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In this study we investigated the relation between anterior disc displacement (ADD) and maxillomandibular morphology in skeletal anterior open bite with changes to the mandibular condyle. Thirty female patients (60 joints) with both conditions were evaluated. Magnetic resonance imaging of the temporomandibular joint (TMJ) was used to diagnose both ADD and changes to the mandibular condyle (erosion, osteophyte, and deformity). The relations among ADD, changes to the mandibular condyle, and maxillomandibular morphology were examined statistically. Changes to the mandibular condyle had a higher score than sym anterior open bite, the deviated side in asymmetric anterior open bite, and the non-deviated side. The score for disc displacement on the non-deviated side was lower than both the sym side and the deviated side. Unilateral changes to the mandibular condyle and unilateral disc displacement were not apparent in sym anterior open bite, but a unilateral non-displaced disc was seen only on the asymmetric side. Mandibular condylar changes were significantly more common on the deviated, than on the non-deviated, side. The SNB angle was significantly smaller, and the ANB, GZN, and SN-mandibular plane angles were significantly larger in sym anterior open bite. Overjet, ANB angle, GZN angle, and SN-MP angle were significantly larger, and the SNB angle was significantly smaller, in the presence of ADD without reduction and mandibular condylar deformity. We conclude that the prevalence of ADD without reduction and changes to the mandibular condyle were related to mandibular asymmetry and mandibular morphology in anterior open bite. This retrospective study suggests that ADD without reduction and mandibular condylar bone changes may be related to the progression of skeletal class II open bite and mandibular asymmetry in cases of skeletal open bite.

In sinus floor augmentation, bony nodular prominence at the floor of the maxillary sinus is an obstruction to lateral window approach. It is challenging to detach and elevate the sinus membrane without making any perforations around the nodular prominence, because the membrane is very thin. To overcome these difficulties, we developed a novel method.The membrane was not detached from the surface of the nodular prominence except for at the basal point, but the nodular prominence was cut at the base. Nodular prominence and sinus membrane were elevated upward together. A resorbable collagen membrane was placed beneath it to provide mechanical support and cover any partial tear in the sinus membrane. Autogenous bone and/or bone substitute were packed in the vacant compartment depending on the condition.This method is very easy to be carried out without any difficulties and worries. It gives us great benefit on the sinus floor augmentation.The online version contains supplementary material available at 10.1007/s12663-021-01572-7.

INTRODUCTION: The aim of this study was to compare body weight loss between postoperative intermaxillary fixation with metal wire and elastic traction and to investigate factors related to body weight loss after orthognathic surgery. MATERIALS AND METHODS: Subjects were 59 patients with dentofacial deformity, comprising 31 patients treated with intermaxillary fixation (IMF) and 28 patients treated with elastic traction without IMF (ELT) just after surgery. Body weight loss was measured at 1 week (T1) and 2 weeks (T2) after surgery. Body weight loss was compared between IMF and ELT, and factors related to body weight loss were statistically analyzed. RESULTS: Body weight loss ratio was significantly increased in IMF (2.6%) rather than in ELT (1.4%) at T1, but only tended to be increased in both groups at T2, showing no statistical difference. Body weight loss ratio was significantly increased at T2 compared to T1 in both groups. Body weight loss was significantly greater at T2 than at T1. CONCLUSION: Both IMF and ELT cause body weight loss after orthognathic surgery, but IMF causes body weight loss earlier than ELT and increased early body weight loss increases continuous body weight loss after orthognathic surgery.

