[Intraoral one-stage curved osteotomy for prominent mandibular angle]

OBJECTIVE

This paper presents a new method of osteotomy for the prominent mandibular angle (PMA).

METHODS

Two modifications have been made to the conventional procedures. The first is the one-stage curved osteotomy of the mandibular angle. The second is non-resection of the masseter muscle. The surgical procedure has been performed through an intraoral approach with a direct field of vision.

RESULTS

From December 1996 to December 1997, a total of thirty-eight patients suffering from PMA have been operated on by this method with satisfactory results. The follow-up is 3 to 12 months.

CONCLUSION

This method is a very simple and ideal procedure with much less complications for surgical treatment of PMA.

Sickle cell anemia as a possible state of enhanced anti-apoptotic tone: survival effect of vascular endothelial growth factor on circulating and unanchored endothelial cells

The biologic processes of apoptosis and angiogenesis are linked in endothelial biology because some endothelial cell growth factors also exert anti-apoptotic effects. We studied whether apoptosis is occurring in circulating endothelial cells (CEC) that have lost the survival signals derived from anchorage to extracellular matrix. Consistent with this expectation, 64% +/- 16% of CEC from normal donors showed evidence of apoptosis (by morphology and TdT-mediated dUTP nick end labeling [TUNEL] assay). However, only 30% +/- 15% (P <.001 v normal) of CEC from donors with sickle cell anemia were apoptotic. Vascular endothelial growth factor (VEGF) levels were significantly (P =.001) higher in plasma of sickle donors (120.1 +/- 81.4 pg/mL) than that of normal donors (37.6 +/- 34.6 pg/mL), and there was an inverse correlation between VEGF and CEC apoptosis (r =. 612, P =.001). Consistent with stimulation by VEGF, CEC from sickle donors exhibited increased expression of alphavbeta3. In vitro experiments showed that VEGF inhibits apoptosis for cultured endothelial cells that are kept unanchored and not allowed to re-establish attachment to extracellular matrix, thus demonstrating that VEGF provides survival signals independent of its ability to promote matrix reattachment. These data suggest the hypothesis that sickle cell anemia is a state of enhanced anti-apoptotic tone for endothelial cells. If true, this has implications for disease pathobiology, particularly the development of neovascularizing retinopathy.

Preparation and Characterization of Nanoscopic Organic Semiconductor of Oxovanadium Phthalocyanine

Nanoscopic particles of oxovanadium phthalocyanine (VOPc, phase-II) with different particle sizes are prepared by aggregation of VOPc molecules in the presence of surfactants for the first time. A size effect in the region of nanoscale was observed in the UV-visible spectra. The photoconductivity of the nanoscopic VOPc is much higher than that of bulk VOPc. Copyright 1999 Academic Press.

VEGF prevents apoptosis of human microvascular endothelial cells via opposing effects on MAPK/ERK and SAPK/JNK signaling

Vascular endothelial growth factor (VEGF), an endothelial cell-specific mitogen, promotes endothelial cell survival and angiogenesis. We recently showed that VEGF can support the growth of human dermal microvascular endothelial cells (HDMEC) and human umbilical vein endothelial cells in serum-free medium. Reasoning that VEGF might be modulating apoptotic signal transduction pathways, we examined mechanisms involved in the anti-apoptotic effect of VEGF on starvation- and ceramide-induced apoptosis in HDMEC. We observed that VEGF ameliorated the time-dependent increase in apoptosis, as demonstrated by morphologic observations, TUNEL assay, and DNA fragmentation. On the other hand, basic fibroblast growth factor only partially prevented apoptosis in serum-starved HDMEC; platelet-derived growth factor-BB was completely ineffective. VEGF activated the phosphorylation of extracellular signal regulated kinase (ERK)1 (p44 mitogen-activated protein kinase; MAPK) and ERK2 (p42 MAPK) in a time- and concentration-dependent manner. Both the VEGF-induced activation and its anti-apoptotic effect were prevented by the specific MAPK/ERK inhibitor PD98059. The presence of VEGF also inhibited the sustained activation of stress-activated protein kinase/c-jun-NH2-kinase (SAPK/JNK) caused by serum starvation and ceramide treatment. Activation of the MAPK pathway together with inhibition of SAPK/JNK activity by VEGF appears to be a key event in determining whether an endothelial cell survives or undergoes programmed cell death.

