Possible association of oestrogen and Cryba4 with masticatory muscle tendon-aponeurosis hyperplasia.

OBJECTIVE: Masticatory muscle tendon-aponeurosis hyperplasia, which is associated with limited mouth opening, progresses very slowly from adolescence. The prevalence rates of this disease are higher among women than among men, suggesting oestrogen involvement. As parafunctional habits are frequently observed, mechanical stress is likely involved in the pathogenesis and advancement of this disease. To elucidate the pathological condition, we examined the effect of oestrogen on tenocyte function and the relationship between mechanical stress and crystallin beta A4 (Cryba4), using murine TT-D6 tenocytes. MATERIALS AND METHODS: Cell proliferation assays, RT-PCR, real-time RT-PCR, Western blot analysis and mechanical loading experiments were performed. RESULTS: The physiological dose of oestrogen increased the levels of scleraxis and tenomodulin in TT-D6 tenocytes. In contrast, forced expression of Cryba4 inhibited scleraxis expression in these cells. Surprisingly, oestrogen significantly promoted cell differentiation in the Cryba4-overexpressing TT-D6 tenocytes. Moreover, tensile force induced Cryba4 expression in these tendon cells. CONCLUSION: Oestrogen and Cryba4 may be associated with the progression of masticatory muscle tendon-aponeurosis hyperplasia.

Masticatory muscle tendon-aponeurosis hyperplasia exhibits heterotopic calcification in tendons.

OBJECTIVE: Masticatory muscle tendon-aponeurosis hyperplasia is a new disease entity associated with limited mouth opening. In this study, we analyzed the microstructural characteristics of muscles and tendons in masticatory muscle tendon-aponeurosis hyperplasia by electron microscopy and energy-dispersive X-ray analysis to determine the elemental composition. METHODS: Histological analysis was performed to detect the calcification. Transmission electron microscopy and scanning electron microscopy were conducted to clarify the microstructural characteristics of muscles and tendons. Energy-dispersive X-ray microanalysis was performed to identify the distribution of elements. RESULTS: Mineralized nodules were observed in tendon tissues of masticatory muscle tendon-aponeurosis hyperplasia as compared with facial deformity. Electron microscopy revealed that the muscle and tendon tissues in masticatory muscle tendon-aponeurosis hyperplasia showed degenerative changes and distinctive histological findings as compared with tissues in facial deformity. We found that Ca, P, and Si were detected only in masticatory muscle tendon-aponeurosis hyperplasia. CONCLUSION: We demonstrated that masticatory muscle tendon-aponeurosis hyperplasia exhibits heterotopic calcification in tendon tissues.

Morphological changes in the inferior nasal passage associated with superior repositioning of the maxilla with/without horseshoe osteotomy or turbinectomy.

Superior repositioning of the maxilla during Le Fort I osteotomy (LFI) may narrow the inferior nasal passage. This retrospective study was performed to investigate morphological changes in the inferior nasal passage following LFI with/without additional procedures performed for nasal ventilation (horseshoe osteotomy or inferior turbinate partial resection). Three groups of patients were compared: those undergoing conventional LFI (Conv, 63 patients), LFI with horseshoe osteotomy (Hs, eight patients), and LFI with inferior turbinate partial resection (Turb, 21 patients). Coronal computed tomography images were used to evaluate the degree of stenosis of the inferior nasal passage. The soft tissue and bony tissue volumes in the inferior turbinate were also calculated three-dimensionally. The rate of obstruction of the inferior nasal passage postoperative was 65.9%, 50%, and 11.9% in the Conv, Hs, and Turb groups, respectively (Fisher's exact test, P < 0.001). Patients in the Turb group had significantly less nasal obstruction regardless of the pitch direction of the maxillary movement or volume of the bone in the inferior turbinate (all P < 0.001). In conclusion, for patients with high superior repositioning and well-developed bony tissue in the inferior turbinate, additional procedures are recommended to maintain the ventilation of the nasal passage postoperatively.

Perforation of the temporomandibular joint disc: cadaveric anatomical study.

