Preprosthetic surgery for severely atrophic maxilla with poor palatal vault form; report of two cases treated by hard palate compression through palatal vault osteotomy

Two cases of severely atrophic maxilla with poor palatal vault form treated by Kitayama's modified palatal vault osteotomy technique are described. The advantages of this osteotomy technique are outlined in comparison with other surgical methods.

Comparison of sedative and analgesic/anesthetic effects induced by medetomidine, acepromazine, azaperone, droperidol and midazolam in laboratory pigs

The sedative and analgesic/anesthetic effects of medetomidine, acepromazine, azaperone, droperidol and midazolam were compared in laboratory pigs. In these sedatives, medetomidine produced the most profound degree of sedation with greater drowsiness than was achieved by other sedatives tested. Medetomidine induced sedation accompanied with weak analgesia and muscle relaxation smoothly and quickly and depressed arousal reaction deeply as compared with other sedatives. Pigs given medetomidine were not aroused easily even by moderately rough stimulation for approximately 60 min after injection.

[Muscle fiber conduction velocity in right and left biceps brachii for badminton players]

The purpose of this study was to investigate the laterality of muscle fiber conduction velocity in biceps brachii for badminton players, who have stronger arm in the handedness side for long term training. The muscle fiber conduction velocity was calculated from the propagation time of the action potentials along the muscle fibers and the electrode separation using cross-correlation method. For badminton players, significant lateral differences (e.g. right side skillful) were observed in the upper arm girth (P < 0.01) and isokinetic peak torque at 0, 10, 20, 30, 40 rpm (P < 0.01). For control subjects, significant lateral differences were in upper arm girth (P < 0.05) and isokinetic peak torque at exactly 30 rpm (P < 0.05). As for muscle fiber conduction velocity, there were no statistically significant differences between right (4.16 +/- 0.34 m/sec) and left (4.08 +/- 0.34 m/sec) sides in badminton players, and the control group exhibited same tendency (right: 4.36 +/- 0.25 m/sec, left: 4.28 +/- 0.33 m/sec) as well. These results suggest no training-induced change in the muscle fiber conduction velocity.

Use of two miniplates for intermaxillary skeletal fixation in the treatment of jaw deformity and fracture

Special techniques of skeletal intermaxillary fixation are described, which may be used in edentulous patients or those with many missing teeth or multiple fractures of the jaw. Two such cases are described in which the usual fixation techniques could not provide sufficient stabilization because of linguoversion and mesioversion or lack of teeth, resulting in inability to maintain a vertical interocclusal relationship. Two long eight-hole Champy miniplates were therefore used distally to the canines on both sides. In the first case, they provided fixation following a sagittal ramus osteotomy to advance the mandible, and in the second case they were used in the treatment of a mandibular fracture.

Marine natural products against tumor development

This review article deals with significant effects of marine natural products in carcinogenesis, namely as chemical probes to understand the process of carcinogenesis and as possible cancer preventive agents in humans.

Antagonism of Medetomidine Sedation by Atipamezole in Pigs

The efficacy of atipamezole as a medetomidine antagonist was evaluated in pigs. The atipamezole doses (intramuscularly) were 80, 160, 320 and 480 micrograms/kg of body weight, which were one, two, four and six times higher than the preceding medetomidine dose (80 micrograms/kg, intramuscularly). Atipamezole effectively reversed medetomidine-induced sedation, and the optimal action was seen at doses of 160 and 320 micrograms/kg. Recovery from sedation was quick and smooth, and adverse effects such as hyperactivity or tachycardia were minimal with either dose.

Genetic study of ossification of the posterior longitudinal ligament in the cervical spine with human leukocyte antigen haplotype

To evaluate the genetic background of ossification of the posterior longitudinal ligament, the relationship between the presence of absence of ossification and human leukocyte antigen haplotypes was studied in 33 families of patients with ossification of the posterior longitudinal ligament. The study revealed that human leukocyte antigen haplotypes formed certain types of clusters, and that some human leukocyte antigen haplotypes were very rare in the Japanese population, suggesting the involvement of human leukocyte antigen-linked factors in the pathogenesis of ossification of the posterior longitudinal ligament of the cervical spine. In the families of these patients, ossification of the posterior longitudinal ligament was demonstrated by radiography in 56% (10/18) of the siblings. Each of these siblings shared both human leukocyte antigen haplotypes with the patient. None of those who shared only one human leukocyte antigen haplotype with the patient had developed ossification of the posterior longitudinal ligament. From these findings, the presence of both pathogenic human leukocyte antigen haplotypes is considered to be necessary for the development of ossification of the posterior longitudinal ligament, and this genetic predisposition may be activated by multiple factors, including regressive degeneration due to aging and the environment.

