Influence of lingual plate fracture pattern on remodelling site during the healing process of sagittal split ramus osteotomy.

The purpose of this study was to investigate whether differences in the pattern of the lingual plate split in sagittal split ramus osteotomy (SSRO) affect the remodelling of the split site. Sixty-one patients with mandibular prognathism (122 sides) underwent SSRO. Computed tomography (CT) was performed at 1 week and 1 year after SSRO. Bone splits were classified according to the lingual split scale (LSS) and the lateral bone cut end (LBCE) by evaluating CT images at 1 week. The remodelling at the split sites was evaluated by superimposing the CT images obtained at 1 week and 1 year. Regarding the LSS pattern, significant differences were observed in the distance between anteroposterior ramus points (P = 0.033) and the ramus area in the axial image (P = 0.011). The LBCE pattern also showed a significant difference in the distance between anteroposterior ramus points (P = 0.043). In conclusion, the differences in the lingual plate split and ramus cut end of the SSRO influence the postoperative remodelling in the anteroposterior region of the split site.

Anti-PD-1 antibody monotherapy versus anti-PD-1 plus anti-CTLA-4 combination therapy as first-line immunotherapy in unresectable or metastatic mucosal melanoma: a retrospective, multicenter study of 329 Japanese cases (JMAC study).

BACKGROUND: Anti-programmed cell death protein 1 (PD-1) antibody monotherapy (PD1) has led to favorable responses in advanced non-acral cutaneous melanoma among Caucasian populations; however, recent studies suggest that this therapy has limited efficacy in mucosal melanoma (MCM). Thus, advanced MCM patients are candidates for PD1 plus anti-cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) combination therapy (PD1 + CTLA4). Data on the efficacy of immunotherapy in MCM, however, are limited. We aimed to compare the efficacies of PD1 and PD1 + CTLA4 in Japanese advanced MCM patients. PATIENTS AND METHODS: We retrospectively assessed advanced MCM patients treated with PD1 or PD1 + CTLA4 at 24 Japanese institutions. Patient baseline characteristics, clinical responses (RECIST), progression-free survival (PFS), and overall survival (OS) were estimated using Kaplan-Meier analysis, and toxicity was assessed to estimate the efficacy and safety of PD1 and PD1 + CTLA4. RESULTS: Altogether, 329 patients with advanced MCM were included in this study. PD1 and PD1 + CTLA4 were used in 263 and 66 patients, respectively. Baseline characteristics were similar between both treatment groups, except for age (median age 71 versus 65 years; P < 0.001). No significant differences were observed between the PD1 and PD1 + CTLA4 groups with respect to objective response rate (26% versus 29%; P = 0.26) or PFS and OS (median PFS 5.9 months versus 6.8 months; P = 0.55, median OS 20.4 months versus 20.1 months; P = 0.55). Cox multivariate survival analysis revealed that PD1 + CTLA4 did not prolong PFS and OS (PFS: hazard ratio 0.83, 95% confidence interval 0.58-1.19, P = 0.30; OS: HR 0.89, 95% confidence interval 0.57-1.38, P = 0.59). The rate of ≥grade 3 immune-related adverse events was higher in the PD1 + CTLA4 group than in the PD1 group (53% versus 17%; P < 0.001). CONCLUSIONS: First-line PD1 + CTLA4 demonstrated comparable clinical efficacy to PD1 in Japanese MCM patients, but with a higher rate of immune-related adverse events.

The immature platelet fraction is a useful marker for predicting the timing of platelet recovery in patients with cancer after chemotherapy and hematopoietic stem cell transplantation.

