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Purpose: Increases in fecal bile acids may play a role in colorectal carcinogenesis. The authors tested the hypothesis that high concentrations of primary and secondary bile acids are more common in patients with colon cancer than in patients with other gastrointestinal diseases., Methods: In this retrospective study the secondary bile acid deoxycholic acid and the primary bile acid cholic acid were measured in the feces by enzyme-linked immunoabsorbent assay in 63 patients with colorectal cancer, 24 patients with gastric cancer, 11 patients with biliary disorders, and 47 healthy volunteers., Results: Preoperatively, the mean deoxycholic acid values tended to be higher and the cholic acid values were significantly lower in patients with colorectal cancer than in healthy subjects. Patients with other gastrointestinal diseases had lower deoxycholic acid and cholic acid values than healthy subjects. In healthy subjects the deoxycholic acid to cholic acid ratio ranged from 0.10 to 2.86 (mean, 0.88), but in almost two-thirds, the ratio did not exceed 1. In contrast, the mean preoperative ratio in patients with colorectal cancer was 2.26 (range, 0.06-7.17; P < 0.0001) and tended to be higher in patients with advanced cancer and in those with sigmoid and rectal tumors. If 1.1 is taken as the upper limit of normal for deoxycholic acid to cholic acid ratio, 67 percent of patients with colorectal cancer had an abnormal value preoperatively., Conclusion: A high deoxycholic acid concentration and deoxycholic acid to cholic acid ratio may be indicators of colorectal cancer. Further study is needed to improve sensitivity and specificity, perhaps by combining fecal bile acid measurements with other tests, and a large prospective trial may be warranted to determine whether these measurements have value in screening for this common cancer.

Purpose: The purpose of this study was to examine disc position and configuration, as well as clinical findings, during the natural course of nonreducing disc displacement of the temporomandibular joint (TMJ)., Patients and Methods: The subjects were 21 patients (24 affected joints) for whom a diagnosis of anterior disc displacement without reduction in the TMJ had been made on arthrography, but who had received no treatment for more than 12 months. The disc position and configuration were examined at a mean follow-up of 27.1 months using magnetic resonance imaging. Clinical signs and symptoms were also examined. As a control, 30 joints in 15 persons who had no current or previous TMJ symptoms were studied., Results: The patients' clinical signs and symptoms tended to be alleviated during the follow-up period. In all patients, the disc was displaced anteriorly on mouth closure, and it did not reduce into normal position during mouth opening at the follow-up, whereas normal disc position was found in all of the controls. In the patients, the disc deviated from the normal biconcave configuration found in all of the controls, frequently showing enlargement of the posterior band, even thickness, folding, and convex configurations in the follow-up magnetic resonance imaging., Conclusion: Disc displacement does not resolve, and continued disc deformity is common in the natural course of nonreducing disc displacement of the TMJ, although the clinical signs and symptoms tend to become alleviated.

Objective: The purpose of this study was to review the reliability of the internal jugular vein when used as a recipient vein in oral microvascular reconstruction., Study Design: A retrospective study was done of 36 consecutive cases in which microvascular reconstruction was accomplished with a free flap using the internal jugular vein in an end-to-side fashion. The postoperative patency of 25 internal jugular veins used as recipient veins was examined by postcontrast computed tomography scanning., Results: The overall flap success rate was 97%. Venous thromboses occurred in 2 cases. A common venous thrombosis occurred in one case, but the flap survived after re-anastomosis. In another case, internal jugular vein thrombosis occurred at 5 days of anastomosis, and the flap could not be salvaged by exploratory surgery. All other cases were completely uneventful. All internal jugular veins assessed on postcontrast computed tomography scans were patent at 51 to 107 days after surgery (mean, 89 days)., Conclusion: Internal jugular vein, if available, is reliable when used as a recipient vein in oral microvascular reconstruction. However, it is not necessarily flawless.

