Radiographic changes during bone healing after mandibular fractures

The study aimed to find out the best time to undertake radiological follow-up examinations and remove fixation materials after fractures of the mandible through a retrospective study of radiographs. Serial radiographs of 325 fracture sites in 231 patients over a 10-year period were examined. Outcome was measured by radiographic features of healing at less than 2, 2-3, 3-4, and 4 or more months. Osteogenic change (osteogenesis and union) was the best radiographic criterion for evaluating follow-up radiographs. This change started to predominate 1-2 months after injury in patients less than 18 years of age (21/31, 68%) and 2-3 months after injury in older patients (21/25, 84%). Overall, union was noted in 98 of 115 patients (85%) 3 months or more after the fracture. We recommend follow-up radiographic examination to confirm clinical judgement during the fifth week after a mandibular fracture in patients less than 18 years of age, and the ninth week for older patients. The fixation materials should be removed during the fifth month after injury.

Diagnostic imaging for a case of maxillary myxoma with a review of the magnetic resonance images of myxoid lesions

The findings of conventional radiography, computed tomography, and magnetic resonance imaging are reported for an odontogenic myxoma arising in the left anterior maxilla of a 50-year-old man. The magnetic resonance imaging characteristics of an intraosseous myxoma are described for the first time. The initial conventional radiographic examination disclosed a unilocular radiolucency with poorly delineated margins as typically seen in malignant tumors. Subsequently, acquired computed tomography scans displayed bony expansion and thinning of cortices on the labial aspect of the lesion. Magnetic resonance imaging revealed a well-defined, well-enhanced mass lesion with homogeneous signal intensity on every pulse sequence. The lesion showed intermediate signal intensity on the T1- and T2-weighted images. Magnetic resonance imaging of the present maxillary myxoma revealed a higher signal intensity on T1-weighted and a lower signal intensity on T2-weighted images than for previously reported myxomas of the soft tissues. This discrepancy might be related to the viscosity of the mucoid substance or the protein density of the tumor.

A novel protein with DNA binding activity from tobacco chloroplast nucleoids

A 41-kD DNA binding protein with a basic pl was purified from chloroplast nucleoids in photomixotrophically cultured tobacco cells, and its amino acid sequence was determined. Using this sequence information, its cDNA (CND41) was isolated, and its nucleotide sequence was determined. The predicted amino acid sequence of CND41 has a transit peptide of 120 amino acids and a mature protein of 382 amino acids. A distinctive helix-turn-helix motif in the lysine-rich N-terminal region of the mature protein and an aspartyl protease active site motif were predicted. Expression of a series of truncated CND41 proteins in Escherichia coli indicated that the lysine-rich region is essential for DNA binding and that CND41 nonspecifically binds chloroplast DNA. Protein gel blot analyses showed CND41 mainly in cells and/or tissues containing nonphotosynthesizing, actively growing plastids. In addition, the accumulation of chloroplast transcripts in these cells and/or tissues (e.g., transcripts for QB binding protein of photosystem II [psbA] and large subunit of ribulose bisphosphate carboxylase [rbcL]) was negatively correlated with the accumulation of CND41. Analyses of cultured cells of transgenic tobacco with reduced CND41 levels showed a higher level of expression of chloroplast genes compared with that of the wild type. We discuss the possible function of CND41 as a negative regulator of chloroplast gene expression.

Expression of alpha-smooth-muscle actin antigen in thymoma and thymic cancer

Using specimens from 95 patients with thymoma and 6 with thymic cancer, we studied the expression of an alpha-smooth-muscle actin antigen immunohistochemically. It was mainly identified in the cytoplasm of small spindle cells within stroma and in the cytoplasm of tumor cells excepting vessels. In thymomas, the stromal expression is related to poor survival, while the cytoplasmic expression within tumor cells correlate with good outcome. Our data indicate that significance of the smooth muscle differentiation may be different between stromal and tumor cells. This antigen may be a useful indicator of survival in thymic neoplasms, especially in thymoma.