The aim of this human cadaveric study was to investigate the relationship between temporomandibular joint disc perforation and bony changes of the mandibular condyle. Overall, 135 cadaveric mandibles were used (69 male, 66 female; all White). Mean age at death was 78.7 years. Perforation of the disc was investigated. Differences in the area of the perforation according to the different types of bony change (erosion, flattening, osteophyte) were evaluated. Perforation of the disc was observed in 34.8% of all mandibles, occurring unilaterally in 53.2% of cases and bilaterally in 46.8%. The prevalence of perforation was 16.4% in cadavers <80 years old (67 heads) and 52.9% in those ≥80 years old (68 heads) (P < 0.001). Osteophyte formation was always identified along with other bony changes (21.7%) and never in isolation. The area of the perforation was significantly larger in the groups with bony changes (one, two, or three changes) than in the 'no bony change' group. The group with osteophyte formation showed a significantly larger perforated area than the group without osteophyte formation; likewise, the group with flattening showed a significantly larger perforated area than the group without flattening. Osteophytes and flattening are probably secondary bony changes that occur following disc perforation. Based on this study, disc perforation should be suspected when these findings are identified on imaging.

A study of unfavorable splits in the sagittal ramus osteotomy with a short lingual cut.

In the bilateral sagittal split osteotomy, a short lingual cut is made on the medial side of the ramus; however, in some cases, a true fracture occurs on the buccal side of the ramus. The purpose of this study was to evaluate the relationship between the splitting pattern of the mandible and the form of the mandible, the surgical technique used, and the postoperative occurrence of relapse after 'unfavorable' splits. The investigation examined 143 patients in whom a short lingual cut was attempted. The rate of unfavorable split was 14.7% (42/286). A strong correlation was observed between the reach of the lateral bone cut to the inferior border of the mandible and an unfavorable split. According to multivariate regression, the factors leading to an insufficient lateral bone cut were the degree of inward curvature of the ramus (P=0.001) and the position of the lateral bone cut (P=0.002). There was no significant difference in relapse between cases of unfavorable and normal splits. An unfavorable split does not affect the prognosis of the occlusion, but it is important to confirm the inward curvature of the ramus and set the position of the lateral bone cut adequately to avoid unfavorable splits.

In situ ATR-FTIR study of oxygen reduction at the Pt/Nafion interface.

We have developed a new half-membrane-electrode assembly (MEA)-type cell that allows us to conduct attenuated total reflectance-Fourier transform infrared (ATR-FTIR) measurements at the Pt/Nafion interface under humidified N(2)/O(2) atmosphere. The cell consists of a gas-diffusion type anode placed on a carbon separator with a gas flow field, a Pt film cathode deposited chemically on an Si ATR prism and a Nafion NRE(R)211 electrolyte sandwiched between them. The construction allows the control of the atmosphere at the cathode by those at the anode via the electrolyte of 20-microm thickness. An infrared absorption band was observed at 1400-1403 cm(-1) under humidified oxygen atmosphere in close association with the appearance of ORR current. Its absence under N(2) atmosphere and insensitivity to the change from H(2)O to D(2)O humidification led us to ascribe the band to the O-O vibration of the adsorbed oxygen molecule O(2)(ads). The band intensity increased with increasing ORR current but decreased significantly in the limiting current region. However, the stability of the species at potentials as high as 1.1 V vs. the reversible hydrogen electrode (RHE) led us to rule out the possibility that the band could be due to adsorbed superoxide O(2)(-).

A Targeted Genetic Association Study of the Rare Type of Osteomyelitis.

Chronic nonbacterial osteomyelitis is a rare bone disorder that can be found in the jaw. It is often associated with systemic conditions, including autoimmune deficiencies. However, little is known about how the genetic and immunologic background of patients influences the disease. Here, we focus on human leukocyte antigen (HLA), killer cell immunoglobulin-like receptors (KIRs), and their specific combinations that have been difficult to analyze owing to their high diversity. We employed a recently developed technology of simultaneous typing of HLA alleles and KIR haplotype and investigated alleles of the 35 HLA loci and KIR haplotypes composed of centromeric and telomeric motifs in 18 cases and 18 controls for discovery and 472 independent controls for validation. We identified an amino acid substitution of threonine at position 94 of HLA-C in combination with the telomeric KIR genotype of haplotype tA01/tB01 that had significantly higher frequency (>20%) in the case population than in both control populations. Multiple logistic regression analysis based on a dominant model with adjustments for age and sex revealed and validated its statistical significance and high predictive accuracy (C-statistic ≥0.85). Structure-based analysis revealed that the combination of the amino acid change in HLA-C and the telomeric genotype tA01/tB01 could be associated with lower stability of HLA-C. This is the first case-control study of a rare disease that employed the latest sequencing technology enabling simultaneous typing and investigated amino acid polymorphisms at HLA loci in combination with KIR haplotype.