INTRODUCTION: We aimed to investigate postoperative stability after orthognathic surgery in patients with skeletal class III malocclusion with severe open bite by comparison between bilateral sagittal splitting osteotomy (BSSRO) and BSSRO with Le Fort 1 osteotomy. MATERIALS AND METHODS: Seventeen patients with skeletal class III malocclusion with severe open bite who were needed more than 6 degree counterclockwise rotation of distal segment by only BSSRO in preoperative cephalometric prediction. The subjects were divided into group A, where 9 patients were treated by BSSRO, and group B, where 8 patients were treated by BSSRO with Le Fort 1 osteotomy. Patient’s characteristics of age, gender, preoperative over jet (OJ) and over bite (OB) were not found to be significantly different between the two groups. Counterclockwise rotation of distal segment in preoperative cephalometric prediction by only BSSRO was not found to be significantly different between group A of 7.6 (6–10.6) degree and group B of 9 (6–13) degree. The amount of rotation was reduced to 5.4 (3–10) degree by bimaxillary surgery using BSSRO and Le Fort 1 osteotomy in group B. OJ and OB were measured as occlusal stability factor. Distance between ANS-to-PNS plane and the edge of upper incisor (NF–U1Ed), and distance between Menton and edge of lower incisor (Me–L1Ed) were measured as skeletal stability factor using cephalometric analysis. These lengths were measured at pre-surgery (T0), 2 weeks after surgery (T1) and 1 year after surgery (T2), and these differences between the two groups were statistically analyzed. RESULTS: OJ and OB kept a good relation at any experimental periods. The change of Me–L1Ed was significantly larger in group A (1.21 mm at T0–T1, 1.02 mm at T0–T2) than in group B (0.14 mm at T0–T1, 0.16 mm at T0–T2). The change of NF–U1Ed was not significantly different between group A (1.07 mm at T0–T1, 0.57 mm at T0–T2) and group B (0.51 mm at T0–T1, − 0.05 mm at T0–T2). CONCLUSION: In case with more than 6 degree counterclockwise rotation of distal segment, skeletal stability was better after bimaxillary surgery than only BSSRO; however, OJ and OB kept a good relation.

INTRODUCTION: In orthognathic surgery, we often experience that model mounting by the occlusal bite record taken at centric relation under the conscious condition in the sitting position does not always correctly replicate the actual maxilla–mandibular relationship under general anesthesia. Mandible often moves backward further in the latter condition. The present study was carried out to investigate the degree of extra retrusion of the mandible under general anesthesia and to determine the characteristics in each of the three original skeletal class patterns in a Japanese population. PATIENTS AND METHODS: Fifty patients with jaw deformities (14 males and 36 females) were enrolled in this prospective study, their ages ranging from 16 to 49 years. The occlusal bite record at the incisor region obtained from a mounted articulator was compared with the records from the oral cavity of the patient under general anesthesia before surgery. RESULTS: Retrusion in the supine position under general anesthesia was observed in all skeletal classes, and it was significantly greater in skeletal Class II, compared to skeletal Class I and Class III. CONCLUSION: This study clearly revealed the difference among three different skeletal classes, and the mandible in the skeletal Class II moved backward significantly compared to other classes.

We report a clinical case of a patient with hereditary angioedema (HAE, Type III) in which, by implementing careful preoperative preparations to prevent the occurrence of edema, good course was achieved without the prophylactic administration of C1-inhibitor (C1–INH). We recommended the prophylactic administration of Berinert P, a human plasma-derived C1–INH formulation; however, due to the risk of developing a viral infection, both the patient and her mother refused to receive Berinert P. In cases where C1–INH cannot be administered as a prophylactic measure, it is essential to make sufficient preparations, including urgent tracheotomy, to prevent sudden occurrence of edema, with the cooperation of the anesthesiologist.

BACKGROUND Limitation of mouth opening is a common complaint following orthognathic surgery. OBJECTIVES This investigation reports on the progress of maximum incisal opening following orthognathic surgery and compares the impact of two different osteosynthesis methods on mouth opening in female patients with Class III dentofacial deformities. METHODS Forty cases of skeletal class III malocclusion were divided into twenty cases treated using the conventional single miniplate osteosynthesis method (P1) and twenty cases using the additional L-shaped miniplate osteosynthesis method (P2). No significant differences in pre-operative clinical status were detected between the P1 and P2 group, and all patients were managed with elastics in the post-operative period. Independent mouth opening exercises were initiated seven days after surgery, and inter-incisal distance was measured as maximum mouth opening (MMO) at 1 week, 2 weeks, and 1, 2, 3, 6 months. Statistical analysis was performed in order to analyse differences in MMO between the P1 and P2 groups (Prism 7 GraphPad software, San Diego, CA). Values of P

