Immunoaffinity purification and characterisation of p29--an estrogen receptor related protein.

p29, a 29 kDa protein recognised by D5, a monoclonal antibody prepared against partially purified cytosolic estrogen receptor (ER), has been purified to homogeneity from ZR-75-1, a human breast cancer cell line. Ammonium sulphate fractionation followed by immunoaffinity chromatography on a three column system using Protein A-Sepharose coupled D5, produced purified p29. Silver stained SDS one-dimensional polyacrylamide gel electrophoresis (PAGE) and two-dimensional PAGE showed p29 to have been purified to homogeneity. Amino acid analysis showed no unusual characteristics. Partial N-terminal sequencing studies showed that purified p29 shared a 100% homology with the sequence of a pp89, murine cytomegaloviral protein.

Management of the premaxilla in bilateral clefts.

Surgical management of the premaxilla in patients with bilateral clefting has been a controversial and perplexing problem. This paper discusses method and timing of treatment and proposes a philosophy of surgical management. By proper timing of repositioning procedures and bone grafting, more tissue can be salvaged and a more satisfactory functional result can be obtained.

Oral dysplasia and in situ carcinoma: clinicopathologic correlations of eight patients.

Eight patients with multiple oral dysplastic epithelial lesions were followed by clinical examinations and serial biopsies for periods varying from four to 22 years. The dysplasias and in situ carcinomas were characterized by persistence, recurrence, and eventual progression to invasive squamous cell carcinoma. It could not be determined whether dysplasia and in situ carcinoma were separate clinical-pathologic entities with similar end points or whether they were part of a continuum in a spectrum of epithelial neoplasia. The need for close clinical observation and local excision was emphasized because of the multiplicity of lesions and because of the protracted clinical course. Treatment of these patients was problematic because of similarities of the disease to lichen planus. It is possible that they had a premalignant disease process that mimicked lichen planus, or that they had an unusual form of lichen planus for which criteria have not been established. The progressive nature of the disease was exemplified by one death, one patient with cervical metastasis, and one with generalized remote metastatic disease.

Major maxillomandibular malrelations and temporomandibular joint pain-dysfunction.

A retrospective questionnaire survey of 102 patients who underwent orthognathic surgery for maxillomandibular disharmonies assessed the incidence of TMJ pain-dysfunction in both pretreatment and posttreatment phases. While retrospective questionnaire studies have obvious limitations, the following conclusions deserve consideration. The incidence of TMJ pain-dysfunction symptoms found in this patient population appears to be higher than the incidence of those symptoms reported in previous epidemiologic studies of general populations which involved subjective symptoms alone. Maxillomandibular disharmonies may be an important etiologic factor in the development of TMJ pain-dysfunction. Surgical correction of the disharmony in a significant percent of patients with maxillomandibular disharmonies and concomitant TMJ pain-dysfunction may alleviate or improve the TMJ pain-dysfunction symptoms. There is a possibility that patients may develop TMJ pain-dysfunction symptoms after orthognathic surgery.

Use of the orthognathic surgery simulating instrument in the presurgical evaluation of facial asymmetry.

The use of Orthognathic Surgery Simulating Instrument (OSSI) is described. Two cases of facial asymmetry, one with hemifacial microsomia and one with unilateral condylar hyperplasia, are presented to demonstrate the diagnostic capabilities of the articulator. The OSSI has greatly improved our ability to plan the treatment of cases of gross facial asymmetry.

Ameloblastic fibro-odontoma: report of case with light and electron microscopic observations.

A case of a large ameloblastic fibro-odontoma has been reported. Its clinical behavior was discussed and descriptions of its characteristics under the light and electron microscope were presented. As a special entity, with a prognosis that permits conservation of peripheral bone margins, this lesion should be understood by all clinicians who manage odontogenic tumors. Within the group of odontogenic tumors, the combined observations of light and electron microscopy may introduce additional criteria for more refined classification.

Neurofibrosarcoma of the mandible.