Sequential dynamics of monocyte chemotactic protein-1 expression in herniated nucleus pulposus resorption

We previously demonstrated that the granulation tissues of herniated nucleus pulposus are composed of a marked infiltration of macrophages that strongly express monocyte chemotactic protein-1. Monocyte chemotactic protein-1 is a chemotactic cytokine that contributes to the activation and recruitment of macrophages. Relatively little is known about its role in the resorption process of herniated nucleus pulposus. To clarify the sequential dynamics of expression of monocyte chemotactic protein-1 in the granulation tissues of herniated nucleus pulposus, we introduced a rat autologous transplantation model of nuclear materials onto its lumbar dura mater and performed immunohistological analysis and competitive polymerase chain reaction assay using the grafted samples. Immunohistological analysis demonstrated that the majority of infiltrating mononuclear cells expressed monocyte chemotactic protein-1. Monocyte chemotactic protein-1 mRNA was expressed in the first 3 weeks after the procedure and was significantly and maximally upregulated at 1 week. To determine whether human recombinant monocyte chemotactic protein-1 facilitates the resorption process of herniated nucleus pulposus, we introduced another model of autologous transplantation, wherein the nuclear materials were grafted to the abdominal subcutaneous tissues and recombinant monocyte chemotactic protein-1 was subsequently applied to these materials. When monocyte chemotactic protein-1 was injected into the murine nucleus pulposus tissues, they reduced in size more rapidly than in the control group. These findings suggest that monocyte chemotactic protein-1 plays an important role in the recruitment of macrophages in the early phase of the resorption process of herniated nucleus pulposus and that its application may physiologically facilitate the resorption process of the nucleus pulposus.

Relationship between microlymphatic vessel density within tumors and lymph node metastasis

We assessed the relationship between microlymphatic vessel density (MLD) within tumors and lymph node metastasis. The SCID mice were injected subcutaneously with various human tumor cells. DNA was extracted from lymph nodes for specific detection of a human beta-globin-related sequence. The discrimination of lymphatic vessels was done by enzyme-histochemistry for 5'-nucleotidase in endothelial cells after an adequate inhibition of the activity. The nodal metastasis could be detected in mice with PC-14, and they developed high MLD. Mice without metastasis had low MLD excepting OST cells. Experimentally, we have observed high MLD within PC-14 tumors and its tendency toward lymph node metastasis.

Human hepatitis B virus enhancer 1 is responsive to human interleukin-6

Serum levels of interleukin-6 (IL-6) are elevated in acute and chronic hepatitis B patients. The effect of IL-6 and its transcription factor of NF-IL6 (a nuclear factor for IL-6) on hepatitis B virus (HBV) enhancer 1 (Enh1), which controls HBV X expression, were investigated in HepG2 cells. Twenty ng/ml of IL-6 increased 4-fold the enhancer activity of Enh1 according to the CAT assay. The IL-6 stimulation was abolished by introducing a mutation either in an AP-1-related site or a C-stretch sequence in the Enh1 sequence, demonstrating that the cis-elements are necessary for the IL-6 response. Co-transfection of NF-IL6 expression plasmid similarly increased the enhancer activity of Enh1 through both binding sites. Further, a specific complex formation of the Enh1 was detected using HepG2 nuclear lysates by electromobility shift assays, and the complex formation was increased in the lysates of cells treated with IL-6 and NF-IL6-transfection. In competition assays, one half of the complex formed was found to remain in the presence of 500-times excess competitor DNA fragment harboring NF-IL2 binding site, suggesting indirect binding of NF-IL6 to the Enh1 sequence. These results indicate that IL-6 increased the enhancer activity of HBV Enh1 through signal transduction pathways, indirectly involving NF-IL6, and may control HBV X expression and viral replication in HBV infected liver.

