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Mouse embryos exposed to 2,3,7,8-tetrachloridedibenzo-p-dioxin (TCDD) develop cleft palates and hydronephrosis. Cleft palates occur after TCDD exposure due to contact and/or fusion failure. We investigated whether cleft palate can be induced by dissociation of the palatine process after fusion. Pregnant mice on gestational day (GD) 12 were randomly divided into two groups: one group was administered through gastric tubes one dose of olive oil (control group) and the other group was administered one dose of TCDD diluted with olive oil, both at a dose of 40 microg/kg body weight. Embryos were removed by cesarean section from pregnant mice during the palatal formation stage (GD 13-18) and the palatal form was observed using a stereoscopic microscope. In TCDD-exposed embryos, palatal fusion was observed on GD 14, 15 and 16 and the incidence of cleft palate was 100% on GD 18. Fusion rates were 17.5 +/- 15.2% and 12.4 +/- 11.8% on GD 15 and 16, respectively. Some palates from the TCDD-exposed mouse embryos showed clearly developed cleft palate after fusion of the lateral palatine processes during palatal formation. A mass of cells, which were chiefly epithelial in the fused palates was observed in the TCDD-exposed mouse embryos. A decrease in E-cadherin expression was observed in this mass of cells, indicating its involvement in the development of cleft palate.

Summary Objective techniques to evaluate a facial movement are indispensable for the contemporary treatment of patients with motor disorders such as facial paralysis, cleft lip, postoperative head and neck cancer, and so on. Recently, computer-assisted, video-based techniques have been devised and reported as measuring systems in which facial movements can be evaluated quantitatively. Commercially available motion analysis systems, in which a stereo-measuring technique with multiple cameras and markers to facilitate search of matching among images through all cameras, also are utilized, and are used in many measuring systems such as video-based systems. The key is how the problems of facial movement can be extracted precisely, and how useful information for the diagnosis and decision-making process can be derived from analyses of facial movement. Therefore, it is important to discuss which facial animations should be examined, and whether fixation of the head and markers attached to the face can hamper natural facial movement.

Objective: To assess the usefulness of maxillo-mandibular fixation (MMF), occlusal and skeletal stabilities were evaluated after bilateral sagittal splitting ramus osteotomy (BSSRO) with or without MMF to treat mandibular prognathism or asymmetry.Patients and Methods: Thirty-three cases who underwent surgical correction of mandibular prognathism or asymmetry were analyzed. The surgical procedure in all cases consisted of SSRO. The segments were fixed rigidly with titanium screws. A postoperative MMF was performed in 16 patients within one day of the SSRO. The MMF was placed for one week. The other 17 patients were free to move their jaw on the day of the surgery, and received occlusal guidance with elastics starting from the third postoperative day. Cephalograms were taken preoperatively, at 1 day postoperatively, and at 1, 3, 6, 12 and 24 months after surgery. Skeletal and occlusal stabilities were then assessed.Results: Even without MMF, occlusion was guided to the planned position with soft elastics after surgery. Later than 1 month, occlusal and skeletal stability were satisfactory in both groups, and there was no correlation between the surgical results and post-operative MMF.Conclusion: MMF may not be necessary after a rigid fixation SSRO to treat mandibular prognathism or asymmetry, considering the risks of airway problems.

Cementogenesis starts with the differentiation of cementoblasts. Mature cementoblasts secrete cementum matrix. Cementum components are similar to bone; moreover, cementoblasts possess many characteristics similar to those of osteoblasts. Runx2 and osterix, the transcriptional factors for osteoblast differentiation, participate in tooth formation. However, the characteristics of Runx2 and osterix during the differentiation process of cementoblasts remain unclear. In this study, we examined the immunolocalization patterns of Runx2, osterix, and osteopontin during rat molar tooth formation. Periodontal ligament cells and osteoblasts located on the alveolar bone surface showed immunoreactivity for Runx2. Colocalization of Runx2 and osterix was detected in cementoblasts, which penetrated the ruptured Hertwig's epithelial root sheath and attached to root dentin. Moreover, osteopontin was observed in Runx2-positive cementoblasts facing the root surface. However, the cells adjacent to cementoblasts showed only Runx2 reactivity. Neither Runx2 nor osterix was seen in cementocytes. These results suggest that both Runx2 and osterix are important for differentiation into cementoblasts. Additionally, osterix may be indispensable for transcription of osteopontin expression. (J Histochem Cytochem 57:397–403, 2009)

