effort to compare conservative and surgical interventions for pediatric frontal bone fractures and to create a treatment schematic that would result in the lowest morbidity.
Methods
A literature review was performed to evaluate all publications related to frontal bon...
Purpose
Within open cranial vault reconstruction (CVR) for craniosynostosis, efforts have been directed at minimizing the bicoronal scar, which contributes to increased patient stigmatization and decreased parental satisfaction. To understand these esthetic considerations across multiple centers, we evaluated demographic and clinical determinants o...
Cutaneous melanoma is a common cancer and cases have steadily increased since the mid 70s. For some patients, early diagnosis and surgical removal of melanomas is lifesaving, while other patients typically turn to molecular targeted therapies and immunotherapies as treatment options. Easy sampling of melanomas allows the scientific community to ide...
Effective and safe liver‐directed gene therapy has great promise in treating a broad range of liver diseases. While adenoviral (Ad) vectors have been widely used for efficacious in vivo gene delivery, their translational utilities are severely limited due to the short duration of transgene expression and solicitation of host immune response. Used a...
Facial sutures contribute significantly to postnatal facial development, but their potential role in craniofacial disease is understudied. Since interest in their development and physiology peaked in the mid–twentieth century, facial sutures have not garnered nearly the same clinical research interest as calvarial sutures or cranial base endochondr...
Introduction
The objectives of this study were to identify factors associated with nonattendance to follow-up in patients seen for traumatic hand and facial injuries at an urban Level 1 trauma center and to elucidate patient-reported reasons for nonattendance.
Methods
A retrospective chart review was performed for all patients seen for hand and fa...
Introduction/Background: The purpose of this systematic review is to assess the literature regarding complications associated with intraoperative blood salvage (IOBS) in the setting of surgical management of craniosynostosis. Methods: A systematic review was performed using PubMed/MEDLINE by 2 independent reviewers which included any primary litera...
Branchial cleft anomalies are congenital head and neck lesions that arise from incomplete maturation of the branchial apparatus during fetal development. The branchial arches are the precursors of the face, neck and pharynx, and disturbances in embryogenesis can present clinically as cysts, sinus tracts, and fistulas in predictable anatomic locatio...
Introduction
Stereolithography, also known as 3D printing (3DP), is a versatile and useful technology with many healthcare applications. While 3DP has gained tremendous popularity, it remains a daunting and perceptibly time-consuming process for the inexperienced user, with most turning to commercially printed products. Commercial vendors are expen...
MicroRNAs (miRNAs or miRs) are single-stranded, ∼22-nucleotide noncoding RNAs that regulate many cellular processes. While numerous miRNA quantification technologies are available, a recent analysis of 12 commercial platforms revealed high variations in reproducibility, sensitivity, accuracy, specificity and concordance within and/or between platfo...
Na Ni Fang Deng Fang He- [...]
Jiaming Fan
Adenovirus (Ad) is a non-enveloped linear double-stranded DNA virus with >50 serotypes in humans. Ad vectors have been used as gene delivery vehicles to express transgenes, siRNAs for gene silencing, or CRISPR/Cas and designer nucleases for genome editing. Although several methods are used to generate Ad vectors, the Ad-making process remains techn...
Background:
Plastic surgery has traditionally been a specialty that places a strong emphasis on away rotations during the final year of medical school. These rotations allow the program and residency candidates to become better acquainted and are often crucial, as a large portion of applicants match at programs where they rotated. The coronavirus...
Lower jaw (mandible) fractures significantly impact patient health and wellbeing due to pain and difficulty eating, but the best technique for repairing the most common subtype—angle fractures—and rehabilitating mastication is unknown. Our study is the first to use realistic in silico simulation of chewing to quantify the effects of Champy and bipl...
Introduction:
The objectives of this study are to analyze the impact of cleft palate (CP) on upper airway obstruction using polysomnography in patients with Pierre Robin Sequence (PRS) undergoing mandibular distraction osteogenesis (MDO) and subsequent CP repair.
Methods:
A single-surgeon, retrospective chart review was performed of all patients...
Ovarian cancer is the third most common cancer and the second most common cause of gynecologic cancer death in women. Its routine clinical management includes surgical resection and systemic therapy with chemotherapeutics. While the first-line systemic therapy requires the combined use of platinum-based agents and paclitaxel, many ovarian cancer pa...
Orbital fractures with entrapment are well described in children but occur less frequently in adults. The true incidence, natural history, and ideal timing of surgical intervention of adult orbital fractures with entrapment are unknown. A single institution, retrospective chart review of 5 adult patients with orbital fractures with entrapment who u...
