Dietary threonine prevented stress-related mucosal diseases in rats

Stress-related mucosal disease (SRMD), or stress ulceration, is a group of conditions ranging from stress-related superficial gastric mucosal damage to deep gastric ulcers that are primarily correlated with mucosal ischemia, and pharmacologic interventions that optimize tissue perfusion or preserve defensive mucus aim to decrease the occurrence of conditions, such as gastric acidity, or enhance gastric defenses. However, the identification of multifactorial pathogenesis may be effective in preventing SMRD, and the use of stress prophylaxis is generally preferred. Since threonine is a component in the polymerization and synthesis of gastric mucin and possibly enhanced defense actions and lignin may provide structural support for defense and antioxidative function, we hypothesized that dietary intake of threonine and/or lignin can enhance defense against SRMD. The water immersion-restraint stress (WIRS) was used in rats and additional groups were pretreated with threonine alone or the combination of threonine and lignin. Based on gross and microscopic evaluations, threonine alone or the combination of threonine and lignin, a natural antioxidant, significantly reduced the development of SRMD (P < 0.05). According to molecular explorations, the levels of inflammatory mediators, such as interleukin (IL)-8, IL-6, IL-1β, inducible nitric oxide synthase (iNOS), tumor necrosis factor alpha (TNF-α), and interferon gamma (IFN-γ), all of which are mediators that play a significant role in controlling WIRS, significantly decreased in the groups pretreated with either threonine alone or the combination of threonine and lignin (P < 0.01). WIRS significantly increased apoptosis in the stomach. However, the apoptotic index significantly decreased with threonine pretreatment. According to periodic acid Schiff staining results, the expression of gastric mucin was significantly preserved in groups pretreated with threonine but remarkedly decreased in the WIRS group. The gastric heme oxygenase-1 levels significantly increased in the group treated with threonine. In conclusion, the dietary intake of threonine or the combination of threonine and lignin is effective in preventing SRMD.

Atypical granular cell tumor in the maxilla: The first report of primary intraosseous granular cell tumor

BACKGROUND

Granular cell tumor (GCT) is a benign soft tissue tumor of neural origin and is characterized by eosinophilic granular cells showing positivity for neuronal markers. Herein, we report the first case of primary intraosseous GCT arising in the maxilla of an adolescent girl.

METHODS AND RESULTS

A 16-year-old female patient presented with palatal swelling. Radiographic findings revealed a well-defined radiolucent lesion centrally located in the right maxilla. Mass excision was performed, and histopathologic examination showed sheets and cords of eosinophilic granular cells with cellular pleomorphism. Tumor cells were strongly positive for vimentin, S-100 protein, and CD56, and negative for cytokeratin, desmin, smooth muscle actin, and c-kit. High expression of p53 and Ki-67 was found. The final diagnosis was atypical GCT.

CONCLUSION

When evaluating an intraosseous radiolucent lesion with histopathologic features of granular cells, clinicians and pathologists should include GCT in the differential diagnosis. © 2016 Wiley Periodicals, Inc. Head Neck 38:E2467-E2470, 2016.

Chondrosarcoma of the temporomandibular joint: a case report and review of the literature

OBJECTIVE

Chondrosarcoma is the second most common sarcoma arising in the bone, but it rarely involves the temporomandibular joint (TMJ). To date, 30 cases of TMJ chondrosarcoma have been reported in the English literature, and the authors report an additional case arising from a cystic lesion in a 60-year-old female patient.

CLINICAL PRESENTATION

The clinical and radiological diagnosis of the lesion was initially synovial cyst, and periodic check-ups were done after aspiration of the lesion. After three years, the patient perceived swelling of the lesion, and surgical excision was performed. The final diagnosis was grade I chondrosarcoma.

CONCLUSION

When clinicians detect a cystic lesion in the radiographic imaging of the TMJ, chondrosarcoma should be included in the differential diagnosis. In addition, computed tomography (CT) as well as magnetic resonance imaging (MRI) is recommended for the accurate diagnosis and proper preoperative planning in TMJ chondrosarcoma.

The Effect of a Combination of Implant Controller and Handpiece from Different Manufacturers on the Torque Value

PURPOSE

To determine the accuracy of applied torque of different implant controller and handpiece combinations by using an electronic torque gauge.

MATERIALS AND METHODS

Four combinations of the following devices were tested: Surgic XT controller (NSK), XIP10 controller (Saeshin), X-SG20L handpiece (NSK), CRB26LX handpiece (Saeshin). For five torque settings, 30 measurements were recorded at 30 revolutions per minute by using an electronic torque gauge fixed to jigs, and means were calculated.

RESULTS

Applied torques were generally higher than the set torque of 10 and 20 Ncm and lower than the set values of 40 and 50 Ncm. The average torque deviations differed significantly among the combinations (P < .05). At 10 and 20 Ncm, the Surgic XT/X-SG20L combination yielded the closest value to the intended torque, followed by the XIP10/X-SG20L combination. At 30 Ncm, the XIP10/X-SG20L combination showed the nearest value. At 40 Ncm, the Surgic XT/X-SG20L, XIP10/CRB26LX, and XIP10/X-SG20L combinations showed deviations within 10%. At 50 Ncm, all the combinations showed lower applied torque than the set value. Large standard deviations were observed in the Surgic XT/CRB26LX (13.288) and Surgic XT/X-SG20L (7.858) combinations.

CONCLUSION

Different combinations of implant controllers and handpieces do not generate significant variations in applied torque. The actual torque varies according to the torque setting. It is necessary to calibrate devices before use to reduce potentially problematic torque.

The potential of interleukin 12 receptor beta 2 (IL12RB2) and tumor necrosis factor receptor superfamily member 8 (TNFRSF8) gene as diagnostic biomarkers of oral lichen planus (OLP)

OBJECTIVE

This study evaluated the potential of interleukin 12 receptor beta 2 and tumor necrosis factor receptor superfamily member 8 as diagnostic biomarkers of oral lichen planus (OLP).

MATERIALS AND METHODS

The mRNA expression of IL12RB2 and TNFRSF8 in FFPE OLP samples (OLP group, n = 38) were investigated with quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) analysis and compared to those of chronic non-specific mucositis (Non-OLP group, n = 25) and normal mucosa (Normal group, n = 18). Predictive modeling of the expression of IL12RB2 and TNFRSF8 was constructed using support vector machine (SVM), random forest (RF), linear discriminant analysis (LDA), neural network (NN) and naive Bayes (NB) methods.

RESULTS

Normalized expression of IL12RB2 in the OLP group (3.78 ± 1.67) was significantly higher than the Normal group (1.97 ± 1.12), but lower than the Non-OLP group (6.86 ± 1.67). TNFRSF8 gene expression in the OLP group (7.46 ± 1.51) was significantly higher than the Normal group (2.90 ± 1.61), but no significant difference was found between the OLP and Non-OLP groups. The ratio of IL12RB2/TNFRSF8 in the OLP group (0.52 ± 0.23) was significantly lower than the Normal group (0.74 ± 0.39) and the Non-OLP group (1.07 ± 0.38). In the predictive modeling, the area under receiver operating characteristic (ROC) curves (AUC) ranged from 0.83-0.92 and their accuracy was higher than 0.75 in all methods.

CONCLUSIONS

The IL12RB2/TNFRSF8 ratio can be a useful diagnostic tool for OLP.

Geriatric oral lesions: A multicentric study

AIM

To carry out an oral biopsy survey in geriatric patients from the participating institutions.

METHODS

The biopsy records of the participating institutions were reviewed for oral lesions from patients aged 65 years and older diagnosed from 2003 to 2012. Demographic data and the site of the lesions were collected. Histopathological diagnoses were categorized into two categories: non-neoplastic lesions (reactive/inflammatory lesion, cyst, allergic/immunologic disorders, potentially malignant disorders, infection and others) and neoplastic lesions (benign and malignant tumors). Data were analyzed by appropriate statistics using stata11.

RESULTS

Of the 76,045 accessioned cases, 11,346 cases (14.92%) were in geriatric patients. The mean age of the patients was 72.98 ± 6.25 years. A total of 5010 cases (44.16%) were diagnosed in males, whereas 6336 cases (55.84%) were diagnosed in females. The male-to-female ratio was 0.79:1. Non-neoplastic lesions outnumbered the neoplastic counterpart. The five most prevalent oral lesions in the geriatric population in the present study in descending order of frequency were squamous cell carcinoma, focal fibrous hyperplasia (irritation fibroma), radicular cyst, osteomyelitis and epithelial dysplasia, respectively. The site of predilection was labial/buccal mucosa, followed by gingiva, mandibular bone, tongue and maxillary bone, respectively.