A case has been reported to illustrate the apparent transition of a neurofibroma into a neurofibrosarcoma. Biopsy of the inferior alveolar nerve, proximal to the lesion, was used to determine the extent of tumor extension. En block excision of the tumor was performed. The patient has been without evidence of recurrence for approximatley 3 1/2 years. Bone graft reconstruction has been completed and full function has been restored to the mandible.

Superficial melanomas of oral mucous membranes.

In accordance with microscopic and clinical criteria established for superficial melanomas of the skin (superficial spreading melanoma, lentigo maligna melanoma, acral-lentiginous melanoma), three oral lesions have been evaluated. The literature on oral melanomas has also been reviewed, with special attention given to those cases that had pre-existing melanosis. One patient with a diagnosis of superficial spreading melanoma eventually died of his untreated lesion 11 years after its first appearance. Two patients had lesions diagnosed as acral-lentiginous melanoma (a group which also includes volar and subungual melanomas) that exhibited aggressive, recurrent behavior. These lesions had microsocpic features similar to lentigo maligna melanoma but did not behave in a manner consistent with that diagnosis. Electron microscopic study of one acral-lentiginous melanoma demonstrated malenosomes and premelanosomes that were like those seen in normal melanocytes and nevus cells. The superficial or radial growth phase of many oral melanomas has apparently gone unrecognized. Melanosis has been reported to be a common feature of invasive oral melanomas but has not generally been related to the natural history of these lesions. Oral lesions with a prolonged intra-epithelial or radial growth phase would be expected to have a better prognosis than nodular melanomas, but meaningful survival data are not available because of the infrequency with which oral melanomas have been subclassified.

Lichen planus: immunologic and morphologic identification of the submucosal infiltrate.

The purpose of this investigation was to specifically identify T cells, B cells, and histiocytes in the infiltrate typically seen in lichen planus. In frozen tissue sections, AET-treated sheep erythrocytes formed immunologic rosettes with the lymphocytes in the infiltrate, designating them as T cells. Rosette assays with reagent erythrocytes, IgGEA, IgMEA, IgMEAC, and E resulted in nonadherence, indicating a lack of B cells and macrophages, and indirectly implicating them as T cells. Scanning electron microscopy of the cellular infiltrate, in situ, showed that the cells had smooth, nonvillous surfaces. These observations were consistent with a T cell origin and were considered supportive of the immunologic data. The results of this investigation support the hypothesis that lichen planus is a disease mediated by thymus-dependent lymphocytes.

Evaluation of the regenerative capacity of the inferior alveolar nerve following surgical trauma.

The fate of 52 nerves where there was altered sensation following sagittal ramus osteotomy and mandibular advancement, and 15 nerves where this occurred after third molar removal were evaluated through questionnaires involving both subjective and objective components. The study covered an interval between six and 54.5 months, with a mean of 31.9 months. Of the altered nerves from sagittal ramus osteotomy, 53.8% returned to normal, while 60% returned to normal in the third molar group. No correlation was found between terms used by the patient to describe the altered sensation and prognosis of nerve regeneration. In addition, correlation was not noted between the topographic distribution of altered sensation and the prognosis or residual deficit. No significant difference was found between the two methods of assessing nerve regeneration. A relationship was noted between age of the patient and increasing incidence of persistent altered sensation.

Effects of physical activity on creatine phosphokinase and the isoenzyme creatine kinase-MB.

Creatine phosphokinase (CPK) and creatine kinase-MB (CK-MB) have been used extensively as diagnostic markers for myocardial infarction and skeletal muscle injury. Many factors affect the variability of serum CPK and serum CK-MB activity, especially physical activity. We discuss the influence of physical activity on muscle and serum CPK and CK-MB. The effect of acute and chronic exercise on CPK and CK-MB activity emphasizes the need to use measurements of serum CPK and CK-MB with caution when evaluating and diagnosing acute myocardial infarctions and skeletal muscle injury.