Effects of various timings and concentrations of inhaled nitric oxide in lung ischemia-reperfusion. The Paris-Sud University Lung Transplantation Group

Experimental studies reveal that inhaled nitric oxide (NO) can prevent, worsen, or have no effect on lung injury in the setting of ischemia-reperfusion (I-R). We tested the hypothesis that these disparate effects could be related to differences in the timing of administration and/or concentration of inhaled NO during I-R. Isolated rat lungs were subjected to 1-h periods of ischemia followed by 1-h periods of blood reperfusion. We investigated the effects of NO (30 ppm) given during ischemia, NO (30 or 80 ppm) begun immediately at reperfusion, or NO (30 ppm) given 15 min after the beginning of reperfusion, on total pulmonary vascular resistance (PVR), the coefficient of filtration (Kfc), the lung wet/dry weight ratio (W/D) of lung tissue, and lung myeloperoxidase activity (MPO). A control group did not receive NO. NO given during ischemia had no effect on Kfc or MPO, but decreased PVR. NO (30 ppm) during reperfusion (early or delayed) decreased PVR, W/D, Kfc and MPO. NO at 80 ppm decreased PVR and MPO but not W/D or Kfc. In conclusion, NO at 30 ppm, given immediately or in a delayed fashion during reperfusion, attenuates I-R-induced lung injury. NO at 30 ppm given during ischemia or at 80 ppm during reperfusion is not protective.

Enzymatic treatment to eliminate the extracellular ATP for improving the detectability of bacterial intracellular ATP

A novel and effective treatment of biological samples with a combination of adenosine phosphate deaminase and apyrase was developed for reducing extracellular ATP, which has been a major problem encountered in improving the sensitivity of assays for intracellular ATP by the firefly luciferin-luciferase (L-L) method. Under the enzymatic reaction conditions, ATP and the related adenosine derivatives were converted to IMP, which are not active to the L-L system. In the model system (3.2 x 10(-8) M ATP in 1% yeast extract solution) the treatment with adenosine phosphate deaminase resulted in the reduction of ATP to 1.3 x 10(-11) M, and the concomitant use of apyrase lowered the concentration to 3.3 x 10(-13) M. The treatment (0.05 U/ml of adenosine phosphate deaminase and apyrase) was applied to the detection of bacteria in broth by the L-L method, affording the detection of 42 colony-forming unit (CFU)/ml of Escherichia coli and 10 CFU/ml of Staphylococcus aureus in the broth.

ACAT inhibitor HL-004 accelerates the regression of hypercholesterolemia in stroke-prone spontaneously hypertensive rats (SHRSP): stimulation of bile acid production by HL-004

The effect of the acyl-CoA:cholesterol acyltransferase (ACAT) inhibitor HL-004 on bile acid production was studied during the regression phase of pre-established hypercholesterolemia in stroke-prone spontaneously hypertensive rats (SHRSP). These rats were fed a hypercholesterolemic diet containing 5% cholesterol, 2% cholic acid, and 20% suet for 30 days to induce hypercholesterolemia. The regression phase was started by switching the diet to normal chow, followed by another 30 days of the diet. The decrease in serum cholesterol level was accelerated by treatment with 0.09% HL-004. At the end of regression, hepatic ACAT activity was significantly lower in the HL-004 treated animals, an event concomitant with the significant decrease in cholesteryl ester content in the liver. In contrast hepatic cholesterol 7 alpha-hydroxylase activity was maintained at a higher level in the HL-004 treated animals. HL-004 increased the secretion of bile acid and biliary lipids in bile duct-cannulated SHRSP. In HepG2:cells, HL-004 at 1-30 microM dose-dependently stimulated bile acid synthesis from [3H]cholesterol. When cholesterol 7 alpha-hydroxylase activity of the liver was compared ex vivo in the presence and in the absence of exogenous cholesterol, it was suggested that the higher 7 alpha-hydroxylase activity of the HL-004 group could be attributed not only to expansion of the endogenous cholesterol pool, which may be the result of hepatic ACAT inhibition by HL-004 but to the direct effect of HL-004 on bile acid production. Thus, HL-004 accelerates the regression of hypercholesterolemia, an event which may be related to the stimulation of bile acid production in the liver.