This paper addresses the in situ expression of transforming growth factor-beta (TGF-beta), platelet-derived growth factor (PDGF), and their receptors in the encapsulation process against a foreign body, using 20 cases of the titanium miniplate as a model of the foreign body, used clinically to fix a fractured mandible. Fibrous tissue formed during the encapsulation process was composed of scar-like and fibrogenic layers, with the former directly facing the foreign body. By immunohistochemistry using pre-fixed frozen sections, only the fibrogenic layer was characterized by expression of type I procollagen (PC-I). Spindle-shaped mesenchymal cells in the fibrogenic layer expressed TGF-beta isoforms and receptors, PDGF isoforms, and PDGF beta-receptor. In contrast, the scar-like layer had few such cells. In both layers, spindle-shaped cells did not express Ki-67 in their nuclei. Double immunofluorescence microscopy for cell identification revealed that most PC-I-positive fibroblasts expressed both isoforms and receptors of TGF-beta and PDGF in the fibrogenic layer, while in contrast, they were expressed by only a small number of CD68-positive macrophages. These results suggest that in the maintenance stage of the human encapsulation process against a foreign body, both TGF-beta and PDGF function cooperatively via their receptors in the fibrogenic layer, with such stimuli markedly diminished in the scar-like layer.

Purpose: Elastic fibers in the attachment regions of the temporomandibular joint (TMJ) are considered important in the movements of the disc during jaw motion. This study was designed to determine whether there are change in the elastic fibers of the TMJ when the disc is perforated for a long period., Materials and Methods: Each TMJ of five rabbits was surgically exposed, and a mediolateral perforation was made in the center of the articulating region of the disc with a scalpel. Five untreated and three sham-operated rabbits were used as controls. The TMJs were removed after 10 months and processed for histochemical demonstration of elastic fibers., Results: Osteoarthritic changes and a significant decrease in number of the elastic fibers in the anterior-inferior attachment and posterior-inferior attachment of the TMJ disc were observed after disc perforation. Conversely, elastic fibers appeared in the fibrous tissue on the resorbed bone of the articular eminence., Conclusions: Experimental disc perforation changes the distribution and density of the elastic fiber in the TMJ as well as causes osteoarthritis. A knowledge of these facts may improve our understanding of perforation of the disc.

Objective: The purpose of this study was to determine whether lavaging of the superior joint space with injection of sodium hyaluronate can be used as an alternative treatment method for nonreducing disk displacement of the temporomandibular joint., Study Design: In 26 patients with nonreducing disk displacement of the temporomandibular joint, the superior joint space was rinsed with 1% xylocaine, and then sodium hyaluronate was injected there (experimental group). As a control group, 50 patients with nonreducing disk displacement of the temporomandibular joint who received no treatment were used (control group). The frequency of the patients with successful clinical resolution was evaluated in each group during 6 months., Results: The frequency of the patients with successful clinical resolution in the experimental group (73.1%) was significantly higher than that in the control group (36.0%) at the 6-month follow-up (chi-squared test, p < 0.05)., Conclusions: This therapy appears to represent an alternative treatment method for nonreducing disk displacement of the temporomandibular joint.

The natural course of untreated nonreducing disc displacement of the temporomandibular joint was evaluated in 52 patients (total of 57 affected temporomandibular joints). The association between the clinical findings at the initial visit and the outcome at 12 months for the age, range of motion for maximum mouth opening, intercuspal-occlusal relationship, morphology of the mandibular fossa and the articular eminence, and the locking duration was evaluated. Good resolution was seen in 59.6% of the patients. The patients with good resolution were significantly younger than those with poor resolution (P < .05, two-tailed t test); however, there were no differences in any other factors between the patients with good resolution and those with poor resolution. Natural resolution of clinical signs and symptoms was suggested for the majority of patients with nonreducing disc displacement of the TMJ, and a younger age at the initial visit appears to be a positive factor in the prognosis.