Prediction of the timing of platelet recovery after chemotherapy and hematopoietic stem cell transplantation (HSCT) allows for optimal platelet transfusion. We assessed the clinical utility of the percentage value of the immature platelet fraction (IPF%) monitored using an XE-2100 automated hematology analyzer to predict the timing of platelet recovery after chemotherapy and HSCT. The IPF% was serially monitored in 31 patients with cancer who received 66 courses of chemotherapy and HSCT. In patients with cancer undergoing chemotherapy and HSCT, a transient increase in IPF% was observed 1-11 days prior to platelet recovery (>30 × 109 /l). In patients undergoing chemotherapy with a peak IPF% >10%, platelet recovery occurred significantly earlier than in those with IPF% peak values ≤10% (median periods were 2 and 5 days; P < 0.05). Platelet recovery appears to occur earlier in patients undergoing HSCT with a peak IPF% >10% than in those with IPF% peak values ≤10% (median periods were 2 and 6 days). Thus, the IPF% peak value is a useful parameter for predicting the timing of platelet recovery after chemotherapy and HSCT and has the potential to facilitate optimal platelet transfusion.

[Pseudo-Kaposi's sarcoma secondary to superficial arteriovenous malformation: Stewart-Bluefarb syndrome]. / Pseudomaladie de Kaposi secondaire à une malformation artérioveineuse superficielle: syndrome de Stewart-Bluefarb.

BACKGROUND: Pseudo-Kaposi's sarcoma or Stewart-Bluefarb subtype acroangiodermatitis is uncommon and is caused by arteriovenous fistula and malformation. We report a new case. CASE REPORT: A 33-year-old man presented with painful red-violet plaque on the dorsum of the toes with angiomatous nodules on the sole. Histological and immunohistochemical studies for CD34 were consistent with Kaposi's sarcoma. Doppler ultrasonography and femoral angiography showed multiple distal arteriovenous shunts. Free-flow embolisation with fragments of Ethibloc gelatin sponge was performed and arteriography, performed immediately afterwards, showed delayed venous drainage. The outcome was good with complete drainage of the angiomatous lesions. DISCUSSION: Pseudo-Kaposi's sarcoma Stewart-Bluefarb subtype begins early in life in male subjects, with unilateral skin lesions. It bears clinical and histological resemblance to Kaposi's sarcoma. Doppler ultrasonography and angiography show arteriovenous fistulas that classically develop at shunts, explaining the role of traumatism and high vascular pressure in the genesis of this disease.

[Cutaneous blastomycosis revealing intravascular B-cell lymphoma: a case in Morocco]. / Blastomycose cutanée révélant un lymphome B intravasculaire: une observation marocaine.

Blastomycosis is a systemic fungal infection caused by a thermally dimorphic fungus, Blastomyces dermatitidis. The incidence in immunocompromised patients has increased in the last two decades. A 55-year-old man consulted for inflammatory nodules on the forearm. Biopsy of one nodules showed a pseudoepitheliomatous hyperplastic epidermis overlaying a dense agranulomatous inflammatory infiltrate containing free-formed ovoid bodies enclosing giant macrophageous cells. These findings were consistent with blastomycosis. After a month of treatment cutaneous lesions regressed partially but the patient's general status continued to deteriorate with the appearance of an edematous-ascitic syndrome and icterus. Laboratory blood testing demonstrated cholestasia and abdominal ultrasound showed hepatosplenomegaly. Needle liver biopsy revealed giant B-cell lymphomatous infiltration of the hepatic ducts. The patient's condition worsened rapidly and he died five months after diagnosis despite four rounds of chemotherapy. Blastomycosis is rare in Morocco. Primary infection is usually a pneumonic process. Isolated cutaneous infection is possible but uncommon. To our knowledge the association of blastomycosis and intravascular lymphoma has not been previously reported. In immunocompromised patients, clinical findings can be alarming and the outcome can be rapidly fatal.

Detoxification mechanism of heavy metals in marine mammals and seabirds: interaction of selenium with mercury, silver, copper, zinc, and cadmium in liver.