Differential effects of cryptoporic acids D and E, inhibitors of superoxide anion radical release, on tumor promotion of okadaic acid in mouse skin

Cryptoporic acids D and E, isolated from the fungus Cryptoporus volvatus, are inhibitors of superoxide anion radical release. Cryptoporic acid E inhibited tumor promotion of okadaic acid in two-stage carcinogenesis experiments on mouse skin, initiated with 7,12-dimethylbenz[a]anthracene. Treatment with cryptoporic acid E using two different doses per application, 1 (1.2 mumol) and 5 mg (5.9 mumol), reduced the percentage of tumor-bearing mice from 73.3 to 53.3% and 20.0%, and the average number of tumors per mouse from 4.2 to 2.3 and 0.5 respectively in week 20 of tumor promotion. However, cryptoporic acid D slightly enhanced tumor promotion rather than inhibition of okadaic acid. Cryptoporic acid D was expected to have additional biochemical activities, such as activation of protein kinases. Cryptoporic acid D at concentrations of up to 100 microM activated protein kinase C and stimulated other protein kinase activity in vitro, whereas cryptoporic acid E did not. These two compounds provided differential effects on tumor promotion of okadaic acid on mouse skin.

Natural history of degenerative spondylolisthesis. Pathogenesis and natural course of the slippage

To clarify the natural course of degenerative spondylolisthesis, the mechanism and progression of disk slippage were studied clinically and radiographically in 40 patients. Progressive slippage was observed in 12 patients (30%). No progression of slippage was noted in patients who showed narrowing of the intervertebral disk, spur formation, subcartilaginous sclerosis, or ossification of ligaments. These suggest that the mechanisms of spinal restabilization prevent progression of the disease. General joint laxity was observed in many patients (65%), and this was believed to be involved in the pathogenic mechanism of this disease. There was no correlation between the clinical symptoms and progression of slippage. These findings suggest that careful consideration of the natural mechanisms of spinal restabilization as well as the natural course of the disease is important.

Anti-tumor-promoting activity of derivatives of abieslactone, a natural triterpenoid isolated from several Abies genus

Abiesenonic acid methyl ester (AVB-I acid methyl ester), a triterpenoid compound prepared from abieslactone, suppressed tumor promoter-induced phenomena in vitro and in vivo; i.e., AVB-I acid methyl ester inhibited 12-o-tetradecanoylphorbol-13-acetate (TPA)-stimulated 32Pi-incorporation into phospholipids of cultured cells and the promoting action of TPA on skin tumor formation in mice initiated with 7,12-dimethylbenz[a]anthracene.

Occipitoatlantoaxial fusion utilizing a rectangular rod

Atlantoaxial subluxation has been treated conventionally by Gallie posterior fusion. This technique, however, has disadvantages such as the frequent occurrence of pseudarthrosis, a high probability of relapse, and the necessity of long-standing strict external fixation until bone fusion. To overcome these problems, posterior occipitoatlantoaxial fusion was performed using a rectangular rod that assures strong internal fixation in 16 patients with atlantoaxial subluxation. The condition was complicated by superior migration of the dens in five patients. Clinical and roentgenographic examinations before and after the operation showed improvements in neurological symptoms and in pain in the neck and occipital region in all patients. Bone fusion was observed in all patients and reduction, performed to the extent possible during the operation, was retained adequately. The present method, which provides strong internal fixation, allows bone fusion and early initiation of rehabilitation with a simple external support of the neck. It also facilitates laminectomy of C1 in patients with associated myelopathy. This procedure, therefore, is particularly effective in patients with marked instability or with rheumatoid arthritis and makes postoperative application of a halo vest or skull traction unnecessary.

