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Ultrasound-guided inferior alveolar nerve block (UGIANB) is a mandibular analgesic procedure in which local anesthetic is injected into the pterygomandibular space (PMS). Several studies have reported the clinical efficacy of UGIANB for mandibular surgeries; however, its effective range has never been investigated. We performed a cadaveric study to investigate the success rate of UGIANB injections and to determine whether injected dye could stain the mandibular nerve (MN) trunk and its branches. We performed UGIANB on the bilateral faces of 4 Thiel-embalmed cadavers. A needle was advanced to the PMS under ultrasound guidance and 5 mL of dye was injected. The cadaver was dissected and inspected for the presence of dye in the PMS; the range of dye spread to any of the inferior alveolar nerve (IAN), lingual nerve (LN), buccal nerve (BN), mandibular nerve (MN), auriculotemporal nerve (ATN), or facial nerves; and for the presence of intravascular dye. We performed eight UGIANB procedures on four cadavers. Dye was observed in the PMS in 7/8 injections. Staining was observed in all IAN, LN, and BNs that could be identified at dissection. No MN or auriculotemporal nerves (ATNs) were stained in any injections. No intravascular dye was observed in any injections. UGIANB can administer anesthetic into the PMS with high accuracy. UGIANB injections reached the IAN, LN, and BNs, but did not reach the MN or ATNs located outside the PMS. The findings of this cadaveric study indicate that UGIANB can provide sufficient analgesia for mandibular surgeries.

Background/aim The role of tumour-infiltrating CD45Ro+ T-cells in oral squamous cell carcinoma (OSCC) is unclear. This study aimed to evaluate prognostic biomarkers for OSCC. Patients and methods We determined the density of tumour-infiltrating CD45Ro+ T cells in the parenchyma and stroma at the tumour centre (TCe) and invasive front (IF) and examined the association between the density of these cells and histopathological status in 142 patients. Results Five-year overall survival (OS) and recurrence-free survival were favourable in patients with high CD45Ro+ T-cell density in the TCe stroma. OS was favourable in patients with high CD45Ro+ T-cell density in the IF stroma. Stepwise Cox regression model analysis indicated that CD45Ro+ T-cells in the stroma of the IF and TCe were an independent prognostic factor for OS. Conclusion CD45Ro+ T-cells in the stroma of the IF and TCe play a role in cancer immune surveillance and may be a useful prognostic factor.

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.

Human leukocyte antigen (HLA) class Ⅰ molecules play a central role in anticancer immunity, but their prognostic value in oral squamous cell carcinoma (OSCC) remains unclear. We examined HLA class I expression in 2 distinct tumor compartments, namely, the tumor center and invasive front, and evaluated the association between its expression pattern and histopathological status in 137 cases with OSCC. Human leukocyte antigen class Ⅰ expression was graded semiquantitatively as high, low, and negative. At the invasive front of the tumor, HLA class I expression was high in 72 cases (52.6%), low in 44 cases (32.1%), and negative in 21 cases (15.3%). The HLA class I expression in the tumor center was high in 48 cases (35.0%), low in 58 cases (42.4%), and negative in 31 cases (22.6%). The 5‐year overall survival and disease‐specific survival rates were good in cases with high HLA class I expression at the invasive front; however, there was no significant difference in survival based on HLA class I expression in the tumor center. In addition, high HLA class I expression was correlated with high CD8+ T cell density, whereas negative HLA class I expression was correlated with low CD8+ T cell density at the invasive front. These results suggest that it is easier for CD8+ T cells to recognize presented peptides in the case of high HLA class Ⅰ expression at the tumor invasive front and could be a prognostic factor for OSCC., Human leukocyte antigen class Ⅰ expression at the tumor invasive front could be a useful prognostic factor for oral squamous cell carcinoma.

Objective To clarify the relationship between mandibular ramus height and function of masticatory muscles in patients with hemifacial microsomia. Design Retrospective study of imaging and physiological data. Setting Images and physiological data were obtained from the records of Sapporo Medical University Hospital. Patients A total of 29 patients with hemifacial microsomia who showed Pruzansky grades I, II deformity. Main Outcome Measures Mandibular ramus height and masticatory muscle volume were evaluated with multi-detector row computed tomography. The electromyographic value was measured by the K7 Evaluation System. The hemifacial microsomia patients were classified into three groups based on the mandibular ramus height ratio of the affected and unaffected sides: group 0, > 1.00; group 1, 1.00 to 0.85; group 2, < 0.85. The Tukey-Kramer method and Games-Howell method were used to determine correlations between parameters. Results Decreased mandibular ramus height was significantly correlated with both reduced electromyographic values of the masseter muscle (P < .05) and the amount of mandibular lateral deviation at the time of maximum opening (P < .05) on the affected side. These differences were prominent in unilateral hemifacial microsomia patients classified as group 2. Conclusions Decreased mandibular ramus height may cause dysfunction of the masseter muscles but not the temporal muscle on the affected side in patients with hemifacial microsomia.