CONCLUSIONS

The geriatric oral lesions from the present study showed a similar trend with studies based on histopathological data, but different from the studies based on clinical data. This study also shed more light on potentially malignant disorders, as well as benign and malignant tumors.

Short duration of lamivudine for the prevention of hepatitis B virus transmission in pregnancy: lack of potency and selection of resistance mutations

This study sought to assess the antiviral efficacy of lamivudine (LMV) administered during third trimester to reduce maternal viraemia and to identify the emergence of LMV resistance. A prospective observational analysis was performed on 26 mothers with high viral load (>10⁷ IU/mL). Twenty-one women received LMV (treated group) for an average of 53 days (range 22-88 days), and the remaining five formed the untreated control group. Serum samples from two time points were used to measure HBV DNA levels and antiviral drug resistance. The LMV-treated women achieved a median HBV DNA reduction of 2.6-log10 IU/mL. Although end-of-treatment (EOT) HBV DNA in four (18%) LMV-treated women remained at >10(7) IU/mL (± 0.5 log IU/mL), no mother-to-baby transmission was observed. In contrast, a baby from the untreated mother was HBsAg positive at 9 months postpartum. Four technologies were used for drug resistance testing. Only ultra-deep pyrosequencing (UDPS) was sufficiently sensitive to detect minor viral variants down to <1%. UDPS showed that LMV therapy resulted in increased viral quasispecies diversity and positive selection of HBV variants with reverse transcriptase amino acid substitutions at sites associated with primary LMV resistance (rtM204I/V and rtA181T) in four (19%) women. These viral variants were detected mostly at low frequencies (0.63-5.92%) at EOT, but one LMV-treated mother had an rtA181T variant that increased from 2.2% pretherapy to 25.59% at EOT. This mother was also infected with the vaccine escape variant (sG145R), which was inhibited by LMV treatment. LMV therapy during late pregnancy only reduced maternal viraemia moderately, and drug-resistant viral variants emerged.

The role of p300 in the tumor progression of oral squamous cell carcinoma

BACKGROUND

EP300 gene encoding p300 is a candidate tumor suppressor gene. This study investigated p300 expression and gene alteration in oral squamous cell carcinoma (OSCC) specimens to assess its role in OSCC development.

METHODS

Genomic DNA extracted from 13 human OSCC cell lines and 40 OSCC patient specimens was subjected to methylation-specific PCR and exon sequencing. Immunohistochemical staining with primary antibodies against p300 and p53 was performed in 48 patients with OSCC. We analyzed the association between the data and clinicopathological factors of OSCC patients.

RESULTS

Methylation-specific PCR revealed that the EP300 promoter region was not hypermethylated in OSCC. Only one cell line demonstrated a point mutation at exon 31. On immunohistochemical examination, patients with metastatic lymph nodes (P = 0.009) and advanced clinical stage (P = 0.046) tended to show increased expression of p300. There was no statistically significant relationship between p300 expression and p53 accumulation in OSCC tissue samples. Patient survival was not correlated with p300 expression.

CONCLUSIONS

EP300 is not a tumor suppressor gene because there was neither epigenetic inactivation of the gene nor a mutation resulting in functional impairment. Based on p300 overexpression and its association with clinical factors in patients with OSCC, it is likely that p300 itself or one of its target genes plays a key role in the aggressive phenotypes of OSCC.

Abstract A184: Knock-down of Cripto-1 expression by small interfering RNA inhibits growth and migration of oral squamous cell carcinoma cells

Background: Cripto-1, also known as teratocarcinoma-derived growth factor-1 (TDGF-1), is a member of the EGF-CFC family. Cripto-1 has been found to be overexpressed in different human carcinomas, including breast, colon, lung, cervix, stomach, pancreas, and nasopharynx, while it was absent or very low in normal adult tissue. In vitro and in vivo studies have shown that Cripto-1 plays an important oncogenic role during carcinogenesis by promoting cell proliferation, migration, invasion, and tumor angiogenesis, as well as inducing the epithelial-to-mesenchymal transition. In our previous study, we first demonstrated that Cripto-1 protein was significantly overexpressed in oral squamous cell carcinoma (OSCC) tissues than in normal oral mucosa and the exogenous recombinant human Cripto-1 protein induced a significant increase in the cell proliferation and migration of OSCC cell lines (SCC-4 and SCC-25). Our data suggested that Cripto-1 may be involved in the tumorigenesis and progression of OSCC. To validate the value of Cripto-1 as a novel molecular target for OSCC treatment, in the present study, we investigated whether the suppression of endogenous Cripto-1 inhibits the growth and migration of OSCC cells.

Methods: We screened 13 OSCC cell lines to select cell lines with high Cripto-1 expression by RT-PCR and western blot analysis. Among them, KOSCC-33A and HSC4 cell lines were selected and transfected with anti-Cripto-1 siRNA and negative control siRNA. Cell proliferation was evaluated 24h, 48h, and 72h after transfection, and migration assay was also performed 24h and 48h after transfection, with anti-Cripto-1 siRNA and negative control siRNA. Statistical significance was determined using t-test.

Results: The results of RT-PCR analysis revealed that the Cripto-1 mRNA in KOSCC-33A and HSC4 cells were effectively suppressed by anti-Cripto-1 siRNA when compared with cells treated with a negative control siRNA. In the cell proliferation assay, we found that Cripto-1 knock-down induced a significant inhibition of the growth of KOSCC-33A and HSC4 cells (P &lt;0.05). In addition, Cripto-1 knock-down resulted in a significant decrease in the migration of both cell lines (P &lt;0.05).

Conclusion: The present study confirms that Cripto-1 plays an important role in the growth and motility of OSCC cells. Our data also suggest that suppression of Cripto-1 expression may be one of the new strategies for the treatment of OSCC. Further studies are in progress to clarify the signaling pathway underlying the oncogenic effects of Cripto-1 in OSCC.

Citation Information: Mol Cancer Ther 2013;12(11 Suppl):A184.

Citation Format: Ji-Hoon Kim, Young-Ah Cho, Ji-Soo Hong, Eun-Jin Choi, Seong-Doo Hong, Jae-Il Lee, Sam-Pyo Hong, Hye-Jung Yoon. Knock-down of Cripto-1 expression by small interfering RNA inhibits growth and migration of oral squamous cell carcinoma cells. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2013 Oct 19-23; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2013;12(11 Suppl):Abstract nr A184.

Clinical outcomes and risk factors of post-polypectomy coagulation syndrome: a multicenter, retrospective, case-control study

BACKGROUND AND STUDY AIMS

Post-polypectomy coagulation syndrome (PPCS) is a well known complication of colonoscopic polypectomy. However, no previous studies have reported on the clinical outcomes or risk factors of PPCS. The aim of the current study was to analyze the clinical outcomes and risk factors of PPCS developing after a colonoscopic polypectomy.

PATIENTS AND METHODS

Data for all patients who underwent colonoscopic polypectomies and required hospitalization in nine university hospitals were analyzed retrospectively. The incidence, clinicopathological characteristics, and clinical outcomes of PPCS cases were examined. Additionally, patients who developed PPCS were compared with controls who were matched by age and sex, in order to assess for possible risk factors.

RESULTS

The rate of PPCS that required hospitalization after colonoscopic polypectomy was 0.7/1000. All patients with PPCS were treated medically without the need for surgical interventions. The median durations of therapeutic fasting, hospitalization, and antibiotic use were 3 days, 5.5 days, and 7 days, respectively. The rates of major PPCS and mortality were 2.9 % and 0 %, respectively. On multivariate analysis, hypertension (OR = 3.023, 95 %CI 1.034 - 8.832), large lesion size (OR = 2.855, 95 %CI 1.027 - 7.937), and non-polypoid configuration (OR = 3.332, 95 %CI 1.029 - 10.791) were found to be independent risk factors related to the development of PPCS.

