[Adenomatoid odontogenic tumor (AOT) of the mandible: a surgical follow-up]. / Chirurgische Verlaufsbeobachtung eines adenomatoid odontogenen Tumors (AOT) im Unterkiefer: Ein Fallbericht.

The AOT is a relative rare benign odontogenic tumor. It most often appears in the canine region of the maxilla and mandible in young patients. Radiolucencies in the region of non-erupted or vital teeth may produce diagnostic problems. The histological diagnosis of AOT is characterised by odontogenic epithelium, ductlike structures, amyloid-like material and calcifying areas. Case report A female patient of eleven years and ten months was referred for surgical exposure of the left mandibular canine by an orthodontist. This tooth was retained and root formation was incomplete. Radiologically, a radiolucency was seen, extending distally from the crown of the tooth towards the root. The deciduous tooth 73 was extracted and the retained left mandibular canine was surgically exposed. Healing was without result and the tooth was moved orthodontically. Two years later the tooth was seen in regular position and occlusion. Vitality tests were positive, distally to the tooth a 1.5[Symbol: see text]mm periodontal pocket was disclosed. A large radiolucency around the root of the tooth was seen. Supposing a cystic lesion a surgical intervention was performed without removal of the tooth. Histopathologically, an AOT was revealed. Conclusions In the sequence of surgical interventions it is highly likely that already at the first operation an AOT was present, however, went unnoticed clinically. The histological diagnosis of an AOT was only revealed after a second operation including tumor removal. In spite of surgical removal of the AOT the involved tooth found its position in the dental arch.

[Oral EBV-associated diffuse large B-cell lymphomas in HIV-negative immunocompromised patients]. / Orale Epstein-Barr-Virus-assoziierte diffuse grosszellige B-Zell-Lymphome bei HIV-negativen immunsupprimierten Patienten.

BACKGROUND: Diffuse large B-cell lymphomas (DLBCL) are non-Hodgkin's lymphomas (NHL) and with a prevalence of 30-40% they comprise the most frequent NHL in adults. Although their etiology is still unknown, a virus induction, especially by the Epstein-Barr-virus (EBV), is the subject of discussion. Patients with congenital or acquired immunodeficiency are primarily afflicted. PATIENT 1: A 39-year-old female patient developed an EBV-associated DLBCL of the plasmablastic subtype in the maxillary alveolar ridge in the region of teeth 11 and 21 after 24 years of immunosuppressive therapy with azathioprine due to myasthenia gravis. Clinically the lesion presented as a localized acute necrotizing periodontitis that was resistant to symptomatic therapy. After polychemotherapy the disease is in complete remission until today. PATIENT 2: A 56-year-old male patient developed an EBV-associated DLBCL of immunoblastic variant of the right maxillary edentulous alveolar ridge in the posterior region 7 weeks after heart transplantation and immunosuppressive therapy with azathioprine and cyclosporine A. Clinically, a soft, nonpainful, swelling measuring 1.5x0.5x0.5 cm with a central ulceration was evident. The tumor was excised followed by local radiation therapy. No recurrence was noted during a 15-year-follow-up. DISCUSSION: The presented clinical cases demonstrate the increased risk of occurrence of oral malignant B-cell lymphomas as adverse effects of immunosuppressive therapy. The demonstration of EBV in the tumor cells in both cases underlines the involvement of this virus in the pathogenesis of oral DLBCL arising in the setting of an immunodeficiency as has been shown previously in patients with HIV. CONCLUSIONS: Due to the varying and often nonspecific clinical appearance of oral DLBCL, an early biopsy and work-up by an institute specialized in hematopathology is essential for diagnosis, because these tumors may disseminate in early stages.

[Bisphosphonates and osteonecrosis of the jaw]. / Bisphosphonate und Osteonekrosen im Kieferbereich.