Skin injury is repaired through a multi-phase wound healing process of tissue granulation and re-epithelialization. Any failure in the healing process may lead to chronic non-healing wounds or abnormal scar formation. Although significant progress has been made in developing novel scaffolds and/or cell-based therapeutic strategies to promote wound...
Currently, the most common approach for treating midface hypoplasia in syndromic craniosynostoses patients is the LeFort III with distraction osteogenesis. Distraction osteogenesis can be performed through either internal or external distraction systems. Each modality offers unique advantages and disadvantages. A rare complication associated with i...
Hedgehog signaling was discovered more than 40 years ago in experiments demonstrating that it is a fundamental mediator of limb development. Since that time, it has been shown to be important in development, homeostasis, and disease. The hedgehog pathway proceeds through a pathway highly conserved throughout animals beginning with the extracellular...
Mesenchymal stem cells (MSCs) are capable of differentiating into bone, cartilage and adipose tissues. We identified BMP9 as the most potent osteoinductive BMP although detailed mechanism underlying BMP9-regulated osteogenesis of MSCs is indeterminate. Emerging evidence indicates that autophagy plays a critical role in regulating bone homeostasis....
Background:
Facial deformities in syndromic craniosynostosis are not only functionally, psychosocially, and aesthetically impairing but also notoriously challenging to reconstruct. Whether facial suture synostosis plays a significant role in the pathogenesis of these deformities is inadequately studied in human patients.
Methods:
The MEDLINE dat...
The health care crisis related to the spread of novel coronavirus (severe acute respiratory syndrome coronavirus 2) has created new challenges to plastic surgery education, mostly because of the decreased volume of procedures. The plastic surgery program directors in Chicago decided to act and identify ways to promote surgical education through cit...
As multipotent progenitor cells, mesenchymal stem cells (MSCs) can renew themselves and give rise to multiple lineages including osteoblastic, chondrogenic and adipogenic lineages. It’s previously showed that BMP9 is the most potent BMP and induces osteogenic and adipogenic differentiation of MSCs. However, the molecular mechanism through which BMP...
Cartilage, especially articular cartilage, is a unique connective tissue consisting of chondrocytes and cartilage matrix that covers the surface of joints. It plays a critical role in maintaining joint durability and mobility by providing nearly frictionless articulation for mechanical load transmission between joints. Damage to the articular carti...
Teeth arise from the tooth germ through sequential and reciprocal interactions between immature epithelium and mesenchyme during development. However, the detailed mechanism underlying tooth development from tooth germ mesenchymal cells (TGMCs) remains to be fully understood. Here, we investigate the role of Wnt/β-catenin signalling in BMP9-induced...
Background: The objective of this study was to analyze and report our experience with using polysomnography (PSG) during the early consolidation phase of mandibular distraction osteogenesis (MDO) in patients with Pierre Robin Sequence and associated tongue-based airway obstruction with management decisions informed by the results. The secondary obj...
Intestinal cancers are developed from intestinal epithelial stem cells (ISCs) in intestinal crypts through a multi-step process involved in genetic mutations of oncogenes and tumor suppressor genes. ISCs play a key role in maintaining the homeostasis of gut epithelium. In 2009, Sato et al established a three-dimensional culture system, which mimick...
Background:
Orthognathic surgery often requires postoperative opioid pain management. The goal of this study was to examine opioid prescribing patterns in adults after orthognathic surgery and to analyze factors associated with high-dose postoperative opioid administration and persistent opioid use.
Methods:
We included opioid naive adults in th...
Purpose
Children with craniosynostosis are vulnerable to stigmatization and social withdrawal. Cranial vault reconstruction (CVR) results in large bicoronal scars, which may trigger further insult to self-esteem and social outcasting. This study aimed to delineate determinants of patient scar self-consciousness, parental scar satisfaction, and pare...
Introduction:
Coronoid fractures are relatively rare fractures of the craniofacial skeleton, but typically occur concomitantly with high-velocity craniofacial trauma to the midface and lateral mandible. Management of coronoid fractures may vary, but when surgical excision is indicated, treatment frequently involves an intraoral approach through a...
Ovarian cancer is one of the most common cancers in women and the second most common cause of gynecologic cancer death in women worldwide. While ovarian cancer is highly heterogeneous in histological subtypes and molecular genetic makeup, epithelial ovarian cancer is the most common subtype. The clinical outcomes of ovarian cancer largely depend on...
Bone is a dynamic organ with high regenerative potential and provides essential biological functions in the body, such as providing body mobility and protection of internal organs, regulating hematopoietic cell homeostasis, and serving as important mineral reservoir. Bone defects, which can be caused by trauma, cancer and bone disorders, pose formi...
