In this study, autologous bone grafts using bone-fixing nails made of magnesium-zinc-calcium ternary alloys were performed using rabbit skulls.Two types of nails for bone fixation were prepared: 2.5 mm width, 3 mm length and 2.5 mm width, 2 mm length. A disk-shaped bone with a diameter of 5 mm was resected from the parietal bone and fixed with a 3 mm long nail. As a control group, a 2 mm long nail was driven into the existing bone. The rabbits were sacrificed at 1, 4, 12, and 24 weeks after surgery. The resected samples were observed with micro X-ray CT, and embedded in methyl methacrylate to prepare non-decalcified specimens. The in vivo localization of elements was examined using energy-dispersive X-ray spectroscopy (EDS).Micro X-ray CT images of samples showed volume reduction due to degradation in both the bone graft and control groups. No significant difference in the amount of degradation between the two groups was observed, however characteristic degradation processes were observed in each group. The samples stained with alizarin red S showed amorphous areas around the nails, which were considered as corrosion products and contacted directly with the newly formed bones. EDS analysis showed that corrosion products were mainly composed of magnesium and oxygen at an early stage, while calcium and phosphorus were detected on the surface layer during the long-term observation.The degradation speed of the magnesium alloy nails varied depending on the shapes of the nails and surrounding tissue conditions. A calcium phosphate layer was formed on the surface of magnesium alloy nails, suggesting that the degradation rate of the nail was slow.
The patient, a 75-year-old man, was referred to our hospital because of discomfort and tenderness of the right temporomandibular joint (TMJ) in April 2010. Computed tomographic (CT) images revealed a large tumor, while 3-dimensional CT showed bone destruction and remarkable deformities in the right mandibular condyle. Surgery was scheduled for September 2010 for a clinical diagnosis of a right mandibular condyle tumor. The tumor was resected surgically by extraoral vertical ramus osteotomy with a simultaneous high condylectomy, and the pathologic diagnosis was synovial chondromatosis of the TMJ. The excised tumor comprised cartilage, and the surface of the mass was covered by a fibrous capsule. Severe condylar resorption and remarkable condylar deformity were confirmed. During the 2.5 years since surgery, periodic observations have shown no evidence of recurrent abnormalities in the TMJ.
Pseudogout is arthrosis caused by the deposition of calcium pyrophosphate dehydrate (CPPD), most cases of which present in the knee, wrist or hand. We report a case of pseudogout with widespread progression from the superior joint space of the temporomandibular joint (TMJ) to the subcutaneous region. A 72-year-old man was referred to our hospital with the chief complaint of swelling around the right TMJ. The interincisal distance was 48 mm without pain. There was no history of TMJ disorder, trauma or systemic joint disease. Computed tomography and magnetic resonance imaging revealed an approximately 20 mm neoplastic lesion outside the right condylar head. Ultrasound-guided fine needle aspiration showed that there were crystalline materials with weak birefringence in the neoplastic lesion, leading to a diagnosis of pseudogout. He underwent a removal of the tumorous mass under general anesthesia. The result of histopathologic examination was similar to the cytological finding. Clinical symptoms disappeared after surgery. There have been no signs of recurrence in over 1-year of follow-up.
A patient with an intermediate state of human T lymphotropic virus type I (WLV‐I) infection and in whom autopsy showed multiple organ failure (MOP associated with extensive metastatic calcification in systemic organs is described. A 56‐year‐old man presented with signs and symptoms of advanced cardiac insufficiency, respiratory disturbance and renal failure. Serologically, the anti‐human T lymphotropic virus type I (HTLV‐I) antibody tier and the levels of both calcium and parathyroid hormonerelated peptide (PTHrP) were dlstinctly elevated. These data suggested a diagnosis of adult T cell lymphoma/leukemia (ATLL). However, examination of a peripheral blood sample revealed only a few atypical lymphoid cells (3%) associated with mild leukocytosis (white blood cell count, 13.7 × 10 3 /mm 3 ). Lymph node swelling was systemic but mild, with some nodes up to 10 mm In diameter. The patient died of MOF. Adult T cell leukemla/lymphoma was unable to be diagnosed definitively because of the short duration of laboratory abnormalities and because of the discrepancy between the laboratory data and the magnitude of lymphoprollferation in both the lymph nodes and peripheral blood. At autopsy, the most conspicuous finding was extensive metastatic calcification in the multiple organs, including the heart, lungs, kidneys, tongue, liver, pancreas, spleen and systemic arterial walls. Very small numbers of medium‐sized atypical lymphoid cells admixed with small reactive lymphocytes were Identified in multiple organs, with no evidence of massive Infiltration. Molecular analyses could not detect monoclonal Integratlon of HTLV‐I provirus DNA or monoclonality of T cell lineage cells. Parathyroid hormone‐related peptide was demonstrated In the cytoplasm of the atypical lymphoid cells on lmmunohls‐tochemical examination. The bone trabeculae generally showed distinct evidence of resorption associated with marked proliferation of osteoclasts. These findings suggested that the hypercalcemia in the present case was categorized as humoral hypercalcemia of malignancy rather than local osteolytic hypercalcemia.