BACKGROUND: Since 2003, reports have been published on necrosis of the jaw bones possibly being associated with the administration of bisphosphonates. Bisphosphonates are highly active inhibitors of osteoclasts which have been used prophylactically or symptomatically in the treatment of plasmocytoma, bone metastasis of malignant disease, tumor-associated hypercalcaemia and in the treatment of osteoporosis. Due to the importance of this side effect of bisphosphonates, we report six cases. CASE REPORTS: Six patients (two women and four men) with a median age of 69 years (range 55-37) were diagnosed with osteonecrosis of the maxilla and/or mandible. These osteonecroses did not react adequately to local treatment and systemic therapy with antibiotics. Four patients suffered from plasmocytoma and two patients had a history of metastasising breast cancer. Besides cytostatic chemotherapies, all patients received bisphosphonates over an extended period. DISCUSSION: Bisphosphonates are considered an important standard in the treatment of plasmocytoma and bone metastasis due to malignancies. Since 2003, several reports have been published describing patients in whom therapy resistant osteonecrosis of jaw bones occurred either after dental extractions or spontaneously. Until then, unknown side effects of bisphosphonate therapy had been suspected. Since patients with malignant diseases receive cytostatic therapy and a range of other drugs, including bisphosphonates, enhancement of the side effects may be presumed. CONCLUSIONS: The probable association of the therapeutic use of bisphosphonates and the occurence of jaw bone necrosis has to be studied in further investigations. Patients receiving bisphosphonates should be followed-up regularly to avoid the occurrence of extended osteonecrotic lesions, which should be diagnosed early and treated adequately.

Glutathione reductase from human erythrocytes: amino-acid sequence of the structurally known FAD-binding domain.

Glutathione reductase (Mr 2 x 52 500), a flavoenzyme of known three-dimensional structure, catalyses the reduction of glutathione disulfide by NADPH. This paper describes the primary structure of the FAD-binding domain which ranges from AcAla-1 to Gly-157. The three CNBr-produced fragments (69, 10 and 80 residues) of the domain were fractionated further by enzymatic and chemical methods; isolated peptides were sequenced mainly by automatic solid-phase Edman degradation. The tryptic peptides were overlapped by chymotryptic peptides. A fragment which results from cleavage at the acid-labile bond between Asp-135 and Pro-136 supplied peptides for overlapping the CNBr-produced fragments. In addition, many peptides were ordered and overlapped by computerized comparison with a complete sequence guessed from the electron density map. With one exception the computer method and the chemical alignment gave the same results. The sequence data are discussed in the light of the secondary and tertiary structure (Schulz et al. (1978) Nature (Lond.) 273, 120--124]. The 17 N-terminal residues are not visible in the electron density map. Consequently our numbering scheme differs from that of Schulz et al. by approximately 20 residues. Acetylation of the N terminus and an unusual composition of the following residues may serve to protect the loose N-terminal section of the protein against proteolysis in situ. The four cysteinyl residues of the FAD domain are of special interest. Cys-2 at the tip of the N-terminal extension is likely to be involved in the aggregation behaviour of glutathione reductase. Cys-58 and Cys-63 (formerly Cys-41 and Cys-46) represent the enzyme's redox-active dithiol. Cys-90 with its location at the twofold axis forms a disulfide bridge with Cys-90 of the other peptide chain of the enzyme. This might be related to the fact that both peptide chains contribute to each of the two active centers. In view of the interchain disulfide bridge glutathione reductase should be regarded as a monomeric protein. The sequence of the FAD-binding domain was compared with the sequence of the NADPH-binding domain of glutathione reductase using a computer program. As discussed, the scarcity of sequence similarities does not argue against the assumption that the two nucleotide-binding domains of glutathione reductase originated by gene duplication. The pyrophosphate moiety of FAD binds to a part of the polypeptide chain which in geometric structure, in topology and in sequence resembles the phosphate loops of other nucleotide-binding proteins and of flavodoxin. Using the phosphate loop as a reference, the N-terminal sequence of five flavoproteins can be aligned. The results of Williams et al. on the sequence of lipoamide dehydrogenase (EC 1.6.4.3) and our data on glutathione reductase (EC 1.6.4.2) show clearly that these two mechanistically similar enzymes possess homologous structures.

[Further results of the Berlin morbidity study 1972. 5. Dental care, DMF index and knowledge of dental health]. / Weiterführende Ergebnisse der Berliner Morbiditätsstudie 1972 5. Mitteilung: Stomatologische Betreuung, DMF-Index und stomatologisches Gesundheitswissen.

The regularity of dental care, preferably provided by one and the same dentist, exerts a positive effect on the incidence of caries and dental health knowledge. The DMF index and the results from interviews aiming at evaluating dental health knowledge were used in comparing groups of subjects without dental care and with regular or irregular dental care delivered by one and the same dentist or by different dentists.

