The effects of changing position and angle of the proximal segment after intraoral vertical ramus osteotomy.

The authors evaluated changes in position and angle of the proximal segment, including the condyle, after intraoral vertical ramus osteotomy (IVRO) with and without a Le Fort I osteotomy to verify whether displacement of the proximal segment could induce postoperative complications. Changes in condylar angle, ramus angle, and displacement of proximal segment were measured pre- and postoperatively. The position of the temporomandibular joint (TMJ) disc was examined pre- and postoperatively. Trigeminal nerve hypoesthesia in the lower lip was assessed bilaterally. The postoperative horizontal condylar angle was significantly smaller than the preoperative one on the deviated and non-deviated sides (P<0.0001). The postoperative coronal condylar angle was significantly larger than the preoperative one on the deviated side (P=0.0483). The postoperative sagittal ramus angle was larger than the preoperative one on the deviated (P<0.0001) and non-deviated (P=0.00005) side. Most joints with an anteriorly-displaced disc with and without reduction improved on the non-deviated side; 5 of 16 joints improved on the deviated side. Results suggest the position and angle of the proximal segment, including the condyle, could change after IVRO. This could be associated with symptomatic improvement in TMJ, and extreme medial displacement of the proximal segment could delay recovery from lower lip hypoesthesia.

The effect of mandibular setback or two-jaws surgery on pharyngeal airway among different genders.

Cephalometric studies show significant gender differences in the size of the pharyngeal airway space. This study aimed to investigate and compare morphologic changes after mandibular setback or two-jaws surgery on the pharyngeal airway in men and women using computed tomography (CT). The sample included 34 women and 13 men diagnosed with Class III skeletal deformities, who had been treated by mandibular setback or bimaxillary surgery (maxillary advancement and mandibular setback). Anteroposterior, lateral and cross-sectional area dimensions of the airway, at the level of soft palate and base of tongue, were measured pre- and postoperatively on CT images. In the mandibular setback group, the anteroposterior and cross-sectional area of the pharyngeal airway at the level of the soft palate and base of tongue were significantly reduced for men or women (P<.05). In the two-jaws surgery group, only midsagittal anteroposterior dimensions at the same levels were significantly decreased for men or women (P<.05). The difference between any values measured between men and women who received bilateral sagittal split ramus osteotomy setback surgery or two-jaws surgery for the treatment of class III anteroposterior discrepancy were not statistically significant (P>.05). This study suggests that oropharyngeal airway measurements, important for airway patency, do not demonstrate sex dimorphism.

Testicular sperm extraction and ICSI in patients with post-chemotherapy non-obstructive azoospermia.

146 MD-TESE procedures were performed in 74 patients presenting with non-obstructive azoospermia (NOA). Five of the 74 patients displayed a history of chemotherapy. Etiology of chemotherapies included testicular cancer, osteosarcoma, Ewing sarcoma, and malignant lymphoma of the stomach. Post-chemotherapy duration was 2.5-18 years. All patients underwent MD-TESE using local anesthesia with spermatic block and sedation. Extracted sperm was cryopreserved for ICSI. Histopathologic examination revealed Sertoli cell-only syndrome in all five patients; however, sperm were retrieved in 3 subjects. Post-chemotherapy MD-TESE and ICSI can be applied successfully in some patients with NOA. However, freezing semen prior to chemotherapy is recommended.

Condylar and disc positions after intraoral vertical ramus osteotomy with and without a Le Fort I osteotomy.

The purpose of this study was to examine the changes in temporomandibular joint (TMJ) morphology and clinical symptoms after intraoral vertical ramus osteotomy (IVRO) with and without a Le Fort I osteotomy. Of 50 Japanese patients with mandibular prognathism with mandibular and bimaxillary asymmetry, 25 underwent IVRO and 25 underwent IVRO in combination with a Le Fort I osteotomy. The TMJ symptoms and joint morphology, including disc tissue, were assessed preoperatively and postoperatively by magnetic resonance imaging and axial cephalogram. Improvement was seen in just 50% of joints with anterior disc displacement (ADD) that received IVRO and 52% of those that received IVRO with Le Fort I osteotomy. Fewer or no TMJ symptoms were reported postoperatively in 97% of the joints that received IVRO and 90% that received IVRO with Le Fort I osteotomy. Postoperatively, there were significant condylar position changes and horizontal changes in the condylar long axis on both sides in the two groups. There were no significant differences between improved ADD and unimproved ADD in condylar position change and the angle of the condylar long axis, although distinctive postoperative condylar sag was seen. These results suggest that IVRO with or without Le Fort I osteotomy can improve ADD and TMJ symptoms along with condylar position and angle, but it is difficult to predict the amount of improvement in ADD.