[A phase II study of Futraful suppository in head and neck cancer]

A phase II study of FT-207 suppository (Futraful Suppository) for head and neck cancer was conducted at the Kagoshima University Hospital Dept. of Otorhinolaryngology and its 6 affiliated hospitals. Forty cases with head and neck cancer were entered in the trial, of which 37 were perfectly evaluable. Partial response (PR) (16.7%) was achieved in one of 6 patients with maxillary cancer, in 2 of 9 cases with oral cancer (22.2%), in one of 7 with laryngeal cancer (14.3%), in 3 of 13 with pharyngeal cancer, while 2 of the same 13 achieved a complete response (CR) (38.5%), for a total response rate of 24.3%. FT-207 suppository was continuously administered as standard, at a dose of 750 mg each twice daily, or 1,500 mg/day. The response rate was dose-dependent; 2 CR cases with a total dose of 105 g for administration over a total period of more than 150 days. Adverse effects appearing in 35.0% of the overall were mainly anorexia, nausea and vomiting; none of them, however, were serious.

Properties of two toxins isolated from the blue-green alga Microcystis aeruginosa

Attempts were made to characterize the two toxins (P-1 and P-2) isolated from the blue-green alga Microcystis aeruginosa, by amino acid analysis, mass spectrometry, 1H- and 13C-NMR. P-2, the major toxin, had a molecular weight of 1044, and consisted of one molecule each of beta-methylaspartic acid, D-Glu, D-Ala, L-Arg, L-Tyr, N-methyldehydroalanine, and 3-amino-9-methoxy-2,6,8-trimethyl-10-phenyldeca-4,6-dienoic acid (Adda). P-1, with a molecular weight of 994, appeared to have almost the same composition except that it contained L-Leu instead of L-Tyr in P-2. Mass spectrometric studies, along with a negative ninhydrin reaction, indicated that each toxin was a cyclic peptide. P-2 showed an LD99 of 70 micrograms/kg mice when injected i.p. and [alpha]D24 of -72.42 degrees (c = 0.095 in methanol), and was decomposed at around 218 degrees C.

(+)-Curcuphenol and dehydrocurcuphenol, novel sesquiterpenes which inhibit H,K-ATPase, from a marine sponge Epipolasis sp

Two H,K-ATPase inhibitors and an inactive related compound have been isolated from a marine sponge Epipolasis sp. They are aromatic sesquiterpene alpha-curcumenes.

Isolation of a hexaprenylhydroquinone sulfate from the marine sponge Dysidea sp. as an H,K-ATPase inhibitor

A hexaprenylhydroquinone sulfate has been isolated as an H,K-ATPase inhibitor from a marine sponge Dysidea sp. It also inhibited phospholipase A2 as well as secretion of gastric acid in rats.

3-Amino-3-deoxy-D-glucose: an antibiotic produced by a deep-sea bacterium

Gram-positive bacteria isolated from deep-sea sediments of the Pacific basin showed considerable antibacterial activity. A Bacillus strain, isolated from a sediment sample collected at a depth of 4310 m, was shown to produce 3-amino-3-deoxy-D-glucose, a known antibiotic.

Histological and histochemical investigations of constant direct current stimulated intramedullary callus

A morphometrical study of the intramedullary callus directly stimulated by electricity was carried out to clarify the relation between callus formation and locus of the cathode. A histochemical study of the cells which appeared in the bone marrow after electrical stimulation indicated promotion of osteogenesis by electrical stimulation by direct activation of osteoblast differentiation. The author used alkaline phosphatase (ALP) activity as a marker of osteoblast. Electrically induced callus formation increased significantly within 0.5 cm of the tip of the cathode. The callus encircled the cathode in a cylindrical fashion at the tip of the cathode. No callus formation from the endosteum was observed. Under histochemical investigation, although the cell morphologically regarded as the osteoblast revealed strong ALP activity on the cell membrane and the Golgi apparatus, mature osteocytes revealed no activity. These findings support the view that electrical stimulation promote osteoblast differentiation.

