The amphiphilic block copolymer poly(isoprene‐block‐ethylene oxide) was used as a structure‐directing agent for a polysilazane preceramic polymer commercially known as Ceraset. Two block copolymers of different molecular weights and poly(ethylene oxide) weight fractions with body‐centered cubic sphere and hexagonal cylinder morphologies were used. To both polymers, 50 wt % of the silazane oligomer (Ceraset) was added. The resulting composites were cast into films and characterized by small‐angle X‐ray scattering and transmission electron microscopy. The silazane was chemically compatible with the poly(ethylene oxide) microdomains of the block copolymer, and this resulted in a swelling of those domains. After the cooperative self‐assembly of the block copolymer and Ceraset, for both systems the structure was permanently set in the lamellar morphology by the crosslinking of the silazane oligomer with a radical initiator at 120 °C. These results suggest that the use of block copolymer mesophases may provide a simple and easily controlled pathway for the preparation of various high‐temperature SiCN‐type ceramic mesostructures. © 2003 Wiley Periodicals, Inc. J Polym Sci Part B: Polym Phys 41: 3346–3350, 2003

These data support our hypothesis that inhibition of BMP activity using Noggin may prevent postoperative resynostosis in this rabbit model. These findings also suggest that Noggin therapy may have potential clinical use to prevent postoperative resynostosis in infants with craniosynostosis.

Postoperative resynostosis and secondary craniofacial growth abnormalities are common sequelae after craniofacial surgery. It has been suggested that an overexpression of transforming growth factor-beta2 (Tgf-beta2) may be related to craniosynostosis and contribute to postoperative resynostosis. Interference with Tgf-beta2 function using neutralizing antibodies may inhibit resynostosis and improve postoperative craniofacial growth; the present study was designed to test this hypothesis. Twenty-nine New Zealand white rabbits with bilateral coronal suture synostosis were used: 1) suturectomy controls (n=9); 2) suturectomy with nonspecific, control IgG antibody (n=9); and 3) suturectomy with anti-Tgf-beta2 antibody (n=11). At 10 days of age, a 3 mm x 15-mm coronal suturectomy was performed. The sites in groups 2 and 3 were immediately filled with 0.1 cc of a slow resorbing collagen gel mixed with either IgG (100 microg/suture) or anti-Tgf-beta2 (100 microg/suture). Three-dimensional computed tomography scan reconstructions of the skulls and cephalographs were obtained at 10, 25, 42, and 84 days of age. Computed tomography scan data revealed patent suturectomy sites and significantly (P<0.05) greater intracranial volumes by 84 days of age in rabbits treated with anti-Tgf-beta2 compared with controls. Cephalometric analysis revealed significant (P<0.05) differences in craniofacial, cranial vault, and cranial base growth by 84 days of age in rabbits treated with anti-Tgf-beta2 compared with controls. These data support the initial hypothesis that interference with Tgf-beta2 function inhibited postoperative resynostosis and improved cranial vault growth in this rabbit model. Thus, this biologically based therapy may be a potential surgical adjunct in the treatment of infants with craniosynostosis.

There is now considerable enthusiasm for the development of emergency medicine as the hospital generalists' specialty. Emergency nursing training has also made a start. Limitations on resources will require flexibility to sustain the project. Further support by emergency physicians will be needed.

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