Hepatitis C virus envelope proteins bind lactoferrin

Hepatitis C virus (HCV) has two envelope proteins, E1 and E2, which form a heterooligomer. During dissection of interacting regions of HCV E1 and E2, we found the presence of an interfering compound or compounds in skim milk. Here we report that human as well as bovine lactoferrin, a multifunctional immunomodulator, binds two HCV envelope proteins. As determined by far-Western blotting, the bacterially expressed E1 and E2 could bind lactoferrin in human milk directly separated or immunopurified and separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. The bindings of lactoferrin and HCV envelope proteins in vitro were confirmed by another method, the pull-down assay, with immunoprecipitated lactoferrin-bound protein A resin. By the same assay, mammal-expressed recombinant E1 and E2 were also demonstrated to bind human lactoferrin efficiently in vitro. Direct interaction between E2 and lactoferrin was proved in vivo, since anti-human lactoferrin antibody efficiently coimmunoprecipitated with secreted and intracellular forms of the E2 protein, but not glutathione S-transferase (GST), from lysates of HepG2 cells transiently cotransfected with the expression plasmids of human lactoferrin and gE2t-GST (the N-terminal two-thirds of E2 fused to GST) or GST. The N-terminal loop of lactoferrin, the region important for the antibacterial activity, has only a little role in the binding ability to HCV E2 but affected the secretion or stability of lactoferrin. Taken together, these results indicate the specific interaction between lactoferrin and HCV envelope proteins in vivo and in vitro.

[A case of intradural xanthogranuloma in the upper cervical spine]

An 18-year-old female patient suffered from posterior neck pain and gait disturbance. The neurological examination revealed left hemiparesis, general hyperreflexia and hypoalgesia on the right neck and upper limb, and left trunk and lower limb. MRI showed a large mass lesion in the right side of the spinal canal at the level of the C1 cervical spine, which was obviously compressing the spinal cord. An operation was performed through a right suboccipital craniectomy and right hemilaminectomy of the first vertebra. Though the mass lesion in the subarachnoid space compressed the spinal cord, it adhered neither to the spinal cord nor to the nerve roots. However, as it clearly adhered to the dura mater, the attachment site was also completely removed. In the pathological examination, lymphocyte, foamed macrophage and the giant cell of Touton type were shown. The immunohistochemical study with CD68 (Kp1) was positive, but it was negative for the lysozyme, neuron specific enolase and S-100 protein. The diagnosis was xanthogranuloma. The patient recovered completely after the operation. This is a rare case of juvenile type xanthogranuloma. This lesion in the spinal canal has usually its onset in the adult age.

A Combination Therapy with Mitomycin C, Etoposide, Doxifluridine and Medroxyprogesterone Acetate as Second Line Therapy for Advanced Breast Cancer Refractory to Combination Chemotherapy of Cyclo-phoshamide, Doxorubicin and 5-Fluorouracil

Thirty-two patients with advanced breast cancer refractory to combination chemotherapy with cyclophosphamide (CPA), doxorubicin (ADR) and 5-fluorouracil (5-EU) (CAF) were treated with the combination of mitomycin C, etoposide, doxifluridine and medroxyprogesterone acetate as second line therapy. Observed responses included 6 patients (18.7%) with complete response (CR) and 7 (21.9%) with partial response (PR). Two (50%) out of 4 patients who had bone pain due to bone metastasis noted pain relief. CR or PR were obtained in 4 out of 12 patients who had not responded to the previous CAF therapy. While grade III myelosuppression was observed in 3 patients, other adverse effects were minimal. It is suggested that this combination therapy may be recommended for advanced breast cancer patients as a second therapy.

A high level of accumulation of 2-hydroxymuconic 6-semialdehyde from aniline by the transpositional mutant Y-2 of Pseudomonas species AW-2

Four transpositional mutants of aniline-assimilating Pseudomonas sp. AW-2 produced 2-hydroxymuconic 6-semialdehyde (HMS) from aniline and accumulated it in a cultural medium. Among the four mutants, strain Y-2 produced the greatest amount of HMS (0.77 mg/ml) from 1 mg/ml of aniline hydrochloride in a 15-h growing culture. The conversion rate of aniline to HMS was 70% on a molar basis. Resting cells of strain Y-2 produced 0.65 mg/ml of HMS during 4h of incubation in a reaction mixture containing 1 mg/ml of aniline hydrochloride (conversion rate, 60%). Transposon Tn5-Mob was found to be inserted into the gene of HMS dehydrogenase in strain Y-2 by sequence analysis.

