RFLP analysis in the TNF-beta gene and the susceptibility to alloreactive NK cells in Behçet's disease.

Behçet's disease is known to be associated with HLA-B51. To address the possibility that a non-human leukocyte antigen (HLA) gene closely linked to the HLA-B gene, such as tumor necrosis factor (TNF)-alpha, TNF-beta, or ECl (the locus that determines the susceptibility to alloreactive natural killer [NK] cells), is involved in the susceptibility to Behçet's disease, NcoI and EcoRI restriction fragment length polymorphisms in the TNF-beta gene and the susceptibility to lysis by alloreactive NK cells were investigated in Behçet's patients. In our NcoI restriction fragment length polymorphism (RFLP) analysis in the TNF-beta gene, the frequency of the NcoI 5.5 kb homozygote was decreased considerably in the patients, especially those with the ocular lesions, in relation to the healthy controls. However, no significant difference was observed between these groups in the EcoRI RFLP band distribution in this gene or the in susceptibility to lysis by alloreactive NK cells. These results indicated that a non-HLA gene located around the TNF gene region centromic of the HLA-B gene was a candidate to control the genetic susceptibility to Behçet's disease.

Microsatellite polymorphism between the tumor necrosis factor and HLA-B genes in Behçet's disease.

Behçet's disease is associated with the HLA-B51 antigen. However, it has not yet been clarified if the HLA-B51 gene itself is the susceptibility gene related to this disease or if it is some other non-HLA gene in linkage disequilibrium with HLA-B51. Therefore, we screened one of the HSP70 genes, HUM70t (HSP70-Hom), around the class III region and the microsatellite sequence located between the HLA-B and TNF genes for genetic polymorphism in BD. A comparison between patients with BD and healthy controls revealed no significant difference in the frequency of the HUM70t polymorphism. In the microsatellite sequence, Tau-a, in the region between the HLA-B and TNF genes, the frequency of 14 repetitions of GT was increased significantly and that of 11 repetitions was decreased significantly in the patient group. Further, the allelic distributions of the B51 antigen-associated microsatellite polymorphism differed significantly between patients and healthy controls, and in the B51 antigen-negative subjects, analysis of the microsatellite polymorphism also revealed a significant difference in the haplotype frequency between the patient and control groups. These results suggest that the HLA-B51 gene may not be the primary locus responsible for BD, and implicate some other gene(s) located between the TNF and HLA-B genes.

In situ staining with DNA-binding fluorescent dye, Hoechst 33258, to detect microorganisms in the epithelial cells of oral leukoplakia.

This study was performed to investigate the presence of microorganisms in the epithelial cells of leukoplakia. Frozen sections of 20 specimens of leukoplakia were stained with DNA-binding bisbenzimide Hoechst 33258. As a control, 20 specimens of normal oral mucosa and five specimens of normal skin were used. In all preparations of leukoplakia, small granular fluorescing structures were observed within the cytoplasm of the epithelial cells, predominantly within the cytoplasm of prickle cells, although the amount of the granular structures varied between specimens, layers of the epithelium and even areas of the epithelium within a single section. Less granular structures were observed, or none at all, in the cytoplasm of the epithelial cells of normal mucosa. No structures were observed in the cytoplasm of the epithelium of skin. The results in this study strongly suggest that microorganisms are present in the epithelial cells of oral mucosa, and that they are closely associated with the development of oral leukoplakia. It is postulated that the microorganisms in the epithelial cells could be bacteria, particularly mycoplasmas.

Treatment results of oral verrucous carcinoma and its biological behavior.

The biologic behavior of and optimal treatment for oral verrucous carcinoma (VC) remain controversial. We analyzed the clinicopathological characteristics of 12 patients with oral VC. Immunohistochemical techniques were used to evaluate p53 protein, CD44 variant 9, and proliferating cell nucleus antigen. The TNM classification (UICC, 1997) was T1 in 1 patient, T2 in 3, T3 in 4, and T4 in 4. All patients were classified as N0M0. Four patients were treated by surgery alone and 8 by surgery after chemotherapy, radiotherapy, or both. After surgery, two patients had primary recurrence of disease. Immunohistochemically, the proliferative activity of tumor cells as evaluated by proliferating cell nuclear antigen labeling index and p53 protein expression was similar in VC and well-differentiated squamous cell carcinoma. However, CD44 varient 9 expression was positive in 8 of 10 VC, suggesting that oral VC is associated with a low risk of lymph node metastasis. Positive CD44 variant 9 expression by most oral VCs, indicating a low risk of cervical lymph node metastasis, suggests that most cases can be controlled by surgical intervention.