Objectives and design: The expressions of human beta defensin-1 (HBD-1), -2 (HBD-2) and -3 (HBD-3) in non-inflamed pseudocysts such as mucoceles were investigated immunohistochemically in this study. Materials and methods: Mucocele specimens were obtained from 21 patients. The expression of HBDs was studied immunohistochemically by using antibodies directed against HBD-1, -2, and -3. Statistical analyses were carried out on serial sections stained with antibodies. Results: Cells expressing HBDs were found in mucoceles. The expression of HBD-2 was observed in floating cells in all the specimens, whereas HBD-1 and HBD-3-expressing cells were detected in 93% and 73% of the mucoceles, respectively. The HBD-2 signal was the most intense and the HBD-3 signal intensity was weaker than that of HBD-1. HBDs were expressed in neutrophils and in other floating cells. Interestingly, the signal intensity and the population of positive cells located close to the centers of cysts were higher than those located in the peripheral areas of cysts. Conclusion: The expression of HBDs was found even in non-inflamed pseudocysts such as mucoceles. These results suggest that an unknown mechanism not involved in biophylaxis for the expression of HBDs may exist.

Morphological and immunohistological examinations were performed to reveal the mechanisms of cleft palate induction by 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). ICR strain mice 8-10 weeks of age were used in the study. TCDD was administered in olive oil on gestation day (GD) 12.5 with gastric tubes at 40 microg/kg. From GD 13.5 to 16.5, palates were examined by scanning electron microscopy (SEM), hematoxyline-eosin (HE) staining, and immunohistochemical staining of FGFR1/2, TGF-beta3, MSX1 and LHX8. In the control group, both of the palatal shelves began elevating on GD 14.0 and finished within 6 h. After the elevation, all of the shelves had completely fused with each other on GD 14.5. In the TCDD-treated group, palatal shelves elevated 1 day later than in the control group. However, all palates had elevated by GD 15.0. After the elevation, the shelves contacted each other and fused; however, they were separated on GD16.0. HE staining showed that medial edge epithelium (MEE) was thinner in the TCDD group than in the control group. MEE observed under a high magnification (x2500) exhibited filopodia-like filaments and the cells were bulged in the control group. In contrast, in the TCDD group, no filaments were observed and the cells were flat with unclear boundaries. Immunohistologically, there were no characteristic findings except for FGFR1. FGFR1 was not expressed in the TCDD group after the fusion phase (GD 14.5). TCDD induces many morphological and molecular changes to MEE cells and causes cleft palates.

Periosteum is a source of osteoprogenitor cells and some investigators advocated the effective use of periosteum as a grafting material for the repair of bone and joint defects. In the present study, we showed bone formation induced from cultured periosteum-derived cells (CPDC) in the rat calvarial defect model. Periosteum taken from a rat tibia was immediately placed in culture medium with 10% fetal bovine serum. After confluence, periosteal cells were re-cultured three dimensionally on a collagen sponge for 7 days. Periosteal cell/collagen complex was grafted in calvarial defect of rats. At 30 and 60 days post grafting, grafted tissue was extracted and compared histologically and radiographically with control groups. In the experimental group at 30 days after implantation, new bone formation was seen. Radiographically, mineralized new bone formation was revealed in the defect at 60 days post grafting. New bone formation in periosteal cell/ collagen complex was greater than the other groups. Our results suggest that CPDC may have an important role in bone formation in the calvarial defect in rats.

The purpose of this study was to evaluate the clinical application of endosseous implants for management of grafted alveolar cleft. Four patients (1 male and 3 female; mean age 26.6 years; age ranging from 21.5 to 30.4 years at first implant surgery) with unilateral cleft lip and palate were evaluated. All patients received autogenous particulate cancellous bone and marrow graft (PCBM) to close the alveolar cleft. After bone bridge formation, implant treatment was performed. All patients with insufficient alveolar bone height, chin or ramus of mandible bone, onlay grafting was performed 4 months before implant installment. A total of 5 implants were placed in the grafted alveoli. The length of implants ranged from 10.0 to 13.0 mm. The follow-up period ranged from 2.2 to 4.1 years after implant placement. The clinical result was acceptable in all patients. The survival rate of implants was 100%. Implant treatment for grafted alveolar cleft was studied and the outcome of treatment was acceptable.

In the oral cavity, epidermoid cysts usually arise in the oral floor and rarely occur in the upper lip. A case of an epidermoid cyst of the upper lip is reported. The patient was a 22-year-old man. A cyst arising in the left side of the upper lip was diagnosed by the patients former doctor, and the lesion was extirpated under local anesthesia 1 year 7 months ago. However, 6 months ago, a painless mass developed slowly on the left side of the upper lip. Palpation, revealed a large movable mass. MRI and ultrasonic examinations showed that the lesion was 25mm in diameter in the subcutaneous tissue of the left side of the upper lip. The lesion was round and homogenous inside. We diagnosed the lesion to be a cyst of the upper lip and extirpated the mass under general anesthesia. The excised material was 20×10 mm in diameter and filled with a yellowish white serous liquid and a yellowish white cheese-like material. The specimen was histopathologically diagnosed to be an epidermoid cyst. Two years after the operation, the left side of the upper lip has healed and there is no evidence of recurrence.