Subcellular distribution of mercury, selenium, silver, copper, zinc, and cadmium was determined in the liver of northern fur seals (Callorhinus ursinus), black-footed albatrosses (Diomedea nigripes), and Dall's porpoises (Phocoenoides dalli). Mercury, selenium, and silver were preferentially accumulated in nuclear, lysosomal, and mitochondrial fraction with an increase in their hepatic concentrations, whereas copper, zinc, and cadmium were accumulated mainly in cytosol with an increase in the hepatic concentrations for all three species. To gain insight into the existing state of the metals, they were extracted with four extractants--sodium dodecylsulfate (SDS); 2-mercaptoethanol; 2-mercaptoethanol + guanidinium thiocyanate; and copper sulfate (CuSO4)--at several concentrations from nuclear, lysosomal, and mitochondrial fraction in liver from a specimen of northern fur seal. Extraction efficiencies of the metals for 2-mercaptoethanol + guanidinium thiocyanate and CuSO4 were much higher than those for SDS and 2-mercaptoethanol. Also, for all individuals of the three species, metals were extracted by the three extractants--2% SDS; 0.25 mol/L 2-mercaptoethanol + 5 mol/L guanidinium thiocyanate; and 0.1 mol/L CuSO4--from nuclear, lysosomal, and mitochondrial fraction of liver. In the northern fur seals with higher concentration of mercury, the molar ratio of selenium to mercury approached unity in the nonextractable fraction of 0.25 mol/L 2-mercaptoethanol + 5 mol/L guanidinium thiocyanate, suggesting the possible formation of mercuric selenide (HgSe) with increasing hepatic concentration. Because the nonextractable content of mercury and its distribution were larger for black-footed albatross than those for the other two species, it was suggested that the black-footed albatross has a stronger ability to form a stable compound(s) of mercury in the liver. It is notable that the existing state of silver was similar to that of mercury as judged by their subcellular distribution and the extraction tests, suggesting that silver also interacted with selenium in the liver of marine animals used in this study.

[Wound myiasis due to Wohlfahrtia magnifica. First human case in Morocco]. / Myiase des plaies dues à Wohlfahrtia magnifica (Schiner, 1862). Premier cas humain au Maroc.

Wohlfahrtia magnifica is a frequent fly in countries with high breeding activity: Australia, South Africa or Arab country The parasitological infestation occurred essentially during the summer, favourable period to the biological evolution of the flies. In this work, we report one case of wound myiasis that complicates a cutaneous lesion caused by larvae of Wohlfahrtia magnifica. This observation constitutes the first human case in our country.

Surface treatment of dentin with GLUMA and iron compounds for bonding indirect restorations.

The purpose of this study was to evaluate five dentin bonding systems simulating indirect restorations. The surface of bovine and human dentin was primed with a glutaraldehyde agent (GLUMA) and placed in a humidor at 37 degrees C for 168 h. In an experimental bonding system (GLUMA/CY/SB), the surfaces were etched with phosphoric acid, primed with cytochrome c, and then bonded to an acrylic rod with a self-curing resin (4-META/MMA-TBB). Specimens using two commercially available bonding systems [All-Bond 2 (AB2) and Super-Bond C & B (10-3/SB)] and two controls with and without GLUMA (GLUMA/10-3/SB and CY/SB) were also prepared. Tensile testing revealed that the bond strengths were influenced by the bonding system, 168 h dentin exposure and their interaction, but not by the tooth origin. AB2 showed the lowest bond strength. With the 10-3/SB system, exposing the dentin to humidity resulted in a decrease in bond strength. After 168 h of exposure, no significant differences were observed between 10-3/SB and CY/SB. The most effective bonding was obtained with the bonding systems of GLUMA/10-3/SB and GLUMA/CY/SB. Improved outcome is expected with these bonding systems when building up abutment teeth with indirect restorations.

Cytotoxicity of reactive oxygen species and related agents toward undifferentiated and differentiated rat phenochromocytoma PC12 cells.

