Reconstruction of lower lip defects after tumor excision: an aesthetic and functional evaluation.

We are presenting a new questionnaire to evaluate the functional and aesthetic aspects after reconstruction of defects of the lower lip resulting from tumor excision. The questionnaire is based on objective parameters with numerical values. The application of the questionnaire is carried out based on 2 different surgical techniques, which have been used in the Department of Oral and Maxillofacial Surgery of La Princesa University Hospital in Madrid. These techniques are used in the reconstruction of surgical defects and concern the location and percentage of the lip resection. These techniques are the rotation-advancement flap by Yu and the rotation-advancement in island flap by Colmenero et al. The defects are located laterally and they include 40% to 60% of the length of the lip, avoiding the commissure. There is also one case with a defect that is almost 100% of the length of the lip. According to the questionnaire, we conclude that in unilateral defects that exceed 50% (up to 70%), Yu's technique provides better results from an aesthetic and functional point of view than Colmenero's technique. In subtotal defects, bilateral Yu flaps provide optimum function, with good position of the scars. This is a technique to be considered when confronted with extensive defects of the lip that do not include the commissures.

Glenotemporal osteotomy as a definitive treatment for recurrent dislocation of the jaw.

Chronic Recurrent Dislocation of the jaw (CRD) is a relatively frequent occurrence, with a multifactorial aetiology. Both conservative and surgical treatments have been applied to this entity. This paper seeks to review the results of surgical treatment applied according to Norman's technique (1984), with certain modifications, applied to CRD. Ten patients were treated by glenotemporal osteotomy and interposition of bone grafts, (four cranial bone grafts and six iliac crest grafts). Previously, all of the patients had suffered numerous episodes, requiring hospital care on more than one occasion. Nine of the patients were female. All of the patients underwent clinical exploration and pre- and postoperative radiological study. Nuclear Magnetic Resonance (NMR) imaging was used in combination with tomography in the preoperative period to evaluate the state of the joint. In the postoperative period, tomography was used as the radiological investigation to carry out regular follow-ups. The patients were followed for between 5 and 51 months. The elements used in osteosynthesis were either wire, screws or nothing. None of the patients complained of any episode of RCD in the postoperative period. Oral opening, which could not be measured in the preoperative period, ranged between 28 and 38mm in the postoperative period. One of the patients operated on still suffered articular pain on attempting this function. In the postoperative period, radiology revealed different degrees of bone resorption in the cases of iliac crest bone grafts, yet this did not affect the clinical result of the operation.

Isolation and characterization of libraries of monoclonal antibodies directed against various forms of tubulin in Paramecium.

Ciliates are very good models for studying post-translationally generated tubulin heterogeneity because they exhibit highly differentiated microtubular networks in combination with reduced genetic diversity. We have approached the analysis of tubulin heterogeneity in Paramecium through extensive isolation and characterization of monoclonal antibodies using various antigens and several immunization protocols. Eight monoclonal antibodies and 10 hybridoma supernatants were characterized by: i) immunoblotting on ciliate and pig brain tubulins as well as on peptide maps of Paramecium axonemal tubulin; ii) immunoblotting on ciliate tubulin fusion peptides generated in E coli, a procedure which allows in principle to discriminate antibodies that are directed against tubulin sequence (reactive on fusion peptides) from those directed against a post-translational epitope (non-reactive); and iii) immunofluorescence on Paramecium, 3T3 and PtK2 cells. Twelve antibodies labeled all microtubules in Paramecium cells and were found to be directed against tubulin primary sequences (nine of them being located in the alpha N-terminal domain, one in the beta C-terminal one, and two in alpha and beta central stretches). The remaining ones decorated only a specific subset of microtubules within the cell and were presumably directed against post-translational modifications. Among these, three antibodies are directed against an N-terminal acetylated epitope of alpha-tubulin whereas the epitopes of three other ones (TAP 952 degrees, AXO 58 and AXO 49 degrees) apparently correspond to still unidentified post-translational modifications, located in the C-terminal domain of both alpha- and beta-tubulins. The AXO 49 degrees specificity is similar to that of a previously described polyclonal serum raised against Paramecium axonemal tubulin [2]. The results are discussed in terms of identification and accessibility of the epitopes and immunogenicity of ciliate tubulin with reference to mammalian and ciliate tubulin sequences.