Terahertz optical clock generation with tunable repetition rate and central wavelength using variable-bandwidth spectrum shaper.

Recently, a number of high-speed optical clock generation technologies have been developed due to their potential useful applications in different fields. Here, we propose a new terahertz optical clock generation technique with tunable repetition rate and central wavelength. The proposed optical clock generator consists of an frequency comb light source and a variable-bandwidth spectrum shaper (VBS). The VBS can generate arbitrary repetition rate pulse trains and waveform by controlling each spectral mode. We experimentally demonstrated optical clock generation with repetition rates of 1.28, 2.56, 3.0, and 4.0 THz.

Treatment of refractory non-union after maxillary osteotomy: A case report.

Maxillary non-union is a rare complication that occurs after an orthognathic surgery such as Le Fort I osteotomy. Here, we report a case of refractory non-union after maxillary osteotomy, which required a second surgery with bone graft. A 33-year-old man who had undergone bimaxillary osteotomy complained of an abnormal sensation in the right alar part about 1 year after the surgery. The patient was diagnosed as having maxillary non-union. Although surgical stabilization was performed using titanium plates, the non-union remained. The re-fusion surgery was performed about 3 years after the bimaxillary osteotomy with autologous bone graft using a biodegradable fixation system. At the 1-year follow up, the maxillary non-union was healed both clinically and radiographically. Re-fusion surgery using bone graft with biodegradable fixation might be an effective treatment option in cases of prolonged non-union that becomes evident after a long period following the initial maxillary osteotomy.

Influence of the anatomical form of the posterior maxilla on the reliability of superior maxillary repositioning by Le Fort I osteotomy.

Certain patients with facial deformities require superior repositioning of the maxilla via Le Fort I osteotomy; however, the magnitude of superior repositioning of the maxilla is often less than expected. In this study, the correlation between the accuracy of superior repositioning of the maxilla and the anatomical form of the maxillary posterior region was examined. Seventy-five patients who underwent Le Fort I osteotomy without forward movement of the maxilla but with superior repositioning of the maxilla were included in this study. The bone volume around the descending palatine artery (DPA), the angle of the junction between the pterygoid process and the tuberosity, and the distance between the upper second molar and the pterygoid process were measured via three-dimensional analysis. A significant negative correlation (r=-0.566) was found between the bone volume around the DPA and the ratio of repositioning (actual movement divided by expected movement). It is possible that the superior repositioning of the maxilla expected prior to surgery was not sufficiently attained because of the large volume of bone around the DPA. The results of this study show that in some patients, superior repositioning was not achieved at the expected level because of bone interference attributable to the anatomical form of the maxillary posterior region.

A randomized controlled trial assessing the effectiveness of professional oral care by dental hygienists.

OBJECTIVES: This study was designed to compare professional oral care (POC) by a dental hygienist with tooth brushing and mouth rinsing by patients themselves according to the instructions of a nurse (control). METHODS: Forty patients were randomly assigned to either the POC group (n = 20) or control group (n = 20). The presence of plaque and bacteria was assessed clinically. RESULTS: One patient in the POC group and three patients in the control group dropped out because of exacerbation of underlying disease or death. Plaque control record scores were significantly lower in the POC group than in the control group on the fifth hospital day and the day of discharge. There was no significant difference between the groups in the detection rate of Candida species; and nosocomial pathogens on either day. CONCLUSIONS: Professional oral care by a dental hygienist is more effective than tooth brushing and mouth rinsing by patients themselves according to the instructions of a nurse.

A two-year follow-up of surgical and non-surgical treatments in patients with masticatory muscle tendon-aponeurosis hyperplasia.

This study re-examined the usefulness of surgery for the management of masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) through a comparison of the outcomes between patients who underwent surgery and those who did not. The duration of follow-up was 2 years. Twenty-eight patients who attended the study hospital and were given a diagnosis of MMTAH were included. Nineteen patients underwent surgery (surgical group) and nine patients were instructed to open their mouths wide once a day and did not undergo surgery (non-surgical group). Maximum mouth opening, impairment of daily activities, satisfaction, and the status of mouth opening training were evaluated after surgery. The mean increase in mouth opening after 2 years was 20.2mm in the surgical group and 2.4mm in the non-surgical group. Adequate mouth opening training led to satisfactory results 2 years postoperative, and sustained mouth opening training for 6 months after surgery was a key factor for obtaining good outcomes. The general condition and personality of individual patients should be evaluated carefully before surgery to estimate whether or not they can endure the pain associated with postoperative mouth opening training. The results of this study suggest that the surgical procedure is useful for the management of MMTAH.

