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Objective: We report a rare case of salivary duct carcinoma possibly arising from the malignant component of carcinoma ex pleomorphic adenoma. Methods: A 56-year-old Japanese male complained of swelling in the left side of jaw for 2 years which was painless until 2 days ago. On extraoral examination, the face was bilaterally asymmetrical. An ultrasonography revealed hypoechoic mass of size 1.5x2.5x2.5 cm on left parotid gland. Computed tomography (CT) revealed a slight irregular mass on left parotid gland with no infiltration to adjacent tissues. Based on these findings, a clinical diagnosis of left parotid benign tumor was made. Results: A surgical excision was performed under general anesthesia. On histopathological examination, the connective tissue was rich in fibrous components and was accompanied by hyaline. Epithelial cells with high atypia proliferating invasively as cords into connective tissue were observed. The intraductal component had Roman-bridge-like architecture with central portion undergoing comedonecrosis. Based on these findings, a final diagnosis of salivary duct carcinoma possibly arising from pleomorphic adenoma was made. p16 hypermethylation is a known phenomenon in oral malignancy. We also checked the methylation status of p16 gene and found high level of methylation in this tumor. Conclusion: We reported a rare case of salivary duct carcinoma possibly arising from pleomorphic adenoma and also demonstrated high methylation level of p16 gene in the tumor.

BackgroundClavicle fractures (CF) after radical neck dissection (RND) for oral cancer are rare but are thought to occur as a result of myotonia and decreased blood supply to the muscles around the clavicle after RND. The current report presents a rare case of a non-neoplastic pathological CF after RND, and discusses the role of imaging examinations for the timely detection of CF.Case reportAn 82-year-old Japanese man underwent RND followed by chemotherapy without radiotherapy for secondary metastasis of the right cervical lymph node after resection of tongue cancer. Computed tomography at 6 months after RND revealed a fracture with bone destruction in the proximal end of the right clavicle. He had no history of trauma at the site of the fracture and no symptoms. The possibility of bone metastasis of the clavicle was considered; however, the bone destruction had not advanced 6 years after the discovery of the fracture. The CF was thus finally considered to be a side effect of RND, rather than metastasis.ConclusionCF is a rare complication following treatment for head and neck cancer but can be caused by neck dissection. Regular imaging examinations, including the clavicular region, are therefore needed before and after surgery to ensure the timely detection of CF.

Highlights • MMTAH is a new clinical entity, misdiagnosed as temporomandibular joint disorder. • MMTAH is diagnosed based on a square mandible, cord-like masseter muscle aponeurosis, and limited mouth-opening. • Aponeurectomy combined with coronoidectomy is the treatment of choice for a better prognosis. • It is important to evaluate the patient’s compliance with mouth-opening training before surgery., Introduction Masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) is a new clinical entity that presents mainly with trismus due to hyperplasia of the masseter aponeurosis and temporalis muscle tendon. However, the etiological factors of this disease are unknown; it is often mistreated as temporomandibular joint disorder (TMD). Presentation of case We report a 32-year-old female patient complaining of bilateral pain in her jaw and difficulty opening her mouth. She was first diagnosed as TMD and treated with a splint; however, her symptoms did not improve. Clinical examination revealed a square mandible, tenderness in the left and right temporalis muscles and masseter muscles, and tenderness along the anterior border of the masseter muscle. Her maximum mouth-opening was 30 mm. Short TI inversion recovery magnetic resonance imaging showed areas of low intensity at the anterior border of the masseter muscle and around the coronoid process where the temporalis muscle tendon attaches. Consequently, the diagnosis made based on the clinical and radiographic findings was MMTAH. Bilateral coronoidectomy was performed, followed by a rehabilitation program for six months. The maximum opening was maintained at 48 mm two years after the operation. Discussion MMTAH was treated as type 1 TMD until it was recognized as a new disease at the conference for the Japanese Society for Oral and Maxillofacial Surgeons. Since then, many clinicians have become aware of this particular condition, and different treatment modalities have been proposed. Conclusion Clinicians should consider MMTAH as a differential diagnosis when the patient’s chief complaint is gradually decreasing mouth-opening.