Detection of autoantibodies to thyroid peroxidase in autoimmune thyroid diseases by micro-ELISA and immunoblotting

Serum autoantibodies to thyroid peroxidase (TPO) in patients with thyroid autoimmune diseases were studied by micro-ELISA and immunoblotting. Twenty-four patients, 15 with Graves' disease and 9 with Hashimoto's thyroiditis, whose serum titers were greater than 3200 on the microsomal hemagglutination test (except for 1 patient with a titer of 800) had autoantibodies to TPO. Both immunoglobulin G and M classes of autoantibodies were detected, with the former being more prominent. When TPO and thyroid microsomes were used as a target in a competitive binding inhibition test, the results suggested that TPO was a major thyroid microsomal antigen. On the other hand, immunoblotting analysis showed 3-4 bands in the 45-60K region stained by patients' sera in addition to human TPO with mol wt of 100K and 107K; only the latter 2 bands stained with antiporcine TPO antibody. In the majority of sera, TPO bands were clearer than others, although some sera showed the clearest band with a mol wt of 55K. These results indicate that patients with autoimmune thyroid disease often have autoantibodies to TPO that can be detected by micro-ELISA and immunoblotting, and that TPO is a major component of the thyroid microsomal antigen.

[A case of amylase-producing ovarian tumor]

A 51-year-old woman with ovarian carcinoma with hyperamylasemia is reported. She was admitted to Osaka General (JNR) Hospital in July 1982. A cystic tumor was palpated in the pelvis. Serum amylase, mainly the salivary type, in electrophoresis, had increased to 1583 Smith-Roe units/dL, while the pancreas was normal on ultrasonography and CT. Chemotherapy (MFC) was performed, and laparotomy revealed bilateral ovarian tumors. Histologically, they were serous cystadenocarcinoma. Serum and urinary amylase values dropped to the normal range after chemotherapy and surgery, and varied directly with the clinical course. Immunohistochemically, amylase was demonstrated in the tumor tissue by the PAP method. In conclusion, amylase was a useful marker in the diagnosis and follow-up of the present patient.

Isolation and identification of three hemolysins from the hydroid Solanderia secunda (Inaba)

Three hemolytic constituents have been isolated from the hydroid Solanderia secunda. They have been identified by spectral and chemical degradation as 1-hexadecyl-sn-glycerol-3-phosphorylcholine, 1-tetradecyl-sn-glycerol-3-phosphorylcholine and 1-(1-hexadecenyl)-sn-glycerol-3-phosphorylethanolamine.

[Marked right ventricular outflow obstruction in two children with hypertrophic cardiomyopathy]

Two children, aged one year and nine months, and six years, both with hypertrophic cardiomyopathy, presented as severe right ventricular outflow obstruction were presented. Initially, both of them were suspected of having heart disease because of precordial systolic murmurs. Their tentative diagnosis was pulmonary stenosis. Their apex cardiograms and carotid pulse waves were not diagnostic. Asymmetrical septal hypertrophy with systolic anterior motion of the mitral valve was identified by echocardiography in both cases. Cardiac catheterization revealed left ventricular outflow tract pressure gradients of 5 mmHg and 30 mmHg, respectively. The right ventricular peak systolic gradient was 100 mmHg and 82 mmHg and left ventricular end-diastolic pressure was 26 mmHg and 18 mmHg, respectively. Selective right and left ventricular angiocardiograms demonstrated severe right ventricular outflow obstruction, and hypertrophy of the interventricular septum. One of them underwent resection of the right ventricular outflow tract muscle, which showed histological findings characteristic of hypertrophic cardiomyopathy. This patient died suddenly at the age of 10 years. Infants or young children with hypertrophic cardiomyopathy often have associated predominant right ventricular outflow tract obstruction, progressive congestive heart failure, and death. Therefore, correct diagnosis and careful treatment are mandatory for proper management.

[Usefulness of contrast echoangiographic diagnosis of congenital tricuspid stenosis]

Congenital tricuspid stenosis is an uncommon congenital anomaly and usually associated with other lesions such as severe pulmonic stenosis or atresia. Sometimes, it is difficult to diagnose this malformation non-invasively, but the differential diagnosis from tricuspid atresia is essential for the surgical considerations. Described here were three patients with congenital tricuspid stenosis who were successfully diagnosed by contrast echoangiography using peripheral venous injection of the contrast medium. Contrast echoes appeared in the right atrium initially and then in the right ventricle through the stenotic tricuspid valve. In conclusion, contrast echoangiography is mandatory in the diagnosis of this entity.

