Evaluation of postoperative changes in vascularized iliac bone grafts used for mandibular reconstruction.

Vascularized iliac bone grafts are used for mandibular reconstruction, but the factors affecting graft maintenance are unknown. This study explored the postsurgical changes in vascularized iliac bone grafts in patients who had undergone mandibular reconstruction after segmental resection. The study involved 24 patients (16 men and eight women) with oral tumours or osteoradionecrosis. Thirteen patients required bare bone grafting (BBG) and 11 patients required reconstruction with soft tissue coverage (six with a skin paddle and five with direct closure). The bone graft maintenance rate (with regard to the height of the centre of the graft) was calculated immediately after surgery and at 3, 6, 12, 24, and 36months after surgery. The maintenance rate was significantly lower in the BBG group than in the soft tissue coverage group at 3, 6, 12, 24, and 36months, and in those who were fitted with dentures compared to those who were not at 6, 12, 24, and 36months. Local infection also influenced the maintenance rate, but not significantly so. These findings indicate that the reconstruction technique and denture use can affect the bone graft maintenance rate after mandibular reconstruction with vascularized iliac bone grafts.

Effect of articulatory rehabilitation after oral cancer surgery on higher brain activation.

The present study aimed to verify the importance of postoperative articulatory rehabilitation in patients with oral cancer and to clarify the neurological changes underlying articulatory functional recovery. A longitudinal assessment of oral function and accompanying brain activity was performed using non-invasive functional magnetic resonance imaging (fMRI). We assessed 13 patients with cancers of the tongue and oral floor before and after ablative surgery. Articulatory function was assessed preoperatively and postoperatively using a conversation intelligibility test and the Assessment of Motor Speech for Dysarthria test. Patients also performed a verbal task during fMRI scans. The assessments were then repeated after the patients had undergone 4-6 months of articulatory rehabilitation therapy. Compared to pretreatment levels, articulatory rehabilitation resulted in a significant increase in activation in the supplementary motor cortex, thalamus, and cingulate cortex. The present study offers a quantitative assessment of the effects of speech rehabilitation by investigating changes in brain activation sites.

Effect of local anesthesia on trigeminal somatosensory-evoked magnetic fields.

For objective neurophysiological evaluation of the function of the trigeminal system, magnetoencephalography- based TSEF (trigeminal somatosensory-evoked field) assessment would be valuable in providing spatial and temporal profiles of cortical responses. However, this necessitates knowledge of how TSEF varies with trigeminal nerve dysfunctions. We introduced a conduction block of the trigeminal nerve using local anesthesia (lidocaine) to temporally mimic nerve dysfunctions, and monitored TSEF changes. Following an electrical stimulation of the lower lip, a magnetic response with peak latency of approximately 20 ms was identified in all participants. Dipole for the peak was estimated on the post-central gyrus in the participant's own magnetic resonance image. After normalization to Montreal Neurological Institute (MNI) space and inter-participant data integration, the summary equivalent current dipole localization among participants remained in the post-central gyrus, suggesting validity of the use of MNI space. Partial anesthesia of the lower lip led to a loss of the waveform characteristics of TSEF for electrical stimulation to the trigeminal nerve. We verified that the 20-ms latency cortical response of TSEF components localized at the primary sensory cortex can serve as a robust neurofunctional marker of experimental trigeminal nerve dysfunction.

Increased expression and activation of matrix metalloproteinase-2 (MMP-2) in O-1N: hamster oral squamous cell carcinoma with high potential lymph node metastasis.

Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers with poor clinical outcome. MMP-2 was implied to contribute to the invasiveness and metastatization of various malignancies because of the degradation of type IV collagen. In this experiment, ELISA, Western blot and Q-RT-PCR was performed to investigate the expression and activation of MMP-2 in serum and tumor from hamster oral cancer model with high lymph node metastasis based on the various stages of OSCC development. Active MMP-2 in the serum was found elevated during oral cancer progression. In the metastatic stage, total MMP-2 level was 46% higher than it in the expansive stage, while active MMP-2 level increased 6-fold than it in the expansive stage. MMP-2 serum activation ratio was significantly enhanced in the metastatic stage than before tumor transplantation and that in the expansive stage. MMP-2 protein and MMP-2 mRNA was found to be increased during oral cancer development in hamster models. The increase of MMP-2 expression and activation starts prior to the metastasis occurrence, indicating the important role of MMP-2 in the early phase of oral cancer progression. Active MMP-2 level in serum may be a useful indicator for monitoring oral cancer progression.

Immobilization stress induces BDNF in rat submandibular glands.