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 Tumor-infiltrating lymphocytes include tumor-reactive lymphocytes and regulatory T-cells. However, the prognostic value of tumor-infiltrating lymphocytes in oral squamous cell carcinoma (OSCC) remains unclear. Methods We used immunohistochemistry to evaluate the presence of tumor-infiltrating FoxP3⁺ T-cells and CTLA-4⁺ cells in four distinct histological compartments (tumor parenchyma and stroma at the tumor center, and parenchyma and stroma at the invasive front) and assessed the association between the prevalence of these cells and the histopathological status of 137 patients with OSCC. Results Five-year overall survival, disease-specific survival, and recurrence-free survival were favorable in patients with high numbers of FoxP3⁺ T-cells in the parenchyma of the invasive front. Recurrence-free survival and metastasis-free survival were decreased in patients with high numbers of CTLA-4⁺ cells in the parenchyma of the invasive front. Conclusions The presence of FoxP3⁺ T-cells in the parenchyma of the invasive front may be a useful prognostic factor. Our results indicate that FoxP3⁺ T-cells may exert site-specific anti-tumor effects but may not play an immunosuppressive role in OSCC. In addition, our results suggest that CTLA-4+ cells suppress the function of FoxP3+ T-cells and promote anti-tumor immunity in OSCC.

To clarify the morphological characteristics of hemifacial microsomia (HFM) by quantitative analysis of cephalometric radiographs.Retrospective study of imaging data.Imaging data were obtained from the records of Sapporo Medical University Hospital.A total of 183 patients with HFM.We used linear and angular measurements and analyzed the middle face and lower face.The ratios of the affected side to the unaffected (A/U) side of the lateral distance of the mandibular condyle, the mandibular ramus height, and the length of the body of the mandible in the HFM group were significantly lower than in the control group. The inclination of the body of the mandible was significantly larger in the side with HFM than in the unaffected side, and the extent of the mandibular ramus was significantly lower than in the unaffected side. The A/U ratios of the extent of the angle of the mandible and the inclination of the body of the mandible in the HFM group were larger than in the control group. Moreover, the length and the inclination of the body of the mandible had significant correlations with the distance of the shift of the menton.It is suggested that improving the hypoplasia of the length of the body of the mandible and the extent of the angle of the mandible on the affected side will lead to more effective treatment of jaw deformity in patients with HFM.

Background Cases of diverticula of the buccal mucosa are extremely rare. Literature searches of databases such as PubMed/MEDLINE for this condition have revealed only 10 case reports. In this case report, we describe our experience in the management of this rare condition and review the previous 10 previously reported cases. Case presentation A 66-year-old man presented with a pouch containing inspissated food debris located posterior to the papilla of the parotid duct in his left buccal mucosa. The diagnosis of a diverticulum arising from the buccal mucosa was confirmed based on clinical and radiographic findings. Gross examination of the locally resected tissue specimen revealed a pouch measuring 14 mm in diameter and 8 mm in depth, that was whitish in color and had an elastic, soft, and smooth surface. Microscopic examination revealed a cyst-like lesion lined by stratified squamous epithelium and granulation tissue, with a chronic inflammatory infiltration in the peripheral stromal tissue of the epithelial layer. After surgical excision of the lesion, there was no recurrence during the follow-up period of 5 years and 10 months. Conclusions We have presented a rare case of a diverticulum of the buccal mucosa. This is the first report of a case confirmed not only by the clinicopathological findings, but also by computed tomography and magnetic resonance imaging findings. From the magnetic resonance imaging and intraoperative findings, we inferred that the diverticulum was caused by an idiopathic developmental anomaly due to a partial defect of the buccinator muscle.

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.

Pathologically proven regional lymph node metastasis affects the prognosis in early stage oral cancer. Therefore we investigated invasive tumor patterns predicting nodal involvement and survival in patients with clinically node-negative T1 and T2 oral squamous cell carcinoma (cT1,2N0M0 OSCC). Ninety-one cases of cT1,2N0M0 OSCC treated with transoral resection of the primary tumor were assessed based on 3 types of invasive tumor patterns on histopathologic and pancytokeratin-stained immunohistological sections: the mode of invasion, worst pattern of invasion (WPOI), and tumor budding. The correlations among invasive tumor patterns, regional metastasis, and disease-free survival were analyzed. Of the 91 cases, 22 (24%) had pathologically proven regional metastasis. The mode of invasion (p

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.