Our aim in the present study was to understand the mechanism whereby specific destruction of acinar but not ductal structure occurs in salivary glands in Sjögren's syndrome (SS). Thus, we examined the effects of cytokines including TNF-alpha and IL-1 beta on the proteolytic activity of cultured normal human salivary gland cell clones, because degradation of the basement membrane by proteolytic enzymes leads to the disruption of acinar or ductal structure in salivary glands. Simian virus 40 (SV40)-immortalized normal human salivary gland cell clones with ductal (NS-SV-DC) or acinar (NS-SV-AC) phenotype were treated either with TNF-alpha or IL-1 beta alone or with a combination of both, and then proteolytic activity was examined. Although cytokine-treated NS-SV-AC demonstrated high matrix metalloproteinase-2 (MMP-2) activity at both protein and mRNA levels, no remarkable increase in MMP-2 activity was detected in NS-SV-DC. Expression of tissue inhibitor of metalloproteinase-2 (TIMP-2), a specific inhibitor of MMP-2, was similarly inhibited by cytokines in these cell clones. Thus, the net balance estimated by MMP-2/TIMP-2 suggested enhanced proteolysis in cytokine-treated NS-SV-AC and, to a much lesser extent, in NS-SV-DC. To examine whether enhanced expression of MMP-2 occurred in acinar cells of SS salivary glands, we carried out an immunohistochemical study using SS salivary gland tissues. This study indicated that acinar cells adjacent to the lymphocytic infiltrate exhibited enhanced expression of MMP-2 compared with those distant from infiltrated lymphocytes or with those in normal salivary glands. By Northern blot analysis, NS-SV-DC and NS-SV-AC expressed receptor mRNA for both cytokines. The signal-dependent activation of the transcription factor NF-kappa B was observed only in NS-SV-AC. I kappa B-alpha, a specific inhibitor of NF-kappa B, was down-regulated by treatment with cytokines in NS-SV-AC. However, the expression of I kappa B-alpha protein was not detected in NS-SV-DC at the basal level. Treatment of NS-SV-AC with calpain inhibitor-I restored the expression of I kappa B-alpha protein in cytokine-treated cells, thus leading to the inhibition of NF-kappa B activation. Reverse transcriptase-PCR analysis confirmed that there was a marked reduction in I kappa B-alpha mRNA expression in NS-SV-DC as compared to that in NS-SV-AC. As such, it seems likely that there is a relationship between the activation of MMP-2 and the activity of NF-kappa B, and that the NF-kappa B/I kappa B-alpha complex is not a signal mediator involved in cytokine-induced suppression of TIMP-2. These observations, therefore, indicate that the divergent response to cytokines in each constituent cell of salivary gland may result in the histopathologic manifestation of SS.

A rare case of leiomyoma of the mandible is reported together with the conventional histologic, immunohistochemical, and electron microscopic findings. On immunohistochemical evaluation the tumor cells were positive for vimentin, desmin, and alpha-smooth muscle actin but negative for neurogenic antigens and markers for vascular endothelial cells. Ultrastructural examination revealed smooth muscle cell differentiation. The Ki-67 labeling index was 4.7%. The tumor showed rapid increase in size and clinical features suggestive of malignancy. However, on histopathologic evaluation it was diagnosed as a benign neoplasm, and this diagnosis was supported by the results for mitotic rate, Ki-67 labeling index, and p53 immunostaining.

Using 2 in vitro systems in which normal human salivary gland cells can be immortalized by transfection with SV40 DNA (NS-SV-DC), and in which a non-metastasizing human salivary gland adenocarcinoma cell clone (HSGc) can be converted to biologically aggressive and metastasizing cancer cells, we analyzed the relationship between the expression of basic fibroblast growth factor (bFGF) and malignant phenotype in human salivary gland cell clones. By enzyme immunoassay, intracellular contents of bFGF were equally detected in all the cell clones, while bFGF contained in serum-free conditioned medium of each cell clone was different: HSGc and metastasizing cell clones, respectively, released 2- and 10-fold more bFGF into media than did NS-SV-DC. Immunoblot analysis also revealed a similar result as that detected by enzyme immunoassay. By Northern blot analysis, bFGF mRNA expression was consistently detected in all the cell clones examined. We then quantitated bFGF contents in sera of tumor-bearing mice by enzyme immunoassay. Although sera from nude mice bearing an HSGc tumor showed significantly higher amounts of bFGF than those of control mice, bFGF concentrations in sera gradually decreased after removal of the tumor. For metastasizing cell clones, serum concentrations of bFGF were 2.2- to 2.6-fold higher than those of HSGc. In addition, bFGF amounts in sera after removal of the tumors were significantly higher in mice bearing metastasizing cell clone tumors compared with those of HSGc tumor-bearing mice. Our results, therefore, indicate that increase in bFGF release occurs along with the progression of human salivary gland cancer cells and that serum bFGF may be useful for evaluation of tumor presence.

