应用脱细胞真皮基质修复口腔黏膜缺损22例报道

目的：评价脱细胞异体真皮基质组织补片用于口腔黏膜缺损修复的临床效果。方法：对22例因肿瘤手术、外伤、瘢痕、不良增生物切除术及修复前外科等原因引起的口腔黏膜的缺损,应用脱细胞异体真皮基质口腔组织补片进行修复。缺损部位主要为软硬腭、舌、口底、颊部、牙龈、前庭沟等。使用的口腔组织补片面积为1cm×1cm～4cm×6cm。术后随访1周～6个月。结果：共修复22例口腔黏膜缺损,其中2例患者2周后失访。随访的20例病例中,成活18例,脱落2例。术后补片收缩发生在2～4周。2个月后补片较稳定,未发生进一步挛缩。结论：脱细胞真皮基质作为一种黏膜缺损替代品,应用于口腔内各种原因引起的黏膜缺损修复,效果满意。     

Sudden change of a large congenital melanocytic nevus to neurocutaneous melanosis

Neurocutaneous melanosis (NCM) is a congenital phakomatosis in which large congenital melanocytic nevi are associated with a benign or malignant melanocytic tumor of the leptomeninges. Because the prognosis of patients with symptomatic NCM is poor, it is essential to monitor the large congenital melanocytic patient regularly for a neurological evaluation. However, it has not been reported how quickly the lesion could appear. We observed a case of NCM suddenly developing in a large congenital melanocytic nevi patient. With this case, the NCM had developed within six months and was aggravated during the subsequent six months.     

Concurrence of replicative senescence and elevated expression of p16(INK4A) with subculture-induced but not calcium-induced differentiation in normal human oral keratinocytes

Primary normal human oral keratinocytes (NHOKs) undergo differentiation in the presence of calcium concentrations higher than 0.15 mM in vitro, which is useful in investigating the mechanisms involved in the differentiation of epithelial cells. Serial subculture of NHOKs to the postmitotic stage also induces terminal differentiation. However, the detailed mechanisms of both differentiation processes remain substantially unknown. To investigate the molecular differences in these processes, NHOKs were induced to differentiate by exposure to 1.2 mM of calcium and by serial subculture to the postmitotic stage. To study whether the cells were induced to differentiate and to undergo replicative senescence, the amount of cellular involucrin and the expression of senescence-associated beta-galactosidase (SA-beta-gal) were measured respectively. The expression of replicative senescence-associated genes and the activity of telomerase from the differentiated cells were also determined. Both calcium treatment and serial subculture to the postmitotic stage notably elevated the cellular involucrin. The percentage of SA-beta-gal-positive cells was significantly elevated by the continued subculture, but such changes were not observed in keratinocytes exposed to calcium. The concentration of cellular p16(INK4A) protein was progressively increased by the continued subculture but was not changed by calcium treatment. On the other hand, the concentrations of cellular p53 were similar in both differentiation processes. However, telomerase activity was lost in NHOKs that had undergone differentiation by both calcium treatment and serial subculture. The results indicate that calcium-induced differentiation of NHOKs has similar characteristics to their serial subculture-induced differentiation, but that the differentiation processes are not identical, because calcium-induced differentiation does not concur with either replicative senescence or the gradually increased concentration of p16(INK4A).     

Eugenol inhibits K+ currents in trigeminal ganglion neurons

Eugenol, a natural capsaicin congener, is widely used in dentistry. Eugenol inhibits voltage-activated Na(+) and Ca(2+) channels in a transient receptor potential vanilloid 1 (TRPV1)-independent manner. We hypothesized that eugenol also inhibits voltage-gated K(+) currents, and investigated this in rat trigeminal ganglion neurons and in a heterologous system using whole-cell patch clamping. Eugenol inhibited voltage-gated K(+) currents, and the inhibitory effects of eugenol were observed in both capsaicin-sensitive and capsaicin-insensitive neurons. Pre-treatment with capsazepine, a well-known antagonist of TRPV1, failed to block the inhibitory effects of eugenol on K(+) currents, suggesting no involvement of TRPV1. Eugenol inhibited human Kv1.5 currents stably expressed in Ltk(-) cells, where TRPV1 is not endogenously expressed. We conclude that eugenol inhibits voltage-gated K(+) currents in a TRPV1-independent manner. The inhibition of voltage-gated K(+) currents is likely to contribute to the irritable action of eugenol. Abbreviations: human Kv1.5 channel, hKv1.5; transient receptor potential vanilloid 1, TRPV1.     