Peanut lectin-binding sites and mucins in benign and malignant colorectal tissues associated with schistomatosis

An immunohistochemical and histochemical comparative study was carried out in benign and malignant colorectal tissues with and without schistosomiasis. This included a quantitative determination of peanut lectin (PNA)-binding sites and proliferating cell nuclear antigen (PCNA) expression and histochemical detection of mucin changes. 133 cases were studied, including 70 cases of colorectal carcinoma associated with schistosomiasis (CCS) and 63 cases of colorectal carcinoma without schistosomiasis (CC). Significant differences were found in the type of mucin-containing carcinomas (MC) between CCS and CC. 65% of non-tumorous mucosa adjacent to MC of the CCS group expressed PNA-binding sites, significantly higher than those of the MC in the CC group (31%). The non-tumorous mucosa in cases of MC of the CCS group also showed a high percentage of sialomucin-predominant secretion (69%, vs 38% in MC of the CC group). Consistently, the presence of PNA-binding sites in MC tumors of the CCS group was increased, compared with that in the same subtype in the CC group (respectively 65% and 31% of strong positivity for PNA). However, no differences in expression of PNA and mucin changes were demonstrated in the surrounding mucosa and tumorous tissues of non-mucin-containing carcinomas (NMC) between CCS and CC. The expression of PCNA was not different between CCS and CC and their subtypes. Our findings suggest a close relationship between mucin-containing colorectal carcinomas and schistosomiasis japonica.

Tissue factor expression by endothelial cells in sickle cell anemia

The role of the vascular endothelium in activation of the coagulation system, a fundamental homeostatic mechanism of mammalian biology, is uncertain because there is little evidence indicating that endothelial cells in vivo express tissue factor (TF), the system's triggering mechanism. As a surrogate for vessel wall endothelium, we examined circulating endothelial cells (CEC) from normals and patients with sickle cell anemia, a disease associated with activation of coagulation. We find that sickle CEC abnormally express TF antigen (expressed as percent CEC that are TF-positive), with 66+/-13% positive in sickle patients in steady-state, 83+/-19% positive in sickle patients presenting with acute vasoocclusive episodes, and only 10+/-13% positive in normal controls. Repeated samplings confirmed this impression that TF expression is greater when sickle patients develop acute vasoocclusive episodes. Sickle CEC are also positive for TF mRNA, with excellent concurrence between antigen and mRNA expression. The TF expressed on the antigen-positive CEC is functional, as demonstrated by a binding assay for Factor VIIa and a chromogenic assay sensitive to generation of Factor Xa. By establishing that endothelial cells in vivo can express TF, these data imply that the vast endothelial surface area does provide an important pathophysiologic trigger for coagulation activation.

Complementation of an Escherichia coli polypeptide deformylase mutant with a gene from Clostridium acetobutylicum ATCC 824

The Clostridium acetobutylicum ATCC 824 DNA containing the 3' end of a PriA homolog, deformylase (def), and the 5' end of formyltransferase (fmt) has been cloned, sequenced, and used to complement an Escherichia coli mutant. While def and fmt have been found sharing an operon in other organisms, the presence of a third gene within a putative operon has not previously been found.

Labeling of recombinant protein for NMR spectroscopy: global and specific labeling of the rat liver fructose 2,6-bisphosphatase domain

Methods for the efficient use of the 13C-labeled nutrients, glucose and histidine, in the production of recombinant protein were developed to provide the large amount of sample required for NMR studies. The nutrient requirements were reduced by determining the minimum amount of these metabolites needed during both the growth and the induction phases of the BL21(DE3) and newly constructed BL21(DE3) histidine auxotrophic Escherichia coli cultures. These methods were developed using the separate bisphosphatase domain of rat liver 6-phosphofructo-2-kinase/ fructose-2,6-bisphosphatase, which is expressed to high levels in the pET3a/BL21 (DE3) bacterial system. Use of the optimized expression methods reduced the requirements for the labeled nutrients, glucose and histidine, by 90 and 93.8%, respectively. The savings realized by use of the minimized media and modified induction protocols were obtained without significant reduction of the yield of purified protein. Comprehensive study of the bisphosphatase domain by NMR spectroscopy requires large amounts of protein because of its low solubility and the short lifetime (2-3 days) of the NMR samples. The significant reduction in the costs of labeled protein samples realized by the optimized expression methods can meet these sample requirements in a cost-effective way, and thereby, allow NMR studies of the bisphosphatase domain to proceed.