Connective tissue growth factor (CTGF/CCN2) is a potent angiogenic factor. In this report, we describe for the first time that vascular endothelial growth factor (VEGF)–mediated induction of the ctgf/ccn2 gene was a post-transcriptional event that was inhibited by a novel angiogenic inhibitor, DN-9693, in human umbilical vein endothelial cells. Steady-state mRNA levels of ctgf/ccn2 were remarkably increased by VEGF in a concentration-dependent manner, whereas the activity of the ctgf/ccn2 promoter was not responsive to VEGF as confirmed by a reporter gene assay and quantitative real-time PCR analysis. By employing a RNA degradation assay, we eventually found that the observed increase in the ctgf/ccn2 mRNA level was due to an increased stability of the mRNA induced by VEGF. DN-9693 at a dose of 0.1 to 2 ng/mL did not affect basal levels of ctgf/ccn2 mRNA; however, enhancement of ctgf/ccn2 mRNA expression by VEGF was specifically inhibited by DN-9693. Of importance, the inhibitory effects could be also ascribed to post-transcriptional regulation, because the VEGF-mediated increase in stability of ctgf/ccn2 mRNA was suppressed by DN-9693. Furthermore, we investigated the effects of DN-9693 on VEGF-induced activation of three subgroups of mitogen-activated protein kinase pathways and found that DN-9693 blocked the activation of these pathways by VEGF. These results suggest that VEGF increases ctgf/ccn2 mRNA stability through mitogen-activated protein kinase–mediated intracellular signaling cascade(s), which can be inhibited posttranscriptionally by a novel angiogenic inhibitor, DN-9693, in human umbilical vein endothelial cells. [Mol Cancer Ther 2006;5(1):129–37]

Connective tissue growth factor (CTGF/CCN2) can be induced by various forms of stress such as exposure to high glucose, mechanical load, or hypoxia. Here, we investigated the molecular mechanism involved in the induction of ctgf/ccn2 by hypoxia in a human chondrosarcoma cell line, HCS-2/8. Hypoxia increased the ctgf/ccn2 mRNA level by altering the 3'-untranslated region (UTR)-mediated mRNA stability without requiring de novo protein synthesis. After a series of extensive analyses, we eventually found that the cis-repressive element of 84 bases within the 3'-UTR specifically bound to a cytoplasmic/nuclear protein. By conducting a UV crosslinking assay, we found the cytoplasmic/nuclear protein to be a 35 kDa molecule that bound to the cis-element in a hypoxia-inducible manner. These results suggest that a cis-element in the 3'-UTR of ctgf/ccn2 mRNA and trans-factor counterpart(s) play an important role in the post-transcriptional regulation by determining the stability of ctgf/ccn2 mRNA.

Connective tissue growth factor (CTGF) is known to be a multifunctional growth factor that is overexpressed in several types of malignancies. In this study, effects of CTGF gene overexpression on the phenotypes of oral squamous cell carcinoma cells were investigated by using a cell line with undetectable endogenous CTGF expression. Surprisingly, our results indicated that CTGF-overexpressed clones were characterized by attenuated cell growth and less potent tumorigenicity, with coincidental downregulation of prothymosin alpha gene. Although CTGF is known to promote cell proliferation in mesenchymal cells, our present results suggest that CTGF acts as a negative regulator of the cell growth in oral squamous cell carcinoma possibly through its interaction with growth modifiers inside the cell.

Vascular endothelial growth factor (VEGF) plays a very important role in vessel invasion during the process of endochondral ossification. Although grafted periosteum shows endochondral ossification, little is known about the role of VEGF in this process. Additionally, some reports have suggested that bone morphogenetic protein-4 (BMP-4) and VEGF work cooperatively in some way during endochondral ossification. In the present study we investigated, using immunohistochemical, histochemical, ultrastructural, and radiographic techniques, the role of VEGF and BMP-4 in bone formation from periosteal grafts taken from Japanese white rabbit tibia. By 14 days after grafting, fibroblasts in the grafted periosteum differentiated into chondrocytes to form cartilage. Some chondrocytes showed VEGF expression. Subsequent vessel invasion into cartilage from the VEGF immunopositive area coincided with commencement of endochondral ossification. Cartilage was replaced by newly formed bone by 35 days. Soft X-ray findings indicated calcification at 35 days after grafting. Chondrocytes and cartilage matrix were both BMP-4 positive. In newly formed bone, BMP-4 and VEGF expression was demonstrated in osteoblasts. These findings suggest that VEGF are related to vascular invasion into the grafted periosteum during endochondral ossification. Further, VEGF production in chondrocytes and osteoblasts may be related to BMP-4 production.