Purpose: The purpose of this study was to examine the natural course of anterior disc displacement without reduction in the temporomandibular joint (TMJ)., Patients and Methods: The subjects were patients who had been diagnosed as having anterior disc displacement without reduction in the TMJ, but who had not undergone any treatment. Forty-four patients were followed for 6 months, 38 for 12 months, and 22 for 18 months. Clinical signs and symptoms were evaluated at each follow-up, and the incidence of successful resolution was determined using the criteria established in 1984 by the American Association of Oral and Maxillofacial Surgeons., Results: The range of motion increased at each time during the follow-up period. Tenderness in the TMJ and the masticatory muscles was alleviated, but the noise in the TMJ remained unchanged at each follow-up time. The incidence of successful resolution was 34.1% at 6 months, 50.0% at 12 months, and 68.2% at 18 months., Conclusions: The clinical signs and symptoms of anterior disc displacement without reduction tend to be alleviated during the natural course of the condition. This should be taken into consideration when anterior disc displacement without reduction is treated.

In this study, we have examined the expression of integrin subunits in normal and malignant human salivary gland cell clones as well as its regulation by transforming growth factor-beta 1 (TGF-beta 1). By the analysis using immunofluorescence staining, an SV40 immortalized normal human salivary gland duct cell clone (NS-SVDC) with no tumorigenic ability by s.c. implantation into nude mice was identified to express the integrin beta 1, alpha 2, alpha 3 and alpha 6 subunits on the cell surface, while the expression of these subunits, except for beta 1 subunit, was reduced or completely diminished in a neoplastic human salivary gland duct cell clone (HSGc) with tumorigenic but not metastatic potential in nude mice and metastatic cell clones derived after in vitro exposure of HSGc to N-methyl-N-nitrosourea. In addition, immunoblot analysis also exhibited the same results as those obtained with immunofluorescence staining. The alpha 1 subunit was not demonstrable in any of the cell clones by both techniques. TGF-beta 1 augmented the expression of the beta 1 subunit in NS-SV-DC, while HSGc and metastatic cell clones demonstrated no changes in the expression of the beta 1 subunit in response to TGF-beta 1. These findings, therefore, suggest that there is an inverse relationship between the malignancy and the expression mode of integrin subunits, especially alpha 2 subunit, in human salivary gland cell clones with varying degrees of malignant potential, and that TGF-beta 1 is a positive regulatory factor in the expression of the beta 1 subunit in normal but not malignant cell clones.

To understand the molecular mechanisms whereby normal human salivary gland cells become malignant and escape growth-inhibitory control by transforming growth factor (TGF)-betaI, we examined the effect of TGF-betaI on the proliferation and expression of TGF-beta receptors in cells and the expression of TGF-beta type II receptor (TbetaR-II) mRNA. An SV40-immortalized normal human salivary gland duct cell clone (NS-SV-DC) with no tumorigenic ability, originally obtained via s.c. implantation into nude mice, was partially resistant to the growth-inhibitory effect of TGF-betaI, while a neoplastic human salivary gland duct cell clone (HSGc) with tumorigenic, but not metastatic, potential in nude mice was more resistant to the growth-suppressive effect of TGF-betaI than NS-SV-DC. Metastatic cell clones derived from carcinogen-treated HSGc were completely refractory to the anti-proliferative effect of TGF-betaI. Affinity cross-linking revealed that NS-SV-DC possesses the types I, II (TbetaR-II) and III receptors. However, HSGc and metastatic cell clones lacked expression of detectable levels of the TbetaR-II protein. Moreover, we evaluated TbetaR-II mRNA expression in these cell clones by Northern blot analysis and observed that, although NS-SV-DC expressed a large amount of TbetaR-II mRNA, a small amount of TbetaR-II mRNA was detectable in HSGc. In contrast, no significant bands were detected in metastatic cell clones. Our results, therefore, suggest that one of the possible mechanisms of escape from autocrine or paracrine growth inhibition by TGF-betaI during human salivary gland carcinogenesis involves reduced expression or lack of TbetaR-II.

To understand the specific cell type responsible for the synthesis of basement membrane components of the salivary gland, the effects of transforming growth factor (TGF)-beta 1 on morphological change, cellular proliferation and collagen synthesis were examined in these immortalized duct and myoepithelial cell clones, and the expression forms of their TGF-beta receptors analysed. When TGF-beta 1 was added to the cell clones in vitro, it induced a morphological alteration, with flattening in myoepithelial but not in duct cells. Although the growth of Mv1Lu mink lung epithelial cells was almost completely inhibited by TGF-beta 1, the duct and myoepithelial cells were partially resistant to such inhibition. By immunoblot analysis of immunoprecipitates, p53 was found bound to the simian virus-40 large T antigen, suggesting a functional loss of p53 in regulation of cell-cycle arrest. In the cloned myoepithelial cells but not the duct cells, TGF-beta 1 stimulated the production of type IV collagen. To attempt to understand the distinct responsiveness of cell clones to TGF-beta 1, the expression forms of TGF-beta receptors were examined by affinity cross-linking. Although the intensities of the cross-linked bands of the TGF-beta type II and type III receptors, particularly the type II, were weaker in the duct than the myoepithelial cell clones, the expression of the type II receptor mRNA was consistently detected in both clones. Accordingly, the reduction of TGF-beta 1 binding may have occurred at the post-transcriptional level. These findings imply that the cloned myoepithelial cells but not the cloned duct cells produce type IV collagen in response to TGF-beta 1 through the receptor-mediated signal transduction pathway, which is presumably disrupted in the cloned duct cells.

