Katsuhiro Horiuchi

Enhancement of the in vivo osteogenic potential of marrow/hydroxyapatite composites by bovine bone morphogenetic protein

A composite of marrow mesenchymal stem cells and porous hydroxyapatite (HA) has in vivo osteogenic potential. To investigate factors enhancing the osteogenic potential of marrow/HA composites, we prepared a bone morphogenetic protein (BMP) fraction from the 4M guanidine extract of bovine bone by heparin-sepharose affinity chromatography. Marrow/HA composites or composites containing marrow mesenchymal stem cells, BMP, and HA (marrow/BMP/HA composites) were implanted subcutaneously in 7-week-old male Fischer rats. BMP/HA composites and HA alone were also implanted. The implants were harvested after 2, 4, or 8 weeks and were prepared for histological and biochemical studies. Histological examination showed obvious de novo bone formation together with active osteoblasts at 2 weeks, as well as more extensive bone formation at 4 and 8 weeks in many pores of the marrow/BMP/HA composites. The marrow/HA composites did not induce bone formation at 2 weeks, but there was moderate bone formation at 4 weeks. At 2 weeks, only marrow/BMP/HA composites resulted in intensive osteogenic activity, judging from alkaline phosphatase and osteocalcin expression at both the protein and gene levels. These results indicate that the combination of marrow mesenchymal stem cells, porous HA, and BMP synergistically enhances osteogenic potential, and may provide a rational basis for their clinical application, although further in vivo experiment is needed.

Cornelia de lange syndrome with cleft palate

4 cases of Cornelia de Lange syndrome with cleft palate are presented. All cases had the characteristic features of this syndrome. As to oral manifestations, high arches were noted in 2 cases, cleft of hard and soft palate in 1 case, submucous cleft palate in 2 cases. As the others abnormalities, partial anodontia and microdontia were presented. In this report, characteristic features of these 4 cases with referential literature are described.

Management of a Deep Space Infection of the Neck in a Patient With Glanzmann's Thrombasthenia

Glanzmann’s thrombasthenia is an autosomal recessive disorder characterized by a deficiency or abnormality of the platelet membrane glycoprotein (GP) IIb-IIIa complex.‘-4 In patients with this disorder, a prolonged bleeding time and absent or substantially reduced platelet aggregation in response to diphosphate (ADP), epinephrine, collagen, or thrombin are observed, although the platelet count, platelet morphologic features, plasma coagulation, and platelet aggregation in response to ristocetin are norma1.2‘4 Clot retraction may or may not be impaired. In thrombasthenic patients, epistaxis, frequent superficial bruising, gingival bleeding, and menorrhagia are common manifestations. Some investigators have reported general or local management of spontaneous and trauma-induced bleeding in patients with thrombasthenia.3,5-7 Surgery and other invasive procedures are frequently complicated by excessive hemorrhaging. This report describes the procedures involved in treating a deep space infection in a patient with Glanzmann’s thrombasthenia.