Erythematous and reticular forms of oral lichen planus and oral lichenoid reactions differ in pathological features related to disease activity

BACKGROUND: Common clinical forms of oral lichen planus (OLP) and oral lichenoid reactions (OLR) are erythematous (ERY) or reticular (RET). The purpose of this study was to find histopathological changes that differ between these forms. METHODS: Epithelial thickness, epithelial proliferation rate, apoptosis, and HLA-DR expression were compared among 10 reticular and 12 erythematous lesions, and 11 normal oral mucosa samples (NOM). RESULTS: The epithelium in ERY was thinner than in NOM, whereas RET showed values between ERY and NOM. Cell proliferation increased significantly in ERY as compared with RET and NOM, with no difference between RET and NOM. Relative numbers of epithelial cell nuclei displaying visible chromatin condensation were reduced in ERY form. CONCLUSIONS: The markedly increased cell proliferation in ERY supports the notion that this form displays a higher disease activity as compared to RET. It can therefore be important to study each disease form separately.     

Excellent results of a femoral press-fit stem cemented with a thin mantle: 116 hips followed for 11–18 years

We report the outcome of a femoral stem designed for press-fit insertion and cemented with a thin mantle. During the years 1986–1992 we performed 346 primary total hip replacements in 305 patients. Their mean age at the time of the surgery was 75 (range, 52–91 years). During the follow-up, 206 patients had died (227 hips) and 3 were lost. This left us with 96 patients (116 hips), who were followed for a mean of 13 years (range, 11–18 years). Stem survivorship according to Kaplan–Meier analysis indicated a total survival of 0.982 (confidence intervals, 0.952–1). The mechanical survival rate was 0.985 (confidence intervals, 0.955–1) at 17 years with one patient at risk. Fifty-nine (70%) of the surviving patients were very satisfied with the operated hip, 22 (26%) were satisfied, 2 (2.5%) were content, and 1 (1.5%) was dissatisfied. Then, the press-fit stem allowing minimal cement has a 17-year survival rate of 0.98.     

Deficiencies of Vitamins in CAPD Patients: The Effect of Supplementation

Concentrations of the vitamins B₁, B₂, B₆, B₁₂, C, folic acid,A, E and ß-carotene were determined in blood and 24-hdialysate in 44 CAPD patients. Twenty-five of these patientswere studied during chronic treatment (mean 313 days, range60–1034 days). Nineteen patients were studied during training.In a longitudinal study, 11 patients were analysed again after77–507 (mean 238) days. In both patient groups a considerable portion of patients (11%–64%)had blood concentrations indicative of a deficiency of the vitaminsB₁, B₆, C and folic acid. The average concentrations of thesevitamins were normal in both groups. The only abnormal findingwas the mean EGOT activity being deficient in patients on chronictreatment. Mean concentrations of vitamin A were above normalin both groups. In the longitudinal study a significant increaseof vitamin B₂ and a decrease of vitamin B₆ in blood was found. When compared to 24-h excretion in normal urine, loss with 24-hdialysate was low for vitamin B₁, normal to relatively highfor vitamin B₂ and B₆, but extremely high for vitamin C andfolic acid. The vitamins B₁₂, A, E and carotenoids were hardlydetectable in the dialysate. In ten other patients the effect of daily supplementation with2 mg vitamin B₆, 100mg vitamin C and 400 µg folic acidwas analysed during a 16-week period. In all patients a significantincrease in blood concentrations was obtained. It is concludedthat these dosages were sufficient to maintain a normal statusof these vitamins in CAPD patients.     

Reduction of lung elasticity due to training and expiratory flow limitation during exercise in competitive female rowers

Lung elasticity and lung volumes at rest were measured in 22 female rowers, in 14 women who just started with rowing, in 21 female cyclists, and in 9 male rowers. The female rowers had a higher specific static and dynamic lung compliance (P less than 0.01) and a lower recoil pressure at functional residual capacity (P less than 0.05) as compared to the other three groups. According to their age, height, and fat-free mass, the female rowers had a normal vital capacity. The residual volume, the functional residual capacity, and the fast expiratory volume in 1 s were also normal. During an increased load test till exhaustion on a bicycle ergometer, the transpulmonary pressure and the expiratory flow were measured. While the expiratory transpulmonary pressure at exhaustion in the female rowers was not markedly lower than in the other groups, expiratory flow did not increase linearly with decreasing expiratory transpulmonary pressure in most of the female rowers. In the other three groups, there was a linear relation between expiratory flow and pressure. The higher lung compliance and lower elastic recoil in the female rowers caused the flow-limiting pressure to be reached at a lower level. The difference in lung elasticity between the male and female rowers showed that the physical stress on the lungs during rowing is not alike in women and men. We assume that the typical female physique requires extra fixation of the trunk during the pull phase of the rowing stroke, which could lead to loss of lung elasticity in female rowers.     

Posterior dislocation of the sternoclavicular joint: report of two cases,with emphasis on radiologic management and early diagnosis

Posterior dislocations of the sternoclavicular joint are uncommon, but are potentially quite serious. Radiologic diagnosis and management are frequently difficult. The specialized projections available are not widely known, and the role of plain films is poorly understood. The incidence, pathomechanics, and clinical manifestations of such dislocations are presented and the radiologic diagnosis is discussed.     

