Picibanil (OK-432) in the treatment of head and neck lymphangiomas in children.

BACKGROUND: Picibanil (OK-432) is a lyophilized mixture of group A Streptococcus pyogenes with antineoplastic activity. Because of its capacity to produce a selective fibrosis of lymphangiomas (LMs), it has been approved by Japanese administration in 1995 for the treatment of LMs. MATERIALS AND METHODS: We treated 15 children (age range: 6-60 months) affected by head and neck macrocystic LMs with intracystic injections (single dose of 0.2 mL) of Picibanil (1-3 injections). RESULTS: Complete disappearance of the lesion was noticed in eight (53.33%) cases, a marked (>50%) reduction of LMs was found five (33.33%) cases, while a moderate (<50%) response was recorded in two (13.33%) cases. Picibanil side effects included fever, local inflammation, and transitory increase of blood platelets' concentration; a single case of anemia was resolved with concentrated red blood cells transfusion. CONCLUSIONS: Intracystic injection of Picibanil is an effective and safe treatment for macrocystic LMs in pediatric patients and may represent the treatment of choice in such cases, especially where surgical excision is associated with the risk of functional/cosmetic side effects.

Effects of demineralized freeze-dried bone allograft on gene expression of osteoblastlike MG63 cells.

Demineralized freeze-dried bone allograft (DFDBA) is widely used in periodontal regeneration procedures as a scaffold for new bone formation in periodontal defects. How this biomaterial alters osteoblast activity to promote bone formation is poorly understood. We therefore attempted to address this question by using microarray techniques to identify genes that are differently regulated in osteoblasts exposed to DFDBA. By using DNA microarrays containing 20,000 genes, the authors identified in an osteoblastlike cell line (MG-63) cultured with DFDBA (Allogro, Dentsply/Friadent-Ceramed) several genes whose expression was significantly up-regulated or down-regulated. The differently expressed genes cover a broad range of functional activities: (1) cell cycle regulation, (2) immunity, (3) vesicular transport, (4) production of cytoskeletal elements, and (5) bone remodeling. The data reported are, to the authors' knowledge, the first genetic portrait of DFDBA effects. They can be relevant to a better understanding of the molecular mechanism of bone regeneration and as a model for comparing other materials with similar clinical effects.

Clinical outcome of 285 Medpor grafts used for craniofacial reconstruction.

Porous polyethylene (Medpor) is an alloplastic material worldwide used for craniofacial reconstruction. To evaluate complications and risk factors associated with this synthetic graft, a retrospective study was performed. A series of 285 Medpor grafts were placed in 187 patients. Age, sex, diagnosis at admission, site, type of surgical insertion, type of fixation, and outcome (no complications, anesthesia, exposure, infection, and implant remodeling and removal) are considered. By means of univariate and multivariate analyses, we detect variables most associated with poor outcome. Univariate analysis showed that graft "survival" curves stratified according to (1) diagnosis at admission and (2) site are statistically significant. Subsequently, a Cox analysis was performed: both variables are also predictors of graft outcome. Porous polyethylene is a reliable alloplastic material that can be satisfactory used for craniofacial reconstruction. However, some sites (i.e., nose, maxilla, and ear) and diagnosis at admission (i.e., syndromic patients previously operated) are related to an higher risk of implant failure.