Brain-derived neurotrophic factor (BDNF) promotes survival and differentiation of the cells of the central and peripheral nervous systems. BDNF has been identified in non-neural tissue, including the heart, lung, platelets, lymphocytes, and lacrimal glands. Immobilization stress modifies BDNF mRNA expression in some organs. The present study examines the effect of immobilization stress on BDNF, and its receptor TrkB, in male rat submandibular glands. Increased BDNF mRNA and protein expression were observed in duct cells as a result of immobilization stress, as demonstrated by real-time PCR, Western blot, immunohistochemistry, and analysis by microdissection. TrkB mRNA was not detected in salivary gland tissue, or oral or esophageal mucosa, by RT-PCR. Rat submandibular gland was thus identified as an organ which expresses BDNF. Furthermore, the results of this study suggest that increased salivary BDNF expression occurs following immobilization stress.

Gene gun-mediated oral mucosal transfer of interleukin 12 cDNA coupled with an irradiated melanoma vaccine in a hamster model: successful treatment of oral melanoma and distant skin lesion.

Malignant melanoma involving the oral cavity has a highly metastatic potential. Curative surgery is required to resect extensive oral tissues and often results in dysfunction as well as a severe cosmetic deformity in patients with the disease. An alternative technology for the local and sustained delivery of cytokines for cancer immunotherapy has been shown to induce tumor regression, suppression of metastasis, and development of systemic antitumor immunity. However, local immunization of the oral cavity has not previously been studied. In this study, we examined the efficacy of particle-mediated oral gene transfer on luciferase and green fluorescent protein production. The results showed that these proteins were more significantly expressed in oral mucosa than the skin, stomach, liver, and muscle. Using an established oral melanoma model in hamsters, particle-mediated oral gene gun therapy with interleukin (IL) 12 cDNA was then conducted. The results indicated that direct bombardment of mouse IL-12 cDNA suppressed tumor formation and improved the survival rate. The skin tumor model created by inoculation of melanoma cells was also significantly inhibited by the oral bombardment of IL-12 cDNA coupled with an irradiated melanoma vaccine administrated to the oral mucosa, compared to treatment with a percutaneous vaccine. IL-12 gene gun therapy, combined with an oral mucosal vaccine, induced interferon-gamma mRNA expression in the host spleen for a long time. These results suggest that immunization of oral mucosa may induce systemic antitumor immunity more efficiently than immunization of the skin and that oral mucosa may be one of the most suitable tissues for cancer gene therapy by means of particle-mediated gene transfer.

Different effects of pemphigus antibody and plasmin on the distribution of keratin intermediate filaments and desmoplakins between cultured oral and epidermal keratinocytes.

In order to clarify the molecular mechanism of blister formation in oral mucosa in pemphigus vulgaris (PV) comparing with that in epidermis, we analyzed the effects of PV serum on the distribution of keratin intermediate filaments (KIFs) and desmoplakins in oral as well as epidermal cultured keratinocytes by immunofluorescence microscopy using anti-keratin and anti-desmoplakin I/II monoclonal antibodies. After incubation with PV serum for 96 h at 37 degrees C, clusters of anti-keratin positive dots were formed around the nucleus in some of the keratinocytes from normal gingiva and soft palate but not in keratinocytes from tongue and skin, and desmoplakins also changed their distribution from linear arrangement at cell-cell contacts to clusters of dots around the nucleus in gingiva but not in epidermal keratinocytes. The dotted structures similar to those induced by pemphigus serum were formed also by incubation with human plasmin in gingival keratinocytes. However, no dot-formation of keratins was induced in these cells after incubation with trypsin. Furthermore, in epidermal keratinocytes, no keratin-dot formation was observed even after incubation with plasmin or trypsin. These results suggest that the dotted structures of KIFs caused by PV serum and plasmin might be a feature characteristic for the response of oral keratinocytes to PV serum and that there are some distinct differences in susceptibility to, and mode of, bulla formation between oral epithelium and epidermis.

The relationship between 67Ga accumulation and ATP metabolism in tumor cells in vitro.

Previously, we reported that the deposition of 67Ga into malignant tumors may be a sensitive index of proliferative activity in tumor cells. For the purpose of elucidation of this hypothesis, we investigated the relationship between the accumulation of 67Ga into malignant tumor cells and the intra cellular ATP metabolism in vitro. The uptake of 67Ga into tumor cells was inhibited by adding NaF which is an inhibitor of ATP production. Furthermore, the uptake of 67Ga into tumor cells was strongly inhibited by adding ouabain which is a specific inhibitor of Na+-K+-ATPase. From these in vitro results, it was concluded that there is a correlation between 67Ga uptake and intra cellular ATP metabolism in tumor cells.

[The difference between the mechanism of 67Ga accumulation and 59Fe accumulation in cultured tumor cells].

