Search

The aim of this study was to examine the clinical and histopathologic effects of neoadjuvant intra-arterial chemoradiotherapy (IACRT) using cisplatin in combination with oral S-1 (tegafur/gimeracil/oteracil potassium) on stage III and IV oral squamous cell carcinoma.Thirty patients received infusions of superselective intra-arterial cisplatin 60 mg/mHistopathologic evaluation of the therapeutic effect was grade 2 in 10 patients and grade 3 in 16 patients. According to the distribution of RGrades, the remaining tumor cells were mostly in the central area of the primary lesion, as seen in 24 patients.These findings indicate that neoadjuvant IACRT with cisplatin and oral S-1 was an effective treatment, suggesting the possibility of reducing the extent of curative surgery based on RGrades.

Intravascular papillary endothelial hyperplasia is an unusual benign lesion of vascular origin. A 56-year-old man presented with a mass in the right side of the lower lip. Before visiting our hospital, he had undergone 3 surgical procedures for recurrence of the mass in a short period of time. Clinical examination revealed a painless, soft, elastic, dark purple obscure mass measuring 17 × 11 mm in the right lower lip. Ultrasonography and magnetic resonance imaging suggested a hemangioma-like lesion. The possibility of malignant transformation could not be ruled out because of the clinical course up to that point, even though it had been histopathologically diagnosed as hemangioma. The lesion was surgically resected and the defect was reconstructed using a vermilion advancement flap combined with a V-Y advancement flap. The histopathological diagnosis was intravascular papillary endothelial hyperplasia. The patient has had no symptoms or any evidence of recurrence in the 4 years since the operation. His postoperative progress has been favorable both functionally and aesthetically.

Objective Epithelial–mesenchymal transition (EMT) plays an important role in cancer invasion and metastasis induced by hypoxia. Here, we examined whether phosphorylation of GSK3-β via phosphoinositide 3-kinase (PI3 K)/Akt signaling is involved in enhancing the hypoxia-induced EMT in oral squamous cell carcinoma (OSCC). Study Design Experiments were performed in OSCC cell lines (HSC-2, HSC-3, HSC-4, SAS, and HO-1-U-1) under normoxic or hypoxic conditions. The EMT was assessed by Matrigel invasion assays and wound healing assays. OSCC cell lines (HSC-2 and HSC-4) overexpressing hypoxia-inducible factor (HIF)-1α were established to examine the effects of HIF-1α on EMT-related factors. Immunohistochemical staining was performed to examine phosphorylation of GSK3-β in 33 cases of tongue squamous cell carcinoma. Results Under hypoxic conditions, OSCC cell lines exhibited HIF-1α expression and showed evidence of the EMT. In cells overexpressing HIF-1α, the levels of phospho-Akt and phospho-GSK3-β were increased, resulting in induction of the EMT. Inhibition of GSK3-β phosphorylation suppressed these effects. Moreover, the intensity of pGSK3-β staining was significantly increased with cN stage and cTNM stage in patients with tongue squamous cell carcinoma. Conclusions Our data showed that the hypoxia-induced EMT in OSCC was enhanced by GSK3-β phosphorylation, suggesting that GSK3-β may be important in the invasion and metastasis of OSCC.

Traumatic facial nerve paralysis is often caused by nerve damage in the temporal bone, such as that from temporal bone fractures, and very rarely by direct facial nerve injuries resulting from stings, cuts, bruises or other damage to areas outside of the temporal bone. We report a case of facial nerve paralysis due to pressure from a small bone fragment from a mandibular condylar fracture in which symptomatic improvement was achieved through surgical treatment. The patient was a 30-year-old woman who was injured during a fall. She visited our department after noticing symptoms the following morning that included malocclusion and abnormalities in the muscles of facial expression such as incomplete eye closure. On presentation, a left-side mandibular condylar fracture and severe left-side facial nerve paralysis were identified. As the likely cause of facial nerve paralysis was not a temporal bone fracture, cuts or bruises, but pressure from a small bone fragment, we performed open reduction and internal fixation (ORIF) surgery. In consideration of the surgical risk to nerves, ORIF surgery was performed using a transoral approach. Antecedent steroid therapy was begun just after hospitalization. Improvements were seen in both the malocclusion and facial nerve paralysis. Here we report a case of facial nerve paralysis due to compression from a small bone fragment from a condylar fracture that was treated with ORIF surgery through a transoral approach performed as decompression surgery with a favorable outcome.

Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy. It accounts for 5% of all salivary gland tumors and 20% of salivary malignancies and has various clinical outcomes. Its prognosis is related to the tumor grade in the WHO classification of head and neck tumors. MEC is divided into high, intermediate and low grades. In general, low-grade MEC with cervical lymph node metastasis is rare, and primary MEC that occurs in a minor salivary gland with cervical lymph node metastasis is very rare. Low-grade lesions have quite different behavior from high-grade ones, leading to differences in the treatment course required for disease control. MEC is associated with recurring chromosomal translocation t(11;19)(q21;p13). CRTC1-MAML2 gene fusion was identified from the recurring translocation, which is often the sole cytogenetic alteration in this disease. This fusion transcript is detected frequently in MEC and is involved in the transformation of epithelial cells. Detection of the CRTC1-MAML2 fusion transcript is associated with a less advanced clinical stage and low-grade tumor histology. The presence of the transcript is associated with longer disease-free and overall survival periods. Here, we report a rare case of low-grade MEC with cervical lymph node metastasis. The findings for this patient show that the CRTC1-MAML2 fusion transcript may be specific to MEC, and associated with a distinct MEC subset that exhibits favorable clinicopathologic features.

Background Facial asymmetry, which is often due to asymmetry of the mandible, is a naturally occurring phenomenon in patients with hemifacial microsomia (HFM). Only a few attempts have been made to develop specific quantitative diagnostic criteria for the mandibular asymmetry of HFM. This pilot study was designed to determine the soft-tissue and skeletal characteristics of patients perceived to have HFM and the factors affecting objective assessment of mandibular asymmetry. Methods Frontal facial photographs and frontal cephalograms of twelve patients who had HFM with mandibular asymmetry were analyzed. Landmarks and reference lines were determined on the basis of frontal photographs and cephalographic analysis. Linear measurements of the right and left sides were performed to assess the degree of asymmetry of the mandible. The differences between the affected side and the unaffected side were calculated and analyzed statistically. Results Significant differences were found for linear measurements of the gonion distance (GoD), full marginal distance (FMD), external marginal distance (EMD), and gonion-menton distance (Go-MeD) in the hard tissue and sFMD, sEMD, sGo-MeD in the soft tissue but not for the gonion distance in soft tissue (sGoD). The differences in sEMD and EMD were significantly correlated, and represented a valid factor affecting the mandibular asymmetry in soft and hard tissues. Conclusions The results of this study suggest that appropriate measurements affecting the outline of the mandible such as sEMD and EMD taken from frontal facial photographs and frontal cephalograms provide a useful, objective means of assessing mandibular asymmetry for patients with HFM.

Purpose Morphologic evaluation of computed tomographic images is an important assessment tool before surgical removal of the lower third molar (LM3). The aim of this study was to ascertain whether the shape of the inferior alveolar canal (IAC) is a reliable predictor for inferior alveolar nerve (IAN) injury during M3 surgery. Materials and Methods This prospective study assessed samples with a high risk of IAN injury during M3 surgery based on orthopantomographic examination. The predictor variables were demographic factors (patient's age and gender), anatomic factors (angulation of the tooth), and radiographic factors (cortication status, buccolingual position, shape of the IAC, number of roots, and root shape). The outcome variable was IAN injury. The relation between predictor and outcome variables was analyzed using the Fisher exact test and a logistic regression model. Results One hundred sixty-nine LM3s (115 patients) were analyzed. IAN injury was observed in 12 of 115 patients and 13 of 169 LM3s (7.7%). All 13 cases with IAN injury exhibited absence of cortication. A dumb-bell–shaped IAC was considered a useful predictor for IAN injury (sensitivity, 69.2%; specificity, 84.6%). In cases with absence of cortication, logistic regression analysis indicated that a dumb-bell–shaped IAC was closely related to IAN injury ( P = .005). Conclusion The cortication status and shape of the IAC are reliable predictors for IAN injury at M3 surgery. Cases exhibiting absence of cortication and a dumb-bell–shaped IAC should be recognized as presenting a high risk of IAN injury at M3 surgery.

Purpose To assess the clinical features of the inferior alveolar canal (IAC) using computed tomography (CT) and to analyze the significance of CT examination at third molar surgery. Materials and Methods A retrospective cohort study was performed involving 99 patients (145 teeth). The relationship between cortication status, buccolingual position, and shape of the IAC on the CT image and inferior alveolar nerve (IAN) injury after third molar surgery were statistically analyzed. Results The shape of the IAC was categorized into 3 groups: round/oval, teardrop, and dumbbell. IAN injury was observed in 7 of 145 cases (4.8%). All 7 cases exhibited absence of cortication; 3 were dumbbell shape and 4 were round/oval. According to logistic regression analysis of cases with absence of cortication, IAC shape was closely related to IAN injury. Conclusions These results suggest that assessment of the IAC shape and cortication status at third molar surgery may be clinically useful.