Recurrent multinodular neurilemmoma of the female upper lip.

Neurilemmoma is the most commonly encountered nerve sheath tumour of the oral cavity. It generally appears as a single encapsulated nodule. The tongue is involved most frequently and the lip rarely. The tumour is usually uninodular. Multinodular neurilemmoma of the upper lip is very rare and has been reported in only one patient. This is the first reported case of multinodular neurilemmoma in the upper lip of a female.

Contractile responses to reactive oxygen species in the canine basilar artery in vitro: selective inhibitory effect of MCI-186, a new hydroxyl radical scavenger.

BACKGROUND: Cerebral vasospasm is one of the important pathological phenomena which influence morbidity and mortality following subarachnoid haemorrhage. Reactive oxygen species (ROSs) generated by the autoxidation of oxyhemoglobin to methemoglobin may be one of the essential factors in the pathogenesis of cerebral vasospasm. The direct vasocontractile effects of hydrogen peroxide (H(2)O(2)), superoxide anion (O(2)(-)), and hydroxyl radical (*OH) on the canine basilar artery and the inhibitory effects of MCI-186 (3-methyl-1-phenyl-2-pyrazolin-5-one), a new *OH scavenger, were investigated. METHOD: Isometric tension was recorded in basilar artery rings from dogs in vitro. H(2)O(2), pyrogallol (O(2)(-) donor), and vitamin C (VitC)/Fe(2+) (*OH-generating system) were used to generate the ROSs. FINDINGS: H(2)O(2) (10 micromol/L), pyrogallol (10 micromol/L), and VitC/Fe(2+) (100 micromol/L each) induced fast onset and transient, slow onset and transient, and sustained contraction, respectively, in the canine basilar artery. Contractions induced by H(2)O(2) were almost completely inhibited by pre-incubation with catalase (800 U/mL) and those by pyrogallol with superoxide dismutase (150 U/mL), but neither with MCI-186 (10 micromol/L). The contraction induced by VitC/Fe(2+) was clearly inhibited by pre-incubation with MCI-186, but not with catalase or superoxide dismutase. INTERPRETATION: ROSs have direct vasocontractile effects on the canine basilar artery in vitro, but different ROSs have different contractile characteristics. Such contractions might be related to the pathophysiology of cerebral vasospasm. MCI-186 had a clear and selective inhibitory effect against *OH-induced contraction in vitro. Comparison of different radical scavengers may be important in pharmacological assessment, especially targeted on cerebral vasospasm.

Sphingosine 1-phosphate contracts canine basilar arteries in vitro and in vivo: possible role in pathogenesis of cerebral vasospasm.

BACKGROUND AND PURPOSE: Sphingosine 1-phosphate (S1P) is a platelet-derived bioactive lipid that exerts a variety of biological responses, including vasocontraction. To understand the involvement of S1P in cerebral vasospasm, we investigated the effect of S1P on vasocontraction of the canine basilar artery in vitro and in vivo. METHODS: We recorded isometric tension in basilar arterial rings from dogs in vitro and estimated time-course changes in the diameter of canine basilar arteries and the S1P concentration in cerebrospinal fluid (CSF) by angiography and radioreceptor assays, respectively, after administering S1P into the cisterna magna. Changes in the supernatant S1P concentration during clot formation were monitored by using the in vitro subarachnoid hemorrhage model, in which blood is mixed with CSF. RESULTS: At concentrations ranging between 100 nmol/L and 10 micromol/L, S1P induced a dose-dependent contraction of the basilar artery in vitro. This effect was significantly inhibited by Y-27632, a highly selective Rho-kinase inhibitor. The administration of S1P into the CSF induced a 60% to 70% decrease in the arterial diameter within 15 minutes, and vasocontraction continued for 2 days thereafter. The concentration of S1P in the supernatant during clot formation in vitro reached approximately 300 nmol/L. CONCLUSIONS: S1P induces vasocontraction in the canine basilar artery in vitro and in vivo, possibly through a mechanism involving activation of the Rho/Rho-kinase pathway. Thus, S1P might be considered as a novel spasmogenic substance involved in cerebral vasospasm after subarachnoid hemorrhage.