粘结式全牙列矫治器联合面具前牵治疗乳牙早期反(牙合)

目的探讨粘接式全牙列矫治器联合面具前牵治疗乳牙早期反     

Activation of vanilloid receptor 1 (VR1) by eugenol

The structural similarity of eugenol with capsaicin suggests that these two agents may share molecular mechanisms to produce their effects. We investigated the effects of eugenol in comparison with those of capsaicin using whole-cell patch clamp and Fura-2-based calcium-imaging techniques in a heterologous expression system and with sensory neurons. In vanilloid receptor 1 (VR1)-expressing human embryonic kidney (HEK) 293 cells and trigeminal ganglion (TG) neurons, eugenol activated inward currents, whereas capsazepine, a competitive VR antagonist, and ruthenium red (RR), a functional VR antagonist, completely blocked eugenol-induced inward currents. Moreover, eugenol caused elevation of [Ca(2+)](i), and this was completely abolished by both capsazepine and ruthenium red in VR1-expressing HEK 293 cells and TG neurons. Our results provide strong evidence that eugenol produces its effects, at least in part, via VR1 expressed by the sensory nerve endings in the teeth.     

Malignant tumor involving paranasal sinuses

Carcinoma of the paranasal sinuses is a very serious disease, but its incidence is lower than that of any other oral malignancy. Failure to diagnose it early because of misleading symptoms resembling sinusitis usually leads to its detection at a stage when it has already destroyed the bony walls of the sinus and has spread to surrounding structures (infratemporal fossa, posterior ethmoid cells, orbit, cribriform plate, nasopharynx, sphenoid sinus or base of the skull). It is uncommon for this cancer to spread to the regional lymph nodes as long as it remains confined within the maxillary sinus. CT scanning provides an accurate assessment of the extent of resection required and is usually used as an indicator of operability. A 56-year-old man with a chief complaint of palatal swelling, pain and pus discharge was referred to Seoul National University Dental Hospital. Orthopantomogram and Waters' view revealed an aggressive bone destruction in the right maxillary molar area, ipsilateral sinus opacification and destruction of the lateral wall of the maxillary sinus. The CT fidding showed that the right maxillary sinus was occupied by a soft tissue mass which represented a central low density, with an irregular shape at some levels. The tumor mass also involved the pterygopalatine fossa, right esthmoid sinus, nasal cavity and hard palate. Incisional biopsy was done and the biopsy report was squamous cell carcinoma. He was transferred to Internal Medicine for chemotheraphy because of inoperability.     

Synthesis and preparation of novel 4-arm star-shape poly(carboxylic acid)s for improved light-cured glass-ionomer cements.

OBJECTIVE: The objective of this study was to synthesize and characterize novel 4-arm star-shape poly(acrylic acid)s (poly(AA)s) via atom-transfer radical polymerization (ATRP) technique, tether in situ light-curable methacrylate functionalities onto the poly(AA) backbone, use these star-shape poly(AA)s to formulate the light-cured glass-ionomer cements (LCGICs), and evaluate the mechanical strengths of the formed cements. MATERIALS AND METHODS: The 4-arm poly(AA)s were synthesized using ATRP and tethered with either 2-isocyanatoethyl methacrylate (IEM) or glycidyl methacrylate (GM). The polymers were formulated with 2-hydroxyethyl methacrylte (HEMA) or methacryloyl beta-alanine (MBA), water, initiators, and Fuji II LC filler. Compressive strength (CS) was used as a tool to evaluate the formed cements. The specimens were conditioned in distilled water at 37 degrees C for 24h prior to testing. RESULTS: The 4-arm poly(AA) showed a lower viscosity as compared to its linear counterpart. Both IEM-tethered and GM-tethered 4-arm poly(AA) constructed LCGICs showed significantly high mechanical strengths. Both types of co-monomer and grafting agent dramatically affected the mechanical strengths. The MBA-containing poly(AA) cements exhibited much higher CS than the HEMA-containing cements. The IEM-tethered poly(AA) cements showed much higher CS and DTS than the GM-tethered cements. CONCLUSIONS: This study developed a novel light-curable 4-arm star-shape poly(AA) system. The system was 13% in CS, 178% in DTS and 123% in FS, compared to Fuji II LC.