CONCLUSIONS

In this study, the rates of major PPCS and mortality were only 2.9 % and 0 %, respectively. Hypertension, large lesion size, and non-polypoid configuration of the lesion were independently associated with PPCS. Therefore, patients may be reassured by the excellent prognosis of PPCS, while endoscopists should be especially careful when performing colonoscopic polypectomies in patients with hypertension or large and non-polypoid lesions.

Gastrin promotes intestinal polyposis through cholecystokinin-B receptor-mediated proliferative signaling and fostering tumor microenvironment

Increased serum gastrin concentrations in patients with colorectal cancer suggested the tumorigenic trophic effect of gastrin. Detailed and global molecular mechanisms explaining trophic effect of gastrin had not been revealed. In the current study, intestinal polyposis of APC(Min/⁺) mice was compared between phosphate buffered saline (PBS) injected and gastrin (10 μg/kg, thrice per week) injected group. Total number of intestinal polyposis was counted and immunohistochemical staining with F4/80 and CD3 was done. MTT assay, cell cycle analysis, and Western blot for cyclin D1, CDK4, and β-catenin were performed in Raw 264.7 and HCT116 cells before and after gastrin administration. Experiments were repeated with YM022 or transfection with si-cholecystokinin-B receptor (CCK-B-R). Intraperitoneal gastrin significantly increased intestinal polyposis in APC(Min/⁺) mice (P<0.005), in which significant increases in macrophage were noted on F4/80 immunohistochemical staining (Plt;0.05) as well as Ki-67 staining (Plt;0.05) after gastrin. On comparative cytokine array, gastrin increased interleukin-1β (IL-1β), interleukin 3Rβ (IL-3Rβ), stromal cell-derived factor-1α (SDF-1α), thymus and activation-regulated chemokine (TARC), and thymus-derived chemotactic agent 3 (TCA-3) in macrophage cells, which was further confirmed with real time polymerase chain reaction (RT-PCR) analysis (P<0.05). In addition to increased inflammatory cytokines, gastrin increased macrophage proliferation accompanied with increased cyclin D1 and CDK4. Targeted for HCT116 cells, gastrin significantly increased proliferation as well as increases in synthetic phase of cell cycle. YM022 as gastrin antagonist significantly abolished the trophic actions of gastrin (P<0.05). HCT116 cells transfected with siCCK-B-R, gastrin did not increase either cell cycle or β-catenin in spite of gastrin administration. Conclusively, gastrin promoted intestinal polyposis through either direct gastrin receptor-mediated proliferative signaling or fostering tumor microenvironment such as macrophage activation.

Plasmablastic lymphoma of the oral cavity in a human immunodeficiency virus-negative patient: a case report with literature review

Plasmablastic lymphoma (PBL) is an aggressive diffuse large B-cell lymphoma variant that is most frequently observed in the oral cavity of human immunodeficiency virus (HIV)-infected individuals. However, in recent years, some cases have emerged in patients without HIV infection and involve other sites like stomach, lung, nasal cavity, and jejunum. We report a rare case of PBL in the maxillary anterior area of a 62-year-old man without HIV infection. The tumor cells were characterized by non-cohesive round or oval shape cells with eccentrically-placed nuclei with a prominent perinuclear halo. Immunohistochemical studies showed that the tumor cells were strongly positive for MUM1, VS38c, VMT, and κ light chain, focally positive for LCA and CD79a, and negative for CD3, CD20, CD56, λ light chain, CK-pan, EMA, and HMB45. The patient was treated with chemotherapy using cyclophosphamide, doxorubicin, vincristine, and prednisone. The lesion showed partial remission.

Hypothetical pathogenesis of eosinophilic infiltration in Langerhans cell histiocytosis of the jaw

OBJECTIVE

The present study investigated the densities of mast cells and CCL-11/eotaxin-1 expression of tumor cells in Langerhans cell histiocytosis (LCH) of the jaw.

STUDY DESIGN

Eleven LCH cases arising in the jaws were selected. We evaluated eotaxin-1 expression in LCH cells via immunohistochemical staining. Toluidine blue was used to stain mast cells, with 20 periapical granuloma specimens serving as the control group.

RESULTS

In all 7 patients with multifocal LCH, jaw lesions were the earliest manifestation. Toluidine blue staining revealed that most of the mast cells involved in LCH were degranulated, and the number of mast cells in LCH lesions was not significantly higher than in periapical granulomas. Upon immunohistochemical examination, all patients but one showed positivity for eotaxin-1 in LCH cells.

CONCLUSION

This preliminary study suggests that eotaxin-1 expression in LCH cells may contribute to eosinophilic infiltration. Further studies of chemokine-receptor interactions will be needed to confirm this.

Restriction fragment mass polymorphism (RFMP) analysis based on MALDI-TOF mass spectrometry for detecting antiretroviral resistance in HIV-1 infected patients

Viral genotype assessment is important for effective clinical management of HIV-1 infected patients, especially when access and/or adherence to antiretroviral treatment is reduced. In this study, we describe development of a matrix-assisted laser desorption/ionization-time of flight mass spectrometry-based viral genotyping assay, termed restriction fragment mass polymorphism (RFMP). This assay is suitable for sensitive, specific and high-throughput detection of multiple drug-resistant HIV-1 variants. One hundred serum samples from 60 HIV-1-infected patients previously exposed to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) were analysed for the presence of drug-resistant viruses using the RFMP and direct sequencing assays. Probit analysis predicted a detection limit of 223.02 copies/mL for the RFMP assay and 1268.11 copies/mL for the direct sequencing assays using HIV-1 RNA Positive Quality Control Series. The concordance rates between the RFMP and direct sequencing assays for the examined codons were 97% (K65R), 97% (T69Ins/D), 97% (L74VI), 97% (K103N), 96% (V106AM), 97% (Q151M), 97% (Y181C), 97% (M184VI) and 94% (T215YF) in the reverse transcriptase coding region, and 100% (D30N), 100% (M46I), 100% (G48V), 100% (I50V), 100% (I54LS), 99% (V82A), 99% (I84V) and 100% (L90M) in the protease coding region. Defined mixtures were consistently and accurately identified by RFMP at 5% relative concentration of mutant to wild-type virus while at 20% or greater by direct sequencing. The RFMP assay based on mass spectrometry proved to be sensitive, accurate and reliable for monitoring the emergence and early detection of HIV-1 genotypic variants that lead to drug resistance.

Comparative immunohistochemical study of ameloblastoma and ameloblastic carcinoma

OBJECTIVE

Ameloblastic carcinoma combines the histologic features of ameloblastoma with cytologic atypia, regardless of whether it has metastasized. Because of its rarity, there are few immunoprofile studies of ameloblastic carcinoma and few comparative studies of ameloblastic carcinoma and ameloblastoma. In this study, we compared the expression levels of cytokeratins (CKs), matrix metalloproteinases (MMPs), and Ki-67 between ameloblastoma and ameloblastic carcinoma, and assessed the usefulness of these markers for differentiating the tumors.

STUDY DESIGN

We assessed CK7, CK14, CK18, CK19, MMP-2, MMP-9, and Ki-67 expression by immunohistochemistry in 10 cases of ameloblastoma and 7 cases of ameloblastic carcinoma and then compared expression patterns between the 2 groups.

RESULTS

Immunostaining for CK14 and CK19 was diffuse and strongly positive in both tumor types, but staining for CK7 was focally positive in only 1 case of ameloblastoma and absent in all cases of ameloblastic carcinoma. However, there was a significant difference in CK18 expression between the 2 tumors (P = .000). Whereas 80% of ameloblastomas showed negative reactivity for CK18, most cases of ameloblastic carcinomas showed a moderate to strong intensity of immunostaining for CK18. Regarding the expression of MMPs, there were significant differences in parenchymal MMP-2 and stromal MMP-9 expression between the 2 tumors. Compared to ameloblastoma, ameloblastic carcinoma showed significantly strong expression of MMP-2 in parenchymal cells (P = .001) and MMP-9 in stromal cells (P = .013). However, there were no differences in MMP-2 expression of stromal cells and MMP-9 expression of parenchymal cells between ameloblastoma and ameloblastic carcinoma. The mean Ki-67 labeling index (LI) of ameloblastic carcinomas was 17.21%, which was significantly higher than that of ameloblastomas (3.57%; P = .002).

CONCLUSIONS

The significant expression of CK18, parenchymal MMP-2, stromal MMP-9, and Ki-67 could provide useful markers for differentiating ameloblastic carcinoma from ameloblastoma.

