Oro-facial dyskinesia (OFD) is involuntary, abnormal, uncontrolled and stereotyped movements, consisting of forehead furrowing, eye opening and closing, smacking and pursing of the lips, lateral deviation and protrusion of the tongue, and occasionally lateral deviation and protrusion of the jaw.1 OFD is known to have various complications including speech difficulty, chewing and eating disorders, and social embarrassment; facial muscle stiffness, mucosal and gingival traumatic lesions. In addition, it may leads to cranio-mandibular joint (TMJ) complications in the presence of intense and prolonged abnormal movements, with pain and degeneration.1,2 There is no previous report of TMJ dislocation due to OFD. In this report, we describe a patient who developed bilateral anterior TMJ dislocation due to OFD which occurred following intra-cranial hemorrhage (ICH).
Movement Disorders ; Dyskinesias

Artecoll (Artes Medical Inc., San Diego, CA, USA) has recently been developed as a permanent synthetic cosmetic filler. We experienced an inflammatory granuloma resulting from a previous injection of Artecoll at the upper lip, which was regarded as a rare side effect of this filler. A 50-year-old female patient complained of swelling, dull pain, and heat in the right upper nasolabial fold area, which had started one week before her visit to Kyungpook National University Hospital. The patient received topical steroid therapy at a local clinic, which was not effective. At the injection site, a hard nodule was palpated and erythema was observed with mild tenderness. Antibiotic treatment and subsequent incision and drainage did not result in complete cure of the facial swelling, and the facial swelling and pain persisted. Computed tomography showed a lesion approximately 1-cm in size without clear boundaries and relatively increased nodular thickening. Finally, a subdermal lesion was removed via an intraoral vestibular approach. The lesion was diagnosed as inflammatory granuloma by a permanent biopsy. The patient had healed at two months after the filler injection. Although the soft tissue filler is widely used for cosmetic purposes, there is potential for complication, such as the inflammatory granuloma should be considered before treatment.
Biopsy ; Collagen ; Cosmetics ; Drainage ; Erythema ; Female ; Granuloma ; Hot Temperature ; Humans ; Inflammation ; Lip ; Nasolabial Fold ; Polymethyl Methacrylate

Aneurysm, False ; Angiography ; Arteries ; Curettage ; Embolization, Therapeutic ; Head ; Hemorrhage ; Hemostasis ; Humans ; Mandible ; Neck ; Odontogenic Cysts ; Odontogenic Tumors ; Petrolatum

Alkalies ; Bicuspid ; Burns, Chemical ; Calcium ; Calcium Hydroxide ; Cheek ; Curettage ; Dental Pulp Cavity ; Female ; Humans ; Hydroxides ; Hypesthesia ; Incisor ; Lip ; Paresthesia ; Root Canal Filling Materials ; Silicones ; Zygoma

Alveolar Process ; Bone Transplantation ; Cleft Lip ; Congenital Abnormalities ; Dentition ; Humans ; Incisor ; Palate ; Retrospective Studies ; Transplants

Synthetic oligodeoxynucleotides (ODN) with a CpG-motif are recognized by Toll-like receptor 9 (TLR9) and pleiotropic immune responses are elicited. Stimulation of macrophages with TLR9 agonist prevented apoptosis induced by serum deprivation through increased expression of FLICE-like inhibitory protein (FLIP). CpG ODN-mediated anti-apoptosis depended on the TLR9-Akt-FoxO3a signaling pathway. Inhibition of TLR9 by small interfering (si) RNA or an inhibitor suppressed CpG ODN-mediated anti-apoptosis. Analysis of signaling pathways revealed that the anti-apoptotic effect of CpG ODN required phosphorylation of FoxO3a and its translocation from the nucleus to the cytosol. Overexpression of FoxO3a increased apoptosis induced by serum deprivation and CpG ODN blocked these effects through FLIP expression. In contrast, siRNA knock-down of FoxO3a decreased apoptosis by serum deprivation. In addition, Akt activation was involved in CpG ODN-induced phosphorylation of FoxO3a, expression of FLIP, and anti-apoptosis. Taken together, these results demonstrate the involvement of Akt-FoxO3a in TLR9-mediated anti-apoptosis and indicate that FoxO3a is a distinct regulator for FLIP expression.
Animals ; *Apoptosis ; CASP8 and FADD-Like Apoptosis Regulating Protein/*genetics/metabolism ; Cells, Cultured ; Forkhead Transcription Factors/genetics/*metabolism ; Macrophages/metabolism ; Mice ; Mice, Inbred C57BL ; Oligodeoxyribonucleotides/metabolism ; Oncogene Protein v-akt/metabolism ; RNA, Small Interfering/metabolism ; Signal Transduction ; Toll-Like Receptor 9/genetics/*metabolism

