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Morphologic and temporal analysis of vascular smooth muscle cell apoptosis induced by c-myc and E1A.

Apoptosis is a physiologic form of cell death present in many disease conditions. When the balance of mitosis versus apoptosis is altered, tumor-like growth or degeneration of tissues may ensue. This appears to occur in several diseases, including those of the cardiovascular system, where apoptosis plays a key role in atherosclerosis and restenosis following angioplasty. Since c-myc is upregulated in the pathogenesis of these diseases, we chose to study the sequential morphologic features of programmed cell death in vascular smooth muscle cells induced by c-myc and by the adenovirus early gene E1A. Morphology and timed events in apoptotic cell cultures were analyzed by scanning electron microscopy, transmission electron microscopy, and time-lapse videomicroscopy. We observed that both c-myc- and E1A-induced apoptosis (in serum-free medium) resulted in numerous, tightly packed clusters of apoptotic blebs, as well as in one or two asymmetrically larger blebs. Transmission electron miscroscopy analysis revealed the larger blebs contained mostly nuclear chromatin, whereas the many smaller fragments often had little or no chromatin. Time-lapse studies showed that apoptosis was induced at a slower rate in cells stably transfected with c-myc versus those stably transfected with E1A. The early changes of apoptosis, including cell shrinkage and intense blebbing, occurred in under 5 min in both cells. Slight alterations such as cell size and further rounding occurred up to 8 h following the initial changes of apoptosis. Rather than being a part of the apoptotic response, release from the culture floor almost entirely resulted from movement of the culture flask. These studies provide a framework of timed morphologic events for future mechanistic investigation into the key aspects of myc- and E1A-induced apoptosis in vascular smooth muscle.

Adenovirus E1A Proteins↗

Microvascular autologous submandibular gland transfer in severe cases of keratoconjunctivitis sicca.

The objective is to evaluate the technique of microvascular autologous submandibular gland transfer for the treatment of severe keratoconjunctivitis sicca. From August 1999 to April 2002, 38 patients with severe keratoconjunctivitis sicca were treated by autologous submandibular gland transfer to the temporal region of the skull. The related vessels were anastomosed to the superficial temporal artery and vein. When the vein was too small, venous bridging was applied. Prior to cutting off the gland, the facial artery was preserved and infused with heparin in normal saline after the gland had been freed to allow inspection of the blood oozing from the three veins. This would be helpful in the selection of a relevant vein for anastomosis. Wharton's duct was transplanted to the upper lateral conjunctiva fornix, and the gland was left denervated. Postoperative scintigraphy with Tc99m pertechnetate, follow-up studies, and management of complications were performed. The transplantations were successful in 33 cases, their symptoms of xerophthalmia disappeared. The discomfort resulting from bright light and wind was also relieved. These patients could stop applying artificial tears. In five patients the transplanted glands did not survive. Epiphora occurred in eight cases. They were successfully treated by reducing the size of the graft. Obliteration of Wharton's duct took place in two cases and was treated by the reconstruction of the duct or duct orifice. Microvascular autologous submandibular gland transfer is a lasting and effective solution for severe cases of keratoconjunctivitis sicca.

Adolescent↗

Arteriovenous fistula after temporomandibular joint arthroscopy successfully treated with embolization.

Temporomandibular joint arthoscopy is a minimal invasive surgical procedure commonly used to effectively treat some internal derangement of the TMJ. However, this method is not free of complications. Arteriovenous fistula (AVF) is a lesion that communicates the high flow arterial system and the low flow venous network. We describe a new case of preauricular traumatic AVF successfully treated with external carotid embolization, along with a review of the medical literature.

Adult↗

Increased accumulation of N-isopropyl-p-(123I)-iodoamphetamine in two cases with mitochondrial encephalomyopathy with lactic acidosis and strokelike episodes (MELAS).

We present two cases with mitochondrial encephalopathy with lactic acidosis and strokelike episodes (MELAS), which showed both increased and decreased accumulation of N-isopropyl-p-(123I)-iodoamphetamine (123I-IMP) in single photon emission computed tomography (SPECT). The increased accumulation of the tracer occurred, before low density appeared on conventional computed tomography, suggesting that 123I-IMP SPECT may be useful in pathophysiological study of MELAS.

Acidosis, Lactic↗

Saving the frontal branch during a low fronto-orbital approach.

This report describes the anatomy of the frontal branch of the seventh nerve and a technique for assuring its preservation when doing a low frontal approach. By dissecting under both layers of the temporal fascia, rapid and safe access to the inferior fronto-orbital region may be achieved. This technique is recommended for exposure of a bony lesion in the fronto-orbital region and when performing an osteoplastic pterional craniotomy.

Child↗

The anatomical basis for ultrasonography of the lateral pterygoid muscle and the infratemporal fossa.

The infratemporal fossa and its contents (particularly the pterygoid muscles) is a region difficult to explore, in spite of its importance in odontostomatological pathology. In order to reduce the indications that justify examination by computed tomography and magnetic resonance imaging, for reasons of economy of health, the authors describe by application of orientated anatomical slices the way in which ultrasonography can be performed. Only the posterior approach between the mandible laterally and the mastoid process medially provided consistently adequate exploration of the infratemporal fossa and the pterygoid muscles.

Humans↗

Regional differences in the responsiveness of isolated arteries from cattle, dog and man.