[Further results of the Berlin morbidity study, 1972. 3. Visits to the dentist, oral hygiene and the periodontal condition]. / Weiterführende Ergebnisse der Berliner Morbiditätsstudie 1972. 3. Mitteilung: Zahnarztbesuch, Mundhygiene und Parodontalzustand.

There are relationships between the child's mode of visiting the dentist and the oral hygiene index of the adult, between the general educational level and the frequency of the visits to the dentist in adulthood, and between the regularity of dental care, the oral hygiene condition and the incidence of periodontal diseases. Regular care by one and the same dentist is without doubt beneficial to the patient.

[Further results from the Berlin morbidity study 1972. 2. Educational level and incidence of periodontal diseases]. / Weiterführende Ergebnisse der Berliner Morbiditätsstudie 1972 2. Mitteilung: Bildungsstand und Häufigkeit von Parodontopathien.

The ratio of subjects without periodontal diseases to those with periodontal diseases is 40:60 for individuals having gained a primary school-leaving certificate, and 53:47 for individuals with higher educational level.

[Further results from the Berlin morbidity study of 1972. 1. Educational level, knowledge of dental health and oral hygiene]. / Weiterführende Ergebnisse der Berliner Morbiditätsstudie 1972 1. Mitteilung: Bildungsstand, stomatologisches Gesundheitswissen und Mundhygiene.

There are relationships between the general educational level and the extent of dental health knowledge on the one hand, and between the dental health knowledge and the oral hygiene condition on the other hand. A higher educational level is associated with a better dental health knowledge and, in most cases, the latter is connected with a lower oral hygiene index. School education exerts a greater effect on the level of dental health knowledge than higher or technical education. The state of dental health education and information of the population is not sufficient. Merely 25% of the interviewed graduates and 10% of the individuals having gained a school-leaving certificate reached maximum scores though only some few and easy questions (with a choice of incorrect and correct answers) had been put to evaluate dental health knowledge.

[Continung results of the Berlin morbidity study 1972. 4. DMF index, educational status and stomatological health education]. / Weiterführende Ergebnisse der Berliner Morbiditätsstudie 1972. 4. Mitteilung: DMF-Index, Bildungsstand und stomatologisches Gesundheitswissen.

The general educational level and the dental health knowledge are negatively correlated with the DMF index and its M component. They are positively correlated with the number of primarily sound teeth. No correlations could be established between the aforementioned criteria and the D component.

[Stomatological morbidity study--Berlin 1972. 5. Caries frequency]. / Stomatologische Morbiditätsstudie--Berlin 1972. 5. Mitteilung: Karieshäufigkeit

Using the DMF index, the authors studied the caries morbidity in a representative sample of the Berlin population (3853 subjects, aged 18 to 100 years). The mean DMF index was 17.74, the value for female individuals being higher than that for male ones.

[Stomatological morbidity study--Berlin 1972. 4. State of prosthetic-stomatologic care and the need for it]. / Stomatologische Morbiditätsstudie--Berlin 1972 4. Mitteilung: Prothetische-stomatologischer Versorgungsgrad und Versorgungsbedarf

In the course of a representative morbidity study in the capital of Berlin of 1972, it was found that almost 56% of the adults needed prosthodontic care. Only nearly half of them had dental prostheses of sufficient quality, one fourth had insufficient dental prostheses, and one fourth were untreated.

[Stomatological morbidity study--Berlin 1972. 3. The frequency of dysgnathias and their symptoms in the subjects of an epidemiologic-stomatological study]. / Stomatologische morbiditätsstudie - Berlin 1972. 3. Die Häufigkeit von Dysgnathien und ihre Merkmale bei Probanden einer epidemiologisch-stomatologischen Studie

Stomatological morbidity study - Berlin 1972. Part III. The frequency of dysgnathias and their symptoms in subjects of an epidemiologic-stomatological study. In the course of a stomatological morbidity study which was performed in Berlin in 1972, the authors investigated the dental conditions of 657 subjects, having an age range from 18 to 30 years. Only 15.2% of the persons under investigation had an eugnathic dentition. Almost 85% of the individuals showed dysgnathias. Apart from the frequency of certain tooth malalignments and malocclusions, associated symptoms were recorded. 15.5 of the subjects under investigation said that they had had orthodontic treatment. Significant differences were found in comparing the results obtained from treated individuals with those from untreated subjects.