It is well known that the mechanism of 67Ga accumulation into tumor cells is mediated with transferrin receptor as well as iron. The present study was designed to explore the difference between the mechanism of gallium accumulation and that of iron by using mouse leukemic cell line L5178Y. When monensin which inhibits the recycle of transferrin receptor was added to the incubated system, accumulation of 59Fe and 67Ga was clearly diminished compared with that of control. However, inhibition of 59Fe accumulation was more remarkable than that of 67Ga. Furthermore, monensin has a action of Na+ ionophore which decreases Na+ gradient between the inside and the outside of the plasma membrane. Following administration of monensin, 67Ga accumulation was diminished according to the loss of the Na+ gradient. On the other hand, following administration of valinomycin, 67Ga accumulation was not affected by the loss of the K+ gradient. From these results, it was suggested that the mechanism of 67Ga accumulation into tumor cells differed from that of 59Fe and transferrin receptor and Na+ gradient of tumor cells played an important role on 67Ga accumulation into tumor cells.

Dynamic association of band 3 with triton shells in human erythrocyte ghosts.

To test a possibility that free band 3 and ankyrin-linked band 3 are exchanged in situ, band 3 was labeled with 125I, using intact red blood cells and lactoperoxidase. The cytoplasmic surface of this labeled band 3 was considered to be intact. When Triton shells were incubated with Triton supernatants prepared from 125I-labeled intact erythrocytes at 37 degrees C in the presence of Mg-ATP under isotonic conditions, the incorporation of free 125I-labeled band 3 to shells was observed. This incorporation was affected by the presence of Triton X-100 in the incubation mixture, and significantly decreased when the content of Triton X-100 was less than 0.04% (v/v). On the other hand, ankyrin-linked 125I-labeled band 3 was released when shells prepared from 125I-labeled intact erythrocytes were incubated with the Triton supernatants at 37 degrees C under the same condition as when free 125I-labeled band 3 incorporation was observed. These results strongly suggest that free and ankyrin-linked band 3 exchanged with each other in the presence of Triton X-100. A water-soluble 43 kDa fragment of band 3 inhibited the incorporation of free 125I-labeled band 3 to the shells and also inhibited the Mg-ATP-dependent shape change of ghosts in the absence of Triton X-100. Both of these inhibitory effects remained, even after 10 min of heat treatment at 100 degrees C, but drastically decreased by treatment with trypsin. Our results strongly suggest that a dynamic exchange of the free band 3 for ankyrin-linked band 3 may occur in intact erythrocytes, and it may even contribute to the shape change of erythrocytes.

Structure and function of red cell cytoskeleton.

Red cell shape changed reversibly depending on the ATP level, but the volume did not change. The surface area of both lipid bilayer and cytoskeleton network changed depending on the ATP level. Mild trypsin treatment of ghosts dissipated only ankyrin band and abolished the shape-and viscosity-change induced by CPZ and ATP+warming. Triton shells losing permeability barrier shrunk on addition of small concentrations of Ca2+ and swelled again on further addition of MgATP. The shells dissociated in 0.1mM MgATP and reassociated in 0.15M KC1. The nucleotide specificity was high. From diameters of cells, ghosts and shells at different pH and others, we propose that the erythrocyte shape is primarily decided by the cytoskeleton, the role of the lipid bilayer is complementary and thirdly the shape is modified by the relative volume of the cytoplasma.

Characterization of human erythrocyte cytoskeletal ATPase.

Human erythrocyte cytoskeletal ATPase was extracted with 0.2 mM ATP (pH 8.0) from Triton X-100 treated ghosts. The ATPase fraction contained mainly spectrin, actin, and band 4.1. When the ATPase fraction was applied to a Sepharose 4B column, 90% of the ATPase activity was recovered in a spectrin, actin, and band 4.1 complex fraction and none was detected in the spectrin fraction. A specific activity of the complex ATPase was 60-120 nmol/(mg protein X h). No ATPase activity was detected in the presence of EDTA. The presence of magnesium in the incubation medium was essential for the ATPase activity. The activity was activated by KCl and was almost completely inhibited by 10(-5) M free calcium in the presence of 0.2 mM MgCl2. The Ki for Ca2+ was 7 X 10(-7) M. Phalloidin and DNase 1, which affect actin, inhibited this K,Mg-ATPase activity by 95%, but cytochalasin B did not inhibit it. N-Ethylmaleimide activated the ATPase 1.6-fold. The order of affinity for nucleotides was ATP greater than ITP greater than CTP, ADP, AMP-PNP, GTP. A specific ATPase activity of purified actin was 50 nmol/(mg X h). These results suggest that the cytoskeletal ATPase is actin ATPase and the actin ATPase is activated by spectrin and band 4.1.

The role of ankyrin in shape and deformability change of human erythrocyte ghosts.