The cytotoxicity of reactive oxygen species and related agents toward cultured rat adrenal medullary phenochromocytoma PC12 cells was examined. These species and agents include hydrogen peroxide, linoleic acid hydroperoxide (LOOH), tert-butyl hydroperoxide, paraquat, 2,2'-azobis(2-amidinopropane) dihydrochloride (AAPH), 2,2'-azobis(2,4-dimethylvaleronitrile) (AMVN), and a hypoxanthine-xanthine oxidase system. The respective 50% lethal concentrations (LC50) for undifferentiated and differentiated PC12 cells were found to be 275 and 165 microM of hydrogen peroxide, 58.3 and 35.3 microM of LOOH, 536 and 212 microM of tert-butyl hydroperoxide, 42.5 and 26.5 mM of paraquat, 79.5 and 74.5 mM of AAPH, 412 and 300 microM of AMVN, and 37.2 and 16.6mU x ml(-1) xanthine oxidase activity of the hypoxanthine-xanthine oxidase system. These results show that the differentiated cells were more susceptible to these oxidative agents than the undifferentiated cells. The glutathione peroxidase activity level of the undifferentiated cells was 2-3 times higher than the differentiated cells, the catalase activity level also tended to be higher, the superoxide dismutase activity level was higher on a per-protein-quantity basis but lower on a per-cell-number basis, and the total and reduced glutathione concentration levels were considerably higher. The enhanced susceptibility of the differentiated cells may result from decreases in the activity of glutathione peroxidase and the concentration of its substrate, reduced glutathione (GSH). Further, the preincubation of PC12 cells with alpha-tocopherol or L-buthionine-(R,S)-sulfoximine (BSO) lowered or enhanced their cytotoxicities, respectively.

[Cutaneous blastomycosis revealing a corticoadenoma]. / Blastomycose cutanée révélant un corticosurrénalome.

BACKGROUND: Blastomycosis is an uncommon chronic granulomatosis caused by Blastomyces dermatitidis. We present a case with a skin localization that disclosed malignant corticoadenoma. CASE REPORT: A 32-year-old man consulted for inflammatory nodules of the face and lower limbs. The histological examination of a nodule biopsy was in favour of blastomycosis. Ketoconazole treatment was ineffective. Amphotericin B provided cure of the skin lesions. Search for extension disclosed a malignant corticoadrenoma. DISCUSSION: Blastomycosis is very rare in Morocco. The portal is usually the lung. Unique skin involvement is very exceptional. To our knowledge this is the first report of a blastomycosis-corticoadenoma association. The clinical situation may be alarming in immunodepressed subjects. Amphotericin B treatment is indicated.

Enhancement of rat hypoglossal nerve regeneration by chitin sheet plus gangliosides.

The effects of chitin sheet interposition with and without brain gangliosides on the regeneration of hypoglossal nerve fibres was studied in the rat following resection of a 5mm length of the nerve. At 10 weeks after operation, the number of horseradish peroxidase (HRP)-labelled motor neurones, indicative of the axonal repair process, on the side treated with chitin and gangliosides was higher than on the control side (where 5mm of the nerve was simply resected). The ratios of HRP-positive neurones in the right hypoglossal nucleus (treated side)/left hypoglossal nucleus (intact side) was 0 in the 5mm-resected group, 53% in the chitin-grafted group, 88% in the ganglioside (0.2 microg)-injected group, 90% in the ganglioside (2 microg)-injected group, 91% in the chitin with ganglioside (0.2mg)-injected group, 91% in the chitin with ganglioside (2 microg)-injected group and 85% in the autograft group, respectively. There were significant differences between the 5 mm-resected group and chitin-grafted group, ganglioside-injected group, chitin with ganglioside group and autograft group, and between the chitin-grafted group and ganglioside-injected, chitin with ganglioside and autograft groups (P< 0.005, respectively). Our results indicated that the use of chitin and gangliosides stimulated the regeneration of severed motor nerve fibres. These findings suggest that chitin and gangliosides might be therapeutically useful for treatment of neuronal degeneration.