Connective tissue growth factor (CTGF) is known to be a potent angiogenic factor. Here we investigated how CTGF and matrix metalloproteinases (MMPs) are involved in the early stage of hypoxia-induced angiogenesis using human breast cancer cell line, MDA231, and vascular endothelial cells. Hypoxic stimulation (5% O(2)) of MDA231 cells increased their steady-state level of ctgf mRNA by approximately 2-fold within 1.5 h, and the levels remained at a plateau up to 6 h, and then decreased by 12 h as compared with the cells cultured under the normoxic condition. Membrane-type 1 MMP (MT1-MMP) mRNA levels was also increased within a few hours of the exposure to hypoxia. Indeed, ELISA revealed that the CTGF protein/cell in medium conditioned by MDA231 cells exposed to hypoxia was maximally greater at 24 h than in the medium from normoxic cultures and that the secretion rate (supernatant CTGF/cell layer CTGF) increased in a time-dependent manner from 24 to 72 h of hypoxic exposure. Hypoxic induction of CTGF was also confirmed by immunohistochemical analyses. Furthermore, zymogram analysis revealed that the production of active MMP-9 was also induced in MDA231 cells incubated under hypoxic conditions. Finally, we found that recombinant CTGF also increased the expression of a number of metalloproteinases that play a role in the vascular invasive processes and decreased the expression of tissue inhibitors of metalloproteinases by vascular endothelial cells. These findings suggest that hypoxia stimulates MDA231 cells to release CTGF as an angiogenic modulator, which initiates the invasive angiogenesis cascade by modulating the balance of extracellular matrix synthesis and degradation via MMPs secreted by endothelial cells in response to CTGF. This cascade may play critical roles in the hypoxia-induced neovascularization that accompanies tumor invasion in vivo.

To establish a qualitative diagnosis of submandibular gland disease, internal echo levels of 97 submandibular glands were measured under constant conditions by ultrasonography, and the influence of aging, fibrous changes, and adipose tissue content were investigated.Although there were no sex-related differences in the internal echo levels of 88 healthy glands, there was a trend toward an increased internal echo level with aging.Histopathologically, 20 glands required extirpation for treatment, and the adipose tissue ratio in these glands was measured.In 11 glands without fibrous changes, the adipose tissue ratio correlated with the internal echo level. In 9 glands with fibrous changes, there was no correlation between these variables, and the average internal echo level was significantly lower than that of the glands without fibrous changes (P

Palatogenesis is directed by epithelial-mesenchymal interactions and results partly from remodeling of the extracellular matrix (ECM) of the palatal shelves. Here, we assessed heparanase distribution in developing mouse palates. No heparanase was observed in the vertically oriented palatal shelves in early stages of palate formation. As palate formation progressed, the palatal shelves were reorganized and arranged horizontally above the tongue, and heparanase localized to the epithelial cells of these shelves. When the palatal bilateral shelves first made contact, the heparanase localized to epithelial cells at the tips of shelves. Later in fusing palatal shelves, the cells of the medial epithelial seam (MES) were labeled with intense heparanase signal. In contrast, the basement membrane heparan sulfate (HS) was scarcely observed in the palatal shelves in contact. Moreover, perlecan labeling was sparse in the basement membrane of the MES, on which laminin and type IV collagen were observed. Moreover, we assessed the distribution of matrix metalloproteinase- (MMP-) 9, MMP-2, and MMP-3 in developing mouse palates and these MMPs were observed in the MES. Our findings indicated that heparanase was important for palate formation because it mediated degradation of the ECM of palatal shelves. Heparanase may, in concert with other proteases, participate in the regression of the MES.

The degree of postoperative relapse associated with micrognathia appears much greater than that observed after operation for mandibular prognathism. The inverted-L osteotomy with bone grafting was considered as an alternative method for true lengthening of the mandible and has been advocated to improve postoperative stability compared with other surgical techniques.The patient was a 18-year 6-month-old female who had mandibular asymmetry and masticatory dysfunction. Computed tomography and panoramic radiograph showed severe deformity of the left ramus and condyle causing micrognathia. After preoperative orthodontic treatment, surgery was performed, including a Le Fort I osteotomy to improve asymmetry of occlusal plane, and advancement of the mandible was accomplished by mandibular sagittal split osteotomy on the right side and the inverted-L osteotomy with interpositioning of a bony autograft on the left side. Furthermore, after a year, onlay graft of the mandible was performed to obtain facial symmetry. The resultant Class I occlusion was apparently stable for a long time. Masticatory function had greatly improved as well as facial esthetics.

