Osteopetrosis complicated by osteomyelitis of the mandible: a case report including characterization of the osteopetrotic bone.

A case of a 53-year-old Japanese man with osteopetrosis complicated by osteomyelitis of the mandible is presented. The patient experienced frequent exacerbations and remissions of osteomyelitis of the mandible, despite undergoing several surgical debridements and sequesterectomies with appropriate antimicrobial therapy, for 3 years. Finally, the patient underwent mandibular segmental resection followed by reconstruction with a titanium reconstruction plate. Fifty-one months after surgery there is no evidence of recurrent osteomyelitis of the mandible, suggesting that a more radical surgical approach is preferable for patients with severe complications resulting from osteopetrosis. Also presented here are the histopathological and biochemical features of the osteopetrotic bone. The osteopetrotic cortical bone was morbidly sclerotic with compact and irregular laminations. Degradation of osteocytes in the osteopetrotic bone was due to hypoxia and lack of nutrition resulting from osteosclerosis. There were no significant differences between osteopetrotic and normal bone according to X-ray diffraction, Fourier transform infrared spectroscopy, collagen content or mineral content. Micro-Vickers hardness measurements showed that osteopetrotic bone was significantly harder than normal bone, and the standard deviation of hardness was greater in osteopetrotic bone. Such a loss of integrity in osteopetrotic bone is considered to be a primary reason for the greater risk of a variety of complications such as pathological fracture and refractory osteomyelitis.

Gene expression of telomerase related proteins in human normal oral and ectocervical epithelial cells.

We analyzed telomerase activities and gene expressions of telomerase components: hTERT, hTR, hTEP1, telomeric repeat binding factors: TRF1, TRF2, and c-myc, Max and Mad in human normal oral and ectocervical epithelial keratinocytes, comparing with those of squamous carcinoma cells and HPV16- or SV40-immortalized cells. Significant telomerase activity and hTERT expression were detected in primary keratinocytes. However, both were dramatically down-regulated during serial passages. The down-regulation of hTERT mRNA was associated with augmented expression of TRF1. Expression of c-myc was slightly decreased, whereas Mad was expressed in parallel with that of hTERT during passages. We also detected an alternate splicing of hTERT transcript in two of four cancer cells and normal aged epithelial cells. These results suggest that the senescence of normal oral and ectocervical keratinocytes is accompanied with up-regulation of TRF1 and down-regulation of telomerase activity due to transcriptional suppression of active form of hTERT in vitro.

[The circadian and pulsatile secretions of prolactin during pregnancy, labour and puerperium].

The circadian and pulsatile secretions of prolactin were studied in 15 pregnant and 5 puerperal women. Blood samples were taken every 15 minutes for 3 hours during daytime and at night. Diurnal levels of prolactin and estradiol were examined in 135 pregnant women. In addition, prolactin and estradiol of 8 parturient women were measured every 15 minutes until 24 hours after delivery. Prolactin and estradiol levels increased gradually in advance of pregnancy, and a positive correlation was revealed between prolactin(Y) and gestational weeks(X): Y = 7.125X-42.997, r = 0.9955. Furthermore, a positive correlation between prolactin(Y) and estradiol(X) levels was observed: Y = 4.439X + 44.115, r = 0.7590. The circadian secretion of prolactin was observed in 15 out of 20 cases studied. The pulsatile secretion of prolactin was revealed in all 20 cases. The daytime pulse-frequency significantly decreased in the 2nd trimester and that of the nighttime also decreased in the 3rd trimester. The pulse-amplitude increased in advance of pregnancy, but amplitude/baseline value ratio was stationary 28% during the daytime and 34% during the nighttime in every trimester of pregnancy. 63.0% of coincidence in prolactin pulse with increase of immunoreactive LH-hCG was observed. The pulsatile secretion of hCG has not been yet reported. However, the pulsatile increase of immunoreactive LH-hCG was observed in 10 pregnancies, while LH was not detected in any pregnancy by highly specific LH assay. This suggested that immunoreactive hCG changed in a pulsatile manner in the blood of pregnant subjects. A highly significant decline of prolactin levels was observed from 10 hours before until 4 hours after delivery, which did not correlate with changes of estradiol levels. These results indicated that the pulsatility and circadian secretion of prolactin were preserved during pregnancy and puerperium and also suggested that prolactin secretion during pregnancy, delivery and puerperium was regulated by at least 3 factors: estradiol, dopamine and LH-hCG.