Major hematological diseases associated with cleft lip and palate.

OBJECTIVE: Cleft lip and palate is among the most common congenital anomalies. Its association with major blood disorders has rarely been reported. The purpose of this study was to report two patients who had major blood diseases associated with cleft lip and palate. PATIENTS AND RESULTS: From June 1995 to December 1997, there were 2700 patients with cleft lip, cleft palate, or both who received treatment at Chang Gung Memorial Hospital. Two of them were found to have major hematological disorders. In both cases, the disorder was detected by preoperative blood cell counts and white cell differentiation. Case 1 was a 21-year-old woman patient with repaired right cleft lip. She was admitted for alveolar bone grafting and closure of oronasal fistula. Abnormal presentation of blast cells was found, and subsequent bone marrow study confirmed acute lymphocytic leukemia. Case 2 was a 26-year-old man with left secondary cleft lip nasal deformity scheduled to receive staged reconstructive operations. An elevated platelet count was found and subsequently confirmed to represent essential thrombocytosis. In both cases, reconstructive operations for the cleft-related deformities were performed. CONCLUSIONS: Association of major hematological disorders and cleft lip, palate, or both is rare and is reported herein.     

Aneurysmal bone cyst of the mandible--a case report

Aneurysmal bone cysts originating in the craniofacial region have seldom been reported in Taiwan. A case of aneurysmal bone cyst arising in the right mandible of a 15-year-old Chinese boy was presented with both the roentgenographic and microscopic findings. In view of the high recurrent rate and the large destructive mandibular lesion, segmental resection with immediate bone grafting for reconstruction and a conscientious follow up regimen was employed. The etiology and pathogenesis of this interesting lesion remained unclear but several theories were reviewed and the differential diagnosis of this lesion was also discussed. Furthermore, immunoperoxidase staining for Factor VIII related antigen was performed to help differentiate between the aneurysmal bone cyst and a central hemangioma and then to elucidate the pathogenesis of the former.     

Reliability of a facebow transfer procedure.

The three-dimensional orientation of a maxillary cast mounting from a simulated-kinematic facebow transfer was evaluated in multiple trials among three operators on a single subject. The anterior and posterior anatomic facial reference points were marked on the subject. Each operator performed a separate series of trials to reset the anterior facebow component, the two posterior facebow components, and a control series with no resetting of any facebow components relative to the subject. The x, y, and z coordinates of three reference points on the maxillary cast were determined with a machinist microscope relative to a fixed reference after each facebow transfer. A range of differences between mountings of the maxillary cast were found between trials with all three methods used. These mounting errors were due to setting of the instrument and would be expected in routine clinical use of this instrument.     

下颌骨骨折动力加压固定断面应力分析

实验采用反射光弹模拟应力分析法,通过受力模型等差线条纹图观测、分析、量化换算,对下颌骨骨折轴向和偏心动力加压固定作断面压应力比较研究.结果显示两种固定状态下骨折断面均表现为挤压应力,沿骨折线应力分布不均匀,板周区和牙槽区呈压应力高峰带,最大应力分量在轴向和偏心加压分别为1.8MPa和2.3MPa(板周区),以及0.5MPa和1.0MPa(牙槽区),中间区受力较弱.轴向动力加压总压力为100N,偏心动力加压总压力为140N,后者比前者断面应力分布稍趋合理.     

Denture stomatitis — a review of the aetiology, diagnosis and management

Denture stomatitis is a common recurring problem of the denture wearers. The aetiology of the disease includes infection, trauma and probably a defect in the host defence mechanism. Current thinking suggests an interplay of most of these factors in the pathogenesis of the disease. The extent of interplay of these factors is still a controversy. Candida albicans has been implicated as the causative organism. However, in the light of recent research it is debatable if it is the only causative organism. Recently, cases resistant to antifungal therapy have been reported. In such cases other micro-organisms have been isolated. At the moment, comprehensive management includes meticulous denture hygiene together with anti-fungal or antibacterial therapy and correction of denture faults.     

Role of type IV collagene and type IV collagenase in the invasion and metastasis of salivary adenoid cystic carcinoma]

Using immunohistochemical ABC method, the authors studied the distribution of type IV collagen and type IV collagenase in 25 cases ACC. The result showed type IV collagen was found in vascular and epithelial basement membrance, and in partly cyst of sieve-like and tubular pattern, and in cytoplasm of tumor cell. Type IV collagenase was detected in membrance and cytoplasm of tumor cell. Expression of type IV collagen and type IV collagenase were correlated with pathologic type, TNM stage and metastasis. Much positive staining of type IV collagen was found in sieve-tubular pattern, early stage of TNM and without metastasis, but much positive staining of type IV collagenase was found in solid pattern, later stage of TNM and metastasis. The result suggested that the loss of type IV collagen and over-expression of type IV collagenase may be markers of malignance of ACC.     

The management of the treatment and diagnosis for the calcifying odontogenic cyst]

18 Patients with calcifying odontogenic cyst underwent surgery in our Department from 1977 to 1993 were reported.8 male and 10 female aged from 11 to 52 with medium or 33 years were included.16 cases were pathologically confirmed as primary intraosseous cyst(central),and 2 as extraosseous cyst(peripheral).There was no recurrence after the local excision for preripheral calcifying odontogenic cyst and local curettage for central one.There were 3 in 6 cases of tumor typed cyst who had recurred postoperatively,two of them had recurred repeatedly and cured by means of local radiotherapy.The authors recommend that the tumor type of intraosseous calcifying odontogenic cyst be classified as a border-line tumor and treated as well as the principles of low malignant tumor.Post-operative radiotherapy could be used for recurrent cases.     

同源盒基因HOXC 13在成釉细胞瘤中的表达

目的研究HOXC13 mRNA在成釉细胞瘤（ameloblastoma，AB）中的表达，探讨其发生的意义。方法采用原位杂交法检测47例AB（原发AB 29例，复发AB 14例，恶变AB 4例），同时选取骨纤维异样增殖症2例，牙源性角化囊性瘤（keratocystic odontogenic tumor，KCOT）10例，正常口腔黏膜上皮7例作对照。结果HOXC13 mRNA AB中阳性率为97．9％（46／47），10例KCOT中7例为HOXC13 mRNA阳性表达，但在7例正常口腔黏膜细胞中仅3例为HOXC13 mRNA阳性表达，AB、KCOT、正常黏膜三组间差异有统计学意义（χ^2=21．665，P=0．001），但角化及颗粒样变退化细胞却为阴性。在部分AB间质成纤维细胞质中也有阳性表达，2例骨纤维异常增殖症纤维也为阳性。结论在AB中存在HOXC13的高表达；HOXC13 mRNA在AB上皮中的表达有异质性，该基因可促进上皮的增殖，其丢失可导致上皮细胞的角化和退变。