Resveratrol is a polyphenolic compound in red wine that has anti-oxidant and cardioprotective effects in animal models. Reactive oxygen species (ROS) and monocyte chemotactic protein-1 (MCP-1) play key roles in foam cell formation and atherosclerosis. We studied LPS-mediated foam cell formation and the effect of resveratrol. Resveratrol pretreatment strongly suppressed LPS-induced foam cell formation. To determine if resveratrol affected the expression of genes that control ROS generation in macrophages, NADPH oxidase 1 (Nox1) was measured. Resveratrol treatment of macrophages inhibited LPS-induced Nox1 expression as well as ROS generation, and also suppressed LPS-induced MCP-1 mRNA and protein expression. We investigated the upstream targets of Nox1 and MCP-1 expression and found that Akt-forkhead transcription factors of the O class (FoxO3a) is an important signaling pathway that regulates both genes. These inhibitory effects of resveratrol on Nox1 expression and MCP-1 production may target to the Akt and FoxO3a signaling pathways.
Antioxidants/*pharmacology ; Cells, Cultured ; Chemokine CCL2/genetics/*metabolism ; Enzyme Activation/drug effects ; Foam Cells/*drug effects/physiology ; Forkhead Transcription Factors/metabolism ; Humans ; Lipopolysaccharides/pharmacology ; NADH, NADPH Oxidoreductases/genetics/*metabolism ; Proto-Oncogene Proteins c-akt/metabolism ; RNA, Messenger/metabolism ; Reactive Oxygen Species/*metabolism ; Signal Transduction ; Stilbenes/*pharmacology

PURPOSE: The nitric oxide (NO) release by inducible nitric oxide synthase (iNOS) is the key events in macrophage response to lipopolysaccharide (LPS) which is suggested to be a crucial mediator for inflammatory and innate immune responses. NO is an important mediator involved in many host defense action and may also lead to a harmful host response to bacterial infection. However, given the importance of iNOS in a variety of pathophysiological conditions, control of its expression and signaling events in response to LPS has been the subject of considerable investigation. MATERIALS AND METHODS: The Raw264.7 macrophage cell line was used to observe LPS-stimulated iNOS expression. The expression of iNOS is observed by Western blot analysis and real-time RT-PCR. Protein kinase C (PKC)-alpha overexpressing Raw264.7 cells are established to determine the involvement of PKC-alpha in LPS-mediated iNOS expression. NF-kappaB activity is measured by IkappaBalpha degradation and NF-kappaB luciferase activity assay. RESULTS: We found that various PKC isozymes regulate LPS-induced iNOS expression at the transcriptional and translational levels. The involvement of PKC-alpha in LPS-mediated iNOS induction was further confirmed by increased iNOS expression in PKC-alpha overexpressing cells. NF-kappaB dependent transactivation by LPS was observed and PKC-alpha specific inhibitory peptide abolished this activation, indicating that NF-kappaB activation is dependent on PKC-alpha. CONCLUSION: Our data suggests that PKC-alpha is involved in LPS-mediated iNOS expression and that its downstream target is NF-kappaB. Although PKC-alpha is a crucial mediator in the iNOS regulation, other PKC isozymes may contribute LPS-stimulated iNOS expression. This finding is needed to be elucidated in further study.
Bacterial Infections ; Blotting, Western ; Cell Line ; I-kappa B Proteins ; Immunity, Innate ; Isoenzymes ; Luciferases ; Macrophages ; NF-kappa B ; Nitric Oxide ; Nitric Oxide Synthase Type II ; Protein Kinase C ; Protein Kinase C-alpha ; Protein Kinases ; Toll-Like Receptors ; Transcriptional Activation