Adenoid cystic carcinoma: DNA as a prognostic indicator

A retrospective study was performed on 20 patients with adenoid cystic carcinomas of major salivary glands to see if DNA. patterns correlated with their prognoses. Fourteen tumors were found to be DNA. diploid; 6 were DNA aneuploid. Histologically, all DNA-aneu-ploid tumors had solid components, compared with only 5 of the DNA-diploid tumors. All of the DNA-aneuploid tumors recurred, in contrast to only 2 of the DNA-diploid tumors; the difference was highly significant (P<0.001). All of the patients with no recurrences had DNA-diploid tumors. In our study, DNA measurements of adenoid cystic carcinomas gave statistically significant information about prognosis and correlated to histological grading. We propose that evaluation of DNA content may be performed before planning the treatment of adenoid cystic carcinomas.     

Effects of preparation techniques on the porosity of acrylic cements

We investigated four acrylic cement preparation techniques for their effects on cement porosity: hand mixing, pressurization in a pneumatic pistol, centrifugation, and vacuum mixing. All the techniques were tested on three types of cement with different viscosity characteristics. The best results were obtained with vacuum mixing using a newly designed experimental system, yielding porosity reductions of 60-80 percent relative to hand mixing. Vacuum mixing with a commercial system was also effective, but to a somewhat lesser extent.

Pressurization and centrifugation had no substantial effect on the overall porosity. Centrifugation led to considerable nonuniformity in the distribution of pores and additives.     

Brain perfusion territory imaging applying oblique-plane arterial spin labeling with a standard send/receive head coil.

A new method for the selective spin labeling of left- or right-sided supplying arteries of the brain without the need for additional RF coils is demonstrated. A clinical 1.5 T scanner was used. The spatial selectivity of the labeling process is based on the limited coverage of the excitation field of a standard send/receive head coil together with an oblique positioning of the labeling plane. A computer simulation was used to optimize key labeling parameters under the condition of laminar flow. The validity of the computer model results was confirmed by MRI measurements with a flow model. For human studies, a double-inversion continuous arterial spin labeling (CASL) sequence was modified to allow for arbitrary positioning of the labeling plane. The obtained perfusion-weighted images showed a clear delineation of the perfusion territories of the selected arteries in the anterior circulation of the brain and good gray/white matter contrast.     

Preservation and redirection of HPV16E7-specific T cell receptors for immunotherapy of cervical cancer

Human papilloma virus (HPV) type 16 infections of the genital tract are associated with the development of cervical cancer (CxCa) in women. HPV16-derived oncoproteins E6 and E7 are expressed constitutively in these lesions and might therefore be attractive candidates for T-cell-mediated adoptive immunotherapy. However, the low precursor frequency of HPV16E7-specific T cells in patients and healthy donors hampers routine isolation of these cells for adoptive transfer. To overcome this problem, we have isolated T cell receptor (TCR) genes from four different HPV16E7-specific healthy donor and patient-derived human cytotoxic T lymphocyte (CTL) clones. We examined whether genetic engineering of peripheral blood-derived CD8+ T cells in order to express HPV16E711-20-specific TCRs is feasible for adoptive transfer purposes. Reporter cells (Jurkat/MA) carrying a transgenic TCR were shown to bind relevant but not irrelevant tetramers. Moreover, these TCR-transgenic Jurkat/MA cells showed reactivity towards relevant target cells, indicating proper functional activity of the TCRs isolated from already available T cell clones. We next introduced an HPV16E711-20-specific TCR into blood-derived, CD8+ recipient T cells. Transgenic CTL clones stained positive for tetramers presenting the relevant HPV16E711-20 epitope and biological activity of the TCR in transduced CTL was confirmed by lytic activity and by interferon (IFN)-gamma secretion upon antigen-specific stimulation. Importantly, we show recognition of the endogenously processed and HLA-A2 presented HPV16E711-20 CTL epitope by A9-TCR-transgenic T cells. Collectively, our data indicate that HPV16E7 TCR gene transfer is feasible as an alternative strategy to generate human HPV16E7-specific T cells for the treatment of patients suffering from cervical cancer and other HPV16-induced malignancies.     

Skeletal tissue engineering-from in vitro studies to large animal models

Bone is a tissue with a strong regenerative potential. New strategies for tissue engineering of bone should therefore only focus on defects with a certain size that will not heal spontaneously. In the development of tissue-engineered constructs many variables may play a role, e.g. the source of the cells used, the design and mechanical properties of the scaffold and the concentration and mode of application of growth factor(s).Models for studying new strategies for tissue engineering of bone should be based on the target tissue to be restored. However, in light of the many potential variables, which may also interact if used in combination(s), there is also a large need for relatively simple models in which variables can be tested in a limited number of animals. Moreover, in compromised bone there may be a problem with the load-bearing capacity of the remaining healthy bone. In this light, an important prerequisite for tissue-engineering constructs is that they can be tested in loaded conditions. Particularly, this latter prerequisite is very difficult to achieve. Therefore, in vitro tests for mechanical stability are very useful for evaluating the mechanical consequences of a particular reconstruction procedure prior to the animal experiment. Before a tissue-engineered construct can be introduced into a clinical trial, a final test should be available in a large animal model that is as close and relevant to a particular problematic clinical situation as possible.In the past, a series of models were developed in our laboratory that are very useful for testing tissue-engineered constructs. In this paper, we focus on the use of relatively new simple in vitro and in vivo models for hip revision surgery, segmental bone defect restoration and tumour surgery.