Cutaneous monomorphous CD4- and CD56-positive large-cell lymphoma.

BACKGROUND: Recently, CD56 (NCAM)-positive lymphomas, such as nasal and nasal-type angiocentric NK/T cell lymphoma, aggressive NK cell leukemia/lymphoma and blastic NK cell lymphoma, were described by several authors as a unique group of lymphoma. OBJECTIVE: In this study, we intend to clarify the clinicopathological features of cutaneous CD4+ and CD56+ lymphoma. METHODS: Four patients with cutaneous CD4+ and CD56+ lymphoma were studied. RESULTS: Age at the first examination ranged from 71 to 89 years (mean = 81.2 years). One patient was female and 3 were males. The organ mainly involved at presentation was the skin. Lymphadenopathy, splenomegaly, leukemic spread and central nervous system involvement were observed as the disease progressed. The mean survival time was 12.2 months. Epstein-Barr virus was not detected within the tumor cells. CONCLUSION: This peculiar lymphoma is different from nasal and nasal-type angiocentric NK/T cell lymphoma and aggressive NK cell leukemia/lymphoma. Similar cases have been reported as blastic NK cell lymphoma/leukemia.

Identification of antigenic proteins encoded by human herpesvirus 8 and seroprevalence in the general population and among patients with and without Kaposi's sarcoma.

To establish a sensitive and specific antibody assay, potent antigenic proteins encoded by human herpesvirus 8 (HHV8) were studied. Fifteen recombinant HHV8-encoded proteins were produced as glutathione S-transferase fusion proteins. The sera from AIDS-associated Kaposi's sarcoma (KS) patients reacted with four proteins encoded by open reading frames (ORFs) K8.1, 59, 65, and 73 in a Western blot assay. An enzyme-linked immunosorbent assay (ELISA) using these four proteins as antigens (mixed-antigen ELISA) revealed that all 26 sera derived from KS patients (24 with and 2 without human immunodeficiency virus infection) became positive for anti-HHV8 antibodies. The presence of HHV8 was demonstrated in 14 (1. 4%) of 1,004 sera from the Japanese general population and 10 (1.9%) of 527 sera from patients without HHV8-associated diseases. The presence of immunoglobulin G (IgG) and IgM antibodies against HHV8 examined further by the mixed-antigen ELISA and Western blotting revealed IgG antibody in all ELISA-positive sera, while IgM antibody against ORF K8.1 was absent. These data suggest that the ORF 73 and 65 proteins are potent antigens for a sensitive serological assay.

Molecular cloning of the gene encoding an outer-membrane-associated beta-N-acetylglucosaminidase involved in chitin degradation system of Alteromonas sp. strain O-7.

The gene encoding beta-N-acetylglucosaminidase (GlcNAcaseA) was cloned using PCR with degenerate oligonucleotide primers from the partial amino acid sequence of the enzyme. The gene encoded a polypeptide of 863 amino acids with a predicted molecular mass of 97kDa. A characteristic signal peptide, which was present at the amino-terminus of the precursor protein, contained four amino acids (Ala-Gly-Cys-Ser) identical in sequence and location to the processing and modification sites of the outer membrane lipoprotein of Escherichia coli, indicating that the mature GlcNAcaseA is a lipoprotein the N-terminal cysteine residue of which would be modified by the fatty acid that anchors the protein in the membrane. The predicted amino acid sequence of GlcNAcaseA showed similarity to bacterial beta-N-acetylglucosaminidases belonging to the family 20 glycosyl hydrolases.

Reciprocal changes in the expression of Bcl-2 and Bax in hypoglossal nucleus after axotomy in adult rats: possible involvement in the induction of neuronal cell death.