AU‐rich elements (ARE) exist in the 3′‐untranslated regions of the mRNA transcribed from cell growth‐related genes such as proto‐oncogenes, cyclin‐related genes, and growth factors. HuR binds and stabilizes ARE‐mRNA. HuR is expressed abundantly in cancer cells and related malignant phenotypes. HuR knockdown attenuates the malignant phenotype of oral cancer cells. In this study, we screened 1570 compounds in the approved drug library by differential scanning fluorimetry (DSF) to discover a HuR‐targeted compound. Firstly, 55 compounds were selected by DSF. Then, 8 compounds that showed a shift in the melting temperature value in a concentration‐dependent manner were selected by DSF. Of them, suramin, an anti‐trypanosomal drug, binds to HuR, exhibiting fast‐on and fast‐off kinetic behavior on surface plasmon resonance (SPR). We confirmed that suramin significantly decreased mRNA and protein expression of cyclin A2 and cyclin B1. The cyclin A2 and cyclin B1 mRNAs were destabilized by suramin. Furthermore, the motile and invasive activities of a tongue carcinoma cell line treated with suramin were markedly lower than those of control cells. The above findings suggest that suramin binds to HuR and inhibits its function. We also showed that the anticancer effects of suramin were caused by the inhibition of HuR function, indicating its potential as a novel therapeutic agent in the treatment of oral cancer. Our results suggest that suramin, via its different mechanism, may effectively suppress progressive oral cancer that cannot be controlled using other anticancer agents.

INTRODUCTION: We developed a novel, reliable and easy method that retains stability of the repositioned flap and vestibular expansion. METHOD: The conventionally elevated mucosal flap is secured to the desired depth of the vestibule by the pressure created by the polyvinyl chloride 6Fr suction catheter which is fixed to the alveolar bone with cortical bone screws passing through the inner lumen of the tube. The keratinized free flap is placed on the periosteum conventionally, and horizontal mattress suturing is performed for immobilization, with the suture running through the inner lumen of the tube transversally. CONCLUSION: This simple method gives us great benefit on the vestibuloplasty.

[Purpose] The purpose of this study was to clarify the differences in ventilation mechanics between quiet breathing and expiratory rib cage compression, and between expiratory rib cage compression on the upper rib cage and on the lower rib cage. [Subjects and Methods] Subjects comprised 6 healthy males. Expiratory rib cage compression was performed manually by compressing the upper and lower rib cages. Changes in the lung volume, flow rate, and esophageal and gastric pressure were examined. [Results] The end expiratory lung volume was significantly lower during expiratory rib cage compression than at rest, but the end inspiratory lung volume was not significantly different. When compared with the esophageal and gastric pressures on the upper and lower rib cages at rest, the gastric pressures were significantly higher at end expiration. Lung resistance was significantly higher during expiratory rib cage compression than at rest. [Conclusion] Although expiratory rib cage compression promoted expiration and increased tidal volume, the lung volume did not increase beyond end inspiratory levels at rest. Lung resistance may increase during expiratory rib cage compression due to a decrease in lung volume. The mechanism by which expiration is promoted differed between the upper and lower rib cages.

[Purpose] The purpose of this study was to clarify the impact of postural changes during tidal breathing on the configuration and motion of chest-wall in order to further breathing motion evaluation. [Subjects and Methods] Chest-wall configuration and motion in the supine, right lateral, and sitting positions were measured using optoelectronic plethysmography in 15 healthy adult men. [Results] The anteroposterior diameters of the chest wall were significantly lower in the supine position for the pulmonary and abdominal rib cages, whereas the mediolateral diameters in the lateral position were lowest for the abdominal rib cage. Regarding chest-wall motion, both craniocaudal and anteroposterior motions of the anterior surface of the pulmonary and abdominal rib cages were significantly greater in the sitting position. Regarding motion of the left lateral abdominal rib cage, lateral motion was greatest in the lateral position. [Conclusion] Chest-wall configuration and motion changed according to posture in healthy men, particularly in the pulmonary and abdominal rib cages.