Optimal experimental methods for antigenicity studies in guinea pigs were investigated on: (1) the effects of different immunizing methods using complete or incomplete Freund's adjuvants (CFA or IFA), and various injection sites, the number of immunizations, the immunizing doses, and the immunizing periods, (2) the relationship between the severity of active systemic anaphylaxis (ASA) reactions and passive cutaneous anaphylaxis (PCA) titers, (3) positive control for oral administration, and (4) the effects of incubation mixture of drug and serum protein as the challenge for the ASA assay. The following results provided useful information for designing more appropriate methods for antigenicity studies: (1) The optimal immunization method for benzylpenicillin (PcG), cephaloridine, 2,4,6-trinitrobenzene sulfonic acid and adriamycin, which were selected as positive controls for low molecular medicines in this experiment, involved subcutaneous administration of 1 ml of a test substance in CFA (1st immunization) or IFA (2nd and 3rd immunizations) at two doses, 1 and 10 mg/animal, 3 times at 2-week intervals on the back of a guinea pig. Blood collection for PCA assay was needed 2 weeks after the last immunization, and ASA assay, 1 or 2 days after the blood collection. (2) The insensitivity of ASA reactions in bovine serum albumin-immunized animals with very high PCA titers was overcome by increasing the challenge antigen dose from 1 to 10 mg/animal. (3) Most animals administered lysozyme at 0.1, 1 or 10 mg/animal by gavage for 2 weeks or more showed ASA and PCA reactions. (4) Incubation of a mixture of 20 mg/ml of PcG and 2 mg/ml of guinea pig serum albumin for 4 hr was the most effective as challenge for the induction of ASA reaction in PcG-immunized guinea pigs.

Background: Systemic lupus erythematosus (SLE) is designated by the Japanese government as one of the intractable diseases and all patients, who suffer from these diseases, are registered to get financial aid for treatment. Using newly registered SLE patients, a case-control study was conducted to evaluate potential risk factors., Methods: Two-hundred and eighty-two women SLE patients, newly registered to receive financial aid for treatment, and 292 randomly selected health examination participants at public health centers (controls) were surveyed from April 1988 through March 1990. By means of a self-administered questionnaire, data concerning demographic variables, smoking and drinking habits, past medical and reproductive history, and family history were collected., Results: Based on unconditional logistic regression analysis, the risk of SLE was significantly increased for current smokers (age-adjusted odds ratio (OR) = 2.31, 95% confidence interval (CI) 1.34-3.97). Alcohol and milk intake were inversely associated with risk. Family histories of asthma and collagen diseases, including SLE, were associated with significantly elevated risk of SLE (OR = 2.07, 95% CI 1.14-3.77; OR = 5.20, 95% CI 1.08-24.95, respectively). Regarding reproductive function, women with menarche at age 15 or later had significantly higher risk than those, who started menstruating before age 12 (OR = 3.82, 95% CI 1.66-8.81 for menarche at > 15 years and OR = 2.90, 95% CI 1.14-7.39 for menarche at > or = 16y)., Conclusions: Our study suggests several risk factors, including smoking, family history, and reproductive history that may increase the risk of SLE.

A method for fixation of mandibular body fracture within the dental arch using a combination of a rigid one-piece cast splint and a pliable miniplate screwed at the inferior border of the mandible was developed with the highest priority placed on restoration of occlusion. This paper presents the results obtained in 36 patients treated by this method. The postoperative occlusion was analyzed using the T-scan system in 20 fully dentate patients without major caries. The data obtained in the patients were well comparable to those in normal subjects.