AHCC®, a standardized extract of cultured Lentinula edodes mycelia, enhances the therapeutic effects and reduces the adverse effects of chemotherapy. Our previous study reported that treatment with AHCC® downregulated the expression levels of tumor-associated proteins in the gemcitabine-resistant pancreatic cancer cell line, KLM1-R. However, to the best of our knowledge, the role of AHCC® in the inhibition of cell migration remains unexplored. Cortactin (CTTN), an actin nucleation-promoting factor, has been reported to be upregulated and correlated with migration, invasion and metastasis in pancreatic cancer cells. The present study aimed to investigate the effects of AHCC® on cell migration and the protein expression level of CTTN in KLM1-R cells. The Gene Expression Profiling Interactive Analysis (GEPIA2), an online bioinformatics platform, was used to analyze CTTN mRNA expression levels in pancreatic cancer tissues compared with normal pancreatic tissues. CTTN mRNA expression and its association with clinicopathological characteristics were assessed by using the GEPIA2 platform. Next, the effects of AHCC® on KLM1-R cell migration were investigated by in vitro wound-healing assay. The KLM1-R cells were treated with AHCC® at a concentration of 10 mg/ml for 48 h. Western blotting was performed on of cell lysates with anti-CTTN or anti-actin antibodies to assess the protein expression levels of CTTN. Bioinformatics analysis indicated that the mRNA expression level of CTTN increased in pancreatic cancer tissues. The increased mRNA expression levels of CTTN were inversely associated with clinicopathological characteristics, including disease stages and prolonged patient survival times. The administration of 10 mg/ml AHCC® significantly inhibited KLM1-R cells migration compared with controls. The protein expression levels of CTTN were significantly reduced in AHCC®-treated KLM1-R cells, whereas actin expression was not affected. The downregulation of CTTN indicated the anti-metastatic potential of AHCC® in pancreatic cancer cells. Overall, AHCC® may have the potential to be a complementary and alternative therapeutic approach in treating pancreatic cancer.

We reported an extremely rare case regarding intraosseous clear cell variant of mucoepidermoid carcinoma in maxilla.

Introduction Vertical maxillary excess, a common orthodontic problem that leads to long faces and open bites, can be repositioned with a Le Fort I osteotomy. However, the Le Fort I osteotomy poses the risk of a variety of complications including descending palatine artery (DPA) injury. Although several Le Fort I osteotomy modifications were reported to avoid complications associated with this osteotomy, only a few of such studies were conducted in Japan, and details remain scarce. Patients and methods We performed a literature review regarding modifications of Le Fort I osteotomies, including Le Fort I with a horseshoe osteotomy, modified horseshoe osteotomy, unilateral horseshoe osteotomy, pyramidal osteotomy, and U-shaped osteotomy. We identified eight relevant studies conducted in Japan; one study did not provide the number of patients examined. The 77 patients (seven studies) with vertical maxillary excess who underwent orthognathic surgery were ≥17 years old. Discussion There were no severe complications after the modified Le Fort I osteotomies. The postoperative maxillary changes obtained by the conventional horseshoe, modified horseshoe, unilateral type of horseshoe, pyramidal, and U-shaped osteotomies were nearly repositioned to the planned position and remained stable for ≥12 months post-surgery. Conclusion Our review indicates that preserving the DPA can lower the incidence of intra- and post-operative complications. Each modification of the Le Fort I osteotomy (i.e., conventional horseshoe, modified horseshoe, unilateral horseshoe, pyramidal, and U-shaped osteotomy) has its respective advantages and indications., Highlights • Vertical maxillary excess (excessive maxilla growth) impairs functions/aesthetics • Vertical maxillary excess is treated with a conventional Le Fort I osteotomy. • Extensive bone removal for the descending palatine artery with impaction is needed. • Various modifications of Le Fort I provide better maxilla repositioning. • Modifications can preserve the DP artery and minimize complications.