The northern part of the Kanto Plain is the area where the most severe land subsidence have been taking a place in recent years. This paper presents the relation between the change of circumstances of groundwater recharge which is caused by the change of the land use and the mechanism of the land subsidence.The land subsidence in this area is classified into two types by the depth of the compacted beds. The one is the compaction of alluvium strata that is about 30 meters in thickness and developed only the lowland. The rest is the compaction in the Pleistocene beds. This compaction is mainly occurring more than 200 meters beneath and spreading widely over the whole area.The groundwater head become lower according to the depth of the aquifers. In the aquifer from 200 to 300 meters under the surface, groundwater head is lowest and it ranks about 25 meters below sea level. Because of the wide lowering of the groundwater head of the deep aquifers, the groundwater is recharged vertically from the adjacent aquifers by leakage. The original source of the groundwater is rainfall and irrigation water. Especially, the recharge from paddy fields takes an important role for raising groundwater table of the unconfined aquifer.For the effective prevention of the land subsidence, it is necessary not only to reduce the amount of the groundwater use from the deep aquifers with low groundwater head, but also to manage the proper land use that is maintain the function of the groundwater recharge.

Sultanat of Oman located at the south-eastern edge of Arabian Peninsula covers an area of 300, 000 km2.Though almost of the area consists of desert, she has 5, 000 year history of irrigation agriculture by groundwater. Although the country produce oil, Omani people, having been aware of the limitation of the resources, have made efforts to the pervation of education and agricultural development.The country is geographically characterized by the existence of two lines of mountain range. Oman mountain chain extending 600 km long in a direction paralle to the Batinah coast consist of many steep 3, 000 m class high peaks.Dohar mountain chain facing to Arabian sea and extending east-west direction has an altitude of about 1, 000 m. Southern side of the mountain chain shows steep topographic feature of fault scarp. Contrary to the fact, northern side of the mountain ridge show very gentle slope and dips toward the Rube al Khali desert.Although Sultanat of Oman climatically belongs to the tropical dry zone, it rarely severe rains in the steep slope of mountain region caused by the upstream air current. The precipitation is the source of ground water of the country. In the Batinah coastal region, irrigation water have been drawn up by small scale wells and in recent years by deep wells with Submarin pumps.Accompany with the increase of irrigated farm, excessive pumpages have outstripped natural recharge of groundwater resulting in the intrusion of sea water.In order to prevent salinitization of groundwater a number of recharge dams which reserve flood temporary and percolate the water under the gound have been constructed.There are no cultivation in the Nejd region located at the northern gentle slope of Dhar mountain chain, owing to very poor available water resources. Only a few nomads are found here and there near the water shed.In Nejd groundwater was first found out by exploration drilling for oil in 1955. In recent years it has been clarified that plenty of good quality groundwater is confined in Tertially limestone aquifers lie 300-600 m under the ground. Hydrological and hydrogeological conditions show that recharge to the aquifers is small, development would inevitably involove mining of groundwater from aquifer storage.It was decided agricultural development must be carrid out step by step appraising the volume of groundwater resoces. Pilot farm 50 ha in area accompany with 2 production wells and 4 monitoring wells is now under construction in technical cooperation with Japan.

We reported a case of skeletal anterior open bite deformity treated with both maxillary anterior and posterior segmental osteotomies. The clinical and radiographic examinations indicated a stable result without relapse. Maxillary posterior segmental osteotomy for skeletal anterior open bite is an effective procedure that could correct the etiological sequence of altered mandibular protrusion, forward tongue posture, and buccal segment extrusion. In addition, combination with maxillary anterior segmental osteotomy shorten the duration of treatment.

Determination of facial landmarks is an essential process in facial measurement. In this investigation, this process, usually performed by hand, was accomplished automatically using a computer program in which landmarks were re-defined in a form allowing for computer analysis.Further more, the stability and reliability of this method were compared with the manual technique. Data for a three-dimensional wire frame model, obtained from facial plaster models by 1 mm mesh automatic measuring by a contact-type, high accuracy, three dimensional measuring system, were sent to a personal computer.The landmarks were then determined by a computer program which was written in “BASIC”, The results demonstrated that the landmarks can be obtained automatically except for a few special conditions. The standard deviations of almost all landmarks obtained by this automatic method were within 0.3-0.5 mm. In contrast, the corresponding values obtained manually were within 2-3 mm. Consequently, the usefulness of this method was demonstrated.

