Proteoglycans were extracted from specimens of articular cartilage obtained from human mandibular condyles and from femoral heads, analyzed by Western blotting using anti-glycosaminoglycan monoclonal antibodies, and compared. The results showed that the cartilage of the femoral head was rich in large-size proteoglycans, suspected to be aggrecan, whereas that of the mandibular condyle consisted mainly of smaller proteoglycans. Analyses of molecular size and immunoreactivity against anti-glycosaminoglycan antibodies suggested that these smaller proteoglycans were fibromodulin and decorin. Our findings suggest that the biological properties of the mandibular condyle differ from those of the femoral head.
Hydroxyapatite (HAP) and titanium (Ti) implants were inserted into the mandible of a dog to study differences in peri-implantitis between these materials. The two implants were evaluated on the basis of gingival index, plaque index, probing depth, amount of exudation from the gingival sulcus, and histopathological examination. The following results were obtained: 1) Inflammation due to plaque adhesion initially occurred around the neck of both the HAP and Ti implants. 2) Peri-implantitis with the Ti implant was severer than that with the HAP implant, and resorption of the alveolar bone with the Ti implant was much more marked than that with the HAP implant. 3) On day 180, the Ti implant showed vertical alveolar bone resorption, while the HAP implant showed slight horizontal resorption. Our results show that HAP is a more suitable material than Ti.
The objective of this study was to investigate the causes of failure of oral reconstruction by free tissue transfer and thereby improve outcome. Oral microvascular reconstruction was performed in 171 patients between April 1995 and March 2002, and these patients were examined. In this series, rupture and thrombi in anastomotic vessels were found in 12 patients (7.0%). The number of cases of rupture, arterial thrombi, and venous thrombi in the anastomotic vessels were 5, 2, and 5, respectively. Although 6 cases responded to secondary microvascular anastomosis, 6 (3.5%) had total flap necrosis. In conclusion, ruptures and thrombi in anastomotic vessels may be prevented by prophylaxis of cervical infection, relief of pressure on anastomotic vessels, and meticulous surgical technique. Postoperatively cervical rest, close observation, and accurate evaluation of flap status are essential to avoid flap necrosis.
Klebsiella pneumoniae, classified as facultative enteric Gram-negative rods, was previously believed to cause few diseases. Recently, however, K.pneumoniaehas been frequently isolated from infections occurring in immunocompromised hosts. We describe a case of liver abscess and maxillary sinusitis due toK. pneumoniaein a previously healthy 30-year-old man. Both infections were found concurrently, and onlyK. pneumoniaewas isolated. Pyogenic liver abscess is often associated with distant infectious lesions, such as endophthalmitis, osteomyelitis, pulmonary abscess, or purulent meningitis; however, there has been no previous report describing an association with maxillary sinusitis. Pulsed-field gel electrophoresis (PFGE) suggested similarities between both isolated strains ofK. pneumoniae.
Peripheral ameloblastoma(PA)is a rare extraosseous odontogenic tumor with histologic characteristics similar to those of commonly occurring intraosseous ameloblastoma. However, PA is rarely associated with invasive or aggressive intraosseous lesions. PA originates from one of two sources: extraosseous remnants of the dental lamina, or the basal cell layer of the oral epithelium. We describe a patient with a PA and report the results of immunohistochemical studies of Ki-67 antigen using MIB-1 antibody. A 48-year-old man was referred to us because of a painless mass of 1 years' duration on the buccal gingival region of the lower left premolar. The mass, 1.0cm in diameter, was hemispherical, sessile, firm, and nontender. Radiographic examination showed no resorption of bone. The mass was clinically diagnosed to be an epulis and was excised under local anesthesia. The surface of the denuded bone was removed owing to the presence of a small depression with granulation tissue. Routine pathological examination demonstrated ameloblastoma of follicular type. Immunohistochemical examination showed that 21.5 % of the tumor cells were Ki-67 antigen positive. The results suggested that the tumor cells may have high growth potential. There has been no sign of recurrence for 2 years 6 months.
A 50-year-old man was referred to our hospital because of a growth in the right side of the hard plate. Radiographic and computed tomographic examinations showed a unilocular radiolucent lesion with a well-circumscribed margin, involving a palatal root of the first molar. Magnetic resonance imaging (T2-weighted) showed increased signal intensity of the tumor. A possible diagnosis of pleomorphic adenoma was made on biopsy, and partial maxillectomy was performed. There has been no evidence of recurrence as of 1 year 8 months after the operation. Histopathologically, the tumor was well encapsulated by fibrous tissue and consisted of elliptical or rounded cells, with homogenous eosinophlic cytoplasm and eccentrically placed nuclei. The pathological diagnosis was myoepithelioma. Immunohistochemically, S-100 protein, vimentin, glial fibrillary acidic protein (GFAP), actin, and wide keratin were positive. Immunoreactivity for 35β H11 or 34β E12 was not detected clearly or markedly. Cells positive for PCNA, MIB-1, or both were rare.
Kimura's disease is a rare chronic granulomatous disease characterized by subcutaneous masses of the head and neck. We describe a case of Kimura's disease spreading from the cheek to the temporal region in a 46-year-old man. He complained of a growing but painless swelling in the right cheek and temporal region. Laboratory examination of a peripheral blood specimen showed no signs of inflammation, except for eosinophilia. Radiographic examinations, including ultrasound, computed tomography, and magnetic resonance imaging, showed a well-defined, contiguous radiopaque solid mass. Surgical enucleation was performed for a clinical diagnosis of a benign tumor of the cheek. Histopathological examination showed lymphoid follicles and chronic inflammation accompanied by eosinophil infiltration and a mature fibrous stroma. IgE-positive cells were intensively seen in the center of the lymphoid follicles and in the surrounding area. The final diagnosis was Kimura's disease. Postoperative blood tests for oral causes found no specific markers. Because laboratory data showed persistence of marked eosinophilia and a high serum IgE level, it was speculated that systemic factors that can induce eosinophil infiltration and serum IgE secretion, such as immunologic abnormalities, may have been involved in the pathogenesis of this case.