Background. Secondary cancers are severe complications in patients who have had allogeneic bone marrow transplantation for childhood leukemia. We describe here a case of squamous cell carcinoma (SCC) of the buccal mucosa in a young adult patient who had had allogeneic bone marrow transplantation for childhood acute leukemia. Methods and Results. The primary tumor was treated with interstitial brachytherapy, and lymph node metastasis was treated by supraomohyoid neck dissection. The patient had a history of acute lymphoblastic leukemia (ALL) at 11 years of age and had received an allogeneic bone marrow transplant from a female donor. Further investigation of the tissue specimens by fluorescent in situ hybridization (FISH) revealed that an XX chromosome pattern was dominant in the tumor region, and this suggested that donor-derived cells might affect carcinogenesis in the recipient. Conclusions. This case presents an incidence of secondary oral cancer associated with allogeneic bone marrow transplantation. © 2008 Wiley Periodicals, Inc. Head Neck, 2009

Solitary fibrous tumor (SFT) is a rare benign tumor that occurs mainly in the pleura; however, it can also arise in other extrapleural sites, including the oral cavity. In 2002, the World Health Organization classified SFT as a tumor of intermediate malignancy characterized by metastases to the lung, bone and, rarely, liver. We report a case of SFT in the left side of the buccal region. A 52-year-old woman visited our hospital in June 2005 because of a painless swelling on the left side of the buccal region. A CT scan and MRI showed awell-defined solid tumor in the left side of the buccal region. The tumor was surgically resected, and histopathological examination revealed a SFT. There has been no recurrence ofthe tumor for 18 months since the operation. We review the literature with regard to the clinicopathologic features of SFT.

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.

舌 (10例) , 口底 (10例) , 下顎歯肉 (4例) 原発のN0の扁平上皮癌症例で片側の肩甲舌骨筋上部郭清術を行った24例について臨床的検討を行った。病理学的に転移リンパ節は8例 (33.3%) にみられたが, それらの臨床経過は良好であった。病理学的に転移リンパ節がみられなかった16例中1例が術後にみられた頸部転移により死亡しているが, 他の15例は再発, 転移なく生存している。3個の転移リンパ節が1例で, 1個が7例で認められた。転移リンパ節はlevel 1に6例で, level 2に2例でみられた。被膜外転移巣はlevel 1に2例でみられた。検索症例の大半では, 原発巣の病理組織学的悪性度は比較的高度であつた。今回の検索より, 原発巣の病理組織学的悪性度を考慮すれば, 肩甲舌骨筋上部郭清術は診断的効果のみならず治療的効果があがることが示唆された。

アデノウイルスベクターを用いた遺伝子治療は口腔癌を含むさまざまな悪性腫瘍に対して試みられている。口腔扁平上皮癌細胞株に対する野性型アデノウイルスベクターによる遺伝子導入効率は細胞株により差はあるものの低かった。これはアデノウイルスベクターの細胞吸着に関与する細胞表面の受容体であるコクサッキーアデノウイルスレセプター (CAR) の発現が低いためと考えられる。口腔扁平上皮癌細胞のCARmRNA発現量をABI PRISM 7700シーケンスディテクターを用いTaqMan PCRにより測定したところアデノウイルスで高い遺伝子導入効率を示す293細胞1として測定したところ, その発現量は0.12-0.54と低かった。そこでCARに非依存的なアデノウイルス遺伝子導入法を開発するために, TPC-COS法によりアデノウイルスファイバーノブのHIループにCDCRGDCFCインテグリン結合モチーフを導入したRGDファイバー変異型アデノウイルスベクターを作製し, 口腔癌細胞株での遺伝子導入効率を検討したところ, 野性型アデノウイルスベクターと比較し, 数倍から10倍の遺伝子導入効率の改善が得られた。以上の結果からRGDファイバー変異型アデノウイルスベクターはCAR発現量の少ない口腔扁平上皮癌に対する有用な遺伝子導入ベクターになりうることが示唆された。

We clinically examined 29 patients with squamous cell carcinoma of tongue, floor of the mouth, and maxillary gingiva who received unilateral functional neck dissection with preservation of the sternocleidmastoid muscle, internal jugular vein, and/or accessory nerve.The 5-year cumulative survival rate of all patients was 80.4%, that of 19 pN (+) patients was 68.6%, and that of 10 pN (-) patients was 100%. Pathologically, 4 metastatic lymph nodes (LNs) were found in 1 patient, 3 LNs in 3 patients, 2 LNs in 6 patients, and 1 LN in 9 patients. LNs were located in level 1 in 5 paitents, level 2 in 12, and level 4 in 2. Extranodular metastatic lesions were found in level 1 in 1 patient and in level 2 in 4. Among the patients with a poor prognosis, 2 LNs were found in 2 patients, 3 LNs in 1, and 4 LNs in 1, extranodular lesions were found in 2 patients, and LNs were located in level 2 in all patients.Our results suggest that functional neck dissection is indicated for patients who have single and movable nodular metastatic lymph node.