Congenital fistula with an island of vermilion-epithelium in the paramidline of the upper lip: report of a case.

An extremely rare case of a congenital fistula with an island of vermilion-epithelium in the paramidline of the upper lip in a 17-year-old male is presented. The fistula was located in the paramidline of the philtrum dimple, and mucoid secretion from the fistula was noted. The fistula's orifice opened in the center of a well-defined, slightly dimpled, round, vermilion-like epithelium just above the vermilion border. The fistulous tract terminated in a cul-de-sac and its end was located near the alveolar process. Fistulectomy was carried out via an extra-oral approach and the epithelial defect was closed using a rotation flap. Histological examination revealed that the fistula was lined by squamous epithelium with sebaceous and mucous glands, and vermilion-like area island consisted of thin keratinized stratified squamous epithelium without skin appendages, the same as the epithelium of the lip vermilion.

Oronasal fistulae in repaired cleft palates.

The study reviews oronasal fistulae occurring after palatoplasty. Subjects were fifty-two patients who had received palatoplasty in our clinic from 1981 to 1987. In twenty-one cases (40%) oronasal fistulae persisted. Two-thirds of these fistulae were slits or pinholes. The ratio of fistula occurrence was relatively high compared to other reports. Most of them were observed at the junction of the premaxilla and maxilla. There was no significant difference between fistula formation and the distance of the push back, and also there was no correlation with the width of the cleft.

[Electrophysiological atlas of human thalamus and adjacent structures.--Microcomputer assisted mapping of neurophysiological data and its application to stereotaxic surgery].

During stereotaxic surgery anatomical structures and their extent on trajectories were identified by neural noise (field potential) obtained by semi-microelectrode technique. Locations of anatomical structures (the white mater, caudate nucleus, thalamus, subthalamic field and nuclei in the subthalamic field) were fed into microcomputer (NEC PC-8001) as 3 dimensional correlates and stored in minifloppy disc system (NEC PC-8031). Data with satisfactory recordings from 48 trajectories from 30 patients (18 parkinsonism, 5 central pain, 7 others) entered this study. Microcomputer was so programmed that locations of the trajectories and electrophysiologically identified anatomical structures at that location in various coronal, sagittal and horizontal planes were displayed. Accumulation of this display from various groups of patients automatically created electrophysiological atlas. For comparison of thus created electrophysiological atlas with anatomical atlas display was made on various sections of the Schaltenbrand and Bailey's Atlas which were also stored in the mimifloppy disc system. Electrophysiological topography of the thalamus and adjacent structures was reasonably similar to anatomical topography with minor, but significant individual variations. In most cases the ventral border of the thalamus was located in the close vicinity of CA-CP line, however, in some cases the thalamus was located deep into the subthalamic field. This was thought to be due to the difficulty in identifying the ventral border of the thalamus by this technique and in such occasions other neurophysiological method for identifying the ventral border of the thalamus, i.e., thalamocortical evoked potential and other stimulation technique, were necessary. Medial aspect of the V. im. nucleus emitted neural noise of different characteristics which in current program was recognized as the subthalamic field. This implies that the medial and lateral aspects of the V. im. nucleus are cytoarchitecturally different and that it is possible to differentiate the medial and lateral aspects of the V. im. nucleus by this technique. The lateral thalamic border, i.e., thalamocapsular border, also showed relatively wide range of individual variations. When various parameters including age, sex, diagnosis and width of the 3rd ventricles were examined for possible cause of these variations, a tendency was noted that the thalamocapsular border was medially placed when the width of the 3rd ventricle was small. In this system it is possible to display sequentially electrophysiologically identified structures along any trajectory. This display method, which was called "tract study," was very usefull for comprehensive understanding of location of trajectory in relation to individually varying anatomical structures...

[A case of duplication of the middle cerebral artery with ruptured aneurysm on its origin during pregnancy (author's transl)].