Symmetrical lipomatosis in the oral cavity is extremely rare. Two cases of symmetrical lipomatosis presenting as macroglossia are presented. Glossectomy was performed in order to reduce the size of the tongue and for diagnosis. Because of their multiplicity, non-encapsulation and invasiveness, the lesions were diagnosed histopathologically as symmetrical lipomatosis.

An experimental psychological study was undertaken to assess the effect of a change in dietary habit upon behavioural development, using as a laboratory animal male Wistar rats maintained on natural foods and a processed food. Forty male Wistar rats were weaned at 21 days of age and divided into two equal groups. Group 1 was fed natural food (pressed wheat, dried fish, peanuts, cabbage and soybeans) and group 2 was fed powdered food. At 68 days of age, the rats were tested in a T-maze. The results showed that Group 1 excelled with regard to T-maze learning.

An extensive swelling in the left parotid region, extending to the buccal and cervical areas, developed in a 30-year-old man immediately after a partial nephrectomy which was performed under general anaesthesia. Radiological examination immediately after the onset revealed no abnormality, but a large swelling was detected by computed tomography in the left parotid region. Serum amylase was significantly elevated. The clinical signs had almost disappeared approximately 2 weeks after the onset, following intravenous infusion of antibiotics and transfusion. This parotid swelling was considered to be acute postoperative parotitis induced during induction of anaesthesia by luxation of the temporomandibular joint or by the positioning of the patient during operation.

Solid and cystic tumor of pancreas is an uncommon neoplasm which is histologically low grade malignant but amenable to cure by surgical excision. It tends to occur in young women. US and CT depict a well circumscribed mass that can be solid, mixed solid and cystic and largely cystic. Their ratio depends on the degree of hemorrhage and necrosis. Angiography shows a mildly to moderately vascular mass which corresponds to solid parts. MRI is useful to detect the hemorrhage which is common in this tumor.

4 cases of blow-out fractures of the orbit in children are presented. Four 6- to 12-year-old boys were successfully operated on via an orbital and transsinus approach. As material for restoration of the broken orbital floor, Silastic was used in 3 patients.

The "rotation-advancement method" was used for primary repair of the incomplete cleft lip in six infants. The skin cleavage lines were visualized using the tissue ablated in the operation. On examining the relation between the post-cheiloplasty scar formation and the direction of the cleavage lines, the scar remained less conspicuous where the incisions parallelled the cleavage lines but grew hypertrophic where the incisions crossed the cleavage lines.

The malar arch consists of both the temporal process of the malar bone and the zygomatic process of the temporal bone. So far, there have been various different surgical approaches to the fractured malar arch. This report deals with 16 cases of the facial bone fractures including the malar arch. The usefulness of a pre-auricular (tragus) skin incision elongated to the haired temporal region is presented.

A case of a lingual mandibular bone defect, like idiopathic bone cavity mimicking a large tumor, is presented. This case is very rare and unique with regard to the site, size and form of the lesion, as compared with cases reported previously.

Antibacterial activities of cefmetazole, a new preparation of cephamycin antibiotic, were determined against selected clinical strains of Escherichia coli (27 strains), Klebsiella sp. (27 strains) and Bacteroides fragilis (27 strains). Activities were evaluated at bacteriostatic and also bactericidal levels with particular reference to time of exposure of microbes to the drug. The minimal drug concentrations producing minimal reduction of colony-forming units at time intervals of 3, 6 and 24 hours after exposure to the drug--approximations to the theoretical bacteriostatic concentrations--were designated as 3-h, 6-h and 24-h MRCs, respectively. Conventional MIC yielding no turbidity after incubation of antibiotic-containing broth for 24 hours was also determined. The minimal concentrations of the drug producing 99.9% killing at time intervals of 3, 6 and 24 hours after exposure to the drug were designated as 3-h, 6-h and 24-h MLCs, respectively. Assuming that the apparent mode of action of a drug is bactericidal when the ratio of bactericidal-bacteriostatic concentrations is low (less than or equal to 4) and bacteriostatic when high (greater than or equal to 8), then cefmetazole appeared to be a bactericidal drug to a considerable number of Gram-negative strains when the exposure time exceeded a period of 6 hours. The data that the mode of action of this drug is bactericidal with such relatively brief exposure times--indicating rapid decrease of colony-forming units--would suggest cefmetazole is an excellent antibacterial agent and would be a useful drug in treatment of bacterial infections.

