Calcitonin-induced osteoplastic reaction in the mandible.

We describe a case of florid osteoplastic response in the mandible to the use of calcitonin. Calcitonin has been used in the treatment of central giant cell granuloma for many years and is widely accepted. We know of no reported cases of calcitonin-related exuberant bony deposition in the jaws or the axial skeleton.

Image-guided navigation in oral and maxillofacial surgery.

Image-guided surgery is the logical extension of imaging as it integrates previously acquired radiological or nuclear medicine images with the operative field. In conventional image-guided surgery, a surgeon uses a surgical instrument or a pointer to establish correspondence between features in the preoperative images and the surgical scene. This is not ideal because the surgeon has to look away from the operative field to view the data. Augmented reality guidance systems offer a solution to this problem but are limited by deformation of soft tissues. Real-time intraoperative imaging offers a potential solution but is currently only experimental. The additional precision and confidence that this technology provides make it a useful tool, and recent advances in image-guided surgery offer new opportunities in the field of oral and maxillofacial surgery. Here, we review the development, current technologies, and applications of image-guided surgery and illustrate them with two case reports.

The composite radial forearm free flap: an anatomical guide to harvesting the radius.

We made an anatomical study of 100 dried cadaveric radii to establish the dimensions of the maximum possible safe harvest of bone for the composite radial forearm flap and how this may be assessed during the operation. We found that the diameter of the radius from its medial to lateral border is consistently 1-3mm less than 40% of the measured minimum circumference of the radius.

Palatal and nasal necrosis resulting from cocaine misuse.

The potential social and economic harm caused by cocaine addiction is well known. The wider health risks and potential nasal complications of septal perforation and nasal collapse are also recognised. We report a case of oro-nasal fistula secondary to cocaine misuse and discuss the aetiology, management and potential methods of repair.

Giant osteomata of the mandible.

Osteomas are benign tumours of bone. They are uncommon in the jaws and usually present because of facial asymmetry or trismus. Osteomas arising from the lingual aspect of the mandibular ramus are rare and asymptomatic, usually discovered on routine radiography. We present two cases, and discuss their aetiology, presentation and management.

An unusual cause of oro-antral fistula.

A case of oro-antral fistula associated with an apparent foreign body following antral packing for a zygomatic complex fracture 10 years previously is presented. This was treated by antral exploration, removal of the antral contents and repair of the fistula. The complications of antral packing for zygomatic and orbital floor fractures are reviewed and those situations where antral packing may be the treatment of choice are defined.

Head and neck cancer and its treatment: historical review.

Head and neck cancer has been known to physicians since antiquity, but until relatively recently any material advance was limited by the lack of anaesthesia. The factors and people that helped to develop the subject of head and neck surgery have been traced through history, and this paper provides a broad historical perspective with which to compare the current standard of management for head and neck cancer.

A measure of the mitotic index: studies of the abundance and half-life of p34cdc2 in cultured cells and normal and neoplastic tissues.

BACKGROUND: The cdc2 gene encodes a protein kinase, p34cdc2, that is essential for mitosis, and is present at high levels in dividing cells. Classical studies of the levels of this protein in dividing and resting cells used antibodies that cross-react with other members of the CDK family, in particular with CDK2. We have therefore re-examined the abundance of p34cdc2 in a variety of tissues and cell lines, using a highly specific, epitope-mapped monoclonal antibody that does not react with CDK2. RESULTS: We observed high levels of p34cdc2 in proliferating cells, especially those in neoplastic tissues. Cells that have withdrawn from the cell cycle have low or undetectable levels. At the end of mitosis, the level of p34cdc2 declines, with simple first-order kinetics, with a half-life which is never less than 6h and is more typically about 18h. The persistence of p34cdc2 after the last cell division is comparable to that of PCNA, a commonly used marker of proliferation. CONCLUSIONS: The immunochemical detection of p34cdc2 provides an accurate, reliable and meaningful measure of the proliferative activity of cells in tissues. We suggest that p34cdc2 should be considered as the most authentic molecular marker of the mitotic index.

Rapid prototyping techniques for anatomical modelling in medicine.

The rapid advances in computer technology, often driven by the demands of industry, have created new possibilities in surgery which previous generations of surgeons could only have imagined. Improved imaging with computerised tomography (CT) has been followed by magnetic resonance imaging (MRI) and, more recently, it has become possible to reformat the data as three-dimensional images. Computer technology has new moved forward with the advent of rapid prototyping techniques (RPT) which allow both the production of models of the hard tissues and custom-made prostheses from computerised scanning data. In this article we review the development and current technologies available in RPT and the applications of this advance in surgery and illustrate this with two case reports.

Cell cycle regulatory proteins--an overview with relevance to oral cancer.

The cell cycle is controlled by a number of highly conserved proteins, found in species as diverse as yeast and mammals. The study of these proteins is a rapidly advancing field that is increasing our understanding of normal and abnormal cell division. Disruption of the cell cycle has been demonstrated in several different types of neoplasm, and there is increasing evidence that, in head and neck tumours, there is aberrant control of cyclins, cell cycle protein kinases and their inhibitors. Because of the phase specificity of some of the control proteins, antibodies to them are proving to be of value in studying cell kinetics of both normal tissues and malignant tumours.

The localization of p34cdc2 in the cells of normal, hyperplastic, and malignant epithelial and lymphoid tissues of the oral cavity.

The expression of p34cdc2 has been examined in normal, hyperplastic, and malignant oral epithelia and lymphoid tissues. Four monoclonal antibodies were prepared against Xenopus p34cdc2, three of which react specifically with human p34cdc2 and not with p33cdk2. These produced similar patterns of staining in both fixed and frozen sections of human material. Staining occurred mainly in the proliferative compartments of normal and hyperplastic tissues. In normal oral epithelia, parabasal and basal cells were the most strongly stained, with lighter cytoplasmic staining in lower prickle cells. In tonsillar germinal centres, a high proportion of cells was stained, with fewer positive cells in interfollicular zones, a distribution in keeping with the known pattern of cell proliferation. In normal cells, the intracellular location of p34cdc2 was cytoplasmic until early prophase, but in oral squamous cell carcinomas and lymphomas, it was located in both cytoplasm and nucleus during interphase and a larger fraction of cells was positive than in the equivalent normal tissues. Higher-grade neoplasms showed both a higher intensity of staining and a higher proportion of p34cdc2-positive cells.