A collagenous cementum-derived attachment protein is a marker for progenitors of the mineralized tissue-forming cell lineage of the periodontal ligament.

The periodontal ligament (PDL) is a fibrous and cellular connective tissue that mediates tooth attachment to bone, and it comprises fibroblastic and mineralized tissue-forming (MTF) progenitors. The MTF progenitors are believed to give rise to the cementoblastic and osteoblastic lineages. Cementum attachment protein (CAP) is a collagenous cementum-derived protein which binds strongly to osteoblasts, moderately to PDL cells, and weakly to gingival fibroblasts. The aim of the present study was to determine the relationship between the capacity of PDL progenitors to bind CAP and their potential to express alkaline phosphatase (ALP) and form mineralized-like tissue in culture. Cloned human PDL progenitor populations obtained from nine human donors were assayed for their constitutive capacity to bind CAP and express ALP, and for the dexamethasone-induced potential to form mineralized-like tissue in culture in the presence of ascorbic acid and beta-glycerophosphate. Forty percent of the progenitor clones produced mineralized-like tissue. Two patterns of mineralization were observed: a spread and flat pattern similar to that produced by human bone cells in culture and a nodular ridge-like type resembling that formed by human cementoma-derived cells. A direct correlation was found between the percentage of ALP positive cells in each progenitor clone and the amount of mineralized-like tissue formed (r = 0.565). Similar correlations were found between the number of ALP positive cells and the binding capacity of each clone (r = 0.392) and between the CAP binding capacity and mineralized-like tissue formation (r = 0.584). Multiple regression analysis indicated that the constitutive capacity of a clone to bind CAP and express ALP is directly correlated to its dexamethasone-induced potential to form mineralized tissue (r = 0.675). These results indicate that CAP binding and ALP expression can serve as markers for the identification of MTF progenitors in the heterogeneous cultured population of the human periodontal ligament. These data show for the first time that binding capacity to extracellular components of mineralized tissues can be a marker for mineralized tissue-forming progenitors.

1,25-dihydroxyvitamin D3 increases the sensitivity of human renal carcinoma cells to tumor necrosis factor alpha but not to interferon alpha or lymphokine-activated killer cells.

Renal cell carcinoma is a chemotherapy-resistant tumor which is relatively responsive to immunotherapy. Immunotherapeutic regimes employ interferons or interleukin 2 with or without lymphokine-activated killer cells. Secondary cytokines, induced by interleukin 2 or interferon, may have an important impact on their anti-neoplastic activity. Notable among them is tumor necrosis factor (TNF alpha). We assessed the effect of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) on the susceptibility of the human renal cell carcinoma cell line SK-RC-29 to the cytotoxic and cytostatic actions of TNF alpha, interferon alpha and lymphokine-activated killer cells. Using uptake of the vital dye neutral red as an indicator of viable cell number, we found that addition of 1,25(OH)2D3 (100 nM) to TNF alpha (30 ng/ml)-treated cultures resulted in a 2.6 +/- 0.2-fold (mean +/- S.E.) increase in the cytotoxic effect of the cytokine. The potentiating effect of 1,25(OH)2D3 was dose-dependent, and significant at concentrations equal to or higher than 10 nM. Another dihydroxylated vitamin D metabolite, 24,25(OH)2D3, had no effect on TNF alpha action. The cytotoxic effect of TNF alpha increased whereas the potentiation by 1,25(OH)2D3 decreased with cell density in culture. 1,25(OH)2D3, in contrast to its potentiating effect on TNF alpha action, did not modulate the cytostatic effect of interferon alpha or the susceptibility of SK-RC-29 to killing by lymphokine-activated killer cells. The findings reported here may explain some of the in vivo anti-tumor activity of 1,25(OH)2D3 and provide a rationale for the employment of active vitamin D analogs during immune anti-cancer therapy.

A pilot study of the efficacy of oral midazolam for sedation in pediatric dental patients.