Effect of the extra n-terminal methionine residue on the stability and folding of recombinant alpha-lactalbumin expressed in Escherichia coli.

The structure, stability, and unfolding-refolding kinetics of Escherichia coli-expressed recombinant goat alpha-lactalbumin were studied by circular dichroism spectroscopy, X-ray crystallography, and stopped-flow measurements, and the results were compared with those of the authentic protein prepared from goat milk. The electric properties of the two proteins were also studied by gel electrophoresis and ion-exchange chromatography. Although the overall structures of the authentic and recombinant proteins are the same, the extra methionine residue at the N terminus of the recombinant protein remarkably affects the native-state stability and the electric properties. The native state of the recombinant protein was 3.5 kcal/mol less stable than the authentic protein, and the recombinant protein was more negatively charged than the authentic one. The recombinant protein unfolded 5.7 times faster than the authentic one, although there were no significant differences in the refolding rates of the two proteins. The destabilization of the recombinant protein can be fully interpreted in terms of the increased unfolding rate of the protein, indicating that the N-terminal region remains unorganized in the transition state of refolding, and hence is not involved in the folding initiation site of the protein. A comparison of the X-ray structures of recombinant alpha-lactalbumin determined here with that of the authentic protein shows that the structural differences between the proteins are confined to the N-terminal region. Theoretical considerations for the differences in the conformational and solvation free energies between the proteins show that the destabilization of the recombinant protein is primarily due to excess conformational entropy of the N-terminal methionine residue in the unfolded state, and also due to less exposure of hydrophobic surface on unfolding. The results suggest that when the N-terminal region of a protein has a rigid structure, expression of the protein by E. coli, which adds the extra methionine residue, destabilizes the native state through a conformational entropy effect. It also shows that differences in the electrostatic interactions of the N-terminal amino group with the side-chain atoms of Thr38, Asp37, and Asp83 bring about a difference in the pKa value of the N-terminal amino group between the proteins, resulting in a greater negative net charge of the recombinant protein at neutral pH.

Cloning and sequencing of the chaperonin-encoding Cctd gene from Fugu rubripes rubripes.

CCT, a chaperonin containing t-complex polypeptide 1 (TCP-1), is a cytosolic molecular chaperone involved in the folding of proteins. We have isolated the Cctd gene from a Fugu rubripes rubripes (Frr) genomic library using a rat Ccta cDNA as a probe, and cloned its cDNA by reverse transcription-polymerase chain reaction (RT-PCR) using a pair of oligodeoxyribonucleotides corresponding to the 5' and 3' non-coding regions of Frr Cctd. Cctd spans a region of 4.7 kb and consists of at least 13 exons with small introns of about 144 bp on average. The Cctd cDNA sequence revealed a deduced polypeptide of 536 amino acids sharing a high degree of homology with that of the mouse Cctd cDNA (88%). Cctd is present as a single-copy gene, as shown by genomic Southern blot analysis, and can be used for evolutionary and classification analyses of Fugu species.

Characterization of Norwalk virus GI specific monoclonal antibodies generated against Escherichia coli expressed capsid protein and the reactivity of two broadly reactive monoclonal antibodies generated against GII capsid towards GI recombinant fragments.