Relationship between the expressions of PD-L1 and tumor-infiltrating lymphocytes in oral squamous cell carcinoma

Tumor-infiltrating lymphocytes (TILs) are considered to represent immune reactions of the host to a malignant tumor. Programmed death receptor ligand-1 (PD-L1) is a surface protein that blocks the function of T lymphocytes and is expressed on cancer cells. Tumor-associated fibroblasts (TAFs), which influence tumor growth have also been reported to express PD-L1 and thus inhibit TILs. In the present study, we investigated the densities of CD4(+)/CD8(+) TILs, PD-L1 expression of tumor cells and TAFs in oral squamous cell carcinoma (OSCC). Forty-five cases of OSCC were selected. We evaluated PD-L1 expression and the infiltration degree of each lymphocyte by immunohistochemical examination. These data were analyzed in connection with clinicopathological factors. Peritumoral CD8(+) TILs were observed in every patient with OSCC, and their densities were correlated with lymph node metastasis (P<0.001), tumor size (P=0.003), and clinical stage (P<0.001). PD-L1 expression on OSCC cells was observed in 39 cases and was associated with the lower density of intratumoral CD8(+) TILs (P=0.047). PD-L1 expression of tumors <4cm in size was correlated with the histological grade of the tumor (P=0.022). TAFs were positive for PD-L1 in 18 cases. Peritumoral TILs were significantly associated with tumor size, lymph node metastasis and clinical stage. Though PD-L1 expressed by OSCC cells did not affect patients' survival, its correlation with decreased number of intratumoral TILs suggests that the development of a strategy to block the interactions of PD-L1 with TIL would be a useful tool for inhibiting tumor growth.

The role of Cripto-1 in the tumorigenesis and progression of oral squamous cell carcinoma

Oral squamous cell carcinoma (OSCC), the most common malignancy of the oral cavity, remains a lethal disease in over 50% of cases diagnosed annually, due mostly to late detection of this cancer in its advanced stages despite the easy accessibility of the oral cavity for regular examinations. Cripto-1 is a member of the epidermal growth factor (EGF)-CFC protein family and is involved in the activation of several different signaling pathways during embryonic development and cellular transformation. Although the Cripto-1 protein is overexpressed in several human cancers including breast, colon, cervix, gastric, and pancreatic cancer, no prior study has evaluated Cripto-1 expression in OSCC. Therefore, our aims in this study were to examine Cripto-1 expression in clinical samples of OSCC patients using immunohistochemistry, to analyze the correlation between Cripto-1 expression and clinicopathologic parameters, and to identify the oncogenic roles of Cripto-1 in OSCC cell lines. Both epithelial dysplasia (73.3%) and OSCC (55.5%) tissue samples showed significantly higher expression of Cripto-1 than normal mucosa (20%) (p=0.031). In the OSCC samples, there was a significant correlation between Cripto-1 expression and the histological differentiation of OSCC (p=0.015) and a high PCNA index (p=0.011). The in vitro cell proliferation assays demonstrated that recombinant human Cripto-1 (rhCripto-1) induced both SCC-4 and SCC-25 cells to proliferate as compared with control cells (p<0.05 and p<0.01, respectively). In in vitro migration assays, treatment of SCC-4 and SCC-25 cells with rhCripto-1 protein induced a 2.4-fold and 1.7-fold-increase in cell migration, respectively (p=0.000 and p=0.008, respectively). Taken together, our data suggest that Cripto-1 plays a role in the malignant transformation of the oral mucosa and is involved in the tumorigenesis and progression of OSCC by promoting the growth and migration of malignant cells.

Multiple calcifying hyperplastic dental follicles: comparison with hyperplastic dental follicles

BACKGROUND

Multiple calcifying hyperplastic dental follicles (MCHDF) is a rare disorder that is characterized by multiple impacted teeth and enlarged dental follicles that include calcifications. The current lack of information characterizing MCHDF impedes clinicians from making prompt differential diagnoses. We describe five cases of MCHDF and analyze their clinical and histopathological features in an effort to compare MCHDF with hyperplastic dental follicles (HDF) of singly impacted teeth.

METHODS

Our five cases of MCHDF were examined and clinically/histologically compared with data from 50 singly impacted teeth with HDFs.

RESULTS

The five patients described in this study were all male. The pattern of impaction varied, but every second molar was impacted in all the patients. Alterations in the number of teeth, such as supernumerary or congenitally missing teeth were observed. Upon microscopic examination, most of the calcifications consisted of basophilic droplets that were fused to one another, and were surrounded by whirling spindle cells. Another type of calcification that was observed less frequently resembled woven bone. These features were consistent with three previously reported cases and observed in HDFs of 20 singly impacted teeth. While the average period of impaction and the time to reach some level of calcification in MCHDFs was shorter than in single calcifying HDFs, the calcification was more generalized in MCHDFs.

CONCLUSIONS

This study indicates that MCHDF is a separate pathologic entity with exclusive male predilection and earlier calcifications, different to HDF. Further studies are needed to understand the etiology of MCHDFs to provide various options for treatment, and to clarify the mechanisms of eruption.

Topical calcitriol restores the impairment of epidermal permeability and antimicrobial barriers induced by corticosteroids

BACKGROUND

The active form of vitamin D(3) , calcitriol, is widely used for the treatment of psoriasis, with or without topical corticosteroids. Topical corticosteroids are known to disrupt permeability and antimicrobial barriers, even with short-term use. Yet, the effect of topical calcitriol on epidermal permeability and antimicrobial barriers disrupted by topical corticosteroids has not been determined.

OBJECTIVES

To examine the effect of calcitriol on epidermal permeability and antimicrobial barrier function that has been impaired by corticosteroids, as well as to elucidate the mechanism of improvement.

MATERIAL AND METHODS

Topical calcitriol or the control vehicle was applied to each flank of hairless mice 20 min after treatment with topical clobetasol propionate and repeated every 12 h for 3·5 days. Barrier function assessment, Nile red staining, electron microscopy, immunohistochemistry, Western blotting, and real-time reverse transcriptase-polymerase chain reaction studies were performed 24 h after the last application.

RESULTS

Epidermis co-treated with topical calcitriol showed an improvement of stratum corneum integrity and barrier recovery, more intense fluorescence staining with Nile red, and an increase in lamellar body (LB) maturation and density, as well as upregulation of major epidermal lipid synthesis-related enzymes (3-hydroxy-3-methylglutaryl-CoA, serine-palmitoyl transferase and fatty acid synthase), mouse beta-defensin 3, cathelin-related antimicrobial peptide and vitamin D receptor.

CONCLUSIONS

We found that topical calcitriol restored both the epidermal permeability and antimicrobial barrier that had been impaired by corticosteroids. This restoration was mediated by both an activation of the cutaneous vitamin D pathway and an increase of epidermal lipids and antimicrobial peptides, promoted by the formation of the LB and the activity of epidermal lipid synthesis-related enzymes.

Low efficacy of entecavir therapy in adefovir-refractory hepatitis B patients with prior lamivudine resistance

We determined the virologic response, incidence of entecavir resistance, and evolution of lamivudine and adefovir-resistant mutants during entecavir (ETV) therapy in adefovir-refractory patients with prior lamivudine resistance. Forty adefovir-refractory chronic hepatitis B patients with prior lamivudine resistance who had received entecavir for > or = 6 months were included and monitored for virologic response and entecavir resistance. Ten per cent of patients achieved HBV DNA < 50 copies/mL by PCR after 24 weeks of ETV therapy, and an initial virologic response was observed in 12 of 40 patients (30%). Higher pretreatment ALT (P = 0.039) and the presence of the rtL180M mutation (P = 0.038) were associated with an initial virologic response. During a mean follow-up of 11.4 months, four patients (10%) experienced virologic breakthrough, while ETV-resistant mutants were detected in six patients (15%). YMDD and adefovir-resistant mutants were detected in 57 and 35% of patients at baseline, respectively. At 48 weeks of therapy, 96 and 4% of patients had YMDD and adefovir-resistant mutants, respectively. These data suggest an early development of ETV resistance and low antiviral response during ETV therapy in adefovir-refractory patients with prior lamivudine resistance.

