Maxillomandibular fixation with minihooks: a clinical evaluation

This article provides the clinical evaluation of a simple but effective method of maxillomandibular fixation that eliminates the morbidity attendant to the conventional methods of maxillomandibular fixation. The indications have been defined on the basis of the clinical experience with this technique.     

Transcatheter closure of aortopulmonary window using Amplatzer device.

Two cases of transcatheter closure of aortopulmonary window (APW) using an Amplatzer duct occluder in one and a septal occluder device in the second are described. Transcatheter device closure of APW should be considered when anatomy is favorable in terms of location and size of the defect with absence of associated anomalies.     

Non-phosphorylated neurofilament protein immunoreactivity in adult and developing rat hippocampus: specificity and application in grafting studies

Neurofilament proteins are critical to the development and maintenance of neuronal shape in the nervous system. These proteins are developmentally regulated and several transition forms are expressed, prior to full neuronal stabilization. We have studied the spatial distribution and time course of expression of non-phosphorylated neurofilament protein (NPNFP) immunoreactivity in several preparations of rat hippocampus, using a mixture (SMI 311) of several monoclonal antibodies directed against NPNFP epitopes. Differential staining was observed in young and adult hippocampus. Large pyramidal neurons in CA3 and CA4 subfields were strongly immunoreactive in adult hippocampus whereas the smaller CA1 pyramidal neurons, most interneurons and dentate granule cells were immunonegative. SMI 311 staining initially appeared at postnatal day (P) 5 with positive staining in apical dendrites and soma in a few pyramidal neurons in CA3, but almost reached the adult pattern by P10. Compared to adult hippocampus, the number of immunoreactive interneurons in all subfields appeared increased at P10 and P15. In cultures of embryonic hippocampus, all neurons, regardless of their morphology, were SMI 311 positive, suggesting loss of differential expression in tissue culture conditions. However, SMI 311 expression in fetal hippocampal neurons grafted to adult hippocampus was similar to hippocampal neurons which had developed in situ. These results suggest that SMI 311 antibody identifies a distinct group of primarily CA3 and CA4 pyramidal cells in adult hippocampus. The application of SMI 311 immunostaining appears suitable for identification of large CA3 and CA4 pyramidal neurons within hippocampal transplants grafted to adult CNS but not in tissue culture.     

Increased specific binding of insulin-like growth factor-I in healing cutaneous wounds

Insulin-like growth factor-I is a polypeptide hormone structurally related to insulin. It is a potent mitogen that promotes growth and differentiation in many tissues. A role for insulin-like growth factor-I in wound healing is suggested by its rapid rise in levels and increased insulin-like growth factor-I messenger RNA expression in tissue after wounding. We designed our study to characterize possible changes in insulin-like growth factor-I receptor binding during wound healing. Surgical wounds created on the abdominal skin of anesthetized New Zealand White rabbits were either left open or closed primarily. Size- and weight-matched specimens were harvested at wounding time (day 0), and at 1, 4, 7, 38, and 50 days after wounding. Preliminary experiments showed that the greatest difference in specific binding occurred between day 0 and day 7. (125)I-insulin-like growth factor-I binding studies were performed on frozen tissue specimens and autoradiography was performed and analyzed by computerized densitometry. Scatchard analysis of the binding data showed a single class of insulin-like growth factor-I binding sites whose affinity that is, binding constant (K(d) = 0.6 x 10(-9)) did not change significantly over time; in contrast there was a threefold increase in the number of receptors per milligram tissue in day 7 wound tissue versus normal skin harvested at day 0 (17.3 +/- 2.6 x 10(10) versus 4.7 +/- 2.5 x 10(10), respectively, p < 0.05). Binding inhibition experiments showed that (125)I-insulin-like growth factor-I binding was most specific to insulin-like growth factor-I with insulin-like growth factor-I > insulin-like growth factor-II > insulin. This increase in binding was due to upregulation of insulin-like growth factor-I receptors rather than increased levels of insulin-like growth factor-I binding protein as less than 20% of the threefold increase in binding at day 7 could be attributed to insulin-like growth factor-I binding protein in membrane-free extracts. The presence of specific, high-affinity insulin-like growth factor-I receptors in the skin and their upregulation at day 7 after wounding suggest that insulin-like growth factor-I plays an important role during wound healing.     

Gastric cancer presenting with acute disseminated intravascular coagulation.

Patients presenting with acute disseminated intravascular coagulation (DIC) as the first symptom of malignancy are rare. A 68-year-old man presented with DIC. On evaluation, he was found to have adenocarcinoma of the stomach. Resection of the growth controlled the DIC for a few days, after which the patient developed altered coagulation parameters and sepsis, and succumbed.     

An innovative design for simultaneous reconstruction of complex maxillo-mandibular defects with single free fibula osteocutaneous flap.

Satisfactory reconstruction of complex maxillo-mandibular defect in a single stage has been a surgical challenge. This is particularly because it necessitates a flap which will reconstruct both the maxilla and mandible along with any associated soft tissue defect, mucosa or skin without adding to functional and cosmetic problems for patient and technical problems for the surgeon. Here we describe an innovative design for simultaneous reconstruction of maxilla, mandible, soft tissue and mucosal lining in one stage using a single fibula osteocutaneous flap.     

Myoclonic dystonia

Myoclonic dystonia is a rare disorder that occurs in an hereditary and a sporadic form. The autosomal-dominantly inherited form is responsive to alcohol but not to other drugs. The sporadic form has been relatively resistant to drug treatment. We report a young man with myoclonic dystonia who displayed only little response to alcohol but improved significantly with a combination of sodium valproate for myoclonus and trihexiphenidyl hydrochloride for dystonia. His rehabilitation, however, was confounded by public authorities who thought the patient's appearance was indicative of drug use.In accordance with the publication procedures of Child's Nervous System, when a case report serves as the basis for a possible new clinical entity, we place it with the original papers and set it off by publishing it as the leading article.     

Interactions between oral surgery and orthodontics in the treatment of children with cleft lip and cleft palate]

The oral-surgical and the orthodontic treatment of patients with cleft lip and palate are interdependent. Consequently, they cannot be performed separately. In most cases, a continuous coordinated treatment planning by both specialties, from the first day of life, will permit to obtain optimal treatment results. The ultimate aim of co-ordinated treatment is not only the aesthetic and functional rehabilitation, but also the securing of the age-related growth of the midface.