Development of an improved protocol to analyse gene expression in temporomandibular joint condylar cartilage of rats using DNA microarrays.

PURPOSE: During recent years, gene expression analyses based on DNA chip technologies have allowed for the genome-wide identification of genes potentially associated with growth processes in a variety of organs. The present study aims to identify genes differentially expressed in the growing temporomandibular joint cartilage by means of transcriptome analyses. MATERIAL AND METHODS: In total, the condylar cartilage of 32 rats comprising 4 age groups (newborn, 10 days, 21 days, 8 weeks) were used for analysis. Transcriptome analyses were carried out using Affymetrix Expression Arrays (Rat Genome 230 2.0 Arrays). The availability of high-quality RNA preparations from homogeneous tissue samples is a fundamental precondition of successful transcriptome analyses using DNA arrays. An optimised preparation protocol allowed RNA isolation of sufficient quality which was validated using capillary electrophoresis. RNA collected from 8 test animals of the 4 age groups respectively was mixed in equimolar RNA pools which served for the transcriptome analyses using Affymetrix arrays. RESULTS: Statistical analysis of the gene expression data indicated the existence of genes differentially regulated in the growing temporomandibular cartilage. This evidence, however, requires validation by RT-PCR using individual animals' RNA. Preliminary candidate genes belong, among others, to the groups of matrix-degrading proteases, protease inhibitors and genes involved in cell growth, apoptosis and bone remodelling. CONCLUSION: These differentially expressed genes in TMJ growth identified using DNA array technology may possibly contribute to a better understanding of growth biology and provide an approach to necessary therapy.

Technique and survival after laparoscopically assisted right hemicolectomy.

BACKGROUND: The role of laparoscopic colon resection in the management of colon cancer is still controversial. In this article, the surgical strategy and techniques are described, with further consideration of the oncologically relevant aspects. METHODS: Between March 1993 and July 2003, we performed laparoscopic right hemicolectomy in 56 patients with right colon carcinoma. Average age was 74.5 years (range, 17-92). We performed a standardized surgical procedure that included mobilization from the vascularized mesenteric bridges with a window technique, transection of the ileocolic lymphovascular pedicle, and lateral and proximal mobilization of the ileocecum, ascending colon, right flexure, and proximale transversum. After enlargement of one of the trocar incisions the exteriorized colon was resected and an extracorporeal anastomosis was performed in the standard manner. RESULTS: There were no conversions to open. The mean operating time was 119 +/- 38 min, the mean length of resected colon was 27.8 +/- 4.48 cm, and the average width of the clear margins was 6.8 +/- 5.3 cm. One patient died. Lymph nodes were positive in 21 patients. The 5-year survival rate in the 48 patients who were operated on with curative intent was 75%. We have had two local recurrences. The overall 5-year mortality-free fraction was 63%. Cox multivariate analysis showed that the mortality-prognostic factors were tumor stage and length of resected colon, whereas Kaplan-Meier analysis showed that the mortality-prognostic factors were positive lymph nodes and tumor stage. CONCLUSIONS: Our results show that laparoscopic right hemicolectomy for colon cancer can be performed safely. Complications and recurrence rates are comparable to those for left-sided laparoscopic and open procedures. Therefore, we recommend this procedure as the method of choice. Laparoscopically treated patients with stage II and stage III disease have almost the same cumulative rate of survival.

[Laparoscopic segmental pancreas resection and pancreatic cystadenoma]. / Laparoskopische Pankreassegmentresektion bei Pankreaszystadenom.

Aside from location, the complex anatomic relationships and advanced laparoscopic skills needed in selected cases of laparoscopic pancreas surgery have increased. We report a 55-year-old woman with cystic adenoma in the area of the corpus who was treated with complete laparoscopic corpus resection while preserving the head and tail of the pancreas and the spleen. The patient was placed in lithotomy position. Four trocars were placed. After opening the bursa, the pancreas showed a 6x6x6-cm, well-bordered, cystic tumor in the corpus. Tail and head of the pancreas were free of tumor and seemed inconspicuous. After exploration of the v. porte and v. lienalis, the healthy tissue in the head area of the pancreas was divided with the linear stapler. Preparation continued in the direction of the pancreatic tail while preserving the v. lienalis. After reaching the healthy pancreas in the tail region, the tumorous segment was resected. The resected pancreas segment was placed in an endobag until removal over a slightly widened trocar incision above the symphysis. The tail segment was anastomized in situ end-to- side with the first jejunum loop behind the Treitz's ligament. There was no postoperative complication, and the postoperative course was observed. The patient returned to normal activity within 10 days after operation. Retaining high surgical standards and preserving the healthy pancreas tissue and laparoscopic anastomosis, laparoscopic surgery in cases of benign tumors of the distal pancreas is possible with all the patient benefits of minimally invasive surgery.

Multi-control analysis of 24-month clinical outcomes of guided tissue regeneration of deep periodontal pockets.

AIM: To evaluate clinical outcome 24 months after guided tissue regeneration (GTR) therapy of deep periodontal pockets in patients poorly responding to conventional flap surgery, to compare its efficacy with conventional flap surgery, and to analyze the factors associated with the healing outcome. METHODS: Twenty defects underwent GTR with ePTFE membranes. Clinical measurements were recorded at the baseline and at 6, 12 and 24 months after the surgery. The 24-months outcomes were compared to those in the same 20 patients previously treated with conventional flap surgery (intra-subject control), and in matched control patients who underwent conventional treatment alone. RESULTS: After 24 months, GTR treatment significantly reduced the probing pocket depth (deltaPPD=2.7+/-1.2 mm, p<0.001) and increased probing attachment level (deltaPAL=2.31+/-1.5 mm, p<0.001) in comparison to the previous conventional treatment. No significant difference was observed before the 24-month measurement compare d to matched controls who responded well to the conventional treatment. However, 24 months after the surgery, dPAL obtained in the GTR group significantly exceeded that after conventional treatment. There was a significant association between 24-month dPAL and dPPD with the configuration and the intrabony depth of the defect, level of oral hygiene, and smoking status of the patient. CONCLUSION: The efficacy of GTR is at least equal to that of conventional flap surgery. It is desirable in patients poorly responding to flap surgery alone. The gain and maintenance of clinical attachment is associated with the level of oral hygiene, smoking status, and morphology and intrabony depth of the defect.

Potential of gingival connective tissue to induce keratinization of an alveolar mucosal flap: a long-term histologic and clinical assessment. Case report.

A maxillary canine and premolar showed a 3.0- to 4.0-mm-deep and 3.0- to 4.0-mm-wide recession defect with 2.0- to 3.0-mm zone of attached gingiva. The denuded root surfaces were covered with nonkeratinized alveolar mucosa in a slightly modified bridge flap technique. The coronal displacement of a nonkeratinized alveolar mucosal flap onto a bed of collagenous gingival connective tissue resulted in the development of keratinized epithelium in the previously nonkeratinized mucosa. This was caused by the inductive stimuli of the underlying tissue and observed in the 6-month specimen. The alveolar mucosa displayed its transformed epithelial structural pattern only in segments, achieving full differentiation of its basal complex over a 10-year period, as demonstrated clinically and histologically.