Evaluation of survivin as a prognostic marker in oral squamous cell carcinoma

BACKGROUND

Poor prognosis of oral squamous cell carcinoma (OSCC) is partly attributed to the lack of significant tumor marker for accurate staging and prognostication. We have evaluated survivin, which is a member of the inhibitor of apoptosis family as a cancer marker associated with proliferation, angiogenesis, oral carcinogenesis, and OSCC patient survival, as we reported a prognostic significance of survivin expression in lymph node previously.

METHODS

To evaluate survivin expression in six OSCC cell lines, Western blotting was performed. Hamster oral carcinogenesis model was used to observe changes of survivin expression in oral carcinogenesis. Finally, we assessed the diagnostic and prognostic significance of survivin in a series of 38 primary OSCC through immunohistochemistry (CD31, PCNA) and Kaplan-Meier's test.

RESULTS

Survivin expression was detected in all OSCC cell lines at a varying level but not observed in normal gingival keratinocyte cells. In hamster model, survivin expression was observed from 8 weeks through 16 weeks and the intensity of expression became strong until 16 weeks. Clinicopathological analysis revealed a significant correlation between survivin expression and lymph node metastasis (P = 0.006) and proliferation (P < 0.001). However, there was no significant relationship with differentiation, micro vessel density, and cancer stage based on TNM. Survivin overexpression had a significant negative effect on survival of patients.

CONCLUSIONS

These results demonstrate the significant relationship between survivin expression and oral carcinogenesis and aggressiveness of OSCC including survival rate of patient. Survivin therefore may be used as a significant cancer marker to gain prognostic information of OSCC.

Prognostic significance of CXCR-4 expression in oral squamous cell carcinoma

OBJECTIVE

We investigated the prognostic significance of CXC chemokine receptor CXCR-4 expression in patients with oral squamous cell carcinoma (OSCC) and its relationship with matrix metalloproteinase 2 (MMP-2), MMP-9, and Ki-67 expression.

STUDY DESIGN

The CXCR-4, MMP-2, MMP-9, and Ki-67 expression was assessed immunohistochemically in 74 OSCC patients. The results were analyzed in connection with clinicopathologic factors.

RESULTS

The CXCR-4 expression was positive in 45 cases and significantly correlated with lymph node metastasis (P = .037), MMP-9 expression (P = .025), and Ki-67 expression (P = .001). Univariate analysis showed that CXCR-4 expression, MMP-9 expression, Ki-67 expression, tumor size, lymph node metastasis, clinical stage, and recurrence positively correlated with prognosis. Multivariate analysis indicated that CXCR-4 expression was an independent prognostic factor for poor survival in patients with OSCC.

CONCLUSION

Expression of CXCR-4 is a significant prognostic indicator for poor survival in patients with OSCC and correlates with expression of MMP-9 and Ki-67. The inhibition of CXCR-4 represents a possible molecular approach to the treatment of OSCC.

Inhibition of Akt activity induces the mesenchymal-to-epithelial reverting transition with restoring E-cadherin expression in KB and KOSCC-25B oral squamous cell carcinoma cells

Background

The Akt/PKB family of kinases is frequently activated in human cancers, including oral squamous cell carcinoma (OSCC). Akt-induced epithelial-to-mesenchymal transition (EMT) involves downregulation of E-cadherin, which appears to result from upregulation of the transcription repressor Snail. Recently, it was proposed that carcinoma cells, especially in metastatic sites, could acquire the mesenchymal-to-epithelial reverting transition (MErT) in order to adapt the microenvironments and re-expression of E-cadherin be a critical indicator of MErT. However, the precise mechanism and biologic or clinical importance of the MErT in cancers have been little known. This study aimed to investigate whether Akt inhibition would restore the expression of E-cadherin and β-catenin, reduce that of Vimentin, and induce the MErT in OSCC cells with low or negative expression of E-cadherin. We also investigate whether inhibition of Akt activity would affect the E-cadherin repressors and signaling molecules like NF-κB, ERK, and p38.

Methods

We screened several OSCC cell lines in order to select suitable cell line models for inducing MErT, using immunoblotting and methylation specific-PCR. We examined whether Akt inhibitor phosphatidylinositol ether lipid analogues (PIA) treatment would restore the expression of E-cadherin and β-catenin, reduce that of Vimentin, and induce the MErT in KB and KOSCC-25B cells using RT-PCR, immunoblotting, immunofluorescence analysis, and in vitro migration assay. We also investigated whether inhibition of Akt activity would affect the E-cadherin repressors, including Snail, Twist, and SIP-1/ZEB-2 and signaling molecules like NF-κB, ERK, JNK, and p38 using RT-PCR, immunoblotting, and immunofluorescence analysis.

Results

Of the 7 OSCC cell lines, KB and KOSCC-25B showed constitutively activated phosphorylated Akt and low or negative expression of E-cadherin. Inhibition of Akt activity by PIA decreased NF-κB signaling, but did not affect phosphorylation of ERK, JNK, and p38 in KB and KOSCC-25B cells. Akt inhibition led to downregulation of Snail and Twist expression. In contrast, inhibition of Akt activity by PIA did not induce any changes in SIP-1/ZEB-2 expression. PIA treatment induced the expression of E-cadherin and β-catenin, reduce that of Vimentin, restored their epithelial morphology of a polygonal shape, and reduced tumor cell migration in KB and KOSCC-25B cells, which was the corresponding feature of MErT.

Conclusion

All of these findings suggest that Akt inhibition could induce the MErT through decreased NF-κB signaling and downregulation of Snail and Twist in OSCC cells. A strategy involving Akt inhibition might be a useful therapeutic tool in controlling cancer dissemination and metastasis in oral cancer patients.

The change in dimension of the masseter muscle in rabbits after radiofrequency therapy

PURPOSE

The objective of this study was to evaluate the change in muscle dimension after administering radiofrequency (RF) therapy.

MATERIALS AND METHODS

This study used 6 male New Zealand rabbits. Groups were divided by number of applications of RF (eg, 1 to 4 points). The dimension of the masseter muscle was measured using a computerized tomogram scan before operation, and at 1, 2, 3, and 4 weeks after RF therapy was administered under the same conditions. Two horizontal cuts were selected for measurement.

RESULTS

The size of the measured areas for each group at 1 week after RF therapy was significantly increased compared with the preoperative value (P< .05). When the measurements of each group at 3 and 4 weeks after RF therapy were compared with the preoperative value, they were significantly decreased (P< .05). The dimensional change was significantly different among groups at 1 and 3 weeks post RF therapy (P< .05). The swelling at 1 week after RF therapy was increased in terms of the number of RF applications. The ratio of dimension was decreased at 3 weeks after RF therapy in terms of the number of RF applications.

CONCLUSION

There was an increase in muscle dimension because of swelling in the early stages of RF therapy. However, this dimension decreased at 3 weeks post-RF administration compared with the preoperative value. Therefore, it can be concluded that the change in the masseter muscle dimension was dependent on the number of RF applications.

Production of transgenic recloned piglets harboring the human granulocyte-macrophage colony stimulating factor (hGM-CSF) gene from porcine fetal fibroblasts by nuclear transfer

We used nuclear transfer (NT) to develop transgenic female pigs harboring goat beta-casein promoter/human granulocyte-macrophage colony stimulating factor (hGM-CSF). The expression of hGM-CSF was specific to the mammary gland, and the glycosylation-derived size heterogeneity corresponded to that of the native human protein. Although various cell types have been used to generate cloned animals, little is currently known about the potential use of fibroblasts derived from a cloned fetus as donor cells for nuclear transfer. The developmental potential of porcine cloned fetal fibroblasts transfected with hGM-CSF was evaluated in the present study. Cloned fetal fibroblasts were isolated from a recipient following the transplantation of NT embryos. The cells were transfected with both hGM-CSF and the neomycin resistance gene in order to be used as donor cells for NT. Reconstructed embryos were implanted into six sows during estrus; two of the recipient sows delivered seven healthy female piglets with the hGM-CSF gene (confirmed with PCR and fluorescent in situ hybridization) and microsatellite analysis confirmed that the clones were genetically identical to the donor cells. The expression of hGM-CSF was strong in the mammary glands of a transgenic pig that died a few days prior to parturition (110 d after AI). These results demonstrated that somatic cells derived from a cloned fetus can be used to produce recloned and transgenic pigs.

