Expression of Rb, pRb2/p130, p53, and p16 proteins in malignant melanoma of oral mucosa.

We previously reported that pRb2/p130 gene, one of the Rb family members, was immunohistochemically abundantly expressed in well-differentiated oral squamous cell carcinomas, whereas in undifferentiated ones the expression was low. Oral malignant melanoma is extremely rare, however the prognosis is poor because it tends to locally invade tissue or metastasize and its biological behavior appears to be different from cutaneous malignant melanoma. The present study dealt with the expression of pRb2/p130, Rb, p53, and p16 in 13 cases of malignant melanoma of oral mucosa as revealed by immunohistochemical staining. The stage classification of the 13 patients was as follows; stage II: eight patients, stage III: three patients, and stage IV: two patients. pRb2/p130 was expressed in only two stage II-cases, neither of which have shown any evidence of recurrence or metastasis for over 14 years. Positive staining for Rb was found in three cases consisting of one stage II-case, one stage III-case, and one stage IV-case. p53 was expressed in two cases, one a stage II and the other a stage IV. Positive staining for p16 was found in seven cases consisting of four stage II-cases, two stage III-cases, and one stage IV-case. pRb2/p130 may be inversely correlated with the malignancy of oral malignant melanoma, but further study is needed.

Differential diagnosis of calcium pyrophosphate dihydrate deposition of the temporomandibular joint.

Calcium pyrophosphate dihydrate (CPPD) deposition disease (pseudogout) of the temporomandibular joint (TMJ) is rare. It is characterized by the presence of crystal deposits that are birefringent under polarized light. Although these crystals are characteristically weakly birefringent, some other crystals such as those of calcium oxalate, synthetic steroids, and ethylenediaminetetraacetic acid are also birefringent. The differential diagnosis should therefore be based on a quantitative analysis of crystals or observation of the crystal structure in calcified sections. We present a case of CPPD deposition disease of the TMJ and report on the value of such an analysis to substantiate the diagnosis.

4p- syndrome and 9p tetrasomy mosaicism with cleft lip and palate.

Chromosome 4p- syndrome is a multiple malformation syndrome associated with partial deletion of the short arm of chromosome 4 (4p-). It is characterized by dysmorphic features and retarded development. Cleft lip and/or palate are the major clinical manifestations. Cases of tetrasomy 9p are extremely rare; the principal clinical manifestations of this condition are characteristic craniofacial abnormalities, generalized hypotonia and severe mental retardation. We present the first case of a female infant with 4p deletion and tetrasomy 9p mosaicism, exhibiting a left-sided cleft lip, alveolus and soft palate. Karyotype analysis of lymphocytes cultured from the patient revealed that she was mosaic: 86% of the cells were 46, XX, add (4) (p15.32) and 14% were 47, XX, add (4) (p15.32), +idic (9)(q12). The G-banding pattern appeared consistent with either translocation or partial proximal deletion of 4p. In order to make a definitive cytogenetic diagnosis of isodicentric chromosome 9, fluorescence in situ hybridization (FISH) was applied. At 8 months, when the patient weighed 4.3 kg, her cleft lip was repaired. Before and after surgery there were no seizures, and the postoperative course was uneventful.

Investigation of titanium leak to bone tissue surrounding dental titanium implant: electron microscopic findings and analysis by electron diffraction.

This study investigated the tissue response associated with dental titanium implants. The mandibular third and fourth premolars and first molar of three adult beagle dogs were extracted bilaterally. Healing was then allowed for 3 months. Six titanium implants were placed in the mandibles of a dog. Three weeks after the implantation, mandibular sections containing the implants were retrieved with the use of a bone saw and investigated by light and electron microscopy, X-ray microanalyzer, and electron diffraction. Scanning electron microscopic observation showed titanium particles on the implant-bone interface, and investigation by microanalyzer revealed titanium not only on the implant-bone interface but also in the bone tissue. Transmission electron microscopic observation and investigation by electron diffraction showed titanium in the bone matrix and cells other than macrophages. In this study, titanium particles from the dental implant were recognized morphologically in the surrounding bone tissue. Thus, study of the influence of titanium particles on the human body is needed.

Microvilli and desmosomes of squamous cell carcinoma cells in tongue carcinoma related to regional lymph node metastasis: ultrastructural and immunohistochemical studies with transferrin receptor.