Human erythrocyte membranes (ghosts) from acid/citrate/dextrose preserved blood were digested with trypsin (protein/trypsin = 100:1) under hypotonic conditions and then analyzed by SDS-polyacrylamide gel electrophoresis. After digestion for about 20-30 s at 0 degree C, only ankyrin had disappeared and other bands including spectrin, actin, band 4.1 and band 3 remained intact. This observation was supported by electron micrographs showing that the horizontally disposed, filamentous structure was a little apart from the lipid bilayer and its components were not destroyed. In contrast to intact ghosts, treatment with chlorpromazine, or Mg-ATP did not induce shape change in these trypsin-treated ghosts. The number of transformable cells correlated closely with the amount of remaining ankyrin in the SDS-polyacrylamide gel electrophoresis pattern. Furthermore, the chlorpromazine- and Mg-ATP-induced decreases in viscosity of suspensions of erythrocyte ghosts were also prevented by trypsin treatment for 20-30 s at 0 degree C. These findings suggest that ankyrin plays an important role in the change in shape and deformability of erythrocyte ghosts. The molecular mechanism of drug-induced shape change and the role of undermembrane structure in regulating erythrocyte shape and deformability are discussed.

Ca2+- and Mg-ATP-dependent shape change of human erythrocyte ghosts and triton shells.

Human erythrocyte membranes (ghosts) prepared from fresh blood changed in shape from spherical to crenated, when suspended in 10(-7)-10(-6) M Ca2+-EGTA buffers. Although the ghosts from long-stored ACD blood (10 weeks) were less sensitive to 10(-7)-10(-6) M Ca2+, the ghosts obtained from this blood after it had been preincubated with adenine and inosine for 3 h at 37 degrees C were highly sensitive to Ca2+. When these highly sensitive ghosts were incubated in 10 mM Tris-Cl buffer (pH 7.4) or 1 mM MgCl2 (pH 7.4) at 0 degrees C, they gradually lost Ca2+ sensitivity within 60 min, but they recovered Ca2+ sensitivity again after re-incubation with 2 mM Mg-ATP for 20 min at 37 degrees C followed by washing with 1 mM MgCl2 (pH 7.4). The shape of these highly Ca2+-sensitive ghosts immediately changed from crenate to disc on addition of 1 mM Mg-ATP even at 6 degrees C in the presence of 10(-7)-10(-6) M Ca2+. A similar shape change was also observed when ghosts treated with 0.5% Triton X-100 (Triton shells) were used. Triton shells from fresh blood ghosts or from long-stored blood ghosts which had been preincubated with 2 mM Mg-ATP for 20 min at 37 degrees C shrank immediately in the presence of 10(-6) M Ca2+ and then swelled on addition of 1 mM Mg-ATP. The specificity to ATP and the dependency on ATP concentration are in agreement with those of the ghost shape change at step 2 (Jinbu, Y. et al., Biochem biophys res commun 112 (1983) 384-390) [18]. These results suggest that cytoskeletal protein phosphorylation enhances sensitivity to Ca2+ and induces erythrocyte shape change in the presence of physiological concentrations of ATP and Ca2+.

Reversible shape change of Triton-treated erythrocyte ghosts induced by Ca2+ and Mg-ATP.

The shape of the human erythrocyte depends on intracellular ATP content and echinocytic erythrocyte ghosts obtained in the presence of Mg-ATP acquire a diskocytic shape after incubation at 37 degrees C; however, agreement is lacking about the molecular basis of the shape changes. The suggestion that phosphorylation of cytoskeletal structures underlying the membrane is involved has been disputed and alternative explanations based on lipid bilayer theory and metabolism of phospholipid have been proposed. Recently, we re-examined the effect of ATP on the shape of ghosts and found that it consists of two distinct steps. We have, therefore, now examined the effect of physiological concentrations of Ca2+ and ATP on the cytoskeleton of the erythrocyte membrane directly using Triton-treated ghosts which had lost this permeability barrier. Our findings suggest that a noncovalent effect of ATP on the cytoskeleton is a prerequisite for shape change.

Two steps in ATP-dependent shape change of human erythrocyte ghosts.

Most human erythrocyte membranes (ghosts) prepared with 10 mM Tris-Cl buffer were spherocytic and changed shape through crenated to discoidal in the presence of 2 mM Mg-ATP at 37 degrees C during 30 min under hypotonic conditions. These discocytic ghosts reverted to spherical form after being washed with 1 mM MgCl2, although their membranes were phosphorylated and they were converted to discocytes again, immediately on addition of 2 mM Mg-ATP, even at 6 degrees C. There seem to be 2 steps in the shape change of the ghosts; the first step proceeds gradually during incubation at 37 degrees C for 30 min in the presence of a physiological concentration of Mg-ATP and the second step occurs rapidly after addition of Mg-ATP even at 6 degrees C. This suggests that not only membrane phosphorylation but also specific ATP-binding (or hydrolysis) is necessary for erythrocyte shape change.