The purpose of this study was to evaluate patients’ nutritional state after orthognathic surgery. The subjects were 40 female patients with dentofacial deformity aged 17–33 years who were undergoing bilateral sagittal splitting ramus osteotomy. Twenty patients were treated with intermaxillary fixation, and 20 patients were treated without intermaxillary fixation. Age and body mass index (kg/m2) were assessed as physical factors, operation time, blood loss, and amount of mandibular movement with or without intermaxillary fixation were assessed as operation stress factors, and the following laboratory data, total protein, serum albumin, total cholesterol, total lymphocytes, and cholinesterase were assessed as nutritional state factors at 1 and 2 weeks after surgery. Statistical analysis was performed for body weight loss and relationship between body weight loss and examination factors. Body weight significantly decreased 2.3% at 1 week and 3.9% at 2 weeks after surgery rather than preoperation. All laboratory data except total lymphocyte were decreased at 1 week after surgery and still remained significantly decreased at 2 weeks after surgery. There was a statistically significant relationship between body weight loss at 1 week after surgery and operation time. These results indicate that long operation time caused body weight loss in orthognathic surgery.

The aim of this study was to investigate the incidence of anterior disc displacement without reduction (ADDwoR) of the temporomandibular joint (TMJ) in patients with dentofacial deformity. Eighty-eight female patients (176 joints) with skeletal class III malocclusion and 33 female patients (66 joints) with skeletal class II malocclusion, with or without anterior open bite and asymmetry, were evaluated. Magnetic resonance imaging (MRI) of the TMJ was used to diagnose ADDwoR. A statistical analysis was performed to examine the relationship between ADDwoR and skeletal structure. ADDwoR was present in 37 of the 66 joints (56.1%) in class II compared to 34 of the 176 joints (19.3%) in class III (P

Purpose To study the feasibility and the laterality of measurements of chest wall volume variation during tidal breathing in the lateral position in healthy subjects. Methods Eighteen normal subjects were studied. Chest wall volume changes were measured by optoelectronic plethysmography in the supine and right and left lateral positions during quiet breathing. The accuracy of measuring lung volume was also examined using hot wire spirometry in 10 of the subjects. Results The measurement errors between lung volume changes and chest wall volume changes were not significantly different in all positions. There was no significant difference between right and left compartmental volume changes in the supine position. However, chest wall volume changes were lower on the dependent side in the lateral position than on the non-dependent side because of the decrease in abdominal rib cage and abdomen volume changes. Conclusion Chest wall volume measurements during quiet breathing in the lateral position have high measuring accuracy and show laterality.

INTRODUCTION: To avoid injury of the descending palatine artery during Le Fort I osteotomy, I believe that it is important to measure the right distance between the piriform rim and the most anterior point of the descending palatine canal on the CT images and to insert the chisel to the correct distance. To achieve this maneuver easily, a novel chisel with depth markings is developed. MATERIAL AND METHODS: The osteotome is based on a general thin osteotome of 6 mm width. Laser-striped markings are made for easy identification of 25, 27, 30, 33, 35, 37, and 40 mm from the top, with unique color-coded stripe. It enables easy bone-cut without anxiety in a short time. It is also a useful instrument for bone-cut where the length and depth are critical. CONCLUSION: This length-marked osteotome is a reliable instrument for secure osteotomy without injuries.

A patient with severe posterior maxillary hypoplasia was simulated using a 3-dimensional model by rapid prototyping, and segmental vertical distraction osteogenesis was planned to advance the posterior maxillary segment. The bi-directional distractor was adapted to the alveolar ridge and zygomatic buttress. After a 7-day latency period, we started distraction at a rate of 0.35mm every 12h. 12mm of advancement of the posterior maxillary segment was achieved. This distraction osteogenesis using a bi-directional distractor with proper therapeutic planning and good surgical technique will help ensure adequate vector control to predictably regenerate the hard and soft tissues during alveolar distraction.

For a sagittal split ramus osteotomy to be secure, the relation between the outer and inner contours of the cortex at the inferior border of the mandible is critical. The lowest point of the outer contour is not always immediately below that of the inner contour, and the former is placed more lingually than the latter in about a third of all cases. This tendency is much more noticeable in skeletal class I and II malocclusions than class III. It is therefore important to examine the lowest point of the inferior border in every case, and to carry the inferior part of the buccal cut on to the lingual side if necessary.