Abstract Background: To clarify the possible role of nitric oxide (NO) and stress proteins in oncogenesis and cytodifferentiation of odontogenic epithelium. Inducible NO synthase (iNOS) and heat shock proteins (HSPs) were analyzed in ameloblastomas as well as in tooth germs. Methods: Specimens of seven tooth germs, 36 benign ameloblastomas and five malignant ameloblastomas were examined by immunohistochemistry using antibodies against iNOS and 27‐, 60‐ and 70‐kDa HSPs (HSP27, HSP60 and HSP70). Results: Immunoreactivity for iNOS was detected in normal and neoplastic odontogenic epithelial cells and was higher in malignant ameloblastomas than in tooth germs and benign ameloblastomas. HSP27 was expressed constitutively in all odontogenic epithelial cells in tooth germs and benign and malignant ameloblastomas. Expression of HSP60 and HSP70 was detected in normal and neoplastic odontogenic epithelial cells and was prominent in cells neighboring the basement membrane. HSP60 reactivity showed no apparent difference between normal and neoplastic odontogenic epithelium, whereas HSP70 expression was slightly higher in benign and malignant ameloblastomas than in tooth germs. Conclusions: Activation of iNOS might be associated with malignant potential of epithelial odontogenic tumors. Elevated expression of HSP70 is considered to be involved in neoplastic transformation of odontogenic epithelial cells.
Mammary Analog Secretory Carcinoma (MASC) is a new entity of malignant salivary gland tumors that morphologically resembles mammary secretory carcinoma and carries the identical ETV6‐NTRK3 fusion gene. We report our first case of MASC in Japan occurring in the parotid gland of a 37‐year‐old female patient with a t (12; 15) (p13; q25) translocation. Histologically, the tumor was composed of monomorphic cuboidal cells with low‐grade vesicular nuclei and pale eosinophilic cytoplasm, and formed microcystic and tubular spaces with periodic acid‐Schiff‐positive secretion. Immunohistochemically, the tumor cells tested positive for cytokeratin, vimentin, and S‐100 protein. MASC is a morphological mimicker of acinic cell carcinoma, but is a distinct neoplasm characterized by a specific chromosomal translocation. An accumulation of similar case studies is mandatory in order to clarify biological behaviors.
To evaluate roles of human epidermal growth factor receptor (HER) family molecules in ameloblastomas, protein expression and gene status were analyzed in odontogenic tissues.Sixty five ameloblastomas, 10 dental follicles, and 11 dentigerous cysts were immunohistochemically examined with antibodies against epidermal growth factor receptor (EGFR) and HER2, HER3, and HER4. Amplification of EGFR and HER2 was evaluated by chromogenic in situ hybridization (CISH). In 18 ameloblastomas, EGFR exons 19 and 21 were analyzed by direct DNA sequencing.Immunohistochemical reactivity for EGFR and HER2, HER3, and HER4 was detected in odontogenic epithelium. Expression of EGFR and HER4 was remarkable in these odontogenic tissues, as compared with that of HER2 and HER3. The level of HER2 immunoreactivity was significantly lower in ameloblastomas than in dental follicles and dentigerous cysts. Follicular ameloblastomas showed significantly higher expression of HER2 and HER4 than plexiform ameloblastomas. Reactivity for EGFR and HER3 was slightly stronger in recurrent ameloblastomas than in primary ameloblastomas. CISH did not reveal obvious amplification of EGFR or HER2 in ameloblastomas; however, EGFR and HER2 gene signals were significantly higher in follicular ameloblastomas than in plexiform ameloblastomas. Direct DNA sequencing of EGFR did not show any gene alteration in ameloblastomas.Expression of HER family molecules, especially EGFR and HER4, in odontogenic tissues suggests that growth signals mediated by these receptor molecules contribute to cell proliferation, survival, and differentiation in both normal and neoplastic odontogenic epithelial tissues. Some of these molecules might be useful for predicting outcomes in patients with ameloblastomas.