Combined preoperative measurement of three inferior alveolar canal factors using computed tomography predicts the risk of inferior alveolar nerve injury during lower third molar extraction.

A retrospective cohort study was performed to assess the clinical usefulness of combination assessment using computed tomography (CT) images in patients undergoing third molar extraction. This study included 85 patients (124 extraction sites). The relationship between cortication status, buccolingual position, and shape of the inferior alveolar canal (IAC) on CT images and the incidence of inferior alveolar nerve (IAN) injury after third molar extraction was evaluated. IAN injury was observed at eight of the 124 sites (6.5%), and in five of 19 sites (26.3%) in which cortication was absent+the IAC had a lingual position+the IAC had a dumbbell shape. Significant relationships were found between IAN injury and the three IAC factors (cortication status, IAC position, and IAC shape; P=0.0001). In patients with the three IAC factors, logistic regression analysis indicated a strong association between these factors and IAN injury (P=0.007). An absence of cortication, a lingually positioned IAC, and a dumbbell-shaped IAC are considered to indicate a high risk of IAN injury according to the logistic regression analysis (P=0.007). These results suggest that a combined assessment of these three IAC factors could be useful for the improved prediction of IAN injury.

Dyskeratosis congenita associated with leukoplakia of the tongue.

Dyskeratosis congenita (DC) is an inherited disease characterized by the triad of skin pigmentation, nail dystrophy, and oral leukoplakia. Among other abnormalities, bone marrow failure and a predisposition to cancer are recognized as the major causes of premature mortality in patients with DC. This disease is associated with short telomeres and mutations in 10 genes associated with telomerase and telomere components. The case of a 35-year-old male patient diagnosed with DC, who presented with leukoplakia of the tongue and had a high degree of hypoplastic marrow, but no haematological abnormalities, is reported here. The diagnosis of DC was confirmed by detection of short telomeres in the blood cells and mutations in the DKC1 gene. This encounter with the case presented suggests that an awareness of the classical forms of DC is important for oral clinicians so that an early diagnosis can be made and the patient can be managed appropriately. Furthermore, genetic analysis is necessary to establish the diagnosis of DC.

In vitro synergistic effects of zoledronic acid and calcium on viability of human epithelial cells.

OBJECTIVE: Bisphosphonate-related osteonecrosis of the jaw is a common complication with defective wound healing of oral mucosa and frequently occurs in patients receiving zoledronic acid (ZA). The aim of this in vitro study was to investigate whether ZA has a cytotoxic effect at clinically relevant concentrations on epithelial cells when calcium conditions are altered. METHODS: HaCaT human keratinocyte cells were treated with ZA in the presence of various concentrations of calcium. The concentrations of ZA included submicromolar ones, which are comparable with those found in the plasma of patients. Cell viability and apoptosis were assessed using MTT assay and annexin V flow cytometry. RESULTS: Under standard culture conditions, cell growth was inhibited at 1 µM of ZA or above, but was unaffected by lower concentrations. However, when calcium concentrations were moderately increased, cell viability was decreased and apoptosis was induced at 0.2-0.3 µM of ZA. Moreover, a 50% reduction in serum in the hypercalcemic medium resulted in a significant decrease in cell viability at a much lower concentration (0.05 µM). CONCLUSION: These results suggest that clinically relevant concentrations of ZA, which alone have little effects, can be toxic to the epithelial cells depending on the conditions of extracellular calcium.

Central cystadenocarcinoma of the mandible.

Papillary cystadenocarcinoma (PCAC) of the salivary gland is a rare malignant tumour and occurs in major and minor salivary glands. PCAC of the mandible is exceptionally rare; only 2 cases have been reported. In this study, the authors report a case of PCAC within the mandible. The patient presented with a painful right mandibular mass that had gradually increased in size. The lesion appeared radiographically as a well-demarcated multilocular radiolucent area, similar to an odontogenic cystic lesion. The authors present a case of PCAC with reference to the relevant literature.

Gene transfer of CD40-ligand to dendritic cells stimulates interferon-gamma production to induce growth arrest and apoptosis of tumor cells.