CXCR-4 knockdown by small interfering RNA inhibits cell proliferation and invasion of oral squamous cell carcinoma cells

BACKGROUND

Oral squamous cell carcinomas (OSCCs) are characterized by a high degree of local invasion and a high rate of metastases to cervical lymph nodes. Downregulation of CXCR-4 by siRNA inhibits invasion and growth of breast and colon cancer cells. However, there have been no reports on the downregulation of CXCR-4 by small interfering RNA (siRNA) in oral cancer cells.

METHODS

We generated two stable CXCR-4-knockdown clones (KBsi and KOSCC-25Bsi) from the KB and KOSCC-25B OSCC cell lines by lentiviral delivery. In vitro invasion and cell proliferation assays were used to investigate the effect of CXCR-4 downregulation on cell proliferation and invasiveness in KBsi and KOSCC-25Bsi. Immunohistochemistry was performed to evaluate the correlation between CXCR-4 expression and proliferation in 26 OSCC tissue samples.

RESULTS

CXCR4-knockdown OSCC cells showed reduced invasiveness. The invasiveness of KBsi decreased to 29.5% of the vector-infected controls, and KOSCC-25Bsi decreased to 38.1% of the control vector-infected cells (P < 0.05). The CXCR4-knockdown OSCC cells grew significantly slower than the vector-infected control cells. KBsi and KOSCC-25Bsi cells proliferated at 69.5% and 71.7%, respectively, of the rate of control vector-infected cells (P < 0.05). CXCR-4-positive group had significantly higher PCNA labeling index than CXCR-4-negative group in OSCC tissue samples.

CONCLUSION

These results suggest that the downregulation of CXCR-4 induces anti-proliferative and anti-invasive effects in OSCC and that CXCR-4 might be a useful target molecule for the treatment of OSCC.

Effective screening of informative single nucleotide polymorphisms using the novel method of restriction fragment mass polymorphism

Restriction fragment mass polymorphism (RFMP) was applied to pooled DNA for selecting informative single nucleotide polymorphisms (SNPs). A total of 225 coding non-synonymous SNPs (cnSNPs) from immunomodulating genes known to be involved in the pathogenesis of asthma were selected from the National Center for Biotechnology Information's (NCBI) SNP database (dbSNP). DNA samples from 200 healthy Koreans were pooled, amplified by polymerase chain reaction, digested with restriction enzymes and the fragments analysed by mass spectrometry. Only 30 of the 225 cnSNPs (13.3%) were informative, i.e.had a minor allele frequency>10%. The percentage of informative cnSNPs varied according to the validation status of the dbSNP, being 42.3% (22/52) when validated by multiple submissions and frequency data, 8.7% (2/23) when validated by multiple submissions alone and 9.1% (3/33) when validated by frequency data alone. Most of the 112 unvalidated cnSNPs were not informative. In conclusion, the RFMP method using pooled DNA is useful in selecting informative SNPs, as also is validation status in the dbSNP.

Suppression of osteoclastogenesis by N,N-dimethyl-D-erythro-sphingosine: a sphingosine kinase inhibition-independent action

N,N-Dimethyl-D-erythro-sphingosine (DMS) competitively inhibits sphingosine kinase (SPHK) and has been widely used to assess the role of SPHK during cellular events, including motility, proliferation, and differentiation. In the present study, the effect of DMS on the differentiation of bone marrow macrophages (BMMs) to osteoclasts was investigated. When the osteoclast precursor cells were treated with DMS, the receptor activator of nuclear factor kappaB ligand (RANKL)-induced osteoclastogenesis was completely blocked. We were surprised to find, however, that knock-down of SPHK by small interfering RNA (siRNA) in BMMs did not reduce osteoclastogenesis. Furthermore, both overexpression of SPHK and exogenous addition of sphingosine-1-phosphate, the product of SPHK activity, failed to overcome the antiosteoclastogenic effect of DMS. These results suggest that DMS inhibited osteoclastogenesis independently of SPHK. Subsequent characterization of the DMS-mediated suppression of osteoclastogenesis revealed that DMS did not affect RANKL-induced activation of JNK, p38, NF-kappaB, and Ca2+ oscillation. On the other hand, DMS strongly inhibited two separate signaling pathways, the RANKL-induced activation of ERK and Akt, which eventually converged on the transcription factors c-Fos and NFATc1. There was significant increase in the osteoclast formation in the presence of DMS when BMMs were overexpressed with c-Fos, suggesting that c-Fos was a critical downstream target of DMS for the inhibition of osteoclastogenesis. Taken together, our data demonstrate that DMS has an antiosteoclastogenic function independently of its SPHK inhibitory activity. Considering previously reported anticancer properties of DMS, our study may also propose that DMS is an ideal drug candidate for bone metastases, for which osteoclastic bone-resorption is crucial.

Resistance to adefovir dipivoxil in lamivudine resistant chronic hepatitis B patients treated with adefovir dipivoxil

BACKGROUND

Adefovir dipivoxil (ADV) is a potent nucleotide analogue against both the wild-type and lamivudine (LMV) resistant hepatitis B virus (HBV). The cumulative incidence of ADV resistant mutations in the nucleoside/-tide treatment naive chronic hepatitis B patient (CHB) at weeks 48, 96, and 144 was 0, 0.8-3%, and approximately 5.9%, respectively.

AIMS

The aim of this study was to characterise the genotypic and phenotypic mutation profiles to ADV in 67 LMV resistant CHB patients who were treated with ADV.

METHODS

Serum HBV DNA was quantified by real time polymerase chain reaction. The ADV mutant was detected using matrix assisted laser desorption/ionisation time of flight mass spectrometry based genotyping assays, termed restriction fragment mass polymorphism (RFMP).

RESULTS

RFMP analysis revealed that a total of 11 amino acid substitutions developed in the rt domain of the HBV polymerase in nine patients. The cumulative incidence of genotypic ADV resistance at months 12 and 24 was 6.4% and 25.4%, respectively. The rtA181V, rtN236T, and rtA181T mutations were detected in five, four, and two of the 67 patients at treatment months 12-17, 3-19, and 7-20, respectively. Serial quantification of serum HBV DNA revealed that two patients with the rtA181V mutation, with or without the rtN236T mutation, and one patient with the rtA181T mutation displayed HBV DNA rebound.

CONCLUSION

Emergence of the ADV mutation in LMV resistant patients who are treated with ADV appeared to present earlier and more frequently than was reported in previous studies on nucleoside/-tide treatment naive patients.

Oligonucleotide microarray analysis of ameloblastoma compared with dentigerous cyst

BACKGROUND

Ameloblastoma is a benign, but locally invasive tumor known for its high rate of recurrence. However, few comprehensive genetic studies have been conducted about its tumorigenesis. Our aim was to identify possible genes involved in the development and progression of ameloblastoma, using microarray analysis with dentigerous cyst as a control.

METHODS

Total RNA was extracted from two fresh dentigerous cysts and ameloblastoma specimens. Following microarray analysis, semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry were performed on selected genes.

RESULTS

Seventy-three genes were overexpressed and 49 were underexpressed. These genes were divided into categories according to function. The microarray results for 13 selected genes were verified with semiquantitative RT-PCR.

CONCLUSIONS

We identified important genes related to the development and progression of ameloblastoma through a large-scale gene expression analysis. This study will stimulate further investigations on genes significant for early diagnosis and prognosis of ameloblastoma.

The differential expression pattern of BMP-4 between the dentigerous cyst and the odontogenic keratocyst

BACKGROUND

Bone morphogenic protein-4 (BMP-4) is widely expressed in oral cavity and involved in tooth morphogenesis, cellular differentiation and proliferation. The purpose of this study was to compare the difference in expression pattern of BMP-4 in odontogenic keratocysts (OKC) and dentigerous cysts (DC).

METHODS

We evaluated 77 cysts, OKC (n = 34) or DC (n = 43). The average age of patients with OKC was 29.5 +/- 14.4 and that of patients with DC was 36.1 +/- 19.4. The male to female ratio was 20:14 for OKC and 27:16 for DC. Ten cases of OKC were recurrences. Expression of BMP-4 was determined by immunohistochemistry and in situ hybridization.