[A case of malignant lymphoma after renal transplantation]

A case of a primary brain malignant lymphoma after renal transplantation and immunosuppressive therapy is reported. A 41-year-old male patient had been treated with 125 mg/day of azathioprine and 10 mg/day of prednisolone after renal transplantation. He had also been suffering from various infectious diseases. Multiple brain tumors were found and diagnosed as having B-cell, diffuse large cell type malignant lymphoma. In spite of moderate response to irradiation, he died of pneumonia. The anti-Epstein Barr virus antibodies changed from a negative to a positive level after renal transplantation and they increased markedly after brain malignant lymphoma had been found. The number of T- and B-lymphocytes also decreased markedly at that time. So the Epstein-Barr virus was suspected to be the cause of the malignant lymphoma.

Evaluation of the clamshell incision for bilateral pulmonary metastases

To treat bilateral pulmonary metastases during a single operation, simultaneous bilateral thoracotomy via median sternotomy is usually employed. With this approach, however, it is sometimes difficult to access lesions located on the dorsal side of the left lower lobe. We have explored the use of clamshell incisions for such difficult cases. From 1990 to 1995, we studied the use of clamshell incisions in 14 patients with bilateral pulmonary metastases. The average duration of surgery was 212 minutes, the average volume of intraoperative blood loss was 477 ml, and the average number of metastatic lesions extirpated was 23. The endotracheal tube could be removed immediately after the operation in 12 patients, while the remaining 2 patients, who underwent an extensive operation, needed 3 and 4 days of intubation. The arterial blood gas analysis on the first postoperative day for the former 12 patients was as follows: the average value of PaCO2 was 44.4 mmHg, and the average value of PaO2 was 140.4 mmHg (FiO2 = 0.4). None of the patients experienced severe pain or respiratory distress that impaired their daily activities due to continuous epidural anesthesia following surgery. The length of time from surgery to discharge was relatively short, averaging 22 days. We have not encountered any sternal override in our patients. Although we cannot ignore the biological behaviour of primary tumors when selecting a surgical approach, the clamshell incision seems to provide a useful means of thoracotomy when treating bilateral pulmonary metastases. We intend to use this approach in future, taking into careful consideration the indication of each individual case.

Novel genes encoding 2-aminophenol 1,6-dioxygenase from Pseudomonas species AP-3 growing on 2-aminophenol and catalytic properties of the purified enzyme

2-Aminophenol 1,6-dioxygenase was purified from the cell extracts of Pseudomonas sp. AP-3 grown on 2-aminophenol. The product from 2-aminophenol by catalysis of the purified enzyme was identified as 2-aminomuconic 6-semialdehyde by gas chromatographic and mass spectrometric analyses. The molecular mass of the native enzyme was 140 kDa based on gel filtration. It was dissociated into molecular mass subunits of 32 (alpha-subunit) and 40 kDa (beta-subunit) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, indicating that the dioxygenase was a heterotetramer of alpha2beta2. The genes coding for the alpha- and beta-subunits of the enzyme were cloned and sequenced. Open reading frames of the genes (amnA and amnB) were 816 and 918 base pairs in length, respectively. The amino acid sequences predicted from the open reading frames of amnA and amnB corresponded to the NH2-terminal amino acid sequences of the alpha-subunit (AmnA) and beta-subunit (AmnB), respectively. The deduced amino acid sequences of AmnB showed identities to some extent with HpaD (25.4%) and HpcB (24.4%) that are homoprotocatechuate 2,3-dioxygenases from Escherichia coli W and C, respectively, belonging to class III in the extradiol dioxygenases. On the other hand, AmnA had identity (23.3%) with only AmnB among the enzymes examined.