In this study, we present evidence that gene transfer of the CD40-ligand (CD154) into human immature dendritic cells (DC) imparts direct antitumor effects on tumor cells. DC infected with adenovirus directed to express human CD154 on the cell surface (CD154-DC) elicited significantly higher levels of immune accessory molecules commonly found on mature DC. We found that co-cultivation with a human squamous cell carcinoma cell line (OSC-70) with CD154-DC significantly inhibited cell growth. We further demonstrate that OSC-70 cells stimulated with CD154-DC were more susceptible to apoptosis via TNF-related apoptosis inducing ligand (TRAIL). Importantly, tumor cells co-cultured with CD154-DC in transwell plates expressed upregulated cell surface TRAIL-R2. CD154-DC produced higher levels of interferon (IFN)-gamma, IL-12p70 and soluble CD154, but the ability of CD154-DC to inhibit tumor cell growth was significantly abrogated by a neutralizing antibody to IFN-gamma, indicating that this was mainly mediated by IFN-gamma. Furthermore, intratumoral injection of CD154-DC significantly suppressed OSC-70 tumor growth in a xenograft model. Overall, these results reveal that CD154-DC have potential as an anti-cancer therapy by producing IFN-gamma to arrest adjacent tumor cell growth and increase the susceptibility of apoptosis via TRAIL.

Sensory requirements for noncontact penile erection in the rat.

Physical contact is not necessary for male rats to display penile erection when placed in the vicinity of females in estrus (noncontact erection, NCE). The modality and reception of sensory stimuli for the induction of NCE were analyzed. Olfactory bulbectomy eliminated NCE, and destruction of olfactory mucosa by zinc sulfate solution caused a significant suppression of NCE, whereas removal of the vomeronasal organ had no effect. Fresh urine collected from estrous females, but not fresh feces, induced NCE. Neither devocalization of estrous females by cutting the inferior laryngeal nerve nor deprivation of visual cues by placing an opaque barrier between the subjects and stimulus females disrupted NCE. The results indicate that olfactory cues emitted by estrous females induce NCE via the olfactory epithelium. Contrary to what had been suggested by previous experiments, vomeronasal inputs are not indispensable for the induction of NCE.

[An active part of female mice in sexual interaction].

Proceptive behavior, according to Beach (1976), maintains and accelerates sexual interactions toward the end goal. Such distinctive type of proceptive behavior as darting or hopping of female rats is not apparent in mice. Nevertheless, it seems more reasonable that females may take an active part as much as their male partners also in this species. Twenty sexually experienced females in estrus were paired with 20 naive males of the same strain (ICR/JCL) and the pairs were observed for 6 hours. Eleven males of the 20 pairs successfully ejaculated. Females exhibited lordosis more frequently when they actively approached the male partners than when they were approached and mounted by males. This indicated that the rate of mating success was higher in the case of female's approach. Female's approaching behavior thus possibly plays a role as a proceptive behavior in mice.

[Cerebrospinal fluid transfer of cefotiam (CTM). Its relationship to CT].

Drip intravenous infusion of cefotiam (CTM) was made on patients who underwent cerebrospinal fluid (CSF) drainage and study was made on CSF transfer of CTM and at the same time on the relationship between CSF transfer of iodine contrast medium and CT scan findings. This study was made on 11 cases of cisternal drainage and 8 cases of ventricular drainage. Cisternal drainage cases were all postoperative cases of ruptured cerebral aneurysm. Cases of ventricular drainage included 4 postoperative cases of ruptured cerebral aneurysm, 1 case of CSF rhinorrhea, 2 cases of brain tumor, and 1 case of ventricular hemorrhage. Drip intravenous infusion of 1.0 g of CTM was made in one hour and at given periods thereafter CSF was collected and measured. CTM transferred to the CSF in cistern at a comparatively high concentration (16.3-0.7 microgram/ml). Hardly any transfer of CTM to the CSF in ventricle was seen in one case of cerebral aneurysm, CSF rhinorrhea, and brain tumor, but transfer was observed in one case of cerebral aneurysm, one case of brain tumor, and case of ventricular hemorrhage. Transfer of iodine contrast medium showed the positive correlation to the transfer of CTM. In cases of brain tumor and ventricular hemorrhage with transfer of CTM with ventricular drainage, enhancement effect of the ventricular wall by the contrast medium could be observed by CT scan. From the foregoing, the following results were obtained. There was good transfer of CTM to the CSF in cistern in postoperative cases of ruptured aneurysm. CTM did not transfer to CSF in the normal ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

[Two cases of spina bifida cystica with congenital dermal sinus].

Spina bifida cystica and congenital dermal sinus are congenital anomalies which are called dysraphic states. Numerous reports of congenital dermal sinus can be seen in Europe and America, but in this country we have been able to find no more than six reported cases. Also in this country, to the best of our knowledge, only two cases of combined spina bifida cystica and congenital dermal sinus have been seen. The small incidence of reported cases may be due to the fact that congenital dermal sinus tends to go unnoticed except when infection develops. Consequently when dermal sinus is asymptomatic, even in both combined cases, it probably is thought to be only spina bifida. We have seen the combination with congenital dermal sinus in two among twenty cases of spina bifida cystica which we have observed during the past seven years. We report on this and discuss it in relation to the other literature.