RESULTS

The intensity scales were (-) for invisible or trace staining, (+) for visible staining, and (++) for dense, strong staining. OKCs exhibited the following staining patterns: the epithelium in 15/34 specimens and the mesenchymal cells in 17/34 specimens showed (++) stain. In contrast, the staining pattern of DC was (-) for epithelium in 37/43 specimens. The mesenchymal cells showed (-) degree staining in 30/43 specimens. The difference between the groups studied was significant (P < 0.001 in epithelium and mesenchymal cells). When recurrent and non-recurrent OKC were compared BMP-4 was expressed more intensely in the recurrent cases (P = 0.036 in epithelium). The difference in BMP-4 expression in mesenchymal cells was not significant. In situ hybridization demonstrated positive mRNA probes to BMP-4 were localized in epithelium and mesenchymal cells of OKCs and DCs.

CONCLUSIONS

BMP-4 was expressed more intensely in OKC when compared with DC, and was more intensely expressed in recurrent cases.

Inactivation patterns of p16/INK4A in oral squamous cell carcinomas

The p16/INK4A is one of the major target genes in carcinogenesis and its inactivation has frequently been reported in other types of tumors. The purpose of this study is to evaluate inactivation patterns of p16/INK4A in oral squamous cell carcinoma. Six different oral cancer cell lines, SCC-4, SCC-9, SCC-15, SCC-25, KB, and SNUDH- 379 were examined for inactivation of p16/INK4A genes. In the analysis of p16/INK4A gene inactivation, PCR amplification, direct sequencing, and methylation-specific PCR methods were adopted for evaluation of homozygous deletion, point mutation, and promoter hypermethylation, respectively. Homozygous deletion was detected in SCC-25 and SCC-9. SCC-15 showed hypermethylated promoter region within p16/INK4A gene. It is suggestive in the present study that inactivation patterns of p16/INK4A were mainly homozygous deletion, promoter methylation rather than point mutation in oral squamous cancer cell lines, so treatment modalities of oral squamous cell carcinoma should be focused on these types of inactivation.

Hematogenous infection of the human temporomandibular joint

Objective This study was designed to discover the relationship between bacteremia and the presence of specific bacterial species in the synovial fluid of the human temporomandibular joint (TMJ). Study design Sixteen volunteers (female to male, 1:2.2; average age, 30.00 +/- 9.93 years) who received operations via intraoral incision participated in this study. Samples from the blood and TMJ synovial fluid of the patients were taken preoperatively and postoperatively and analyzed by PCR assays with specific primers for the clinically important bacteria Staphylococcus aureus , Streptococcus mitis , and beta-hemolytic Streptococcus . Results PCR-based assays revealed the occurrence of S aureus in 68.8% and 50% of the total blood and synovial fluid samples collected immediately after the operations, which statistically differed from the preoperative samples ( P < .05). However, the frequency of the other bacteria, S mitis and beta-hemolytic Streptococcus , in pre- and postoperative blood samples had no such a difference ( P > .05). The chi-square test showed a significant association between the presence of S aureus in the blood and in TMJ synovial fluid (chi 2 = 6.409, P < .05), and the probability of hematogenous infection of the TMJ was estimated as 55.5%. Conclusion Hence, the data obtained provided evidence that the invasion of S aureus into TMJ synovial fluid was due to the presence of these bacteria in the blood. To our knowledge, this is the first report of the bacteremia-related mechanism of S aureus invasion in the human TMJ.

Relationship of phenotype and genotype in X-linked amelogenesis imperfecta

X-linked amelogenesis imperfectas (AI) resulting from mutations in the amelogenin gene (AMELX) are phenotypically and genetically diverse. Amelogenin is the predominant matrix protein in developing enamel and is essential for normal enamel formation. To date, 12 allelic AMELX mutations have been described that purportedly result in markedly different expressed amelogenin protein products. We hypothesize that these AMELX gene mutations result in unique and functionally altered amelogenin proteins that are associated with distinct amelogenesis imperfecta phenotypes. The AMELX mutations and associated phenotypes fall generally into three categories. (1) Mutations (e.g., signal peptide mutations) causing a total of loss of amelogenin protein are associated with a primarily hypoplastic phenotype (though mineralization defects also can occur). (2) Missense mutations affecting the N-terminal region, especially those causing changes in the putative lectin-binding domain and TRAP (tyrosine rich amelogenin protein) region of the amelogenin molecule, result in a predominantly hypomineralization/hypomaturation AI phenotype with enamel that is discolored and has retained amelogenin. (3) Mutations causing loss of the amelogenin C terminus result in a phenotype characterized by hypoplasia. The consistent association of similar hypoplastic or hypomineralization/hypomaturation AI phenotypes with specific AMELX mutations may help identify distinct functional domains of the amelogenin molecule. The phenotype-genotype correlations in this study suggest there are important functional domains of the amelogenin molecule that are critical for the development of normal enamel structure, composition, and thickness.

Transforming growth factor-α and oral fibroma: immunohistochemical and in situ hybridization study

PURPOSE

Transforming growth factor-alpha (TGF-alpha) is usually expressed in cell lines derived from sarcomas. It is known as a mitogen for fibroblasts. The aim of this study was to determine whether there were any differences in the expression pattern of TGF-alpha between normal oral mucosa and oral fibroma.

PATIENTS AND METHODS

Fourteen pathologic specimens (6 males and 8 females; 37.2 +/- 23.2 years) and 10 normal oral mucosal specimens (5 females and 5 males; 43.8 +/- 17.7 years) were used for this study. Identification of TGF-alpha was sought by using immunohistochemistry and in situ hybridization.

RESULTS

The samples from normal oral mucosa did not express TGF-alpha. One sample from oral fibroma did not express TGF-alpha (7.1%). Five samples from oral fibroma expressed TGF-alpha sparsely (35.7%). Eight samples showed diffuse expression of TGF-alpha (57.1%). The immunopositive reaction to TGF-alpha in oral fibroma was localized in the basal layer and the fibroblasts that resided beneath the epithelium. This pattern was also shown in the in situ hybridization study as well.

CONCLUSION

TGF-alpha is expressed in oral fibromas. It suggested that TGF-alpha might play a role in fibroblast proliferation in oral fibromas.

The small bovine amelogenin LRAP fails to rescue the amelogenin null phenotype

Amelogenins are the most abundant secreted proteins in developing dental enamel. These evolutionarily-conserved proteins have important roles in enamel mineral formation, as mutations within the amelogenin gene coding region lead to defects in enamel thickness or mineral structure. Because of extensive alternative splicing of the primary RNA transcript and proteolytic processing of the secreted proteins, it has been difficult to assign functions to individual amelogenins. To address the function of one of the amelogenins, we have created a transgenic mouse that expresses bovine leucine-rich amelogenin peptide (LRAP) in the enamel-secreting ameloblast cells of the dental organ. Our strategy was to breed this transgenic mouse with the recently generated amelogenin knockout mouse, which makes none of the amelogenin proteins and has a severe hypoplastic and disorganized enamel phenotype. It was found that LRAP does not rescue the enamel defect in amelogenin null mice, and enamel remains hypoplastic and disorganized in the presence of this small amelogenin. In addition, LRAP overexpression in the transgenic mouse (wildtype background) leads to pitting in the enamel surface, which may result from excess protein production or altered protein processing due to minor differences between the amino acid compositions of murine and bovine LRAP. Since introduction of bovine LRAP into the amelogenin null mouse does not restore normal enamel structure, it is concluded that other amelogenin proteins are essential for normal appearance and function.

The presence of bacteria in the synovial fluid of the temporomandibular joint and clinical significance: preliminary study

PURPOSE

The objective of this study was to find any relation between the presence of specific bacterial species in the synovial fluid of the temporomandibular joint (TMJ) and clinical parameters.

PATIENTS AND METHODS

We studied 43 patients (male-to-female ratio, 1:1.69; average age, 34.37 +/- 14.55 years). Thirty-three patients had a displaced disc in the TMJ (DD group), and 10 patients did not have a displaced disc of the TMJ or any symptom related to TMJ disorders (NDD group). Clinical examinations were made to determine maximum mouth opening, joint sounds, previous trauma history, systemic disease, and TMJ pain. Six bacterial species that were reported in other studies were chosen to evaluate the presence of bacteria in the TMJ for this study.

