Faculty Bibliography

Preparing for catastrophic events, both human-made and natural, is in the national interest and has become a priority since catastrophic events in Oklahoma City, Washington, DC, and New York City. Dentists are a large source of non-physician health manpower that could contribute to the public welfare during catastrophic events that require additional public health human resources. Dentists, by virtue of their education, understand biomedical concepts and have patient care skills that can be directly applied during a catastrophic event. Dentists also can provide training for other types of health care workers and can supervise these individuals. In this article, we propose that dentistry can make a significant contribution as part of a national response before, during, and after a catastrophic event or at the time of a public health emergency. We describe the potential collaboration among a dental school, city and state health departments, law enforcement, the military, and others to develop a curriculum in catastrophe preparedness. Then we describe one dental school's effort to build a catastrophe preparedness curriculum for our students. The competencies, goals and objectives, and sources of content for this catastrophe preparedness curriculum are described as well as suggestions for sequencing instruction

Traumatic fractures of the lunate are rare. This article presents two patients who had displaced oblique lunate fractures and distal radius fractures. Both fractures achieved union; however, transient avascular necrosis occurred in the proximal healing of one patient.

Expression of beta 3 integrins is increased in invasive melanoma. In this study we show that K1735 cell proliferation is enhanced by the expression of either beta 3 or a constitutively active Src. We investigated possible modulators of FN matrix assembly and found that matrix metalloproteinase 2 (MMP2) was activated by alpha v beta 3. alpha v beta 3 integrin was localized to focal contacts whereas alpha v beta 5 was peripherally distributed. MMP2 was also activated by expression of CASrc. MMP2 activation inversely correlated with FN matrix assembly, in that it dramatically reduced the organization of a FN matrix. K1735 cell migration on VN and invasion through a reconstituted basement membrane were decreased in the presence of anti-MMP2 antibodies. These results demonstrate that the expression of the alpha v beta 3 complex modulates melanoma cell behavior including activation of Src, organization of the cytoskeleton, assembly of the extracellular matrix, cell motility, and activation of MMP2.

We conducted a retrospective chart review of treatment outcomes in 17 adults who had been selected to undergo concomitant chemotherapy and radiation (chemo/XRT) for late-stage oropharyngeal cancers. All patients had been treated at the West Los Angeles VA Medical Center between March 1, 1998, and Sept. 30, 2000. Nine patients had a primary tumor at the base of the tongue, five had a primary tumor in the tonsillar area, and three had a tumor that affected both sites. Of this group, 15 patients completed one to three cycles of chemo/XRT, and the remaining two died during therapy. At the most recent follow-up, 9 of the 17 patients (52.9%) were documented to still be alive; seven patients had earlier died as a result of their primary tumor or a distant metastasis, and one patient had been lost to follow-up after completing treatment. At study's end, the duration of post-treatment survival ranged from 2 to 36 months (mean: 12.5). Based on the results of our small series, we conclude that chemo/XRT is a valid alternative to surgery with postoperative radiation and to radiation alone. Chemo/XRT yields acceptable rates of local control and allows for organ preservation with tolerable side effects.