Fresh compact bone, the candidate graft material for bone regeneration, is usually grafted for horizontal bone augmentation. However, the dense calcified structure inhibits the release of growth factors and limits cellular and vascular perfusion. We aimed to create mechano-chemically altered dense skull bone by ultrasonic treatment, along with partial demineralization using commercially available acidic electrolyzed water (AEW). The parietal skull bone of an 11-month-old Wistar rat was exposed and continuously treated with a piezoelectric ultrasonic scaler tip for 1 min, using AEW (pH 2.3) or distilled water (DW, pH 5.6) as irrigants. Treated parietal bone was removed, cut into plates (5 × 5 × 1 mm3), grafted into the back subcutaneous tissues of syngeneic rats, and explanted at 1, 2, and 3 weeks. AEW bone showed an irregular surface, deep nano-microcracks, and decalcified areas. SEM-EDS revealed small amounts of residual calcium content in the AEW bone (0.03%) compared to the DW bone (0.86%). In the animal assay, the AEW bone induced bone at 2 weeks. Histomorphometric analysis showed that the area of new bone in the AEW bone at 2 and 3 weeks was significantly larger. This new combination technique of AEW-demineralization with ultrasonic treatment will improve the surface area and three-dimensional (3D) architecture of dense bone and accelerate new bone synthesis.

AHCC(®), a standardized extract of cultured Lentinula edodes mycelia, enhances the therapeutic effects and reduces the adverse effects of chemotherapy. Our previous study reported that treatment with AHCC(®) downregulated the expression levels of tumor-associated proteins in the gemcitabine-resistant pancreatic cancer cell line, KLM1-R. However, to the best of our knowledge, the role of AHCC(®) in the inhibition of cell migration remains unexplored. Cortactin (CTTN), an actin nucleation-promoting factor, has been reported to be upregulated and correlated with migration, invasion and metastasis in pancreatic cancer cells. The present study aimed to investigate the effects of AHCC(®) on cell migration and the protein expression level of CTTN in KLM1-R cells. The Gene Expression Profiling Interactive Analysis (GEPIA2), an online bioinformatics platform, was used to analyze CTTN mRNA expression levels in pancreatic cancer tissues compared with normal pancreatic tissues. CTTN mRNA expression and its association with clinicopathological characteristics were assessed by using the GEPIA2 platform. Next, the effects of AHCC(®) on KLM1-R cell migration were investigated by in vitro wound-healing assay. The KLM1-R cells were treated with AHCC(®) at a concentration of 10 mg/ml for 48 h. Western blotting was performed on of cell lysates with anti-CTTN or anti-actin antibodies to assess the protein expression levels of CTTN. Bioinformatics analysis indicated that the mRNA expression level of CTTN increased in pancreatic cancer tissues. The increased mRNA expression levels of CTTN were inversely associated with clinicopathological characteristics, including disease stages and prolonged patient survival times. The administration of 10 mg/ml AHCC(®) significantly inhibited KLM1-R cells migration compared with controls. The protein expression levels of CTTN were significantly reduced in AHCC(®)-treated KLM1-R cells, whereas actin expression was not affected. The downregulation of CTTN indicated the anti-metastatic potential of AHCC(®) in pancreatic cancer cells. Overall, AHCC(®) may have the potential to be a complementary and alternative therapeutic approach in treating pancreatic cancer.

