Functional improvement in a patient with cerebral calcinosis using a bisphosphonate

Fourteen healthy, lactating women (aged 25-38 y and between 2 and 8 mo postpartum) participated in both a maximal graded exercise test and a 30-min rest period to determine the influence of exercise on the concentration of selected milk minerals and electrolytes. Treatment order was randomized and treatments were conducted on different days. Milk was expressed before treatment and at 10, 30, and 60 min postexercise or after the rest period. Milk was wet-ashed by using nitric and sulfuric acids. Aliquots were analyzed for total phosphorus concentration by colorimetric assay and for calcium, magnesium, sodium, and potassium by inductively coupled plasma atomic emission spectrophotometry. Baseline mineral concentrations were not significantly different (P>0.05). Repeated expression of milk at 10, 30, and 60 min did not show significantly altered mineral concentrations (P>0.05). Interwoman variation was responsible for most of the variation in mineral concentrations. A portion of this may be explained by the variation in stage of lactation, which is known to affect mineral composition. Stage of lactation was inversely correlated with concentration of calcium, total phosphorus, magnesium, and sodium (P<0.05). In conclusion, maximal exercise did not alter concentrations of phosphorus, calcium, magnesium, potassium, or sodium in milk. Thus, with respect to mineral concentrations in milk, there is no contraindication for exercise during lactation.     

Desmoplastic fibroma of the mandible in a child: report of a case

A 6-year-old girl was seen with a history of progressive trismus and expansion of the right mandible over a 9-month period. Desmoplastic fibroma was diagnosed on biopsy. This report reviews the diagnostic criteria and surgical management of this uncommon primary bone tumor of the maxillofacial region.     

The effects of warfarin on calcinosis in a patient with systemic sclerosis

We describe the use of low doses of warfarin to treat calcinosis in a patient with systemic sclerosis or CREST syndrome. Our patient had Raynaud's phenomenon, skin sclerosis of the neck and the distal surface of the elbows, and pitting ulcers and scarification of the fingers as well as cutaneous calcinosis. After beginning warfarin, no calcium containing substance was discharged from the fingertip ulcers. There was no tendency to bleed and activated partial thromboplastin time and prothrombin time were normal. Sequential radiographs of the hands showed that calcinosis had improved. Since there seem to be few adverse effects, the use of warfarin in patients with calcinosis warrants further study.     

Fractures of the mandible in children

A review of 219 fractures of the mandible in children treated from 1960 through 1970 has been presented. The etiology, location, and treatment required were considered in relation to patient's age and dentition. The most common form of treatment was closed reduction and intermaxillary fixation.     

Spontaneous regression of tumoral calcinosis in an infant: a case report

A case of tumoral calcinosis presenting as a supraclavicular mass in an infant is reported. After confirmation by incisional biopsy, the lesion spontaneously resolved without further surgical or medical treatment. This phenomenon has not been described previously in a child with this condition.     

Dystrophic kyphoscoliosis in neurofibromatosis type I: a report of two cases and review of the literature

As the Department of Defense initiates Tricare, its new system of integrated health delivery, outcome assessment will become increasingly important. Traditional outcomes have focused on disease and its more serious consequences, disability and death. Patient satisfaction is only recently emerging as an important measure of the quality of health care delivery. In this paper, we focus on patient satisfaction, exploring its historical roots, its evolution as an outcome measure, and its potential utilities and weaknesses in quality assessment.     

Recurrent osteoblastoma of the mandible: a case report

Amiodarone decreases plasma and tissue triiodothyronine (T3) and increases plasma cholesterol levels resembling changes seen during hypothyroidism. To elucidate the mechanism of amiodarone-induced hypercholesterolemia we investigated gene expression of three key proteins in cholesterol metabolism (cholesterol 7 alpha-hydroxylase, LDL receptor, HMG-CoA reductase) in livers of rats. Animals were treated with amiodarone or propylthiouracil (to induce mild hypothyroidism). The LDL receptor mRNA was downregulated (approximately 50%) in both amiodarone-treated and hypothyroid animals, while the other mRNA remained unchanged after 14-day treatment. The results suggest that amiodarone-induced hypercholesterolemia is associated with decreased LDL receptor mRNA levels.     

Osteosarcoma of the mandible

We describe a case of osteosarcoma of the mandible presenting as a soft tissue mass associated with an enlargement of the mandibular canal at imaging work-up. Radiographic, isotopic, CT and MR features are reported.     

Biomechanics of torsion in the human mandible

Staff competence in the application of behavioral techniques is critical to improve quality of life for persons with a developmental disability. Development of efficient staff training programs is therefore of great importance. This paper describes some of the procedures most frequently used in staff training research. Research in this area is reviewed in relation to client outcomes as a function of staff training, maintenance of staff skills, and transfer of staff skills across settings, clients, and programs. Current concerns and further improvements in behavioural techniques, acquisitional strategies, and assessment are discussed.     