Summary The purpose of this clinical trial was to assess the toxicity and efficacy of docetaxel plus nedaplatin induction chemotherapy in patients with locally advanced oral squamous cell carcinoma (OSCC). Twenty-one patients were enrolled in this phase I/II clinical study. The toxicities, response rates, and the maximum tolerated dose of nedaplatin that could be safely given preoperatively were assessed. Patients received escalating doses of nedaplatin (60, 70, 80, 90 mg/m 2 ) combined with a fixed dose of docetaxel (60 mg/m 2 ) on day one. Dose-limiting toxicity (DLT), grade 4 leukopenia lasting for two days or more, was seen in one patient at dose level 3; no other DLT was observed at any dose level. The overall response rate was 66.7%. The response rate was 100% at nedaplatin dose level 4, while that at dose level 1 was low (33.3%). Given these results, the recommended dose of nedaplatin in this regimen combined with fixed dose docetaxel (60 mg/m 2 ) was determined to be 90 mg/m 2 . Docetaxel 60 mg/m 2 plus nedaplatin 90 mg/m 2 induction chemotherapy can be recommended for patients with locally advanced oral squamous cell carcinoma. Based on these results, an early phase II clinical study using this dose level was conducted; docetaxel plus nedaplatin induction chemotherapy appears to be a useful regimen for the treatment of OSCC. A late phase II clinical study is warranted.

In acute myocardial infarction (AMI), prognosis and mortality rate are closely related to the infarct size and the progression of postinfarction cardiac failure. Angiogenic gene therapy has presented a new approach for the treatment of AMI. Angiopoietin-1 (Ang1) is a critical angiogenic factor for vascular maturation and enhances vascular endothelial growth factor (VEGF)-induced angiogenesis in a complementary manner. We hypothesized that gene therapy using Ang1 for AMI might promote angiogenesis cooperatively with intrinsic VEGF, since high concentrations of circulating VEGF have been reported in AMI. To evaluate our hypothesis, we employed a rat AMI model and adenoviral Ang1 (HGMW-approved gene symbol ANGPT1) gene transfer to the heart. A significant increase in capillary density and reduction in infarct sizes were noted in the infarcted hearts with adenoviral Ang1 gene treatment compared with control infarcted hearts treated with saline or adenoviral vector containing the β-galactosidase gene. Furthermore, the Ang1 group showed significantly higher cardiac performance in echocardiography (55.0% of ejection fraction, P < 0.05 vs control) than the saline or adenoviral controls (36.0 or 40.5%, respectively) 4 weeks after myocardial infarction. The adenoviral delivery of Ang1 during the acute phase of myocardial infarction would be feasible to attenuate the progression of cardiac dysfunction in the rat model.

BACKGROUND pRb2/p130 is one of the retinoblastoma (Rb) gene family and a suppressor oncogene. Immunohistochemically, the expression of pRb2/p130 was reported to be correlated inversely with the degree of malignancy in lung carcinoma and endometrial carcinoma. In the current study, the correlation between expression of pRb2/p130 and clinicopathologic factors in oral squamous cell carcinoma was investigated. METHODS One hundred twenty-two specimens from patients with oral squamous cell carcinoma were investigated by staining with a polyclonal antibody against pRb2/p130. The correlation between the expression of pRb2/p130 and various clinicopathologic factors was studied. RESULTS Positive staining for pRb2/p130 was observed in 61 of 122 cases (50.0%). pRb2/p130 expression was found to be correlated significantly with clinical stage (P = 0.050), cervical lymph node metastasis (P = 0.035), and tumor differentiation (P = 0.050). In the entire group a significantly reduced 5-year cumulative survival rate was observed in patients with pRb2/p130-negative tumors compared with patients whose tumors positively expressed pRb2/p130 (P = 0.0004). When tested with Cox proportional hazards regression analysis, the most significant independent prognostic factor for the entire group of 122 patients was found to be pRb2/p130 expression. CONCLUSIONS Expression of pRb2/p130 may be a good prognostic indicator in patients with oral squamous cell carcinoma and also may be utilized for the subclassification of tumors with the Grade 3 mode of carcinoma invasion. Cancer 2001;92:2117–25. © 2001 American Cancer Society.

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: 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.