Regulated expression of a repressor protein: FadR activates iclR

The control of the glyoxylate bypass operon (aceBAK) of Escherichia coli is mediated by two regulatory proteins, IclMR and FadR. IclMR is a repressor protein which has previously been shown to bind to a site which overlaps the aceBAK promoter. FAR is a repressor/activator protein which participates in control of the genes of fatty acid metabolism. A sequence just upstream of the iclR promoter bears a striking resemblance to FadR binding sites found in the fatty acid metabolic genes. The in vitro binding specificity of FadR, determined by oligonucleotide selection, was in good agreement with the sequences of these sites. The ability of FadR to bind to the site associated with iclR was demonstrated by gel shift and DNase I footprint analyses. Disruption of FadR or inactivation of the FadR binding site of iclR decreased the expression of an iclR::lacZ operon fusion, indicating that FadR activates the expression of iclR. It has been reported that disruption of fadR increases the expression of aceBAK. We observed a similar increase when we inactivated the FadR binding site of an iclR+ allele. This result suggests that FadR regulates aceBAK indirectly by altering the expression of IclR.

Effects of Coriolus versicolor polysaccharides on superoxide dismutase activities in mice

AIM

To study if Coriolus versicolor polysaccharides (CVP) influence the superoxide dismutase (SOD) activities in mice.

METHODS

Normal, tumor-bearing, and radiated ICR mice were injected ip with CVP daily for 3-15 d. The SOD activity was assayed by epinephrine autoxidation test.

RESULTS

The SOD activities in lymphocytes and thymus were increased by CVP in both the normal mice with or without delayed hypersensitivity (DH). In tumor-bearing mice, CVP exerted not only inhibitory effects on tumor, growth and SOD activity in tumor tissue but also complete or partial restorative effects on the suppressed DH and on the declined SOD activities in lymphocytes, spleen, and thymus. The total SOD and manganese-containing SOD (MnSOD) activities in lymphocytes and thymus were dose-dependently enhanced by CVP (5-20 mg.kg-1) on d 3 after the tumor transplantation. In the mice exposed to 60Co (3 or 6 Gy), DH and SOD activities were dose-dependently decreased. These changes were completely or partly prevented by CVP.

CONCLUSION

CVP exerted the favorable effects on SOD activities in mice. Coriolus versicolor polysaccharides (CVP) exert inhibitory effects on experimental and clinical tumors. These effects are presumed to be mediated mainly by host-defence mechanism, especially immunological responeses. Superoxide dismutase (SOD) plays an important role in protecting cells against superoxide radical (O2-.) damages and over-production of O2-. or SOD abnormities exist in many diseases. The present study was to investigate if the CVP could exert some favorable effects on SOD activities in vivo.

Autoregulation of iclR, the gene encoding the repressor of the glyoxylate bypass operon

The aceBAK operon was partially induced by a multicopy plasmid which carried the promoter region of the gene which encodes its repressor, iclR. Gel shift and DNase I analyses demonstrated that IclR binds to its own promoter. Disruption of iclR increased the expression of an iclR::lacZ operon fusion. Although aceBAK and iclR are both regulated by IclR, aceBAK expression responds to the carbon source, while expression of iclR does not.

Differences in colorectal cancer between China and Japan: a clinical and histological study of two groups of cases

It is well known that most tumours are attributed to life style, especially the tumours of the digestive system. Clinical and histopathological investigation of tumours in different human groups and societies, and analysis of the variations will provide evidence for this, and is one of the approaches to study carcinogens. Clinical data obtained from 391 patients with colorectal cancer at the Sakai Municipal Hospital, Japan, and Shanghai Jinshan Hospital and Cancer Hospital, China, from 1987 to 1992, included the sex, age and tumour subsite. Sections of histological specimens were also retrieved. The results were compared between two countries. The average age of patients with colorectal cancer in Shanghai was 8.5 years less than in the Sakai group. The age peak of the former was 51-60, and in the latter, 61-70 years. The most frequent site of the cancer in the Shanghai group was the rectum, contrasting with the higher percentage of sigmoid colon cancer in Sakai group. There was also a significant difference in histological subtype of the cancer between the two groups. Mucinous adenocarcinoma was notably more common in the Shanghai group than in the Sakai group, and the high frequency was mainly in the colon. All of the variations were suggested to be attributable to differing socioeconomic circumstances and lifestyle, especially the dietary habits of the countries.