Maxillary sinus hypoplasia is a relatively rare condition and opportunities to encounter this pathology are scarce. We describe a bilateral case in a 64-year-old woman with swelling of the nasal floor mucosa resulting from periapical periodontitis in the condition of maxillary sinus hypoplasia, similar to the swelling of the sinus membrane in the condition of normal anatomical structure.

Introduction: Alveolar distraction is mainly used to increase height and width of the alveolar crest. This technique, however, is not typically used for lengthening the perimeter of the dental arch or improving teeth axes. We applied alveolar distraction in a tooth-borne manner in the second stage of our original method and obtained favorable results. We therefore present an outline of this method. Case Report: Genioplasty was first performed to create an infrastructure for sequential advancement of the subapical alveolar segment. After bone union, anterior subapical alveolar osteotomy was performed. The stump of the osteotomized dentate segment was moved forward without changing the incisal edge position, and a box-type bioabsorbable plate with four holes was fixed only onto the dentate segment using two screws. After a latency period, two distraction devices were placed bilaterally to the brackets and activated at 1.0 mm/day. After reaching the desired position, the distractor was immobilized, and then replaced by resin temporary teeth to retain the created space. After the consolidation period, orthodontic treatment was restarted and teeth moved into the newly created space. Bimaxillary surgery was performed after completing pre-surgical orthodontic treatment. Finally, both desirable occlusion and functional masticatory function were obtained. Conclusion: This tooth-borne distraction system is one applicable method for patients with skeletal class II and crowding of lower anterior teeth, achieving good results particularly in combination with our original method.

Purpose: Relapse caused by clockwise (opening) rotation of the distal segment (dentate segment) in the sagittal plane is one of the postoperative complications sometimes seen after sagittal split ramus osteotomy. The force involved in this movement is primarily exerted by the masticatory and suprahyoid muscles. For postoperative stability, we have used two plates on each side: a straight plate placed over the vertical osteotomy line at the buccal surface of the first molar and an L-shaped plate placed at the distal or lateral part of the last molar over the osteotomy line, just crossing over the upper-lateral edge of the buccal shelf, to prevent the tail of the distal segment from moving upward. Although postoperative stability was clinically fine, experimental evaluations have not previously been performed. To clarify the effects of the L-shaped plate, we performed an experimental study using a bioabsorbable plate system. Methods: A custom-fabricated jig was made to simulate rotational movement of the segments. Two segments made from polyoxymethylene resin were fixed with a four-hole straight or four-hole box poly-L-lactate ioabsorbable plate. An L-shaped plated was then added for rigidity, and mechanical testing was performed. Result: The yield load exerted by the four-hole straight plate alone was 152.4±11.0 N. This increased significantly to 273.8±43.7 N with addition of an L-shaped plate (p

The purpose of this study is to evaluate the incidence, risk factors and postoperative nausea and vomiting (PONV) in patients who underwent orthognathic surgery.The subjects were 139 patients aged 17-52 years (47 males and 92 females) who underwent orthognathic surgery in the Hokkaido University Hospital from January 2001 to December 2003. Ninety-four Sagittal splitting ramus osteotomy (SSRO), 34 Le Fort I osteotomy and SSRO (Le Fort I+SSRO), and 11 surgically assisted rapid palatal expansion (SARPE) were performed. Anesthesia was maintained with sevoflurane and nitrous oxide in oxygen. There were no cases of maxillomandibular fixation. The factors investigated included age, gender, type of surgery, amount of bleeding, operation time, anesthesia time, anesthesia induction drugs, fentanyl dose and incidence of PONV. A statistical study was performed using logistic regression analysis to confirm the statistical significance among age, gender, amount of bleeding, operation time, anesthesia time, difference of anesthesia induction drugs, fentanyl dose, and incidence of PONV. A Chi-square test for independence was used to confirm the statistical significance between the type of surgery and incidence of PONV. Differences were considered significant for a P