A rare case of duplication of the middle cerebral artery with a ruptured aneurysm on its origin during pregnancy was reported. A 29-year-old woman, primipara, was admitted to our clinic at 17 weeks' gestation on June 26, 1979 with a history of sudden onset of severe headache and vomiting, followed by unconsciousness fit for 30 minutes. The patient displayed typical features of subarachnoid hemorrhage. Lumbar puncture revealed bloody CSF. Right carotid angiogram 20 days after admission demonstrated duplication of the middle cerebral artery arising from the terminal internal carotid artery and a small aneurysm at its origin. There was evidence of associated spasm in the internal carotid artery, M1 and A1 portion without hematoma. The patient was treated conservatively for 2 months and then aneurysm surgery was performed. At operation, under the hypotensive anesthesia, on August 21, 1979, the presence of duplication of the middle cerebral artery on the right side and ruptured aneurysm on its origin were confirmed. The neck of aneurysm was completely clipped. Fetal heart rates were monitored by Doptone monitor during the operation. Postoperative course was excellent. Three months postoperatively, the patient went into spontaneous labor, at 40 week's gestation, and delivered a healthy infant. Clinical management of subarachnoid hemorrhage in pregnancy and the relationship between anomaly of the middle cerebral artery and aneurysm were discussed with the literature.

Toxicity of singlet oxygen generated thermolytically in Escherichia coli.

Three water-soluble derivatives of naphthalene endoperoxide were prepared to examine the toxicity of singlet oxygen towards Escherichia coli. On incubation without irradiation, these endoperoxides produce singlet oxygen thermolytically in a dose-dependent manner. The amount of singlet oxygen produced per unit time can be controlled by varying both the incubation temperature and the number of methyl substituents of the naphthalene endoperoxide derivatives. 3-(1,4-Dihydro-1,4-epidioxy-4-methyl-1-naphthyl)propionic acid (EP-1), one of the derivatives, inhibited E. coli growth dose- and incubation temperature-dependently and caused E. coli lethality. Furthermore, EP-1 did not induce superoxide dismutase or catalase in E. coli even when the cells were incubated in nutritionally rich medium containing trypticase/soy/yeast extract. Singlet oxygen, one of the reactive oxygen species, did not act as a signal for induction of superoxide dismutase and catalase, in contrast to the actions of superoxide and hydrogen peroxide.

Treatment of mandibular arteriovenous malformation by transvenous embolization: A case report.

BACKGROUND: Arteriovenous malformations (AVMs) of the mandible are relatively rare and potentially life-threatening lesions. Treatment is usually difficult. This study presents a case with high-flow AVM of the mandible in which most of the AVM were occluded by transvenous coil embolization. METHODS: Transvenous embolization using several size 57 microcoils and 3 Gianturco coils was performed through a right femoral vein access. The small residual AVM was occluded by superselective transarterial injection of cyanoacrylate. RESULTS: Angiography after embolization showed almost complete obliteration of AVM. Panoramic radiograph 2 years after treatment confirmed reossification. There was no recurrence of the symptoms in a follow-up evaluation 2 years later. CONCLUSION: Transvenous coil embolization may be a safer and more effective method in the treatment of mandibular AVM.

Heterotopic brain of the tongue.

A 6-week-old male infant with lingual mass suffered from feeding difficulty and respiratory distress. Resected specimens revealed brain tissue composed of astroglia, oligodendroglia, ependyma, choroid plexus, neuronal cells, and primitive cells but no other elements suggestive of teratoma, therefore it was diagnosed as heterotopic brain of the tongue.

[Application of a stent splint to protect intraoral organs from radiation injury in a 97-year-old patient with multiple oral cancers who survived to over 100 years old].

Radiation therapy had been used with increasing frequency in recent years in the management of oral cancers of advanced ages. In those cases we have to take good care to maintain the oral health of patients undergoing cancerocidal dose of radiation therapy. Using splints, as a tissue displacer, during radiation, we could treat a 99-year-old female patient without serious radiation sequelae, successfully she survived over 100 year-old. As she visited us at 97 year-old, the primary lesions located on the left upper lip, nose, upper and lower gums were diagnosed as multiple verrucous carcinoma histologically. Seventeen months after the first radiotherapy to the lip, nose and upper jaw, we planned again radiotherapy to the recurrent tumor of the lower gum. In order to eliminate and minimize side effects of the second irradiation for the contiguous intraoral organs, we devised a splint to exclude the tongue and upper gum apart from a radiation field. The splint, as tissue displacer, was made of heat-cured acrylic resin and divided into two pieces which were formed like full denture without artificial teeth. They were applied to the upper and lower jaws. The lower one had a large wing to exclude the tongue from irradiation field. After setting of the splint, she had been clenched slightly with an aid of chin cap. Then we could finish successfully the radiotherapy with 10 MV X-ray 40 Gy as scheduled without serious troubles.