Oral midazolam is being used for conscious sedation in dentistry with little documentation assessing its efficacy. In order to accumulate preliminary data, a randomized, double-blind, controlled, crossover, multi-site pilot study was conducted. The objective was to determine if 0.6 mg/kg of oral midazolam was an equally effective or superior means of achieving conscious sedation in the uncooperative pediatric dental patient, compared with a commonly used agent, 50 mg/kg of oral chloral hydrate. Twenty-three children in three clinics who required dentistry with local anesthetic and were determined to exhibit behavior rated as "negative" or "definitely negative" based on the Frankl scale were assessed. They were evaluated with respect to acceptance of medication; initial level of anxiety at each appointment; level of sedation prior to and acceptance of local anesthetic; movement and crying during the procedure; and overall behavior. The results showed that the group randomly assigned to receive midazolam had a significantly greater initial level of anxiety for that appointment (P < 0.02), a finding that could clearly confound further determination of the efficacy of these drugs. Patients given oral midazolam had an increased level of sedation prior to the administration of local anesthetic compared with those given chloral hydrate (P < 0.015). No statistically significant differences were noted in any of the other parameters. The age of the patient was found to have no correlation with the difference in overall behavior (r = -0.09). These preliminary data warrant further clinical trials.

Generalized odontodysplasia concomitant with mild hypophosphatasia--a case report.

An abnormal exfoliation pattern of the primary teeth is a sign of a systemic abnormality affecting more than just the oral structures. A prompt investigation of the cause of this condition is mandatory to identify any disease process and to initiate the required treatment. This article presents a case of mild hypophosphatasia concomitant with odontodysplasia in a 4 1/2-year-old female. The child's condition was first detected due to the early exfoliation of her primary teeth. This article also discusses the two different disease entities and the reasoning that led to the final diagnosis.

The effect of tricyclic antidepressants on cortex- and amygdala-kindled seizures in the rat.

The anticonvulsant effects of amitriptyline, imipramine, nortriptyline and desipramine were tested against focal and generalized seizures, triggered from either the amygdala or the cortex in fully kindled rats. Tests were administered on a 72- or a 24-hour schedule. Significant seizure suppression was achieved with only one drug, amitriptyline, and it occurred only at toxic or near-toxic doses. The differential, low-dose suppression of amygdala-kindled seizures, reported in earlier studies, was not seen in the present experiments. It may occur only in the short-interval test paradigms used by previous experimenters.

Ewing's sarcoma: metastatic tumor to the jaw.

Metastatic tumors to the jaw are a rare occurrence. The incidence of metastatic Ewing's sarcoma to the jaw has been reported to be less than 2% of all cases of Ewing's sarcoma. Early detection of such lesions is difficult because the signs and symptoms do not appear until the lesion has progressed considerably. The treatment options are therefore limited to palliative care of the patient rather than cure. This article reports a case of Ewing's sarcoma that had metastasized to the mandible and reviews the literature.

Melanotic neuroectodermal tumour of infancy. A case report.

Melanotic neuroectodermal tumour of infancy is a rare neoplasm of neural crest origin, predominantly affecting the anterior maxilla of infants. Treatment generally consists of surgical excision. Long-term follow-up is important since recurrence and malignant transformation have been reported. The literature about melanotic neuroectodermal tumour of infancy is reviewed and a case occurring in a 4-month old infant is presented.

Composite resin short-post technique for primary anterior teeth.

A technique using a "mushroom shaped" composite resin short post constructed inside the pulp-treated root canal provides sufficient retention to build a composite resin crown on the reinforced superstructure of the remaining crown dentin. This technique was tested for 1 year in 92 teeth; they showed no failures of retention of the short post. Recurrent caries and severe bruxism--factors beyond operator control--posed some problems that were readily resolved.

Cheilitis glandularis: a pediatric case report.

Cheilitis glandularis is a rare disorder, usually affecting the lower lip of adults. This case involved both lips of an adolescent male. A familial history of the condition may have contributed to the involvement of both lips, and may reinforce the importance of hereditary tendency in the development of cheilitis glandularis. Emotional disturbance and poor oral hygiene also had a role in the disorder in this case, which was successfully treated with surgery.