Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P50583 (asymmetrical)
 12,197 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The development of genu valgum in a child after a fracture of the upper metaphysis of the tibia with a medial gap is due to the interposition of a flap of fibrous tissue consisting of pes anserinus and periosteum avulsed from the lower fragment. The ensuing biomechanical disturbance induces bowing of the shaft and asymmetrical growth at both ends of the bone. Four cases of established deformity are reported, together with two cases of fresh fracture successfully treated by surgical clearance of the fibrous tissue from the gap.
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PMID:Fibrous interposition causing valgus deformity after fracture of the upper tibial metaphysis in children. 89 6

Proximal tibial epiphyseal fractures are rare injuries occurring predominantly in older children and adolescents. They have not previously been reported in infants. The present case is that of a 7-month-old female infant with a displaced Salter-Harris type II fracture secondary to child abuse. This represents the youngest documented case of a proximal tibial epiphyseal fracture. Open reduction and internal fixation were performed because of failure to obtain an anatomic alignment by closed reduction. The anatomic reason for unsuccessful closed reduction intraoperatively was found to be an infolding of the pes anserinus and periosteum. Tibia valga occurred postoperatively because of asymmetrical physeal overgrowth and required corrective osteotomy.
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PMID:Proximal tibial epiphyseal fracture in an infant. 669 54

We used a rabbit model to investigate the mechanism by which the angulation of fractures is corrected in children. We produced a transverse proximal tibial fracture in one leg of 12 eight-week-old New Zealand white rabbits and measured bone alignment and length and the patterns of bone growth and remodelling. The angle between the joint surfaces changed rapidly to correct the alignment of the limb as a result of asymmetrical growth of epiphyseal plates. In an adult with closed plates, the angle between the joint surfaces cannot therefore improve. The angle at the fracture itself showed slow improvement because of bone drift and the asymmetrical growth of the epiphyseal plates. Remodelling corrected the shape of the bone in the region of the fracture. Periosteal division on the convex side increased the growth of the epiphyseal plate on that side, thus slowing the correction. The effect was relatively small, providing an indication that factors other than the periosteum are important in inducing correction. External torsional deformities developed because of helical growth at the plate. This was probably caused by abnormal posture which induced a torque at the growth plate. Helical growth is the mechanism by which rotational deformities can occur and correct.
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PMID:Bone growth and remodelling after fracture. 889 25

The subperiosteal face lift is a procedure designed to rejuvenate the upper and middle thirds of the face. Herein is reviewed a 4-year series of 200 consecutive patients who have undergone a subperiosteal face lift with a special emphasis on handling of the zygomatic arch. The main operative indication was significant ptosis of the midface soft tissue. Dissection of the maxilla, zygoma, periorbital areas, and the anterior arch was carried out through either a gingivo-buccal sulcus incision (39 cases) or a subciliary incision (161 cases). Dissection of the posterior arch was carried out in a plane superficial to the innominate fascia. A back-cut was made in the superficial musculoaponeurotic system and subcutaneous tissue down to midtragus, and a subperiosteal tunnel was entered by piercing through the posterior arch periosteum. By using a Cottle elevator (sweeping superiorly and inferiorly), the arch dissection was completed in a posterior to anterior direction. All patients underwent a concurrent brow lift (190 endoscopically and 10 by means of coronal incision). The forehead incision was used to dissect the lateral orbital rims. Twelve patients (6 percent) had undergone a previous rhytidectomy. All but four patients were women and ranged in age from 34 to 76 years (mean, 54+/-11). Mean follow-up period was 27 months (1 to 41 months). The postoperative complication rate was 5 percent and included transient frontal branch weakness (n = 2), resolved at 41 and 71 days postoperatively; hematoma (n = 2); transient infraorbital nerve paresthesia (n = 1); asymmetrical smile (n = 3); and facial tics (n = 2). Two patients (1 percent) required a secondary surgery on their brows or midface. An upper blepharoplasty was needed in 26 patients (13 percent). The overall aesthetic results were excellent, with good elevation of the eyebrows, lateral canthus, and the midface soft tissues. In conclusion, the subperiosteal face lift is a procedure designed to rejuvenate the upper and middle thirds of the face. Approaching the arch posteriorly and in a systematic fashion simplifies the procedure and reduces the risk of facial nerve injury.
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PMID:Subperiosteal face lift: a 200-case, 4-year review. 1019 Apr 64

Childhood cortical porosity is attributable to giant asymmetrical drifting osteonal canals that arise predominantly along the primary-secondary bone interface (PSBI). Bone from the external iliac crest cortex of 92 subjects aged 0 to 25 years was examined histomorphometrically for differences in microstructural properties between primary and secondary bone that might account for features of drifting osteonal canals. Primary compared with secondary bone showed greater numbers of osteocyte lacunae, thinner collagen lamellae, and a scaffold of elastic perforating fibers (PFs). The greater number of osteocyte lacunae compounded by known perilacunar strain amplification and the presence of elastic PFs are expected to be associated with greater bone tissue strain in primary than in secondary bone and thus with strain gradients at the PSBI. Strain gradients may lead local osteocytes to originate resorption canals and to promote transverse drift of the resorption front into lower-strain secondary bone, thus creating giant asymmetrical drifting osteonal canals that remodel primary to secondary bone. PFs extended from muscle fibers through periosteum and primary bone to the PSBI, where they were resorbed by origination of drifting canals. Growth modeling by periosteal osteoblasts proceeds in the gaps between PFs. Through the direct connection between muscle and the PSBI via PFs, muscle forces may influence not only modeling by raising strain but also remodeling of primary to secondary bone by increasing strain gradients at the PSBI. With reduction in primary bone width after the mid-teens, numbers of drifting canals and porosity declined. Differences in microstructural properties between primary and secondary bone are expected to generate strain gradients at the PSBI that contribute to site, transverse drift, asymmetry and large size of drifting canals, and, hence, to cortical porosity. Cortical porosity in children is a physiological feature of bone growth in width. Advisability of therapeutic intervention remains to be defined.
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PMID:Childhood cortical porosity is related to microstructural properties of the bone-muscle junction. 2504 78