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Upper eyelid ptosis can present both functional and aesthetic problems. Because proper correction of ptosis can be difficult to achieve, numerous surgical procedures have been developed. Plication of levator aponeurosis can be combined with aesthetic blepharoplasty and facial rejuvenation procedures to successfully address ptosis. The authors assessed the effectiveness of levator aponeurosis plication for correction of acquired upper eyelid ptosis in patients presenting for concomitant cosmetic facial procedures. The medical records of 74 consecutive patients 68 women and six men who had upper eyelid ptosis correction in conjunction with cosmetic facial procedures from January of 1994 to January of 2000 were reviewed. During this period, 400 endoscopic forehead lifts and 479 face lifts were performed. The correction was performed through an external upper blepharoplasty approach removing an ellipse of skin and orbicularis muscle. Once the orbital septum was opened, a plication of the levator aponeurosis was accomplished by one or more horizontal mattress sutures of 60 clear nylon with the first bite placed at or just medial to the vertical level of the pupil. The average followup period was 14 months. Longterm correction of the ptosis was excellent. The complications were minor, with the most common occurrence being asymmetry. Revisions were performed on only four patients. Correction of ptosis can be performed safely and effectively in conjunction with periorbital and facial rejuvenation. The technique described is simple, reliable, and reproducible. Plast. Reconstr. Surg.112 655, 2003.

Previously, we demonstrated that proteolytic processing within the globular domain of the α3 subunit of laminin-5 (LN5) converts LN5 from a cell motility-inducing factor to a protein complex that can trigger the formation of hemidesmosomes, certain cell-matrix attachment sites found in epithelial cells. We have prepared a monoclonal antibody (12C4) whose epitope is located toward the carboxy terminus of the globular domain of the α3 laminin subunit. This epitope is lost from the α3 subunit as a consequence of proteolytic processing. Antibody 12C4 stains throughout the matrix of cells that fail to process the α3 laminin subunit, but does not recognize the matrix of confluent cultures of MCF-10A cells, which efficiently process their α3 laminin chain. In subconfluent populations of MCF-10A cells, 12C4 only stains matrix deposited at the outer edges of cell colonies. In these cells, integrin α3β1 occasionally colocalizes with the staining generated by the 12C4 antibody but α6β4 integrin does not. In wounded MCF-10A cell cultures, the 12C4 antibody stains the extracellular matrix beneath those cells at the very edge of the cellular sheet that moves to cover the wound site. A similar phenomenon is observed in human skin wounds, since we also detect expression of the unprocessed α3 laminin subunit at the leading tip of the sheet of epidermal cells that epithelializes skin wounds in vivo. In addition, using α3 laminin subunit and integrin function-inhibiting antibodies, we provide evidence that LN5 and its two integrin receptors (α6β4 and α3β1) appear necessary for wound healing to occur in MCF-10A cell culture wounds. We propose a model for healing of wounded epithelial tissues based on these results.

Changes in ornithine decarboxylase (ODC) activity in the mouse uterus following stimulation of the decidual cell reaction (DCR) have been examined. ODC activity in the stimulated horn increased sixfold over sham-operated controls 6 h after intraluminal injection of oil. Six hours after trauma stimulation, the activity of ODC in the stimulated horn increased fourfold over contralateral control horns. Indomethacin pretreatment, previously shown to block the oil-stimulated DCR, blocks the increase in ODC activity in the oil-stimulated horn. These results suggest that increased ODC activity is an early event following stimulation of the DCR and may be causally related to the cellular proliferation which occurs as part of the process.

Skin ultrastructure was examined in patients undergoing CO2laser resurfacing for facial rejuvenation. The lasers used in this study were the Coherent Ultrapulse CO2laser with computerized pattern generator, the Sharplan Feathertouch laser, and the Laserscope Paragon70 pulsed CO2laser with computerized pattern generator. Results showed that the epidermis was totally removed with one pass of the CO2laser. After one laser pass, there was little compaction of collagen in the dermis, but after two and three passes, there were sequential graded increases in collagen compaction with loss of the intervening extracellular gel matrix. There was no “collagen shrinkage,” and the collagen itself was marginally affected, except for occasional losses in striations at the surface of the specimens. Elastin was very much affected by the laser such that with only one pass, the elastin was abnormal, presenting with a mottled heterogenous structure. This elastin aberrancy was present in both the papillary and reticular dermis. After one laser pass, fibroblast necrosis was present in the papillary dermis and the reticular dermis depending on which laser was used, and the extent and depth of necrosis increased with multiple laser passes. Plast. Reconstr. Surg.102 509, 1998.