Squamous cell carcinomas of the tongue (n = 49), consisting of 21 cases with cervical lymph node metastasis and 28 nonmetastatic cases, were examined by electron microscopy with special emphasis on tumor cell attachment. No difference of tumor size (T classification) or pathological findings between the metastatic group and the nonmetastatic group was found. The metastatic cases had numerous microvilli and a small number of desmosomes regardless of the width of the intercellular spaces. The nonmetastatic cases had few microvilli in relatively wide intercellular spaces, or, in the cases in which numerous microvilli were present in the narrow intercellular spaces, the tumor cells were connected by a large number of desmosomes. Transferrin receptor, which is a marker of cell proliferation, was localized in the cell membrane by immunohistochemistry and especially in microvilli by immunoelectron microscopy. It is suggested that microvilli might be related to the proliferation and the metastasis of squamous cell carcinoma cells.

Immunohistochemical investigation of new suppressor oncogene p130 in oral squamous cell carcinoma.

New onco-suppressor gene p130 is one of the Rb family forms and is reported to undergo allelic loss in hepatocellular, prostate, and breast carcinomas; however, no report of p130 has been made in oral tumors. The present study dealt with the expression of p130 and Rb proteins by immunohistochemical staining in oral squamous cell carcinomas (n = 110) and oral mucosa. The site of the carcinomas included tongue (n = 48), gingiva (n = 32), oral floor of the mouth (n = 15), oropharynx (n = 6), buccal mucosa (n = 5), and others (n = 4). Histologically there were 65 well-differentiated carcinomas, 33 moderately differentiated carcinomas, and 12 poorly differentiated ones. Positive staining for p130 and Rb was localized to suprabasal cell layers of the normal oral epithelium. In the oral squamous cell carcinoma, positive staining for p130 and Rb was observed in well-differentiated carcinomas (p130, 66.2%; Rb, 78.5%), more than in poorly differentiated ones (p130, 16.7%; Rb, 50.0%). In immunoelectron microscopic features, p130 protein was localized in the nucleus and mitochondria. The expression of p130 was related to the degree of tumor differentiation as that of Rb. It is suggested that p130 gene may be associated with the development of a wide variety of human malignancies rather than the progression.

[Electronmicroscopic study on tongue squamous cell carcinoma--radiotherapy cases].

We examined the ultrastructures of the tongue squamous cell carcinomas which received radiotherapy and compared the metastatic cases with the non-metastatic cases. The results were as follows: 1. The non-metastatic cases were clinically T1N0 or T2N0 and histologically Grade I or II of the WHO classification. Electronmicroscopic observation of these cases revealed that numerous microvilli and a small number of desmosomes were found and the cell attachment seemed to be weak. These findings were different from those of the non-metastatic cases which received surgery. 2. In the metastatic cases of which the primary lesions were controlled, microvilli were not developed and a number of desmosomes were shown as compared with those in the non-metastatic cases. However, cell atypia and dispersion of the nuclear chromatin were clearly recognized.

Aetiology of maxillofacial fracture.

The aetiological factors associated with maxillofacial fractures, and the trends in these factors over a 13 year period are reported. The First Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokyo Medical and Dental University, managed 695 patients with maxillofacial fractures between 1977 and 1989. The male to female ratio was 3.2:1 and the majority of patients were aged between 10 and 30 years old. Road traffic accidents and accidental falls were the main causes of fractures throughout the 13 year study period. Mandibular fractures occurred in 477 patients (68.6%). A high percentage of patients were treated by closed reduction and maxillo-mandibular fixation, or occlusal splinting.

Maxillofacial fractures in children.

A clinico-statistical and long-term follow-up study was performed on 81 pediatric fractures seen during the 14 years between 1977 and 1990. Of all maxillofacial fractures, the incidence of pediatric fractures was 14.7%. The ratio of boys to girls was 2.1:1, and the highest incidence involved boys over 13 years of age. Fractures of the upper alveolar bone and mandible were common. Conservative therapy, such as maxillomandibular fixation using orthodontic brackets was usually performed and was found to be successful. The long-term follow-up study revealed that 5 out of 21 patients with alveolar fractures complained of malocclusion and it is suggested that a longer duration of intramaxillary fixation and long-term follow-up might be needed for alveolar fractures in children.