The cleavage lines experimentally produced on the facial region in 30 Japanese cadavers were investigated macroscopically and histologically. The results obtained showed the same directional arrangement of the cleavage lines, fibrous connective tissues (especially the collagen fibres) and blood vessels.

As viewed in relation to cleavage lines, the histological structure of scar tissues, whether old or new, closely simulates the structure of a cable. Bundles of collagen fibres, the main component of scar tissue, that run at right angles to the direction of the cleavage lines, may be likened to a cable core while fibres that surround the main structure of the scar tissue, parallel with the direction of the cleavage lines, may be likened to the coating material of a cable.

Previously published data on the mucosal cleavage lines were compared with data on the formation of scar tissue after palatoplasty and it was found that, in the palate and surrounding tissues, scar formation is light when incisions are parallel to the long axis of the cleavage lines but severe when incisions are made at right angles to the cleavage lines. A few cases were also found where jaw movement was severely restricted because of the formation of hypertrophic scar between the upper and lower alveolar ridges. It is therefore desirable that surgical incisions in thepalate and surrounding tissues be made parallel to the long axis of the mucosal cleavage lines.

The pharmacokinetics of coenzyme Q10 (CoQ10) in man was studied by utilizing deuterium-labelled coenzyme Q10 (d5-CoQ10). The absence of an isotope effect in the disposition of d5-CoQ10 in man was confirmed from the plasma concentration time curves after simultaneous oral dosing of d5-CoQ10 and unlabelled CoQ10. After oral administration of 100 mg of d5-CoQ10 to 16 healthy male subjects, the mean plasma CoQ10 level attained a peak of 1.004 +/- 0.370 micrograms/ml at 6.5 +/- 1.5 h after administration, and the terminal elimination half-life was 33.19 +/- 5.32 h. In most of the subjects, plasma d5-CoQ10 showed a second peak at 24 h after dosing. This unusual plasma level curve was well described by a newly proposed compartment model based upon the assumption that absorbed CoQ10 is taken up by the liver and then transferred mainly to VLDL and redistributed from the liver to the systemic blood.

An incision placed at right angles to the direction of skin cleavage lines is susceptible to the development of a haematoma within the sutured wound. Moreover, the edges of the sutured incision are not firmly fixed together by the material and the sutured incision is subjected to direct tension. For these 3 reasons an incision not conforming with the direction of skin cleavage lines may frequently allow stretching and postoperative hypertrophy of a scar. The biological function of a young hypertrophic scar may be an expansion-relaxation movement of the capsule of scar tissue like a bellows, at right angles to the direction of skin cleavage lines in near, though not quite, synchronism with the surrounding dermis. The biological function of a mature scar may be a movement of the scar tissue in exact synchronism with the dermis as activated by the combination of a bellows-like movement of the capsule of scar tissue in the direction at right angles to the skin cleavage lines and an expansion-relaxation movement of the main structure of the scar tissue in the direction parallel with the skin cleavage lines.

A case of Goltz's syndrome complicated with both incomplete transverse facial cleft and characteristic tumour of the upper and lower lips is presented. Tumour excision and repair of defect were successfully performed.

Since Langer published his work on the cleavage lines of the skin in 1861, many Japanese and foreign authors have referred to Langer's lines as the most appropriate guides for skin incisions giving minimum scarring after heelings, but it has recently been suggested that the cleavage lines of Langer do not constitute a suitable guide for making an incision. Furthermore, comparison with directions of the lines described in the published textbooks has shown some discrepancies in detail among these descriptions, especially in the face. Therefore, Japanese cleavage lines were examined in the facial region of seven male and four female Japanese cadavers, and the following results were obtained. 1) Forehead: The long axes of the cleavage lines tend to run transversely as a whole. 2) Eyelids: The lines run, drawing a concentric loops, aroung the eye-fissures. 3) Lips: The main direction of the lines on the upper lip is radial upwardly, and the lines radiate downward on the lower lip.

In order to correct the condition or restricted jaw movement due to hypertrophic scar tissue after palatoplasty, the scar is first cut laterally. After cutting away the scar tissue from under the mucosa and suturing the incision longitudinally, a drastic improvement in free faw movement is obtained.

Cleavage lines were experimentally reproduced in the oral mucosa of Japanese cadavers. They were investigated macroscopically and histologically. The reproduced cleavage lines showed little directional variation by sex or age. From the histological findings, the mucosal cleavage lines were interpreted to represent cleavage split along the direction of connective tissue fibres in the lamina propria.