The treatment of skeletal anterior open bite deformity using the single-stage maxillary posterior segmental osteotomy has been followed for 5 years to evaluate the final outcome of the operation. The clinical and radiographic examination during the control period show a remarkable stable result without a relapse. Treatment planning based on clinical, ceahalometric, dental plaster model examination and tongue posture analysis allows the accurate and predictable correction of this deformity. In addition, tongue posture had shifted from anteriorly and superiorly to posteriorly and inferiorly after surgery. The stable occlusion and this improvement of tongue posture after maxillary posteriorly segmental osteotomy is an effective surgical procedure for the skeletal open bite.

There are two accurate methods to measure facial configurations, especially the external nose, as three dimensional objects. One is laser-scanning which can immediately measure faces directly and without contact. The other method, which we usually use, measures plaster models, obtained from facial impressions made with dental impression materials, by means of a contact-type, high accuracy three dimensional coordinate measuring system (contact measuring system).This study was designed to assess the accuracy and stability of these two methods, an issue previously paid little attention. Four 25-year-old men without facial deformity were examined with these systems. Multiple plaster models were taken from each subject to investigate model stability. All data were integrated into three dimensional models, shown as computer graphics, and compared by the “best fit program, ” which can handle and superimpose the two sets of curved surface data to derive minimum differences in normal vector direction at every site of the surface.The two sets of curved surface data obtained from the same plaster model by each system were almost identical except for areas of the alar groove. In data derived from the laser-scanning system, more than 1.0 mm of distortion was noted around areas of overhang. Facial and plaster model data obtained by the laser-scanning system showed very good fit, with deviation between data being 0.2-0.3 mm.These results show the high accuracy of facial plaster models. The stability of plaster models was also examined with a contact measuring system and deviation between data was 0.1-0.2 mm. In conclusion, although the two systems employed in this study have different characteristics, both are highly accurate and useful for clinical measurement.

In a series of 43 cases treated for mandibular prognathism by sagittal-split osteotomy, the change in mandibular position effected by surgery and the degree of relapse 6 months postoperatively were analyzed using lateral cephalograms. In addition, the post-surgical stability of the mandible was compared for prognathism with and without open bite.Overall, the mean changes in vertical and horizontal skeletal parameters were generally small. Post-surgical vertical relapse of prognathism with open bite was larger than that without open bite. Multiple regression analysis did not reveal any association between preoperative morphological pattern and postoperative relapse. Based on these results, the etiology of relapse was discussed.

In sagittal split ramus osteotomy, positioning and fixation of external fragments influences on relapse or temporo-mandibular-joint (TMJ) function. We take a line to keep preoperative TMJ positions, if we observe no sign of TMJ clinically and roentogenographically. Then we established external fragment repositioning system making use of “Wurzburg sagittal split system” and ready-made facebow and double buccal tubes for orthodontic treatments. This system requires no special instruments, materials and complex laboworks, do not elongates operation time too much to interfere the manipulations, and realizes sure and exact reposition of external fragment. From July 1990 to November 1991, we applied this system to 26 cases of mandibular prognathism or skeletal open bite, and obtained good clinical results.

Osteoma often occurs in the skull and facial bones, but rares arises in the mandibular ramus. We report a case of peripheral osteoma arising inside the mandibular ramus. The patient was a 37-year-old man who had spontaneous pain at the right parotid region. The tumor was resected extraorally. The pathological specimen showed compact osteoma.

Pycnodysostosis is a rare and hereditary sclerosing bone disorder characterized bydwarfism, open cranial sutures, mandibular angle loss and hypoplasia of the maxilla. Weexperienced to treat a 39-year-old female patient and analyzed her general, oral, and maxillofacialmorphology.We mentioned characteristics of the disease and discriminating points of similar diseases.

We have recently experiencd a case of large ameloblastoma with severe hypoproteinemia. The patient was a 34-year-old man, who was pointed out the existence of ameloblastoma in the left molar region of the mandible 13 years ago in our hospital, but refused to receive a therapy for ameloblastoma. After 13 years, he came to our hospital with a complaint of airway obstruction. He had a difficulty in eating, so his general condition was very bad. Especially, he had severe hypoproteinemia as total protein in his blood was 3.0g/dl. We tried to recover his general condition but failed to normalize his hypoproteinemia because of a leak of serum through a fistula opening in the oral cavity. Before the treatment for restoration sudden bleeding from the tumor compelled us to perform an operation, but we could not resect all of the tumor because of massive bleeding. After that, we used a sclerosing agent. Though it was locally effective, his general condition became worsened and he ultimately died of lung edema.We report a case of advanced ameloblastoma with severe hypoproteinemia.

