Implant therapy in the cleft site offers a reliable option for patients. Particular attention should be focused preoperatively on whether bone volume can provide primary implant stability.

Background. Some cutaneous T‐cell lymphoproliferative diseases (LPD), such as lymphomatoid papulosis and pityriasis lichenoides et varioliformis acuta, are characterized by an indolent or waning and waxing clinical course. However, such T‐cell LPD are rarely documented in other organs. Methods. A patient with T‐cell LPD of the digestive tract characterized by repetitive episodes of self‐healing ulcers in the oral and intestinal mucosa over the course of 17 years is reported. Biopsy specimens from oral and intestinal mucosa were studied by conventional pathology, immunocytochemistry, and Southern blot analysis of T‐cell receptor (TCR)‐beta and ‐gamma gene rearrangement. Results. Immunocytochemically, the infiltrating lymphocytes were lamina propria T cells with a dominant phenotype CD3+, CD4+/‐, CD8‐, and HML‐1‐. DNA study revealed the same rearranged configuration of TCR‐beta and ‐gamma genes in specimens from both oral and colonic lesions. Conclusions. The present case may represent a novel T‐cell lymphoproliferative disease (i.e., a digestive‐tract mucosal counterpart of cutaneous dysplastic LPD). Cancer 1995;75:1728‐33.

Cultured rat keratinocyte sheets form hair follicles in combination with rat vibrissa dermal papillae when they are transplanted subcutaneously in syngeneic rats and athymic mice. In the present study, the histologic details of these induced follicles were analyzed by preparing cultured sheets mixed with normal rat keratinocytes and green fluorescent protein (GFP)-transgenic rat keratinocytes. Histologic examination demonstrated that some induced follicles maintained their size and morphology for at least 18 weeks, whereas others decreased in size and others totally differentiated into cornified structures between 3 and 6 weeks. The percentage of the grafts with GFP-positive cells decreased during the same period. This finding suggests that some GFP-positive cells were transient-amplifying cells that turned into terminally differentiated cells and were lost during this period. Some large follicles and some small follicles maintained their hair-producing ability and the proliferative activity in their hair matrix for 18 weeks. In addition, one 6-week-old follicle contained label-retaining cells in the outer root sheath. Seven of 25 follicles induced from chimera epithelium contained both GFP-positive cells and GFP-negative cells. These results suggest that stem cells are present in the induced follicle and the induced follicle consists of polyclonally derived cells. The presence of early anagen-like large follicles at week 6 and 9 and a telogen-like small follicle at week 18 also suggests that hair-growth cycle phases proceeded in the induced follicles. In conclusion, the follicles induced in the cultured keratinocyte sheets maintained hair-producing ability and proliferative activity for at least 18 weeks. This and the presence of label-retaining cells suggest that there are stem cells in the induced follicles, which seem to have a hair-growth cycle.

The Common Achievement Test (CAT) in Japan, which will be implemented in 2005, involves a medical interview that is the core task to be completed by students during an Objective Structured Clinical Examination (OSCE). Standardized/ Simulated Patient instructors (SPs), posing as patients in medical interviews, are trained in standard fashion in terms of expression of symptoms as well as the emotional affect of actual patients. Institution of appropriate training programs for SP instructors in the CAT is also necessary. We trained seven individuals to function as standardized patients (in-school SPs) during a three-day SP training program described in this article. Following completion of the OSCE, we conducted a comparison study among evaluations completed by the evaluators and two types of SP instructors. We observed high correlation, according to Spearman significance testing, between scores of evaluators and those of both newly trained in-school SPs and veteran SPs who had more than five years of experience. Correlation coefficients between the veteran SPs (r=0.77) and the in-school SPs (r=0.73) were nearly identical. These results suggest that our training program for SP instructors is an effective protocol, particularly with respect to reliability and efficiency.

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