Microinjection of antisense c-mos oligonucleotides prevents the progression of meiosis in human and hamster oocytes.

OBJECTIVE: To investigate the role of c-mos proto-oncogene in the progression of meiosis in human and hamster oocytes. DESIGN: Controlled basic research study. SETTING: Assisted reproduction units at medical institutions. PATIENT(S): Consenting in vitro fertilization patients. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Maturation to metaphase II (MII) 24 hours following microinjection of prophase I (PI) hamster oocytes with antisense (AS) and sense (S) c-mos oligonucleotides. Control oocytes (C) injected with medium or left uninjected (UI). In human oocytes, maturation to metaphase II was also measured except culture was extended to 48 hours and the sense group was omitted. RESULT(S): The percentage of hamster oocytes reaching metaphase II after 24 hours was as follows: 1.5% (1 of 65) for the antisense group; 63.1% (41 of 65) in the sense group; 66.1% (41 of 62) in the control group; and 69.3% (52 of 75) in the uninjected group. The percentage of human oocytes at metaphase II was 33.3% (4 of 12) in the antisense group, 83.3% (10 of 12) in the control group, and 82.8% (24 of 29) in the uninjected group. CONCLUSION(S): These results demonstrate that injection of c-mos antisense oligonucleotide significantly inhibits the progression of meiosis in hamster (P=.0001) and human (P=.05) oocytes. Thus, c-mos proto-oncogene may be one of the critical regulators of meiosis in these two species.

Cervical cancer in young Japanese women.

This study was performed to determine whether the incidence of cervical cancer in women aged 35 or younger has changed over the last 10 years and to examine the clinical characteristics of the cases. The incidence of cervical cancer in women aged 35 or younger were significantly greater in 1987-1991 than 1992-1996 (p = 0.001). Most new cases were detected by routine cytological screening.

[The amnioinfusion therapy of saline solution for premature rupture of the membranes before 27 weeks' gestational age].

Saline solution amnioinfusion was performed for 12 cases of preterm PROM before 27 weeks gestational age complicated by oligohydramnios in order to suppress chorioamnionitis, prevent fetal pulmonary hypoplasia and delay delivery. The results were as follows. 1. The mean gestational ages at diagnosis of premature rupture of membranes and initiating saline solution amnioinfusion were 23.6 +/- 2.9 weeks and 24.9 +/- 1.5 weeks, respectively. The mean duration of saline solution amnioinfusion was 14.7 +/- 11.9 days. The mean gestational age at delivery was 27.2 +/- 1.7 weeks. The mean birth weight was 1,056 +/- 220g. 2. Saline solution amnioinfusion was effective in relieving oligohydramnios in all cases. No pulmonary hypoplasia was observed in the infants. 3. Clinically saline solution amnioinfusion was effective in suppressing chorioamnionitis in 9 cases out of 12. Histologically the picture of chorioamnionitis was revealed in 10 cases out of 12. no serious infection was observed in the infants. 4. Nine infants out of 12 survived. There were 2 IUFD and one neonatal death. The perinatal survival rate was 75%. 5. It is concluded from the above results that saline solution amnioinfusion is an effective treatment for preterm PROM before 27 weeks' gestational age.

Effect of sympathetic nerve stimulation on lung vascular permeability in the rat.