RESULTS

Mycoplasma genitalium was most frequently detected in synovial fluid (86.0%). Staphylococcus aureus, Mycoplasma fermentans/orale, Actinobacillus actinomycetemcomitans, and Streptococcus mitis were detected in 51.2%, 37.2%, 25.6%, and 7.0% of samples, respectively. beta-Hemolytic Streptococcus was not detected. The prevalence of S aureus was significantly higher in the DD group than in the NDD group (P <.05). The patients who had M. fermentans/orale were 5.40 times more likely to be younger than 30 years than were those without M. fermentans/orale (P <.05). Those with M. genitalium were 5.81 times more likely to be female than were those without M. genitalium (P <.05).

CONCLUSION

The presence of S. aureus in TMJ synovial fluid was related to TMJ disorder symptoms and clinical parameters seemed to be influenced by bacterial presence in TMJ synovial fluid.

Ganglion cyst of the temporomandibular joint

We report a case of cystic lesion in a 37-year-old woman. The patient had an oval-shaped lesion adjacent to the temporomandibular joint. Thick fibrotic tissue and muscle were observed microscopically, but the epithelium lining was not observed. The lesion was diagnosed as a ganglion cyst. The patient's general medical history was non-contributory. High performance liquid chromatography (HPLC) and mass spectrophotometry (MS) revealed some proteins from the fluid in the lesion, such as a filaggrin precursor, dystroglycan, a polyprotein of the hepatitis C virus, and proteins originating from bacteria. The follow-up examinations revealed no recurrence. The probable pathogenesis of the lesion is discussed.

Anti-cancer effect of genistein in oral squamous cell carcinoma with respect to angiogenesis and in vitro invasion

Oral squamous cell carcinoma (OSCC) is one of the most common head and neck cancers. OSCC generally has a poor prognosis due to its tendency towards local invasion and subsequent metastasis, which is mediated by multiple proteolytic enzymes and angiogenesis. The purpose of this study was to evaluate the anti-cancer effects of genistein, a soybean product known to be an effective natural anti-angiogenic agent, with respect to tumor growth, angiogenesis and in vitro invasion in an OSCC model. Northern blot analysis for vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and matrix metalloproteinase-2 (MMP-2), in vitro invasion assay and gelatin zymography were carried out for HSC-3 cells treated with genistein (27.3 microg/ml). In the animal experiment, genistein (0.5 mg/kg) was injected into tumor (HSC-3)-bearing mice (male balb/c/nu). The tumor growth rate and metastasis to lymph node or lung were compared and the microvessel density (CD31) was subsequently analyzed by immunohistochemistry. The genistein-treated group showed a down-regulation in VEGF mRNA expression, but not in bFGF and MMP-2 mRNA expression. Genistein reduced in vitro invasion through the artificial basement membrane and gelatin zymography also showed a reduced gelatinolytic activity in the genistein-treated group. In the genistein-treated mice, a significantly lower CD31 immunoreactivity was found. However, the tumor growth and metastatic behavior in the experimental group and the control group were similar and there were no significant differences. These results suggest the possible use of genistein as an anti-cancer agent in oral squamous cell carcinoma. However, it appears from the present study that anti-angiogenic therapy consisting of a single application of genistein may not provide a satisfactory treatment for OSCC. As a result, further research is recommended to confirm that genistein may be employed as an adjunct treatment modality for OSCC.

Small sewage treatment system with an anaerobic-anoxic-aerobic combined biofilter

The objective of this study was to investigate a small sewage treatment system that could improve nitrogen and BOD5 removal efficiency as well as generate less solid using an anaerobic-anoxic-aerobic biofiltration system. Wastewater temperature was in the range of 14-25 degrees C, and hydraulic residual times were 12 h for each reactor. The upflow anaerobic digester equipped with anoxic filter was fed with both raw sewage and recycled effluent from the aerobic filter to induce denitrification and solid reduction simultaneously. In the subsequent aerobic filter, residual organic carbon and ammonia might be oxidized and finally nitrate formed. In the anaerobic reactor, about 71% of influent TCOD was removed by sedimentation of the un-filterable COD at the recycle ratio of 300%. Another 20% of influent TCOD was removed in the anoxic filter by denitrification of the recycled nitrate. After 100 days operation, solid reduction and nitrification efficiency were about 30% and 95%, respectively. Overall removal efficiencies of COD and total nitrogen (T-N) were above 94% and 70% at the recycle ratio of 300%, respectively. Total wasted solid from the system after 100 days operation was about 316 g, which was only 44% of the solid generated from a controlled activated sludge system operated at sludge retention time of 8 days.

Expression of membrane type I-matrix metalloproteinase in oral squamous cell carcinoma

A local invasion and lymph node metastasis (LNM) of an oral squamous cell carcinoma (OSCC) has a poor prognosis, and involves the degradation of the extracellular matrix mediated by multiple proteolytic enzymes including membrane type I-matrix metalloproteinase (MT1-MMP). This study aimed to determine the role of MT1-MMP in OSCC, to evaluate the immunohistochemical expression of MT1-MMP with regard to the invasiveness and LNM of the OSCC, and to evaluate the major source of MT1-MMP mRNA and its protein using immunohistochemistry and in situ hybridization. MT1-MMP expression was examined in 46 OSCCs via immunohistochemistry and non-radioisotope in situ hybridization. The relationship between MT1-MMP expression and LNM, as well as the histological invasiveness, was statistically analyzed. The results showed that whereas 12 out of the 18 OSCCs (66.7%) with LNM showed moderate to strong MT1-MMP expression, only nine of the 28 OSCCs (32.1%) without LNM expressed MT1-MMP strongly. MT1-MMP expression was significantly higher with regard to LNM (P=0.022). As the invasion grade became stronger (from grade a to grade d), MT1-MMP was significantly more strongly expressed (P=0.033). These results suggest that MT1-MMP is primarily secreted in the OSCC cells and is involved in the invasiveness of the OSCC and LNM. Moreover, MT1-MMP combined with other markers may be used to predict the metastatic potential of an OSCC.

Geobacillus toebii sp. nov., a novel thermophilic bacterium isolated from hay compost

A thermophilic, spore-forming rod isolated from hay compost in Korea was subjected to a taxonomic study. The micro-organism, designated strain SK-1(T), was identified as being aerobic, Gram-positive, motile and rod-shaped. Growth of the isolate was observed at 45-70 degrees C (optimum 60 degrees C) and pH 6.0-9.0 (optimum pH 7.5). The G+C content of the genomic DNA was 43.9 mol%. Chemotaxonomic characteristics of the isolate included the presence of mesodiaminopimelic acid in the cell wall and iso-C15:0 and iso-C17:0 as the major cellular fatty acids. The predominant isoprenoid quinone was MK-7. The chemotaxonomic characteristics of strain SK-1(T) were the same as those of the genus Geobacillus. Phylogenetic analysis based on 16S rDNA sequences showed that strain SK-1(T) is most closely related to Geobacillus thermoglucosidasius. However, the phenotypic properties of strain SK-1(T) were clearly different from those of G. thermoglucosidasius. The level of DNA-DNA relatedness between strain SK-1(T) and the type strain of G. thermoglucosidasius was 27%. On the basis of the phenotypic traits and molecular systematic data, strain SK-1(T) represents a novel species within the genus Geobacillus, for which the name Geobacillus toebii sp. nov. is proposed. The type strain is strain SK-1(T) (= KCTC 0306BP(T) - DSM 14590(T)).

Nucleotide sequence of envelope protein of Japanese encephalitis virus SA14-14-2 adapted to vero cells

Live attenuated Japanese encephalitis (JE) virus SA(14)-14-2 produced in primary dog kidney cells (PDK) was adapted to Vero cells. In an effort to gain insight into the molecular basis of the biological characteristics of the SA14-14-2(Vero) strain, the 1500 nucleotide sequence encoding the envelope (E) gene which possesses major neutralizing epitopes was determined and compared with the sequences of two other attenuated JE virus strains, SA14-14-2(PHK) and SA14-14-2(PDK). The amino acid sequence of the C-terminal region (a.a. 280-500) was found to be identical for all three strains, while the N-terminal region (a.a. 1-279) shows sequence variation. The distribution of mutations in the N-terminal region was nearly the same among the three attenuated strains, suggesting that the N-terminal sequences might be related with virus-host cell specificity. However, it was found that Lys and Val (a.a. 138 and 176, respectively), known to be responsible for attenuation, are still conserved in SA(14)-14-2(Vero). Animal testing showed that SA(14)-14-2(Vero) has an attenuation phenotype similar to that of the parent SA(14)-14-2(PDK) strain in mice.