Diabetes. Interview by Veronica L. Conley.
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Diabetes Mellitus↗
Biomedical subjects
C S Miller
Publications and source records attributed to C S Miller.
Cross-sectional tomography. A diagnostic technique for determining the buccolingual relationship of impacted mandibular third molars and the inferior alveolar neurovascular bundle.
Twenty-two patients with 31 impacted mandibular third molars were examined with a new, precise, cross-sectional tomographic technique to assess the radiographic size, shape, branching pattern, location, and degree of cortication of the mandibular canal, and the inclination of impacted mandibular third molars in the buccolingual plane. The mandibular canal, including bifid canals, was accurately identified in 30 cases (96.8%). The cross-sectional appearance of the canal was an uncorticated, or partially corticated, radiolucent oval that measured on average (+/- SD) 2.9 +/- 0.7 x 2.5 +/- 0.6 mm in diameter. It was located more frequently (45.2%) on the buccal aspect of the impacted mandibular third molar. About 60% of the mandibular canals notched the inner cortical plate of the mandible or the third molar root surface. Cystic expansion and quantification of cortical bone destruction were readily assessed by this technique. It was concluded that diagnostic information obtained from cross-sectional tomograms significantly aids the oral and maxillofacial surgeon during the preoperative diagnostic workup and that the radiation risks are comparable to those of other accepted localization techniques.
Adult↗
Proliferative mass found in the gingiva.
The clinical course of peripheral ossifying fibroma is slow and the growth of most lesions is limited in size, usually up to 1.5 cm. Complaints are rare unless the surface becomes ulcerated, or the lesion compromises oral function or esthetic appearance. Treatment is surgical excision with close postoperative follow-up. Tooth extraction is seldom necessary. Proper surgical intervention, which includes excision of reactive tissue down to periosteum, affords a low recurrence rate of 14% to 16%.
Fibroma↗
Basal cell carcinoma initially recognized by the dentist: report of a case.
This case report illustrates the features of basal cell carcinoma and the importance of proper evaluation of the head and neck by the dental practitioner.
Basal Cell Nevus Syndrome↗
Subtle manifestations of AIDS.
The current AIDS epidemic continues unabated. The steadily increasing number of HIV-infected persons in United States, and the prolonged latent period from time of infection to the development of clinical signs and symptoms, increase the likelihood of the undiagnosed patient arriving a t the dental office for treatment. Keen examination skills are required to recognize the early manifestations of infection. The purpose of this article is to present the clinical features of HIV infection and indicator oral diseases, and to illustrate the importance of the dental hygienist in providing early recognition of the very subtle clinical findings often associated with AIDS Related Complex.
Acquired Immunodeficiency Syndrome↗
Correction of sphingomyelinase deficiency in Niemann-Pick type C fibroblasts by removal of lipoprotein fraction from culture media.
The average sphingomyelinase activity of fibroblasts obtained from 12 Niemann-Pick type C patients was 37.9% of that of normal fibroblasts (27.2 versus 72 nmol (mg protein)-1 h-1) when the cells were cultured in minimum essential medium containing 13% fetal bovine serum. Following replacement of the above medium with medium in which the lipoprotein fraction had been removed from the fetal bovine serum, the sphingomyelinase activity rose over a 7-day period from about 1/3 of normal to normal or above. Upon reintroduction of medium containing 10% fetal bovine serum which had not been extracted, the sphingomyelinase activity of the Niemann-Pick type C cells again fell within 48 h to 30% of the normal controls. In contrast, cell lines from patients with either Niemann-Pick Type A or B were not influenced by the presence or the absence of lipoprotein, i.e. lacked sphingomyelinase activity under all culture conditions examined. Histochemical staining with filipin showed an inverse relationship between the sphingomyelinase activity and intracellular, free, unesterified, cholesterol level. Moreover, immunochemical staining with an antibody against a lysosomal membrane protein provided direct evidence that the accumulation of unesterified cholesterol in cells cultured in regular (non-extracted) medium occurred within lysosomes and/or related organelles.