RNA interference (RNAi) is mediated by an ∼21-nt double-stranded small interfering RNA (siRNA) and shows great promise in delineating gene functions and in developing therapeutics for human diseases. However, effective gene silencing usually requires the delivery of multiple siRNAs for a given gene, which is often technically challenging and time-c...
Objective
This article describes the methodology used for the Pediatric Craniofacial Collaborative Group (PCCG) Consensus Conference.
Design
This is a novel Consensus Conference of national experts in Pediatric Craniofacial Surgery and Anesthesia, who will follow standards set by the Institute of Medicine and using the Research and Development/Uni...
SATB2 (special AT-rich sequence-binding protein 2) is a member of the special AT-rich binding protein family. As a transcription regulator, SATB2 mainly integrates higher-order chromatin organization. SATB2 expression appears to be tissue- and stage-specific, and is governed by several cellular signaling molecules and mediators. Expressed in branch...
Primary bone tumor, also known as osteosarcoma (OS), is the most common primary malignancy of bone in children and young adults. Current treatment protocols yield a 5-year survival rate of near 70% although approximately 80% of patients have metastatic disease at the time of diagnosis. However, long-term survival rates have remained virtually uncha...
Introduction: Mandibular Distraction Osteogenesis (MDO) is an alternative to tracheostomy and works via lengthening the mandible in order to reduce glossoptosis and airway obstruction. While many patients who undergo mandibular distraction avoid the use of a tracheostomy, some patients will require re-distraction or tracheostomy, often due to recur...
Custom alloplastic temporomandibular joint (TMJ) reconstruction has been well established for the management of end-stage TMJ disease. However, its use in congenital TMJ deformities is limited. Here, the authors present initial outcomes of skeletally mature patients who underwent custom alloplastic TMJ reconstruction and simultaneous orthognathic s...
Background:
The COVID-19 crisis has brought many unique challenges to the healthcare system. Across the United States, social distancing measures have been put in place, including stay-at-home orders (SAH), to combat the spread of this infection. This has impacted the type and volume of traumatic injuries sustained during this time. Meanwhile, ste...
Background
The COVID-19 pandemic forced surgeons to reconsider concepts of “elective” surgery. Perceptions regarding the time-sensitivity and medical necessity of a procedure have taken on greater significance during the pandemic. The evolving ethical and clinical environment requires reappraisal of perioperative factors such as personal protective...
Notch is a cell-cell signaling pathway that is involved in a host of activities including development, oncogenesis, skeletal homeostasis, and much more. More specifically, recent research has demonstrated the importance of Notch signaling in osteogenic differentiation, bone healing, and in the development of the skeleton. The craniofacial skeleton...
Objective
To investigate airway morphology changes in patients with Pierre Robin sequence (PRS) pre–/post–mandibular distraction osteogenesis (MDO) and to compare morphologic changes to age-matched controls.
Design
Retrospective case–control study.
Setting
Urban, academic, tertiary medical center.
Patients, Participants
Fifteen patients with PRS...
MN1 encodes a transcriptional co-regulator without homology to other proteins, previously implicated in acute myeloid leukaemia and development of the palate. Large deletions encompassing MN1 have been reported in individuals with variable neurodevelopmental anomalies and non-specific facial features. We identified a cluster of de novo truncating m...
Background:
Several studies have verified that BMPs may be involved in the development of craniosynostosis; little attention has been focused on the role of BMP9 in cranial suture biology. BMP9 is the most osteogenic BMP and promotes the osteoblastic differentiation of mesenchymal stem cells. We investigated the role of BMP9 in suture progenitor c...
With the significant financial burden of chronic cutaneous wounds on the healthcare system, not to the personal burden mention on those individuals afflicted, it has become increasingly essential to improve our clinical treatments. This requires the translation of the most recent benchtop approaches to clinical wound repair as our current treatment...
Background:
Autologous bone grafts used for surgical reconstruction are limited by infection or insufficient supply of host material. Experimental agents that promote differentiation of stem cells into mature bone are currently being studied for future use in the repair of bone defects. We hypothesized that Imiquimod, a synthetic immune response m...
The complexity of plastic surgery procedures often requires visualization of the anatomy in three dimensions and therefore demands the development of new and innovative teaching methods. This work describes the development and manufacture of a 3D silicone cleft lip and palate (CLP) model evaluated by surgical residents on its similarity to the biol...
Although bone morphogenetic proteins (BMPs) initially showed effective induction of ectopic bone growth in muscle, it has since been determined that these proteins, as members of the TGF-β superfamily, play a diverse and critical array of biological roles. These roles include regulating skeletal and bone formation, angiogenesis, and development and...