Brown tumor of the mandible

OBJECTIVE: To investigate the inhibitory effect of IL-10 on inflammatory reaction in rat mesangial cells (rMC). METHODS: Cell proliferation was tested by 3H-thymidine uptake and absolute cell counts. The production of IL-1 and TNF alpha by rMC was assessed by bioactivity assay and their gene expression by Northern blot hybridization. The expression of intercellular adhesion molecule-1 (ICAM-1) on rMC was determined by ELISA. RESULTS: IL-10 (25 ng/ml) inhibited 5% FCS and IL-1 induced cell proliferation by 39% and 52% respectively. It also suppressed the production of IL-1 and TNF alpha bioactivity by rMC by 48% and 68%, which was consistent with the decline of IL-1 and TNF alpha gene expression. The IL-1-induced expression of ICAM-1 on surface of rMC was attenuated by IL-10 treatment. CONCLUSION: Our data suggest that IL-10 may be an inhibitory cytokine in regulation of inflammatory reaction in glomerular mesangial cells.     

Ameloblastic carcinoma of the mandible

BACKGROUND: Ameloblastic carcinoma is a rare, aggressive odontogenic neoplasm of the jaws in which the epithelial cells exhibit cytologic features of recognizable ameloblastoma and malignancy. Cases with metastasis have been infrequently reported. METHODS: A case of a 64-year-old white woman with mandibular ameloblastic carcinoma with documented distant metastasis is presented. The patient's presenting symptoms included facial asymmetry of the right jaw over 2 months and the development of moderate trismus. Clinical manifestations, pathology, treatment, and biologic behavior are discussed. The nomenclature and classification of odontogenic carcinomas are reviewed, including entities that should be considered in the differential diagnosis. RESULTS: The patient underwent surgical resection consisting of mandibulectomy, parotidectomy, and modified radical neck dissection followed by radiation to both necks and tumor bed. Postsurgically, the patient developed pulmonary metastasis at 11 months and expired with widespread metastatic disease at 28 months. CONCLUSIONS: This case demonstrated an unusual behavior pattern in that local recurrence and regional metastasis did not occur. Distant metastasis occurred despite apparent adequate control of the primary mandibular tumor. The ameloblastic carcinoma is a highly malignant neoplasm which requires aggressive therapy. Prognosis is poor. Further reporting of ameloblastic carcinoma is encouraged.     

Cross-sectional area of the mandible

PURPOSE: The anatomy of the mandible was examined by measuring the cross-sectional area (CSA) of multiple regions of 10 fully dentulous hemimandibles to provide a better understanding of regional structural differences that may have implications regarding biomechanical strength, surgical reconstruction, and fracture site frequency. MATERIALS AND METHODS: Fifteen cuts from the condyle to the symphysis were made of each hemimandible (n = 150 cuts). A Zeiss Videoplan digitizer was used to determine the CSA. RESULTS: The total CSA through the condyle was greater than the CSA through the condylar neck. The CSA through the ramus exceeded that of the condylar neck. The total CSA of the midramus was significantly greater than that of the upper ramus. The total CSA at the body, parasymphysis, and symphysis was significantly greater than at the mid-angle. The total CSA of the cortex increased anteriorly; these differences become significant between the condylar neck and the body, parasymphysis, and symphysis. The total CSA, and the CSA of the cortex and spongiosa, remained relatively constant from the inferior angle anteriorly. CONCLUSIONS: Significant differences exist in the CSA at different points, with an increase in the total, cortical, and spongiosal CSA anteriorly from the condylar neck to the angle. The total CSA and the CSA of the cortex and spongiosa remain relatively constant anterior to the inferior angle. These data suggest that bony CSA alone is not the sole factor in determining fracture site frequency.     

Arteriovenous malformation of the mandible. Apropos of a case in a 6-year-old child

Arteriovenous malformations of the mandible are uncommon. Though characteristic clinical and radiological presentations are well described, management in the case of children is still a matter of debate. We report a mandibular angioma in a 6-year-old girl which was treated with superselective embolization. This method is the treatment of choice for mandibular arteriovenous malformations in children because of the low complication rate and the preservation of healthy tissue. When the malformation continues to develop despite repeated embolizations, surgical treatment may be necessary.     

Peripheral ameloblastic fibroma of the mandible: report of a case

Immunoadsorption plasmapheresis (IAP) using a tryptophan linked gel column has been shown to effectively remove serum IgG anti-GQ1b antibody which may contribute to the pathogenesis of Miller Fisher syndrome. Two patients are reported on with Miller Fisher syndrome, who developed bilateral facial palsy during IAP using a tryptophan column, while ophthalmoplegia, ataxia, and, areflexia were improving. In these patients, the titre of anti-GQ1b antibodies was reduced. The IAP using a tryptophan column has a beneficial effect on Miller Fisher syndrome but may not inhibit the development of facial palsy. The mechanism of such a dissociated effect of IAP on Miller Fisher syndrome is discussed.     

Congenital leukemia cutis: an unusual manifestation of a rare disease

This paper discusses a case of congenital leukemia cutis of lymphoblastic type presenting as a solitary frontonasal tumor. The presentation is unusual when compared with other reported cases of neonatal leukemia and represents the only reported case with comparable presenting features to the authors' knowledge. The differential diagnosis with other frontonasal tumors is discussed.