Cells, Cultured↗
Evidence for non-lysosomal storage of N-acetylneuraminic acid (sialic acid) in sialuria fibroblasts.
The results of the investigations reported here indicate that patients affected with the infantile sialic acid storage disorder (ISSD) and the original French sialuria patient suffer from distinct and fundamentally different disorders. While phase microscopy and immunochemical studies demonstrated abnormal storage within intracellular inclusions in ISSD cells, no morphological evidence of storage within any subcellular organelles was found in the sialuria cells. Moreover, comparative subcellular fractionation studies on gradients of colloidal silica showed the excess sialic acid in ISSD cells to be located within the light (buoyant) lysosomal fraction, while the excessive, free sialic acid in the sialuria cells was found in the cytoplasmic fraction with no increased storage within the lysosomal fractions. It is concluded that the sialic acid abnormalities in ISSD and the French type of sialuria are the result of very different biochemical and genetically unrelated abnormalities.
Fibroblasts↗
Bluish dome-shaped nodule of the lip.
A patient with a lymphangioma involving the labial commissure is reported. Key features of this disorder include its occurrence in young patients, asymptomatic nature, compressibility, and slow growth. Clinicians should understand that the lymphangioma may appear as a soft, grayish-blue, dome-shaped nodule, an irregular and papillary vesicular mass, or as a diffuse swelling. Appropriate clinical and radiographic tests are recommended before surgical excision. Histologically, the features of the lymphangioma may closely resemble those of a hemangioma.
Child↗
White corrugated mucosa.
A patient with white sponge nevus involving the buccal mucosa, labial mucosa, and soft palate is reported. The salient clinical and histological features of the disease were discussed. This diagnosis should be considered when bilateral white lesions of buccal mucosa are encountered. Early onset, a familial history, and the asymptomatic nature are key features to the disease. If historical data and clinical features are suspect, an incisional biopsy is adequate for diagnosis.
Adult↗
Failure of use of cemental annulations in teeth to determine the age of humans.
The reliability of cemental annulation counts in teeth was examined to determine its value as an age indicator for humans. One hundred extracted human teeth were embedded in polyester casting resin and sectioned using a diamond wafering saw. Thin sections were photomicrographed, projected, and counted in a double blind random method of presentation. The age of the specimen was determined by adding the number of cemental annulations counted by the observers and the eruption age of the specific tooth that was used. The data analyzed by simple regression indicated that determining chronologic age in humans from cemental annulations is not possible.
Adolescent↗
Anticonvulsant drugs, growth, and development.
Height and stage of puberty of 67 children with epilepsy were measured before beginning treatment with anticonvulsant drugs and annually to a maximum five years' treatment. Blood concentrations of the drugs used (phenytoin, sodium valproate, carbamazepine, ethosuximide, and phenobarbitone) were monitored throughout. No significant deviation in growth patterns was detected.
Adolescent↗
Blue-black macule on the maxillary palate.
A cellular blue nevus located on the palate of a 72-year-old female is reported. This intraoral finding is uncommon and should be distinguished from clinical entities it closely resembles. Practitioners should be aware that a pigmented palatal lesion in fact may be a malignant melanoma. Surgical excision with microscopic examination is the only means by which an accurate diagnosis can be made.
Aged↗
Accumulation of [3H]sialyl-conjugates in sialidosis (sialidase-deficient) fibroblasts cultured in the presence of [3H]-N-acetylmannosamine.
