Interaction between nandrolone decanoate and calcitonin in bone formation markers (osteocalcin and bone specific alkaline phosphatase) and IGF-I in rats.

Bone tissue has been shown to contain numerous cell-to-cell signaling peptides called growth factors. These growth factors are thought to have important regulating effects for bone remodeling, due to their potent effects on bone cell metabolism. Our investigation was intended to assess the effect of nandrolone decanoate and calcitonin treatment on biochemical markers of bone formation (bone alkaline phosphatase - osteocalcin) and insulin-like growth factor-I in rats. We studied 48 adult male rats. The animals were divided into four groups. Group (A) served as control. Animals in Group (B) were injected with 4 mg/kg/day nandrolone decanoate. Animals in Group (C) were injected with 400mU/rat/day calcitonin and Group (D) received combined therapy for seven days. Nandrolone decanoate and calcitonin have a mild but significant effect on insulin-like growth factor-I without affecting osteocalcin levels, while calcitonin alone decreases the BALP levels. The coadministration of two agents caused notable elevation on insulin-like growth factor-I, followed by a significant increase of osteocalcin and bone alkaline phosphatase.

Changing trends in the treatment of zygomaticomaxillary complex fractures: a 12-year evaluation of methods used.

PURPOSE: The efficacy of the current methods for the treatment of fractures of the zygomaticomaxillary complex was evaluated. PATIENTS AND METHODS: One thousand two hundred seventy-seven patients with fracture of the zygomaticomaxillary complex and 196 patients with fractures of the zygomatic arch that were admitted between 1984 and 1995 were evaluated. One thousand one hundred fifty surgical procedures were performed, and in 401 cases, no operative treatment was considered necessary. The Gillie's approach was used in 514 cases, intraosseous wiring in 89 cases, bone plate osteosynthesis in 322 cases, Roger-Anderson pins in 180 cases, antral packing in 17 cases, and elevation with a hook in 28 cases. RESULTS: The best results were achieved with the use of semirigid fixation with miniplates applied at one or more sites of the fractured complex, occasionally used in combination with other methods such as Roger-Anderson pins. CONCLUSIONS: Semirigid fixation with miniplates offers the most reliable method available today for the treatment of zygomatico-orbital complex fractures and has practically replaced every other method in our institution. The increased cost and occasionally the necessity to remove the hardware are the main disadvantages of the method.

An audit of mandibular fractures treated by intermaxillary fixation, intraosseous wiring and compression plating.

As the principles of rigid internal fixation and compression osteosynthesis were adopted by maxillofacial surgeons during recent years the time-honoured methods of intermaxillary fixation and intraosseous wiring have gradually been abandoned. We have reviewed our cases of mandibular fractures operated on in recent years and the changing trends in treatment.

Use of lag screws for the management of mandibular trauma.

OBJECTIVE: To test the effectiveness of lag screw fixation in their application in the treatment of mandibular fractures. MATERIAL AND METHODS: Sixty-nine mandibular fractures in 30 patients treated with lag screws were evaluated retrospectively regarding the cause, the type, and the site of fracture as well as the local situation and the complications encountered. RESULTS: In 19 fractures a neutralization plate was used and in another 17 the lag screw was applied in combination with a compression plate. In 33 cases at least 3 lag screws were inserted. Seventy-five percent of the cases were in patients between 10 and 39 years old; 70% were the result of road traffic accidents. Most patients presented two mandibular fractures; the symphyseal area were most frequently affected. Teeth in the line of fracture were not removed, and no drains were used. Complications included two minor malocclusions, one delayed union, two cases of temporary paresis, two cases of transient hypesthesia, two cases of scar formation on the incision line, and a case of temporary trismus. CONCLUSIONS: Approximately 30% of the patients treated with lag screws according to the methods outlined in this study developed complications that were either minor, transient, or both; some were related to the approach rather than the method. The most frequent complications were minor malocclusions, transient facial paralysis, hypoesthesia, and scar formation.

[Laryngeal insufficiency as a post-traumatic complication of facial skull injury]. / Larynxinsuffizienz als posttraumatische Komplikation einer Gesichtsschädelverletzung.