The present study was undertaken to evaluate the role of sympathetic nerves in increasing lung vascular permeability. An isolated rat sympathetic nerve-lung preparation was used. Three minutes after an increase in lung weight was induced by elevating the intravascular pressure, stimulation of sympathetic nerves was performed in the presence of papaverine, which further increased the lung weight in a graded manner. After the nerve stimulation, deposits of carbon were observed in alveolar macrophages and perivascular walls, indicating an increase in vascular permeability. The response of lung weight to the sympathetic nerve stimulation was altered, depending on the magnitude of intravascular pressure change as well as on the voltage and frequency of electrical stimulation. Furthermore, these responses were prevented by tetrodotoxin. Calculation of the relationship between the maximal slope of the graded lung weight gain and the slope obtained just before the nerve stimulation gave a slope ratio at a frequency of 30 cps in normal rats of 4.47 +/- 0.21. Treatment with phentolamine diminished the value to 1.93 +/- 0.15, and with reserpine, to 1.43 +/- 0.14. In reserpinized rats, the slope ratio was restored by an administration of norepinephrine to 2.11 +/- 0.05 at 30 cps, being further increased by propranolol and blocked partially by phentolamine. The capillary filtration coefficient was not affected by either of the agents. In capsaicin-treated rats, sympathetic nerve stimulation did not cause any response in terms of lung weight (slope ratio = 1.0).(ABSTRACT TRUNCATED AT 250 WORDS)

A case of amylase-producing lung cancer.

A case of lung cancer with hyperamylasemia was studied. Small cell carcinoma was diagnosed histologically. The salivary gland and pancreas had no clinical involvement in the hyperamylasemia. Saliva-type amylase was dominant as observed from amylase isozyme patterns in the serum and tumorous tissue. Levels of amylase were higher in tumorous tissue than in normal lung tissue. Immunohistochemical study showed amylase localized in tumor cells. Observation of the ultrastructure revealed electron-dense granules in the cytoplasm of the tumor cells. Findings suggested that amylase was being produced by the lung cancer in this case.

Effects of a new nitro compound on the systemic circulatory system in dogs.

The present study was undertaken to evaluate the effects of a newly synthesized nitro compound (E-4701) on the systemic circulatory system with special reference to venous return and vascular compliance. Dogs were anesthetized with sodium pentobarbital. After opening the chest, cannulae were inserted into the superior and inferior vena cavae and into the right atrial appendage. The venous flow from the caval veins was redirected to a blood reservoir with an outlet at a constant height. The blood was pumped into the right atrium at a constant flow rate. E-4701 had a hypotensive effect, and also caused a decrease in reservoir blood volume; i.e., a decrease in venous return. Venous return via the superior vena cava was increased, whereas return via the inferior vena cava was decreased. Similar effects on the systemic circulatory system were observed with nitroprusside. The lowest dose of nitroprusside that caused a significant reduction in blood pressure was the same dose as that which caused a decrease in reservoir blood volume. However, a low dose of E-4701 caused a significant reduction in reservoir blood volume without affecting the systemic blood pressure. Arterial and venous compliances were increased by both E-4701 and nitroprusside. Nitroglycerin and isosorbide dinitrate increased venous compliance, but did not affect arterial compliance. The results suggest that E-4701 caused an almost equipotent reduction in blood pressure and venous return by dilating the arterial and venous vascular beds. The capacitance vessels may be more sensitive to E-4701 than the resistance vessels.

Effect of a new Ca2(+)-calmodulin-dependent protein kinase II inhibitor on GABA release in cerebrospinal fluid of the rat.

