Glucocorticoids regulate hippocampal function in part by modulating gene expression through the glucocorticoid receptor (GR). GR binding is highly cell type specific, directed to accessible chromatin regions established during tissue differentiation. Distinct classes of GR binding sites are dependent on the activity of additional signal-activated transcription factors that prime chromatin toward context-specific organization. We hypothesized a stress context dependency for GR binding in hippocampus as a consequence of rapidly induced stress mediators priming chromatin accessibility. Using chromatin immunoprecipitation sequencing to interrogate GR binding, we found no effect of restraint stress context on GR binding, although analysis of sequences underlying GR binding sites revealed mechanistic detail for hippocampal GR function. We note enrichment of GR binding sites proximal to genes linked to structural and organizational roles, an absence of major tethering partners for GRs, and little or no evidence for binding at negative glucocorticoid response elements. A basic helix–loop–helix motif closely resembling a NeuroD1 or Olig2 binding site was found underlying a subset of GR binding sites and is proposed as a candidate lineage-determining transcription factor directing hippocampal chromatin access for GRs. Of our GR binding sites, 54% additionally contained half-sites for nuclear factor (NF)-1 that we propose as a collaborative or general transcription factor involved in hippocampal GR function. Our findings imply a dose-dependent and context-independent action of GRs in the hippocampus. Alterations in the expression or activity of NF-1/basic helix–loop–helix factors may play an as yet undetermined role in glucocorticoid-related disease susceptibility and outcome by altering GR access to hippocampal binding sites.

Midline clefts of the lower lip, tongue, and mandible are a rare type of facial cleft classified as “Tessier 30.” We present the case of a female patient with an isolated Tessier 30 facial cleft affecting the tongue, lower lip, and mandibular symphysis with ankyloglossia. This was reconstructed with a template-guided resorbable “U”-shaped plate at 10 months of age. The procedure was carried out in one stage, which avoided the need for a repeat general anesthetic for the patient. We had a successful outcome with normal dental eruption and we believe such an approach could be considered as a relevant treatment modality for future cases.

Coronectomy procedures are widely carried out in secondary care, involving the removal of the dental crown, while retaining the roots in situ. This paper defines and explains the rationale behind coronectomy. It also seeks to review the indications for referral of wisdom teeth, and how to identify high-risk wisdom teeth radiographically using two- and three-dimensional imaging. Using this information, this article aims to provide the practitioner with information on short- and long-term management of high-risk wisdom teeth and discusses coronectomy versus extraction. It also discusses the complications of coronectomy and the importance of adequate consent.

The anatomy of the coronary sinus is briefly reviewed. Atrial reflux and efficiency of the ostial valve are examined. A heart showing a posterobasal left ventricular aneurysm is described, and it is suggested that concomitant obstruction of the sinal ostium may have caused the aneurysm. A simple flow experiment, and examination of zOO routine postmortem hearts and 42 foetal hearts suggest that: (i) atrio-sinal reflux does not normally occur except in foetal life; (ii) the valve of the coronary sinus ostium is probably a vestigial structure with little efficiency; and (iii) some cases of submitral aneurysm may be due to obstruction of the coronary sinus.The coronary sinus is the terminal channel of the coronary venous system. It drains the bulk of the blood from the vascular bed of the left coronary and a small part of that of the right coronary artery (Gregg, I948). It is 2-3 cm long, o-5-i*o cm in diameter, lies on the back of the heart in the posterior atrioventricular groove, and opens into the right atrium between the orifices of the inferior vena cava and the tricuspid valve (Davies, x967).

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