Gene targeting using short interfering RNA (siRNA) has become a common strategy to explore gene function because of its prominent efficacy and specificity. For the application of siRNA technology to gene therapy, however, still more efficient transduction of siRNA into target cells is needed. In this study, we developed an adenoviral vector harboring a tandem-type siRNA expression unit, in which sense and antisense strands composing the siRNA duplex were separately transcribed by two human U6 promoters. Targeting survivin, an antiapoptotic molecule widely overexpressed in malignancies but not detected in terminally differentiated adult tissues, this type of adenoviral vector (Adv-siSurv) successfully exerted a gene knockdown effect and induced apoptosis in HeLa, U251, and MCF-7 cells. These cancer cells, once infected with Adv-siSurv, displayed remarkably attenuated growth potential, both in vitro and in vivo. Moreover, intratumoral injection of Adv-siSurv significantly suppressed tumor growth in a xenograft model using U251 glioma cells. This novel modality may be a promising tool for cancer therapy.

Objective: This study describes the patterns of the cervical metastatic lymph nodes of patients with oral carcinoma who received unilateral neck dissection and their correlation with the clinical course. Patients and Methods: Clinical examination of 72 patients with tongue, floor of the mouth, and mandibular gingival squamous cell carcinoma who had received unilateral neck dissection during an 11-year period between 1987 and 1997 was performed. Results: The survival rates of patients with 3 or more metastatic lymph nodes, and/or extracapsular nodes, and/or a metastatic level of III or IV were all lower than for patients with less than 3 metastatic lymph nodes (p = 0.002) and/or intracapsular nodes (p = 0.0118), and/or metastasis of level I or II (p = 0.0067). Multivariate analysis revealed that the number of metastatic lymph nodes was the factor of greatest influence in terms of prognosis. Conclusion: The prognosis for patients with 3 or more metastatic lymph nodes and/or extracapsular nodes are poor, so postoperative therapy such as radiotherapy should be considered for these patients.

Background: Ischemia and reperfusion (I/R) injury is one of the important causes of early graft dysfunction and graft loss. Among factors that may be involved in the etiology of I/R injury, apoptosis is an early event after I/R injury of heart. Thus, inhibition of myocardial apoptosis might be a rational therapeutic strategy to reduce the preservation injury in the heart transplantants. We previously reported that Bcl-xL gene transfer can confer resistance against warm I/R injury and result in the improvement of cardiac function and the reduction of infarct size in rat heart. These evidences indicate that Bcl-xL would be also useful as a cardiac protective alternative in heart cold preservation. In this study, we employed adenoviral Bcl-xL gene transfer to the heart, and evaluated the cardiac protection of Bcl-xL in the heart transplantation after long cold preservation.

Background: Sendai virus (SeV) is negative-stranded RNA virus, which is classified as a type I parainfluenza virus belonging to the family of Paramyxoviridae. SeV has been known as rodent respiratory virus, however it is considered to be non-pathogen for humans. Recently, efficient gene transduction into various types of cells and tissue has been reported. Angiopoietin-1 (Ang1) is a critical angiogenic factor for vascular maturation and enhances vascular endothelial growth factor (VEGF)-induced angiogenesis in a complementary manner. Previously we reported Ang1 gene therapy clearly promoted myocardial angiogenesis and prevented remodeling in a rat AMI model. In the present study, we created recombinant Sendai virus vector (SeVV) encoding human Ang1 and evaluated therapeutic effect in the cardiovascular diseases. We also evaluated the angiogenic effect of mesenchymal stem cells (MSCs) transplantation with SeVV-mediated Ang1 gene modification.

Background: Clinical trials for severe coronary ischemia and critical limb ischemia using vascular endothelial growth factor (VEGF) gene have been on going for several years. However, the indication of VEGF therapy for ischemic heart disease is only limited to chronic ischemia, and acute myocardial infarction (AMI) is exception for this therapy at present. High levels of circulating VEGF were reported to arise following AMI in a short period after the ischemic event and surmised that it protects the blood vessels from apoptosis, modulates vasomotor response, and supports vessel formation in the ischemic area, and to contribute to quick recovery from the ischemic state. In this regard, we attempted adenoviral VEGF gene therapy for rat myocardial infarction model. However, we found the increase mortality of animals receiving adenoviral VEGF. Therefore, we re-evaluated the adverse effect of myocardial administration of adenoviral vector encoding VEGF in AMI rat.

Background: Sendai virus (SeV), a rodent respiratory virus considered non-pathogenic for humans, is a negative-strand RNA virus, classified as a type I parainfluenza virus belonging to the family Paramyxoviridae. Recently, efficient gene transduction into various primary cultured cells and tissues by a recombinant Sendai virus vector (SeVV) has been reported. However, the feasibility of using SeVV in the context of myocardial gene therapy was not evaluated. In the present study, we evaluated SeVV-mediated gene-transfer into cardiomyocytes in vitro and in vivo