In the field of oral and maxillofacial surgery, since symptoms appear in and around the oral cavity, we have used tube feeding for post operative nutritional management.Many kinds of enteral nutrients have been developed and put on the market, but had some weak points.In this study, comparison was made between Besvion®and conventional liquid diet with respect to the nutritional state and side effects. It was concluded that Besvion®was a superior product and appropriate as enteral nutrient in oral and maxillofacial surgery.

We report a case of malignant lymphoma presenting with multiple ulceration of the palate, maxillary gingiva, and mandibular gingiva in a 79-year-old woman. This case of malignant lymphoma was immunohistochemically diagnosed as diffuse large angiocentric NK/T cell lymphoma, which has very unique clinical features. In the oral and maxillofacial region, there have been few reports of this disease, and its concept is not generally recognized.

Bone formation in the autogenous periosteum of the tibia grafted to the floor of the mouth to bridge the mandible was studied by micro-CT to assess its efficacy in evaluating bone formation in rabbits. On soft radiographs, bone formation was observed from both ends of the periosteum on day 14. The bone increased in width and extended medially; contact was made in the center on day 28. The time course of the development of bone trabeculae was well demonstrated three-dimensionally on micro-CT. Indices of bone quality such as Tb-Th, Tb.N, and BV, which reflect the growth of trabeculae, increased gradually from days 14 to 21 and more rapidly from days 21 to 28, whereas Tb. S decreased gradually after grafting. The results suggest that micro-CT is useful in evaluating bone formation threedimensionally.

It is well-known that TCDD (2,3,7,8, tetrachloridedibenzo-p-dioxin) induces cleft palates (CPs) in pregnant C57BL mice. However, it is unclear if TCDD is a possible teratogen for cleft lip. We examined maxillofacial malformations including cleft lip in three animal strains: A/J mice, C57BL/6J mice and ICR mice. The A/J mouse develops cleft lip and palate spontaneously at a 5-10% rate. TCDD was administered in olive oil on gestation day (GD) 12.5 with gastric tubes at 10 microg/kg, 20 microg/kg, or 40 microg/kg to examine the dose-response, and on a single day from GD 8.5-14.5 to examine the timing effects of TCDD administration on lip and palate formation. Furthermore, the palatal shelf movements during GD 8.5-14.5 were observed with a stereoscopic microscope. All embryos had cleft palates when the TCDD was administered just before palatogenesis (GD11.5-GD12.5). With respect to the TCDD effects, there were large differences among the strains. In the A/J mice, the difference between a lethal dose and a dose that could induce a cleft palate was close. Cleft lips were not induced, even when the TCDD was given just before labiogenesis. Morphologically, both palatal shelves contacted perfectly along their lengths, but separated and formed cleft palates. In conclusion, TCDD is a strong inducer of cleft palates, and interferes with the fusion phase of the secondary palate, but has no effect on the lip.

To analyze the lip movement of patients with cleft lip and palate in detail, we developed a novel technique to produce a range image from a video-based motion capture system, and a unique technique to analyze lip movements in detail three-dimensionally. The accuracy of the range image obtained from the present system was investigated using a positioning actuator with a high accuracy and a known object, and by comparisons with the range images produced from a laser scanner with a cast model of a face. The lip motions of six healthy adults during phonation ɯ was analyzed.

The expression of human beta-defensin genes in oral squamous cell carcinomas(SCCs) was demonstrated by in situ hybridization. The expression of HBD-2 was observed not only in the inflamed lesions with bacterial infection but also in the non-inflamed carcinomas themselves (evident in 15 out of 20 carcinomas). However, HBD-3 expression was found in only 4 out of 20 SCCs. In the normal oral epithelia, the expression of HBD-2 and HBD-3 was only detected in the areas adjacent to the SCCs. These results suggest that HBD-2 might play a role in SCCs, which is different from the native defensive role of these proteins. HBD-2 may lead to the death of normal keratinocytes adjacent to the SCCs, which might, in turn, indirectly assist in the multiplication of tumor cells.