Skin fibroblasts from normal individuals and a patient with the infantile form of sialidosis were cultured for up to 72 h in medium containing [3H]-N-acetylmannosamine. The sialidosis fibroblasts consistently accumulated more labeled compound(s) than the control cells, i.e. 37-88% more cpm per mg protein. Precipitation of sonicates of these cells with 10% trichloracetic acid, TCA, demonstrated that the excess radioactivity in the sialidosis fibroblasts was in one or more TCA soluble compounds. There was no detectable difference in the amount of label in the TCA insoluble material. The TCA soluble, labeled, material from the sialidosis and the control fibroblasts was separated, isolated and purified on AG1-X8, QAE Sephadex A-25 and Bio-Gel P-4 chromatography columns. Analysis of the isolated material showed the excess radioactivity in the sialidosis fibroblasts to be due to increased levels of [3H]sialic acid covalently bound to a variety of anionic sialyl conjugates. These compounds have been separated and partially purified. Finally, acid hydrolysis and chromatographic analysis of the TCA insoluble fractions showed that greater than 80% of the label in this material was also due to [3H]sialic acid. There was no detectable difference between the control and the sialidosis patient in the amount of label in this fraction.
Carbohydrate Metabolism, Inborn Errors↗
Diagnosis of white lesions of oral mucosa.
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Color↗
Accumulation of N-acetylneuraminic acid (sialic acid) in human fibroblasts cultured in the presence of N-acetylmannosamine.
Human skin fibroblasts incubated for 72 h in medium containing 10 mM N-acetyl-D-mannosamine accumulate material that yields a chromophore in the presence of thiobarbituric acid. This material was tentatively identified as free (unbound) sialic acid due to its reactivity with thiobarbituric acid prior to acid hydrolysis, its solubility in 10% trichloroacetic acid, its chromatographic properties on an anion-exchange column and its enzymatic susceptibility to acylneuraminate pyruvate-lyase. Mass spectrometry analysis established that the accumulated material was, in fact, N-acetylneuraminic acid. Loading studies demonstrated a linear relationship between the amount of N-acetylmannosamine in the medium and the level of sialic acid accumulating within the cells. Cells grown in the absence of N-acetylmannosamine contained an average of 5 nmol free sialic acid/mg protein, while cells cultured for 72 h in 20 mM amounts of this material contained an average of 156.3 nmol free sialic acid/mg protein. When the cells were removed from the N-acetylmannosamine-enriched medium and incubated in regular medium, more than 80% of the accumulated, intracellular sialic acid disappeared within the first 96 h. It was concluded from these data that normal fibroblasts cultured in medium enriched with N-acetylmannosamine store large amounts of N-acetylneuraminic acid and can thus serve as an excellent model for the study of both normal and abnormal sialic acid metabolism, transport, storage and/or metabolic (feedback) regulation in human tissue.
Biological Transport, Active↗
Childhood and psychoanalysis.
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Adaptation, Psychological↗
Overproduction of N-acetylneuraminic acid (sialic acid) by sialuria fibroblasts.
Fibroblasts from the original sialuria patient are shown to contain high levels of free sialic acid, i.e., an average of 87 versus a normal average of 2 nmol/mg of protein. Gas liquid chromatography-mass spectrometry analysis confirmed that the accumulated material is N-acetylneuraminic acid. Addition of D(+) glucosamine (0-5 mM) to the media of these cells increased the intracellular free sialic acid concentrations from 74 to 137 nmol/mg protein. In contrast, normal cells treated in an identical manner maintained their normal free sialic acid level of less than 4 nmol/mg protein. Addition of 20 mM N-acetylmannosamine in place of glucosamine resulted in a marked increase in free sialic acid in both the patient and the control, i.e., increases of 157 (from 95 to 252) and 120 (from 3 to 123) nmol/mg protein, respectively. Finally, while normal cells in the presence of glucosamine accumulated high levels of uridine diphosphate N-acetylhexosamine, the patient's cells accumulated much lower amounts of this compound. It is concluded that the elevated sialic acid level in sialuria is due, at least in part, to overproduction of free N-acetylneuraminic acid. Indirect evidence is presented that this may result from either hyperactivity or increased levels of the enzyme (uridine diphosphate N-acetylglucosamine 2-epimerase) that has been shown in other tissues to convert uridine diphosphate N-acetylglucosamine to N-acetylmannosamine.
Cells, Cultured↗