Changes in tension of spiral strips from basilar, external carotid, temporal and muscle arteries from cattle, dog and man were monitored isometrically. Dose-response curves for 5-HT, noradrenaline and ergotamine indicated a variation in responsiveness between different arteries of the same species as well as between the same arteries of different species. When tested against 5-HT ergotamine consistently acted as non-competitive dualist but it antagonized responses to to noradrenaline only in peripheral arteries from dog and man. In all arteries from the carotid vasculature and in bovine muscle arteries the vasoconstrictor effects of ergotamine and noradrenaline were independent additive. It is suggested that the therapeutic value of ergotamine in the treatment of migraine headache is due to its selective vasoconstrictor activity in the external carotid vasculature mediated through independent additive vasoconstrictor effects of ergotamine and noradrenaline.

Animals↗

The expanded polytetrafluoroethylene (ePTFE) in the surgical treatment of Parry-Romberg syndrome: case report.

Expanded polytetrafluoroethylene (ePTFE) was used in conjunction with autologous fat and silicone prosthesis to reshape the facial contour in a patient with mild Parry-Romberg syndrome (PRS). Patches of ePTFE were implanted in the temporo-malar and parotidean areas, fat was injected into the genian area and lower lip, and a middle-density solid silicone device was implanted in the chin. No complications were observed. The correction remained stable at follow-up 24 months post-op, permitting facial movements without alterations in contour. As far as we know, there has been no previous experience of ePTFE use in the treatment of PRS reported.

Adult↗

[Rare entity of a macroscopically visible tumor cone of squamous cell carcinoma in the greater veins of the head and neck].

Cones of malignant tumors are commonly known but only a few descriptions of cones in the head and neck area exist - as seen in a 91-year-old patient under our care. Cones of thymic and thyroid cancers are described in the literature. There are no descriptions of cones of head and neck squamous cell carcinomas. Metastases of squamous cell carcinoma in the head and neck area are very aggressive and have a high potential for vascular neogenesis. A vascular cone might be possible by vascular formation or by mechanical intrusion as described elsewhere.

Aged, 80 and over↗

Temporal soft tissue glioneuronal heterotopia in a child with a seizure disorder: case report and review of the literature.

Tissue and cellular elements generally attributed to the central nervous system (CNS) are infrequently found in areas outside the CNS proper. Most of these lesions contain predominantly glial tissue. In rare instances, heterotopic CNS tissue is found in the scalp, many associated with an intracranial connection and overlying skin and hair anomalies. In follow-up of these patients, development is normal. We present a case of a temporal scalp mass in a 19-month-old girl with a seizure disorder beginning at about age 1 year. At the time of excision, the mass was not associated with intracranial connection or overlying cutaneous abnormalities and demonstrated abundant neuronal and glial elements with features of dysplastic CNS tissue. We speculate that, in certain circumstances, aberrantly localized CNS tissue may be related to abnormal CNS development.

Brain↗

Non-linear amplification of electromyographic signals with particular application to human chewing.

A method is described for logarithmically-amplifying electromyographic signals so that the most commonly-occurring events within them are enhanced selectively before digital conversion. There is a need to resolve low and intermediate levels of activity during chewing, while preserving the occasional high-level responses. Besides achieving a higher resolution in subsequent digital sampling, this signal-processing technique increased the representation of low and intermediate activities in polygraphic displays. It further ensured that signals were presented to the A/D converter within the code width of the instrument.

Amplifiers, Electronic↗

Biomechanical implications of lateral pterygoid contribution to biting and jaw opening in humans.

The contributions of the lateral pterygoid muscle to a variety of different tasks were analysed by a linear programming mode based on the equations for static equilibrium in three dimensions and containing 12 muscles. The model was used to study lateral pterygoid activity at maximum bite force (MBF) for changes in (i) the direction and point of application of the bite force, (ii) the orientation of the masseter and medial pterygoid muscles and (iii) the slope of the articular eminence (glenoid slope). The effects on MBF of removing one or both lateral pterygoids were also examined. Lateral pterygoid provided a very important indirect contribution to some clenching forces. Under some conditions removing one lateral pterygoid muscle (simulating guarding an injured muscle) halved the MBF. Its activity at MBF was reduced as masseter was tilted more forward, the glenoid slope was made more horizontal and the bite force was made more vertical. The muscle helped to oppose (balance) the horizontal reaction forces at the bite point and joints, which potentially pushed the condyle backward. A balancing muscle is now defined as one (like lateral pterygoid) whose activity increases the output force by far more than its direct contribution to that force. In a larger model containing 16 muscles, every muscle was most active when its line of action was parallel to the output force. Finally, in a model which divided lateral pterygoid into superior and inferior heads, activity suddenly switched from the superior head to the inferior head when the angle of opening changed from 120 degrees (forward from the vertical) to 140 degrees.

Biomechanical Phenomena↗

The arterial anatomy of the temporal region and the vascular basis of various temporal flaps.

The arterial anatomy of the temporal region was examined macroscopically and radiographically in 10 fresh cadavers which had been injected with lead oxide. The blood supply of the temporal region is derived from the superficial temporal, middle temporal, deep temporal, posterior auricular, transverse facial, zygomatico-orbital, zygomaticotemporal, zygomaticofacial, and middle meningeal arteries. The vascular network formed by these arteries can be divided into four arterial networks corresponding to the different layers of the temporal region. With a new understanding of the arterial networks and their anastomoses, the techniques for elevating various flaps in the temporal region are discussed.

Angiography↗