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Osteoclast differentiation requires the interaction of RANK (receptor activator of NF kappaB) and RANK ligand, conserved member of the TNF (tumor necrosis factor) receptor and TNF families, respectively. We tested the ability of a peptide mimic (WP9QY) of a critical contact site on the TNF receptor to inhibit RANK ligand induced osteoclastogenesis and discuss whether it could work as both TNF-alpha and RANKL antagonists, and the possibility of the drug development using the techniques in the structural biology.

Ampulla (Takotsubo) cardiomyopathy resembles acute myocardial infarction, with absent coronary stenosis. We report a case of catecholamine resistant ampulla cardiomyopathy, successfully managed using intra-aortic balloon pumping (IABP). After laparotomy, the patient developed circulatory collapse. T wave inversion was observed on electrocardiogram. In spite of circulatory support using high dose cathecholamines, the hemodynamics of the patient showed no improvement. Upon starting IABP, the patient's hemodynamics were improved and the dose of catecholamines could be reduced. Because the ampulla cardiomyopathy is considered a subtype of 'stunned myocardium' and the hemodynamic disorder is temporary and reversible, IABP appears effective for hemodynamic management.

Purpose: To review the outcome of surgery for strabismus due to ethmoid sinus surgery., Cases and Methods: The series comprised 13 cases, 1 of inferior rectus paresis, 1 of superior oblique paresis, 6 of medial rectus paresis, and 5 of medial rectus muscle palsy due to third nerve palsy. In the cases of paresis of the rectus muscle, resection of the rectus muscles was mainly performed. In the cases of palsy of the rectus muscle, transposition of the extraocular muscle with simultaneous recession of the lateral rectus muscle was performed. The major aim of surgery was to bring both eyes into alignment and to eliminate diplopia in the primary position., Results: The mean preoperative horizontal deviation of 18.1 degrees of exotropia in the paresis cases was reduced to 1.4 degrees of exotropia after surgery. The mean preoperative vertical deviation of 3.8 degrees of hypertropia was reduced to 1.4 degrees of hypertropia postoperatively. The mean preoperative horizontal deviation of 35.6 degrees of exotropia in the palsy cases was reduced to 9.4 degrees of exotropia after surgery. The mean preoperative vertical deviation of 2.0 degrees of hypertropia was increased to 2.6 degrees of hypertropia postoperatively. Postoperatively, diplopia was absent in 11 cases with a slightly compensatory head posture., Conclusion: Surgery for strabismus due to sinus surgery induces improvements in eye position and diplopia.

The experimental model of ovariectomy (OVX) has been well used as a model for studying the pathogenesis of postmenopausal osteoporosis. It is known that the hematopoietic environment in the bone marrow is altered leading to the up-regulation of osteoclastogenesis after the estrogen withdrawal. We discuss the possibility whether this alternation of lymphocyte-lineage cells could trigger off a risk factor for the periodontal disease.

The bone resorption in the oral area can be divided into the inflammatory and the metabolic bone resorption. In this review, we show a possibility for drug treatment in oral area, focusing on the drug development of TNF antagonist which inhibits the actions of both TNF-alpha and RANKL; the cytokines which have a critical role in the inflammatory bone resorption.

Purpose: To review the outcome of surgery for bilateral third nerve palsy., Cases and Methods: The series comprised 16 cases. The eye deviation in the primary position averaged -27.0 degrees horizontally. Surgery was aimed at bringing both eyes into alignment in the primary position by recession-resection of the horizontal muscles. Transposition of the superior oblique was performed for complete third nerve palsy. Surgery was initially performed on the nonfixating eye. The fellow eye received further surgery for residual disorders., Results: Within 6 months after surgery, the eye deviation in the primary position averaged -0.7 degrees horizontally. After longer follow-up, the eye deviation averaged -4.7 degrees horizontally. Postoperatively, diplopia in the primary position was absent in 11 and present in 5 cases., Conclusion: Surgery for bilateral third nerve paresis or palsy induced lasting cosmetic or functional improvements in the majority of cases.