This clinical study was performed in order to investigate the spectrum of dentofacial deformities, management, surgical outcomes and the living area of orthognathic patients treated at Kushiro Red Cross Hospital in the eastern part of Hokkaido. Fifty-three patients were treated for dentofacial deformities in our hospital from April 1989 to December 2004. These patients have increased in recent years. There were 13 male and 40 female patients. According to clinical diagnosis and operation procedure, mandibular prognathism was the most predominant diagnosis and only sagittal split ramus osteotomy was performed in most cases. The patients lived over a wide area of eastern Hokkaido. As Kushiro Red Cross Hospital cooperats with Hokkaido University Hospital and nearby dental clinics, patients could receive the greater part of orthognathic treatments in Kushiro Red Cross Hospital. However, most patients had to go to Hokkaido University Hospital a few times. Patients could benefit from developing orthognathic management at Kushiro Red thus Cross Hospital as well as at Hokkaido University Hospital.

透析患者の血糖 (BG) コントロールの指標としてグリコヘモグロビン (HbA1c) およびグリコアルブミン (GA) の2つを比較検討した. 対象は, 糖尿病を有する慢性維持血液透析患者41名 (男性31名, 女性10名, 平均年齢65±9歳) であり, 全例が昼間透析である. 透析来院時に, 透析開始時, 透析中昼食前, 透析終了時の3ポイントで血糖値を, また透析開始時の採血でHbA1cとGAを測定し, それぞれの関係を検討した. また, 同日から遡り過去4週および2週間の透析開始時平均血糖値 (朝食後平均143分後) を求め, これら平均値とHbA1c, GAおよび他の因子との関係についても検討した. 結果は, GAとHbA1cとは良好な相関関係が認められた (r=0.663, p

A patient with traumatic anterosuperior dislocation of the mandibular condyle into the temporal fossa without condylar fracture is reported. This form of dislocation is rare — only 2 reports have been published. For this patient, unlike previously reported patients, the intraoral approach was used to perform coronoidotomy and condylotomy, and a favourable result was obtained with the subsequent use of elastic traction.

We report a case of complex odontoma that had unique radiological features. A 25-year-old man was referred to the Department of Dentistry and Oral Surgery, Sapporo General Hospital because of swelling and pain at the right side of the mandible. Panoramic radiographs showed a lesion with a mottled appearance over an impacted wisdom tooth. Computed tomographic examination clearly showed a lowdensity mass containing some cavernous-bone-like radiopacities. The mass was diagnosed to be a mandibular tumor and was removed surgically. The impacted wisdom tooth was then extracted. Histopathological examination of the mass revealed a complex odontoma, which was not suspected before operation. To our knowledge, there have been no previous reports of complex odontoma associated with the features of this case. We therefore describe and comment on this quite rare case.

We report a case of myoepithelioma arising in the left mandibular notch, between the temporal and the masseter muscle.A 37-year-woman visited our Department of Dentistry and Oral Surgery because of gradual swelling of the right cheek and trismus of 2 months' duration. A panoramic radiograph showed a radiopaque circumscribed lesion between the coronoid and the articular process. A computed tomographic examination clearly showed a large mass involving the exo-lateral and posterior parts of the coronoid process. The mass was 20mm in diameter. Total enucleation of the mass was performed via the oral cavity with an ostectomy of the coronoid process under general anesthesia. The mass was diagnosed histopathologically as myoepithelioma, which had not been suspected. Given that myoepithelioma generally where glands are located, we believe that occurs the tumor arose from an ectopic salivary gland and developed at its unique location. To our knowledge, no report has previously described a myoepithelioma arising in the same region as ours, including those on pleomorphic adenomas, from which myoepithelioma was distinguished in the revised WHO classification in 1991. We therefore present this rare case with some comments.

Dislocation of the temporomandibular joint (TMJ) is a thorny problem not only for a patient but also a doctor. Especially for the elderly edentulous patients, it is very hard to treat the condition although there are many surgical and non-surgical procedures. We successfully treated it in two elderly edentulous patients by injection of OK-432 as a sclerosing agent.