CT diagnosis of renal vein thrombosis in nephrotic syndrome

Forty-seven patients with nephrotic syndrome were prospectively studied for renal vein (RVT) and inferior vena caval (IVCT) thrombosis with dynamic CT. Renal venography and inferior vena cavography was performed on the 12 patients with and on 5 of the patients without CT evidence of thrombosis. Dynamic CT revealed thrombi in 12 of 47 (26%) of the cases (RVT in 8, IVCT in 5); all were confirmed by venography. In one of the cases with RVT, a thrombus in a superior branch of the left renal vein was revealed by venography but not by CT. Venography was normal in all five patients evaluated with normal dynamic CT. We believe that dynamic CT can be used to effectively examine patients with suspected RVT.

Ossification of the spinal ligament. A radiographic reevaluation in Bologna, Italy

A radiographic reevaluation of cervical spine films of 1,258 adult patients and of thoraco-lumbar spine films of 488 of these was performed at the Rizzoli Orthopaedic Institute (Bologne, Italy), in order to detect ossification of the posterior longitudinal ligament (OPLL), the anterior longitudinal ligament (OALL), the yellow ligament (OYL) and the nuchal ligament at the cervical level, and OPLL, OALL and OYL at the thoraco-lumbar level. The incidence of OALL, OYL and ossification of the nuchal ligament corresponded with those previously reported in the literature. Cervical OPLL was found in 1.83%, with a definite prevalence in the 45-64 age group where the figure was 2.83%. This incidence is much higher than that hitherto reported in Caucasians, and is nearly the same as that in Japan. Possible explanations for this discrepancy are proposed.

The treatment of acetabular fractures

The results are reported of 52 acetabular fractures treated surgically and followed up for 6 to 16 years. The cases were sufficiently comparable for statistically significant analysis. Satisfactory results were obtained in 34 cases (65%), and poor in 18 (35%). The poor results were due to: epiphyseal necrosis (8%), secondary arthritis (17%), periarticular ossification (9%). The treatment of these poor results is discussed, including the indications for intertrochanteric osteotomy and, in particular, total hip replacement.

Cervical myelopathy due to ossification of the posterior longitudinal ligament

Ossification of the posterior longitudinal ligament in the cervical spine may be a cause of cervical myelopathy. This ossification has often been encountered in Japan, but only sporadically among the Caucasian races. It is therefore probable that racial factors are relevant to the pathology. During the past four years, due to the routine use of computerised axial tomography (CAT) in the pre-operative study of cervical myelopathy, we were able to show that in 13 cases stenosis of the vertebral canal was due to ossification of the posterior longitudinal ligament. This was visible in the standard radiographs in only two out of these 13 cases. The clinical data, diagnostic criteria and results of treatment are reported. This is the largest series yet reported outside Japan.

Cervical myelopathy. Technique and results of spinal cord decompression by lateral laminectomy

The Authors describe the technique of lateral laminectomy devised by Gui in 1965 for the treatment of cervical myelopathy secondary to cervical spondylosis. Spinal cord decompression is obtained by a lateral laminectomy with the maximum saving of bone, ligaments and muscles of the cervical spine. CAT scan demonstrated very well the effective decompression of the spinal cord achieved with this technique. The results of 87 cases treated in this way between 1968 and 1980 are reported. The average follow-up was 2.5 years. There was an improvement in the neurological symptoms in 82% of the cases.

Diagnosis and treatment of cervical instability

Instability of the cervical spine gives rise to vertebral and neurological symptoms which may be progressive. The principal causes of instability are: trauma, sequelae of laminectomy, malformations, vertebral infections, rheumatoid arthritis, primary tumours (benign and malignant), metastases, and chronic degenerative disease of the discs. Each of these forms of instability must be identified and, depending on the symptoms and pathogenesis, is capable of responding to the appropriate treatment.

A new device ("G3 - IOR") for external fixation

External fixation is nowadays an essential part of orthopaedic and traumatological surgery, since it offers a method of firm fixation, which can be applied at some distance from the fracture. It is easy to apply and to remove and, most important, there is no direct contact with the fracture site. THe writers present an apparatus of their own design which should eliminate all the disadvantages of the apparatus at present in use, while at the same time being simpler to apply and more effective in action.