Treatment of bronchial stricture due to endobronchial tuberculosis

Between 1974 and 1995 we encountered 19 cases of bronchial stricture or obliteration caused by endobronchial tuberculous lesions. In 11 the involvements were located at the right bronchus (including involvements of segmental and middle lobe bronchi) and in 8 at the left bronchus. On bronchoscopic biopsy of the stenosed bronchus, 7 patients showed histopathologic findings of tuberculous bronchitis, but 12 patients showed nonspecific inflammatory granular tissue. Five patients were kept under conservative observation because of mild subjective symptoms or refusal to undergo operation. Two patients underwent stent procedures but had poor outcomes. Twelve patients underwent operation. As the bronchial lesions in four of them were confined to the lobar or segmental bronchus, lobectomy was performed. One patient with a history of infantile tuberculosis had developed complete obliteration of the left main bronchus and cystic bronchiectasis in the entire lung parenchyma; pneumonectomy was essential. Seven patients who had strictures involving the main bronchus underwent bronchoplastic surgery with right (n = 4) or left (n = 3) upper sleeve lobectomy. None of the patients treated surgically showed any postoperative complication or recurrence of the tuberculosis. These surgical results for endobronchial tuberculosis indicate the need for early detection and operation. Bronchoscopy and computed tomography are the methods of choice for accurate diagnosis of bronchial involvement and assessment of the surgical indications. It is emphasized that bronchoplastic surgery is the best treatment for bronchial stricture involving bilateral main bronchi.

Inhaled nitric oxide attenuates reperfusion injury in non-heartbeating-donor lung transplantation. Paris-Sud University Lung Transplantation Group

BACKGROUND

Non-heartbeating-donor (NHBD) lung transplantation could help reduce the current organ shortage. Polymorphonuclear neutrophil (PMN) activation plays a pivotal role in ischemia-reperfusion injury (I-R), and can be inhibited by nitric oxide (NO). We hypothesized that inhaled NO might be beneficial in NHBD lung transplantation.

METHODS

The effect of inhaled NO on PMNs was studied by measuring in vivo PMN lung sequestration (myeloperoxidase activity) and adhesion of recipient circulating PMNs to cultured pulmonary artery endothelial cells (PAECs) in vitro. Pigs were randomly assigned to an NO or a control group (n=9 each). In the NO group, cadavers and recipients were ventilated with oxygen and 30 parts per million of NO. After 3 hr of postmortem in situ warm ischemia and 2 hr of cold ischemia, left allotransplantation was performed. The right pulmonary artery was ligated, and hemodynamic and gas exchange data were recorded hourly for 9 hr. Recipient PMN adherence to tumor necrosis factor-alpha- and calcium ionophore-stimulated PAECs was measured before and after reperfusion, and lung PMN sequestration was determined after death.

RESULTS

NO-treated animals exhibited lowered pulmonary vascular resistance (P<0.01), as well as improved oxygenation (P<0.01) and survival (P<0.05). Adhesion of PMNs to PAECs was inhibited in the NO group before (P<0.001) and after reperfusion (P<0.0001). Lung PMN sequestration was reduced by NO (P<0.05).

CONCLUSIONS

Inhaled NO attenuates I-R injury after NHBD lung transplantation. This is likely due to the prevention of I-R-induced pulmonary vasoconstriction and to the direct effect on peripheral blood PMN adhesion to endothelium, which results in reduced sequestration and tissue injury.

Chemonucleolysis with human stromelysin-1

STUDY DESIGN

Immunohistologic analysis was performed on surgically removed samples of herniated nucleus pulposus to examine the expression of stromelysin-1. We performed in vitro and in vivo experiments to determine whether recombinant human (rh) stromelysin-1 is capable of degrading nucleus pulposus.

OBJECTIVE

To analyze the production of stromelysin-1 in various types of herniated nucleus pulposus, and to examine the effects of this recombinant protein on nucleus pulposus tissues.

SUMMARY OF BACKGROUND DATA

The authors previously demonstrated a progressive decrease in herniated nucleus pulposus size in some of the transligamentous and sequestration types of herniated nucleus pulposus using magnetic resonance imaging. An increased production of stromelysin-1, a cartilage proteoglycan degrading enzyme, in herniated nucleus pulposus was reported recently. The authors speculated that if stromelysin-1 is involved in the degradation of herniated nucleus pulposus, stromelysin-1 itself may be used as a chemonucleolytic agent.