In orthognathic surgery, posterior crossbite caused by a skeletal width deficiency should be corrected to establish proper postoperative lateral guidance. When the basal arch of the alveolar bone in the molar region of the maxilla is absolutely narrow and orthodontic treatment alone will be unlikely to improve the posterior crossbite while maintaining a desirable range for tooth axis, improvement should be achieved by segmental alveolar osteotomy in conjunction with jaw osteotomy rather than by aggressive torque control of the tooth axis. Surgically assisted rapid palatal expansion (SARPE) is one of the options frequently performed nowadays, but the expansion modality is a fan-shaped opening of the palate, and it brings about greater expansion in anterior region than in posterior region. It is not a desirable strategy particularly when transverse expansion in molar region is required.1 Therefore, three-piece Le Fort I osteotomy by employing horseshoe-shaped circumpalatal osteotomy is often performed.2 Although a small amount of expansion can indeed be achieved using only this method, it does not always accomplish the planned expansion, which is wider than 3~4 mm in our experience, due to the limitations to stretching the palatal mucoperiosteum by local manual manipulation alone. We have developed a novel device for this acute palatal expansion, the palatal expander, to efficiently stretch the palatal mucoperiosteum widely, irrespective of tooth and gingival conditions.

We investigated the therapeutic effects of ONO-4007, a novel synthetic lipid A derivative with low toxic activities, on transplanted hepatocellular carcinoma KDH-8 in WKAH rats. ONO-4007 brought about complete cures in about 60% of rats bearing tumor necrosis factor (TNF)-alpha-sensitive KDH-8 cells, whereas no complete cure was observed in rats bearing cKDH-8/11 which is identical to KDH-8 but a TNF-alpha-resistant cell line, KMT-17 and KEG-1. Then we examined the influence of rabbit anti-TNF-alpha antibody on the therapeutic effects of ONO-4007 against the TNF-alpha-sensitive KDH-8. The concomitant administration of the rabbit anti-TNF-alpha antibody completely abrogated the therapeutic effects of ONO-4007. On the other hand, rechallenged tumor cells of both KDH-8 and cKDH-8/11 were completely rejected in the rats cured of KDH-8 tumor, although no rejection of KEG-1 was observed. Moreover, Winn assay, i.e. the tumor cell neutralizing assay, indicated that CD4+ T cells were involved in the antigen-specific transplantation resistance. These findings suggest that antigen-specific T cell responses are involved in the complete cure of tumors after the treatment with ONO-4007, although its therapeutic effect is initiated by TNF-alpha.

We have sometimes encountered difficulty in improving labially inclined teeth, particularly in patients with mandibular retrognathia, because the symphysis menti is often thin and insufficient space is available to permit sagittal rotation of the teeth without root exposure from the alveolar bone. We have previously described a three-stage method to overcome this problem, involving genioplasty for improving the retruded chin, and to construct the infrastructure for subsequent subapical segmental alveolar osteotomy, subapical segmental alveolar osteotomy itself, and, finally, two-jaw surgery. Bone augmentation with thin cortical bone at the gap created on the upper surface of the advanced genial segment was also addressed in the previous report. In the present study, to confirm the benefits of the three-stage method using objective data, cephalometric evaluation was performed in each step. In all cases, pogonion (Pog) was moved forward substantially. Net linear forward movement of Pog and net changes in SN-Pog were from 12 mm to 20 mm and from 4.8° to 7.0°, respectively. Angle of mandibular incisors and interincisal angle also improved to desirable levels. Although this method requires three separate surgeries, the approach safely improves the clinical situation and accentuates treatment efficacy.

The toxic effects of linear alkylbenzenesulfonate (LAS) and quaternary alkylammonium chloride on Dunaliella sp. were studied by measuring 13 C-glycerol. 13 C-glycerol (five isomers of [1,2,1′- 13 C 1,2,3 ]-glycerol) was produced in Dunaliella sp. from 13 C-sodium bicarbonate added and the amounts of 13 C-glycerol was lowered quantitatively with increased concentration of surfactants. The ratio of glycerol to 13 C-glycerol was found to be about 45 : 55 by gas chromatographic/mass spectrometric analysis. The 24-h median effective concentration (EC50-24h) were 3.5 mg/l for LAS, 0.79 mg/1 for alkyltrimethyl-ammonium chloride (TM), 18 mg/l for dialkyldimethylammonium chloride (DM) and 1.3 mg/l for alkyldimethylbenzylammonium chloride (BM) : the toxic potencies were in the order of TM>BM>LAS>DM. The suppression of 13 C-glycerol formation by LAS seemed to be related to the process of photosynthesis from 13 C-sodium bicarbonate.