[Echocardiographic assessment of anatomical detail in patients with hypoplastic left heart syndrome]

Hypoplastic left heart syndrome is a disease with poor prognosis, which is characterized by severe heart failure in early neonatal period. However, there are some patients who survive for relatively longer period. In the light of this fact, 18 patients with this syndrome were studied by echocardiography, and the anatomical and functional classification was attempted. Hypoplastic left heart syndrome was classified into three types: type I was mitral atresia and aortic atresia, type II was mitral atresia and aortic stenosis, and type III was mitral atresia with an abnormality of cono-truncal relationship, respectively. M-mode echocardiography was performed in 15 of the 18 patients, and two-dimensional echocardiograms were recorded in seven cases. Heart catheterization was performed in all patients. Autopsy was performed on 14 of the 18 patients, and its findings were compared with the findings obtained by echocardiography. Two-dimensional echocardiographic classification of this syndrome was possible in all the patients using above-mentioned criteria. Patent ductus arteriosus was detected in two of six cases having this syndrome, and foramen ovale in 4 of 5 cases. The morphological evaluation of both the interatrial and interventricular septum was made by two-dimensional echocardiography, and it contributed to decide the indication of balloon-atrial septostomy. The patients with type I had the poorest prognosis, and the patients with type III survived longer period. Anatomical classification of this syndrome and detection of associated anomalies by two-dimensional echocardiography are recommended to consider the prognostic and surgical considerations.

Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study

Between January 1973 and December 1979, 290 patients with Kawasaki disease were evaluated with coronary angiography after the acute stage of illness. Of these patients, 43 (15 percent) were diagnosed as having coronary aneurysms. Forty-two patients have been followed up for an average of 4 years (range 15 months to 8 years). One 8 month old girl died of myocardial infarction after 4 months of illness. Follow-up coronary angiography was performed in 42 patients 5 to 18 months after the acute illness. Four groups can be distinguished. Group I: In 21 (50 percent) of 42 patients angiography showed that the coronary aneurysms had regressed, so that no observable lesions were seen. During convalescence, electrocardiography, exercise stress testing and thallium scintigraphy were within normal limits. In the other 21 patients abnormal findings persisted on follow-up angiography. Group II: Ten patients showed persistent coronary aneurysms, although reduced in size. Group III: In seven patients the aneurysms had disappeared, but complete obstruction or marked stenosis of coronary arteries was found. Group IV: In four patients, irregularities of the coronary arterial wall without stenosis were seen. Among patients with abnormal angiographic findings myocardial infarction and mitral regurgitation were also seen. Early initiation of aspirin therapy aneurysms show regression on angiography in 1 or 2 years in about half of patients. The remaining patients are at risk for ischemic heart disease. Thus, Kawasaki disease should be considered an important cause of ischemic heart disease in children and a possible risk factor of premature coronary atherosclerosis.

[Fetal echocardiography: structural evaluation of the fetal heart and prenatal diagnosis of congenital heart disease (author's transl)]

Two-dimensional echocardiography has developed to the routine examination to diagnose congenital heart disease. In this study, we studied the value of two-dimensional echocardiography for evaluating the development of the fetal heart and for prenatal diagnosis of congenital heart disease. We studied 100 fetuses whose gestational ages were 16-40 weeks of pregnancy. The examination was performed with Toshiba Sonolayer-V model SSL-53M. The scanners were the 2.25 MHz linear and sector transducers. The images were recorded on videotapes. Changing the scanner direction according to the fetal position, we recorded the left ventricular long-axis view, short-axis view of great arteries and four-chamber view. In the four-chamber view, diameters of the tricuspid and mitral valve rings were measured. In the short-axis view of great arteries, the diameters of the aorta and pulmonary artery were measured. We identified the right and left ventricles by detecting both the great arteries and attaching sites of the atrioventricular valves. The identification of the aorta was made by detecting the arch and the identification of the pulmonary artery was made by depicting its two branches. Cardiac structures were identified on the fetus over five months of pregnancy. In many instances recordings were obtained in 7 months fetuses. The success rate to get clear recordings was 88% of all cases in the four-chamber view, 75% in the short-axis view of great arteries and 71% in the left ventricular long-axis view, respectively. The average ratio of the mitral to tricuspid valvular diameter and that of the pulmonary arterial to aortic diameter were both less than 1, suggesting the right ventricular dominance in fetal hearts. From these findings, it might be possible to diagnose prenatally certain congenital heart diseases such as atrioventricular valve atresia and semilunar valve atresia which require the critical evaluation and management in the neonatal periods.