BACKGROUND: Norwalk virus causes outbreaks of acute non-bacterial gastroenteritis in humans. The virus capsid is composed of a single 60 kDa protein. In a previous study, the capsid protein of recombinant Norwalk virus genogroup II was expressed in an E. coli system and monoclonal antibodies were generated against it. The analysis of the reactivity of those monoclonal antibodies suggested that the N-terminal domain might contain more antigenic epitopes than the C-terminal domain. In the same study, two broadly reactive monoclonal antibodies were observed to react with genogroup I recombinant protein. RESULTS: In the present study, we used the recombinant capsid protein of genogroup I and characterized the obtained 17 monoclonal antibodies by using 19 overlapping fragments. Sixteen monoclonal antibodies recognized sequential epitopes on three antigenic regions, and the only exceptional monoclonal antibody recognized a conformational epitope. As for the two broadly reactive monoclonal antibodies generated against genogroup II, we indicated that they recognized fragment 2 of genogroup I. Furthermore, genogroup I antigen from a patient's stool was detected by sandwich enzyme-linked immunosorbent assay using genogroup I specific monoclonal antibody and biotinated broadly reactive monoclonal antibody. CONCLUSION: The reactivity analysis of above monoclonal antibodies suggests that the N-terminal domain may contain more antigenic epitopes than the C-terminal domain as suggested in our previous study. The detection of genogroup I antigen from a patient's stool by our system suggested that the monoclonal antibodies generated against E. coli expressed capsid protein can be used to detect genogroup I antigens in clinical material.

New apparatus for studying behavioral thermoregulation in rats.

The operant system described here contains a box that can be convectively heated or cooled. A rat moves freely in the box. Its location is monitored photoelectrically while its deep body temperature is monitored by a telemetry system. In heat-escape experiments, hot air (40 degrees C) flows through the box. When the rat enters a reward zone the air source is switched and cold air (0 degrees C) flows through the box for a given period (30 s). Conversely, in cold-escape experiments cold air flows through the box and when the rat enters the reward zone the air source is switched to a warm one. Experiments show that rats quickly learn to stay near the reward zone and move in and out of it periodically. This system is based on behavior more natural than the frequently used lever-pressing response, and has many advantages for use in studies involving behavioral thermoregulation.

Standard protocol for exchange of health-checkup data based on SGML: the Health-checkup Data Markup Language (HDML).

OBJECTIVES: To develop a health/medical data interchange model for efficient electronic exchange of data among health-checkup facilities. RESULTS: A Health-checkup Data Markup Language (HDML) was developed on the basis of the Standard Generalized Markup Language (SGML), and a feasibility study carried out, involving data exchange between two health checkup facilities. The structure of HDML is described. RESULTS: The transfer of numerical lab data, summary findings and health status assessment was successful. CONCLUSIONS: HDML is an improvement to laboratory data exchange. Further work has to address the exchange of qualitative and textual data.

Pathologic and imaging findings of an oncocytoma in the deep lobe of the left parotid gland.

Oncocytoma is a rare salivary gland tumour consisting of oncocytes with many hyperplastic mitochondria. It usually occurs in the parotid gland. Because the features of oncocytoma resemble those of other benign and low-grade-malignant salivary gland tumours, clinical diagnosis is often challenging. This report presents the pathologic and imaging findings of an oncocytoma arising in the deep lobe of the left parotid gland in a 66-year-old man. Oncocytoma was diagnosed on the basis of histological, magnetic resonance imaging, and scintigraphic findings. The tumour showed accumulation of technetium-99m pertechnetate and decreased signal intensity on both T1- and T2-weighted magnetic resonance images.

Multiple macrodonts with odontoma in a mother and son--a variant of Ekman-Westborg-Julin syndrome. Report of a case.

A case of multiple macrodonts with a complex odontoma in a mother and son is reported. This condition is thought to represent a variant of the Ekman-Westborg-Julin syndrome. The authors discuss the relationship between macrodontia and odontoma, and the involvement of hereditary factors is suggested.

Comparison of the effectiveness of arthrocentesis in acute and chronic closed lock: analysis of clinical and arthroscopic findings.

The objective of this study was to investigate the effectiveness of temporomandibular joint arthrocentesis in acute and chronic closed lock patients. Eighteen patients with closed lock of the temporomandibular joint (TMJ) were treated with fine needle fiber arthroscopic observation following arthrocentesis. Maximal mouth opening (MMO) and intensity of pain (VAS) were evaluated at pretreatment and each posttreatment appointment (one week, one month, three months following treatment). The clinical and arthroscopic findings were analyzed categorizing two groups into: good (A) and poor (B) groups. At pretreatment there was no significance relative to age or the mean MMO and VAS between the groups, but the mean of duration of the symptoms in group B was significantly longer than in group A (P < 0.03). Group B showed more severe synovitis, adhesions, and chondromalacia than group A (P < 0.01). Results suggest that arthrocentesis is more effective in closed lock of short duration where there is less severe synovitis, adhesions, and chondromalacia.