A new method to assess the toxic effects of linear alkylbenzenesulfonate (LAS : alkyl carbon number; 12) and quaternary alkylammonium chloride was established by using living green alga, Dunaliella sp.. This method is based on the 1 H-NMR determination of glycerol which decreased quantitatively with increased concentrations of surfactants. The flagella immobilities and the cell mortalities following the exposure of LAS and TM (alkyltrimethylammonium chloride : alkyl carbon number ; 16–18 ) increased with decreased glycerol contents. High correlations were found between the glycerol contents and the flagella immobilities, and the cell mortalities. No leakage of glycerol of which detection limit was 0.02 mM/L media into the media was detected. The EC 50-24h values of surfactants were 3.3 mg/L for LAS, 0.38 mg/L for TM, 18 mg/L for DM (dialkyldimethylammonium chloride : alkyl carbon number ; 16–18) and 1.8 mg/L for BM (alkyldimethylbenzylammonium chloride: alkyl carbon number; 12–14). The toxic potencies were in the order of TM>BM.LAS>DM.

The toxic effects of linear alkylbenzene sulfonate (LAS), quaternary alkylammonium chlorides (cationic surfactants[CS]), and their complexes (LAS-CS) were examined in Dunaliella sp. by proton nuclear magnetic resonance spectroscopic analysis of glycerol and in Chlorella pyrenoidosa by growth inhibition. The glycerol content decreased quantitatively with increased concentrations of LAS, CS, and LAS-CS complexes. The 24-h median effective concentration (EC50] values of LAS and CS in free form were 0.38 to 18 mg/L and the toxic effects were in the order alkyltrimethylammonium chloride (TM) > alkyldimethylbenzylam-monium chloride (BM) > LAS > dialkyldimethylammonium chloride (DM). The 24-h EC50 values of LAS-CS complexes at molar ratios of 1:1 and 2:1 were 1.3 to 13 and 5.6 to 9.6 mg/L as LAS-equivalent concentration, respectively. The order of toxic effects was LAS-TM > LAS = LAS-BM > 2LAS-BM > 2LAS-DM > 2LAS-TM > LAS-DM. The toxic effect of LAS was enhanced by equimolar complex formation with TM. The 96-h EC50 values of LAS and CS on the inhibition of growth in C. pyrenoidosa were 0.28 to 29 mg/L for the compounds in free form and their toxic effects were in the order TM > BM ≫ DM > LAS. The 96-h EC50 values of LAS-CS complexes at molar ratios of 1:1 and 2:1 were 1.4 to 59 and 11 to 86 mg/L, respectively, and the order of toxic effects was LAS-BM > LAS-TM > 2LAS-BM > 2LAS-TM > LAS > LAS-DM > 2LAS-DM. The toxic effects of LAS were also enhanced by the formation of complexes with TM or BM at molar ratio of 1:1 and 2:1. Thus, not only LAS but also its CS complexes might exert toxic effects on organisms in the environment.

Summary: In this study, we demonstrated that immobilized fibronectin (FN) enhanced lymphokine-activated killer cell (LAK) activity, and that the enhanced LAK activity was completely abrogated by an anti-VLA-5 monoclonal antibody and RGD peptide. Fresh spleen cells expressed VLA-4, VLA-6, and vitronectin receptor, whereas VLA-5 was expressed only on the spleen cells activated with interleukin-2. LAK cells showed increased adhesion to immobilized FN compared with that to control bovine serum albumin, and the increased adhesion of LAK cells to immobilized FN was inhibited by anti-VLA-5 monoclonal antibody. Conjugate-formation assay showed that the LAK cells cultured on immobilized FN bound to target cells more efficiently than the control LAK cells, and that anti-LFA-1 monoclonal antibody inhibited the LAK-target cell binding. Immobilized type IV collagen and laminin, as well as FN, enhanced LAK activity. All of these results suggest that the interaction of integrins expressed on LAK cells with extracellular matrix proteins acts in a costimulatory manner for the enhancement of LAK activity, and that anchorage is necessary for full activation of LAK cells.