The role of Ca2(+)-calmodulin-dependent protein kinase II (CaM kinase II) in the central nervous system has been studied with special reference to the effect of CaM kinase II inhibitor on gamma-aminobutyric acid (GABA) release. We have used two different selective inhibitors of Ca2(+)-calmodulin-dependent enzymes such as a calmodulin antagonist, N-(6-aminohexyl)-5-chloro-1-naphthalene-sulfonamide (W-7), and a newly synthesized selective inhibitor of CaM kinase II, 1-[N,O-bis(1,5-isoquinolinesulfonyl)-N-methyl-L-tyrosyl]-4-phenylpipe raz ine (KN-62). N-[1-[P-(5-Isoquinolinesulfonyl)benzyl]-2-(4- phenylpiperazinyl)ethyl]-5-isoquinolinesulfonamide (KN-04), a derivative of KN-62, which has a much lower inhibitory activity on the enzyme, was also synthesized for use as a control. Although i.v. injection of the drugs did not produce any effect, infusion of W-7 or KN-62 into the 4th ventricle produce any effect, infusion of W-7 or KN-62 into the 4th ventricle of the rat caused hypertension and tachycardia, associated with the diminished rate of GABA release in cerebrospinal fluid. The ability of KN-62 to produce these effects was more potent than that of W-7. Intracisternal infusion of KN-04 influenced neither systemic blood pressure nor GABA release at the concentration up to 100 microM. The same order of potencies of three agents (KN-62 greater than W-7 much greater than KN-04) has been obtained in their effects on either in vitro CaM kinase II activity, the in vivo autonomic nervous system or the rate of GABA release.(ABSTRACT TRUNCATED AT 250 WORDS)

Capsaicin-sensitive nerves exert an inhibitory effect on the development of fibrin-induced pulmonary edema in rats.

This study was undertaken to evaluate the role of vagal nerves in the development of neurogenic pulmonary edema. We injected fibrinogen and thrombin into the cisterna magna of rats, a model of neurogenic pulmonary edema. When the vagal nerves were left intact, pulmonary edema occurred (fibrin-induced pulmonary edema) at a rate of 33%. Vagotomy at the midcervical portion increased the incidence of pulmonary edema to a rate of 100%, whereas pretreatment with atropine did not affect the incidence. These results suggested that vagal afferent nerves or nonadrenergic-noncholinergic efferent nerves played an important role in inhibiting the development of fibrin-induced pulmonary edema. Furthermore, in vagotomized and vagal nerve-intact rats pretreated with capsaicin, the incidence of pulmonary edema was 100%. Pretreatment with a substance P antagonist, [D-Pro2, D-Trp7,9]-SP, also increased the incidence to 100% in the vagal nerve-intact rats. On the other hand, intravenous administration of some neuropeptides that may be released from the capsaicin-sensitive nerves (e.g., substance P or calcitonin gene-related peptide) inhibited the development of pulmonary edema in vagotomized rats. We concluded that the vagal capsaicin-sensitive nerves exerted an inhibitory effect on the development of fibrin-induced pulmonary edema.

5-Hydroxytryptamine receptor subtypes participating in pulmonary edema in dogs.

The present study was undertaken to evaluate the effects of 5-hydroxytryptamine on pulmonary vascular resistances and vascular permeability with respect to the 5-hydroxytryptamine receptor subtypes. Left lower lobe of lungs isolated from the dog was perfused with constant heights of arterial and venous blood reservoirs and was maintained at zone III condition (pulmonary venous pressure greater than airway pressure). Drugs were administered into blood reservoir (1 l of total blood volume). Infusion of 5-hydroxytryptamine (100 micrograms/min) increased the pulmonary pre- and post-capillary resistances, but did not change the filtration coefficient. In the presence of ketanserin (10 mg), the infusion of 5-hydroxytryptamine caused an increase in filtration coefficient that was prevented by methysergide (30 mg). ICS 205-930 (10 mg) did not prevent such an increase in filtration coefficient. Infusion of 5-carboxamidotryptamine (100 micrograms/min) increased the filtration coefficient as well as both pre- and post-capillary resistances. These results suggested that the 5-HT1-like receptor mediates the increase in pulmonary vascular permeability.

Cortical excitability after myoclonus: jerk-locked somatosensory evoked potentials.

Cortical excitability after myoclonus was investigated by electrically stimulating the median nerve just at the time of, or at intervals after, the onset of myoclonus and by averaging the EEG and EMG, using the myoclonus onset pulse as a trigger (jerk-locked somatosensory evoked potential technique). In a patient with "cortical reflex" myoclonus, cortical excitability was relatively enhanced for 20 msec just after the myoclonus, although it was suppressed throughout the postmyoclonus period. In a patient with Creutzfeldt-Jakob disease, cortical excitability was suppressed between periodic myoclonic jerks. In a patient with oculopalatal-somatic myoclonus, there was no change of cortical excitability in relation to myoclonus.