BACKGROUND: When surgeons plan mandible ortho surgery for patients with skeletal class III facial asymmetry, they must be consider the exact method of surgery for correction of the facial asymmetry. Three-dimensional (3D) CT imaging is efficient in depicting specific structures in the craniofacial area. It reproduces actual measurements by minimizing errors from patient movement and allows for image magnification. Due to the rapid development of digital image technology and the expansion of treatment range, rapid progress has been made in the study of three-dimensional facial skeleton analysis. The purpose of this study was to conduct 3D CT image comparisons of mandible changes after mandibular surgery in facial asymmetry patients. MATERIALS & METHODS: This study included 7 patients who underwent 3D CT before and after correction of facial asymmetry in the oral and maxillofacial surgery department of Yeungnam University Hospital between August 2002 and November 2005. Patients included 2 males and 5 females, with ages ranging from 16 years to 30 years (average 21.4 years). Frontal CT images were obtained before and after surgery, and changes in mandible angle and length were measured. RESULTS: When we compared the measurements obtained before and after mandibular surgery in facial asymmetry patients, correction of facial asymmetry was identified on the "after" images. The mean difference between the right and left mandibular angles before mandibular surgery was 7degrees, whereas after mandibular surgery it was 1.5degrees. The right and left mandibular length ratios subtracted from 1 was 0.114 before mandibular surgery, while it was 0.036 after mandibular surgery. The differences were analyzed using the nonparametric test and the Wilcoxon signed ranks test (p<0.05). CONCLUSION: The system that has been developed produces an accurate three-dimensional representation of the skull, upon which individualized surgery of the skull and jaws is easily performed. The system also permits accurate measurement and monitoring of postsurgical changes to the face and jaws through reproducible and noninvasive means.
Facial Asymmetry ; Female ; Humans ; Jaw ; Male ; Mandible ; Skeleton ; Skull ; Surgery, Oral

BACKGROUND: CpG DNA plays an important role in immune cell function. This study examined whether the temporal control of toll-like receptor (TLR)9 by CpG DNA can regulate the expression of matrix metalloproteinase-9 (MMP-9). MeETHODS AND MATERIALS: Macrophages were cultured in the presence of 10percent FBS. For the various MMP genes analysis, RT-PCR and real-time PCR were performed. In addition, zymography assay performed for the MMP activity. The phosphorylation assay did for the ERK1/2 and NFkappaB activation, and luciferase promoter assay was for the NFkappaB activity. RESULTS: CpG DNA induced the mRNA expression of MMP-2, MMP-9, and MMP-13, but not of MMP-7, MMP-8, and MMP-12, in a time-dependent manner. Especially, the mRNA expression of MMP-9 was strongly induced by CpG DNA using real-time RT-PCR. The TLR9 inhibitor, chloroquine, suppressed CpG DNA-induced MMP-9 expression and its activity. Moreover, CpG DNA induced the phosphorylation of ERK and the inhibition of ERK by U0126 suppressed CpG DNA-induced MMP-9 expression and its activity. CpG DNA stimulated IkappaB-alpha degradation and luciferase activity. In addition, pretreatment of SN-50, the inhibitor of NFkappaB, strongly blocked the CpG DNA-induced MMP-9 expression and activity. CONCLUSION: These observations suggest that CpG DNA may play important roles in the activation of macrophages by regulating the production of MMP-9 via the sequential TLR9-ERK-NFkappaB signaling pathway.
Chloroquine ; DNA ; Luciferases ; Macrophages ; Matrix Metalloproteinase 9* ; Phosphorylation ; Real-Time Polymerase Chain Reaction ; RNA, Messenger ; Toll-Like Receptors*