After organ transplantation, severe osteoporosis is occasionally seen, and the use of immunosuppressants is thought to be one of the causes of such osteoporosis. In the present study, we investigated the effects of FK506 monotherapy on bones and determined the mechanism of onset of osteoporosis, both by assessing chronological changes in bone metabolism and by identifying factors that facilitate bone resorption. In 8-week-old male Sprague-Dawley rats, FK506 (1 mg/kg) was injected intraperitoneally every day for 5 weeks (FK506-treated group), and for comparison, physiological saline was administered in the same manner in a control group of rats. Serum and urine samples were collected at weeks 0, 1, 3, and 5 of administration. The femur and tibia were collected within 24 h of the final administration. When compared to the control group, findings on three-dimensional micro-computed tomography of the femur for the FK506-treated group showed a significant decrease in trabecular bone volume. The level of serum osteocalcin in the FK506-treated group at week 1 of administration was significantly higher than the control. Throughout the administration period, the sum of urinary pyridinoline (PYD) and deoxypyridinoline (Dpd) was significantly higher in the FK506-treated group. Of the various bone resorption factors tested, the level of serum parathyroid hormone (PTH) in the FK506-treated group was significantly higher than the control at week 3 of administration. The results of the present study confirmed that FK506 monotherapy in rats induced high-turnover osteoporosis. Soon after the start of FK506 administration, bone formation and resorption were elevated, and PTH appeared to have been involved in the maintenance of the elevated bone resorption.

A 4-day-old female with a Tessier No.3 facial cleft on the left was accompanied to us. Her cleft arose from left medial canthus, ran downward obliquely through medial side of the lachrymal point and the nasolabial groove along the lachrymal fissure, turned round the alar base and went into the nasal floor linking with the cleft lip, the alveolar cleft and the cleft palate. Complete defect of the maxillary frontal process was observed. She was bilateral microphthalmia and had no visual acuity, too. The plastic operation for the facial cleft was performed 6 months after birth. The Cronin's method was applied similarly for the lip, the buccal cutaneous flap was rotated and advanced for the facial cleft, and the Z-plasty was applied on the eyebrow to improve the lower displacement of medial canthus.

To overcome the disadvantages of metallic osteosynthetic devices that should remove after the operation, bioabsorbable, ultra high strength poly-L-lactid osteosynthetic devices were developed, and have been applied to the treatment of bone fractures[1.5.6]. On the other hand, it is not known how much stress is actually generated on these devices when an external force was added and minor segment was displaced. In order to know the stress distribution generated in the devices, using 3-dimensional-CAD software, we created the solid model of these devices and the blocks, and assembled these parts just as the two blocks were fixed with these devices. We simulated of fixed one block in the two blocks, and moved a constant amount in four directions to the other block, and analyzed the stress generated in these devices using 3-dimensional stress analysis software. In these simulations, the biggest stress was generated when the plate was tensiled.

We report here 2 cases of patients with Sjogren's syndrome with dry mouth that were successfully treated with cevimeline hydrochloride. The first case was diagnosed as Sjogren's syndrome at our clinic, and the saliva secretion increased by more than three-fold following oral cevemeline hydrochloride. The second case was diagnosed at another hospital, and the saliva secretion was increased by more than two-fold by the medication.

Background The chondrosarcoma-derived HCS-2/8 has been known to be an excellent model of human articular chondrocytes. By mimicking the arthritic conditions through the treatment of HCS-2/8 cells with cytokines, we estimated the gene expression response of ccn1 and ccn2 during the course of joint inflammation in vitro. Results In order to mimic the initiation of inflammation, HCS-2/8 cells were treated with tumor necrosis factor (TNF)-α. To induce pro-inflammatory or reparative responses, TGF-β was employed. Effects of an anti-inflammatory glucocorticoid were also evaluated. After stimulation, expression levels of ccn1 and ccn2 were quantitatively analyzed. Surprisingly, not only ccn2, but also ccn1 expression was repressed upon TNF-α stimulation, whereas both mRNAs were uniformly induced by transforming growth factor (TGF)-β and a glucocorticoid. Conclusion These results describing the same response during the course of inflammation suggest similar and co-operative roles of these 2 ccn family members in the course of arthritis.

Lipoma is a benign tumor derived from nonepithelial origin and may occur almost anywhere on the body. In the oral cavity, however, lipoma is a relatively rare tumor.In this report, 30 cases of lipomas treated in our department during past 24 years are reviewed.1) The incidence of lipoma in our department is 4.1% of all benign tumor. Salivary gland tumors and epulis are excluded in this report.2) 16 patients were male and 14 female.3) Age ranged from 47-day-old baby to an 82-year-old man; mean age was 47.9 years.4) 11 cases were in the buccal mucosa, 4 in the mucogingival junction, 3 in the retromolar pad, 3 in the tongue, etc.5) Tumor size ranged fron 5×5mm to 50×50×40mm in the oral cavity, and from 25×25mm to 80×50mm out of the oral cavity.6) 24 tumors were histologically diagnosed as lipoma, 5 as fibrolipoma, and 1 as angiomyolipoma.