METHODS

Immunohistologic analysis using streptoavidin-biotin method was performed on 20 herniated nucleus pulposus samples to investigate the expression of stromelysin-1. Five herniated nucleus pulposus samples were incubated in a tissue culture medium in the presence or absence of rh stromelysin-1. After 24 hours of incubation, their weight changes were measured, and the loss of proteoglycan was assessed by Safranin O staining. Rat nucleus pulposus tissues were obtained from coccygeal intervertebral discs, and autologous subcutaneous transplantation was performed. Rh stromelysin-1 was injected into the grafted materials, and the reduction in size was followed by two-dimensional measurements from the skin surface, using engineer's calipers.

RESULTS

Immunohistologic analysis demonstrated the production of stromelysin-1 in the granulation tissues of herniated nucleus pulposus. When stromelysin-1 was injected into the murine nucleus pulposus tissues, they reduced in size more rapidly than the control group. In addition, human herniated nucleus pulposus materials obtained at surgery showed significant weight loss when treated with stromelysin-1 in an organ culture system. Safranin O staining revealed extensive depletion of proteoglycan in these herniated nucleus pulposus samples.

CONCLUSIONS

Stromelysin-1 is a possible key enzyme in herniated nucleus pulposus resorption, and stromelysin-1 may be a good candidate for use in chemonucleolysis. Administration of human stromelysin-1 may physiologically facilitate the resorption process of herniated nucleus pulposus, increase the healing rate and decrease complications after chemonucleolysis.

Expression of Indian hedgehog in osteoblasts and its posttranscriptional regulation by transforming growth factor-beta

Indian hedgehog (Ihh) was recently reported to be expressed in chondrocytes and to regulate chondrocyte differentiation. This report examined the expression of Ihh in osteoblastic cells and its regulation by calcitropic cytokines. We found that Ihh messenger RNA (mRNA) was expressed as a single 2.5-kilobase band at a modest level in rat osteoblastic osteosarcoma ROS17/2.8 cells. In sharp contrast to the previous observation of dpp regulation of hedgehog expression in Drosophila embryos, bone morphogenetic protein-2 did not affect Ihh expression in these cells. On the other hand, treatment with 2 ng/ml transforming growth factor-beta1 (TGFbeta1) increased the steady state level of Ihh mRNA 2- to 4-fold. Western blot analysis of the cell lysates using antisera also showed enhancement of the Ihh protein level by TGFbeta1 treatment. The effect of TGFbeta1 on Ihh mRNA abundance started within 3 h, peaked at 24 h and lasted at least 48 h after the initiation of the treatment. The effect of TGFbeta1 on the increase in Ihh mRNA was dose dependent, starting at 0.2 ng/ml and saturating at 2 ng/ml. Neither actinomycin D nor cycloheximide blocked this effect. Experiments using 5,6-dichloro-1-beta-D-ribofuranosylbenzimidazole showed an enhancement of Ihh mRNA stability by TGFbeta1, indicating the presence of posttranscriptional regulation. We then examined the effects of TGFbeta1 on Ihh mRNA in osteoblast-enriched cells isolated from neonatal rat calvariae. TGFbeta1 also enhanced Ihh mRNA expression in these cells. Our data indicate for the first time that Ihh is one of the members of the cytokines produced by osteoblastic cells and that the expression of Ihh is regulated posttranscriptionally by TGFbeta.

Masking the protrusion of the receiver-stimulator of electronic implants in otology

Protrusion of the receiver-stimulator of a cochlear implant or a piezoelectric implantable hearing aid (IHA) was masked using bone dust applied in the gap between the receiver and the surrounding bone, making a smooth transitional border. The bone dust was then fixed with fibrin glue. Bone pâté (a mixture of bone dust and fibrin glue) was also used to fix the lead wire of a cochlear implant at the region of the posterior tympanotomy and to fasten an IHA vibrator holder to the temporal bone. Over the past two years, the use of these techniques in six patients with cochlear implants and two patients with IHAs has resulted in gratifying results; the edge of the receiver remained flush in all cases. They have been free from problems such as infection of the wound, necrosis of the overlying skin, and protrusion or migration of the receiver.