Laryngeal incompetence is characterised by incoordination in deglutition and fluid leakage around the tracheostomy tube. It occurs very rarely and is attributed to injury of the recurrent laryngeal nerve. To our experience this condition demands no treatment and gradually disappears. In this paper we present a case of a 24-year-old male patient with facial fractures presenting laryngeal incompetence.

Posttraumatic osteotomies of the jaws.

The increase in road traffic accidents as well as injuries caused by violence has resulted in an increase of fractures of the facial bones. These fractures are not always treated properly. Sometimes they are not treated at all because of their complexity or, more often, because of the associated, mainly neurological, injuries. With the advances in orthognathic surgery a variety of osteotomy techniques have become available. Originally designed to treat congenital deformities, they can also be used to improve posttraumatic malposition of the maxillofacial bones.

Phleboliths. A report of three unusual cases.

Phleboliths are well established pathological entities that are often associated with vascular lesions. Three cases are reported in which no vascular malformation was detected.

The normal range of mouth opening.

The maximal mouth opening of 1,160 healthy Greek adults, 18 to 70 years old, was measured. The results were similar to those reported by investigators in other countries.

Emphysema and similar situations in and around the maxillo-facial region.

The introduction of air into the soft tissues surrounding the maxillofacial region is the subject of this report. We present seven cases varying from emphysema following dental manipulation, severe facial trauma, with and without clinical or radiographic evidence of fracture, to a case that resulted in blindness and another case that required emergency tracheostomy. We propose the modification of the term emphysema so as to include the entry of air into the brain by the same mechanism.

Fracture of the hyoid bone--report of a case.

The hyoid bone, well protected under the protruding chin, seldom sustains fractures in road traffic accidents. We report such a case and review 14 cases found in the world literature.

Plasma cell myeloma of the jaws.

Solitary myeloma may be the first manifestation of the disseminated form, known as multiple myeloma, and characterized by multiple skeletal lesions, general metabolic alterations, impairment of renal function and eventually death. Involvement of the jaws is not unusual, although infrequently reported. We present 2 cases, where oral involvement was the first indication of the disease.

Orbital apex syndrome.

The orbital apex syndrome is a very rare complication of fractures of the facial skeleton, as well as other conditions and is characterized by blindness, fixed dilated pupils, proptosis, ptosis of the eye and ophthalmoplegia. We are reporting such a case we had the opportunity of treating.

Benign neurogenic tumors of the oral cavity.

Neurogenic tumors are rare in the oral cavity, particularly so when malignant. Traumatic neuroma, although usually included with neurogenic tumors, is a reactive process rather than a true neoplasm. Neurofibroma and schwannoma derive from nerve fibers, the perineurium, the endoneurium and the neurolemmomal cells. They present histological differences. The neurofibroma may present in solitary and generalized types; the latter also known as neurofibromatosis or von Recklinghausen's disease of the skin. We here report typical cases of benign neurogenic tumors of the oral cavity.

Chondrosarcoma of the orofacial region. Review of the literature and report of two cases.

Chondrosarcoma of the jaws arises from vestigial rests and is considered a rare entity, although it is more common than its benign counterpart. Occasionally it may be extremely difficult under the microscope to decide whether a case is benign or malignant. The treatment of choice is surgical with wide margins. In our review of the literature we found 169 cases of oro-facial chondrosarcoma including two from our Institution. There was a 2:1 male/female ratio and the maxilla was involved twice as frequently as the mandible. Over half of the cases were between 20 and 50 years old.

Aneurysmal bone cyst of the jaws. Review of the literature and report of 2 cases.

Strictly speaking, the aneurysmal bone cyst is not a true cyst. It is a lesion characterized by replacement of bone by fibro-osseous tissue containing blood-filled cavernous spaces. It is usually treated by surgical curettage, and access within the jaws may sometimes be difficult. We reviewed the world literature and found 63 cases of aneurysmal bone cysts involving the face, 22 reported in the maxilla, and 63 in the mandible. One was found in the zygomatic arch. Of the patients reported, 88% were younger than 30 years old; there was an equal sex distribution. Included in this report, are two cases of our own, one involving the maxilla and one the mandible.