Numerous studies of neonatal neuronal development in mammals have revealed that neuronal cell death following axotomy is apoptotic in nature. In adult animals, however, neuronal cell death following axonal injury may or may not exhibit features of apoptosis. Bcl-2 and Bax have been identified as inhibitor and promoter proteins, respectively, of apoptosis. To investigate the relationship between these proteins and neuronal cell death following axotomy in adult animals, we performed axotomy of the right hypoglossal nerve in adult male Wistar rats, and sacrificed the rats at various intervals after axotomy. We analyzed the expression of Bcl-2 and Bax immunohistochemically in the hypoglossal nuclei of the adult rats following axotomy. Our analysis showed an increase in the percentage of Bax-positive motoneurons relative to the total number of motoneurons in the hypoglossal nucleus on the axotomy side at three days after axotomy. In contrast, a low percentage of Bcl-2-positive motoneurons to the total number of motoneurons was noted at the same time interval after axotomy. Quantitative analysis of the signal intensity for Bcl-2 and Bax in individual neurons showed that Bax immunostaining significantly increased 7 days after axotomy, while the intensity of Bcl-2 immunostaining decreased in most of Bcl-2-positive neurons. Our results confirmed the occurrence of motoneuron cell death in adult rats after axotomy, and that a close temporal relationship exists between the reciprocal changes in Bcl-2/Bax expression and the loss of motoneurons. These results indicate the possible involvement of the Bcl-2/Bax system in the induction of neuronal cell apoptosis after axotomy in adult rats.

Evidence that the cannabinoid CB1 receptor is a 2-arachidonoylglycerol receptor. Structure-activity relationship of 2-arachidonoylglycerol, ether-linked analogues, and related compounds.

An endogenous cannabimimetic molecule, 2-arachidonoylglycerol, induces a rapid, transient increase in intracellular free Ca2+ concentrations in NG108-15 cells through a cannabinoid CB1 receptor-dependent mechanism. We examined the activities of 24 relevant compounds (2-arachidonoylglycerol, its structural analogues, and several synthetic cannabinoids). We found that 2-arachidonoylglycerol is the most potent compound examined so far: its activity was detectable from as low as 0.3 nM, and the maximal response induced by 2-arachidonoylglycerol exceeded the responses induced by others. Activities of HU-210 and CP55940, potent cannabinoid receptor agonists, were also detectable from as low as 0.3 nM, whereas the maximal responses induced by these compounds were low compared with 2-arachidonoylglycerol. Anandamide was also found to act as a partial agonist in this assay system. We confirmed that free arachidonic acid failed to elicit a response. Furthermore, we found that a metabolically stable ether-linked analogue of 2-arachidonoylglycerol possesses appreciable agonistic activity, although its activity was apparently lower than that of 2-arachidonoylglycerol. We also confirmed that pretreating cells with various cannabinoid receptor agonists nullified the response induced by 2-arachidonoylglycerol, whereas pretreating cells with other neurotransmitters or neuromodulators did not affect the response. These results strongly suggested that the cannabinoid CB1 receptor is originally a 2-arachidonoylglycerol receptor, and 2-arachidonoylglycerol is the intrinsic physiological ligand for the cannabinoid CB1 receptor.

Preparation of heat-labile antigens on air-dried cytologic specimens for immunocytochemical analysis.

OBJECTIVE: To demonstrate the efficacy of Zamboni's solution and storage medium for immunocytochemistry of Ki-67, p53 tumor suppressor gene product and CD3 on long-preserved, air-dried cytologic specimens. STUDY DESIGN: Air-dried imprint cytologic specimens obtained from 13 lymphatic tissues and 13 colorectal cancers were fixed with Zamboni's solution and stored for various periods in storage medium including 50% glycerol at -10 to -20 degree C. Mouse monoclonal antibody PC, PAb 1801 and anti-Leu-4 were used for immunostaining. RESULTS: Immunocytochemical identification of Ki-67, p53 and CD3 was possible on specimens stored for 36, 32 and 16 weeks, respectively. CONCLUSION: Our method, using Zamboni's solution and storage medium, is feasible for immunocytochemistry on long-preserved, air-dried cytologic specimens using the three antibodies were employed.