BackgroundDNA hypermethylation of tumor suppressor genes is observed in precancerous lesions and oral cancer of individuals with the habits of betel quid (BQ) chewing.SIRT1has been identified as playing a role in the maintenance of epithelial integrity, and its alteration is often related to carcinogenesis. However, the methylation and transcription status ofSIRT1in patients with BQ chewing-related oral cancer has not been investigated. We examined the methylation status ofSIRT1in paraffin-embedded tissue samples of oral squamous cell carcinoma (OSCC) obtained from BQ chewing and non-chewing patients and in tissue samples from healthy control subjects. In addition, we examined whether the hypermethylation ofSIRT1followed by its transcriptional downregulation in the human gingival epithelial cells could be caused by arecoline, a major component of BQ. Furthermore, we investigated the methylation status ofSIRT1in smear samples of macroscopically healthy buccal mucosa from subjects with a habit of BQ chewing.ResultsSIRT1was significantly hypermethylated in tissue samples of OSCC from BQ chewers and non-chewers than in oral mucosa from healthy control subjects. Results also showed that the hypermethylation level ofSIRT1was significantly higher in OSCC of patients with BQ chewing habits than in those of non-chewing habits (p< 0.05). Our in vitro model showed that hypermethylation is followed by downregulation of the transcriptional level ofSIRT1(p< 0.05). The methylation levels ofSIRT1in the smear samples obtained from BQ chewing individuals were significantly higher than those in the samples obtained from individuals that did not chew BQ. The duration of BQ chewing habits was correlated positively to the frequency ofSIRT1hypermethylation (p< 0.05).ConclusionsOur results suggest that DNA hypermethylation ofSIRT1is involved in the occurrence of oral cancer in BQ chewing patients and that hypermethylation in the oral mucosa of BQ chewers could be a predictive marker for the occurrence of malignant transformation. This is the first report that showed DNA hypermethylation in clinically healthy oral epithelium of BQ chewers. Our study shows evidence that DNA hypermethylation may be an early event of oral carcinogenesis prior to observable clinical changes.

BACKGROUND/AIM We have previously reported that treatment of pancreatic cancer cells with active hexose-correlated compound (AHCC), an extract of a basidiomycete mushroom, decreases the levels of tumor-associated proteins including heat-shock protein 27 (HSP27), heat shock factor 1 (HSF1) and sex-determining region Y-box 2 (SOX2). The transmembrane glycoprotein, CUB domain-containing protein 1 (CDCP1) has been reported to be up-regulated in various cancers, and be associated with invasion and metastasis. The aim of this study was to examine the effect of AHCC on the expression of CDCP1 in KLM1-R cells. MATERIALS AND METHODS Gemcitabine-resistant pancreatic cancer cells (KLM1-R) were treated with AHCC (10 mg/ml) for 48 h. Western blot analysis of cell extracts with anti-CDCP1 or anti-actin antibodies was performed to assess the expression of CDCP1. RESULTS Expression of CDCP1 was reduced by AHCC treatment of KLM1-R cells, whereas expression of actin was not affected. The ratio of intensities of CDCP1/actin in AHCC-treated KLM1-R cells was significantly suppressed (p

Background: Betel quid chewing is known as a crucial risk factor for oral diseases such as periodontal diseases, oral cancer, and precancerous lesions in Southeast Asian countries. Although abnormal oral bacterial flora may be linked to betel quid related-oral diseases such as oral cancer, precancerous lesions, and periodontal diseases, little information is available on alterations of their oral flora thus far. To identify these alterations, we analyzed the oral flora in betel quid chewers (BQC) and non-chewers (NC) in Sri Lanka. Methods: Samples obtained from buccal swabs of BQC and NC were analyzed with a next generation sequencer. Data were processed and analyzed using the QIIME software package. Mann–Whitney U test and Permutational multivariate analysis of variance were used for statistical analyses. P values

Adenomatous ductal proliferation/hyperplasia (ADP/H) is a rare hyperplastic condition of the salivary gland. It is mostly associated with other salivary gland pathologies such as tumors and inflammations, and is incidentally found in tissue sections during histopathological examinations of those diseases. Herein, we report a case of ADP/H in the parotid gland not associated with any other pathological lesions, and present a review of the literature on this condition. A 60-year-old Japanese female complained of swelling on the left side of parotid region. Clinical examination revealed a swelling on the lower lobe of the left parotid gland. The lesion was firm but non-tender and was not attached to adjacent structures. A clinical diagnosis of benign salivary gland tumor was reached, and surgical excision was performed under general anesthesia. Histopathological examination revealed an intact parotid gland capsule with isomorphic and basaloid cells within scanty cytoplasm. In addition, an admixture of hyperplasia and proliferation of the intercalated ducts, the presence of zymogen granules, the absence of solid nests, and a peripheral palisaded arrangement of the cells were observed. Based on these findings, a diagnosis of ADP/H was confirmed. ADP/H is a non-tumorous lesion; therefore, tumor involvement should be ruled out before the diagnosis is reached.

Introduction Mucoceles are mucous extravasation phenomena resulting from spontaneous ductal rupture or, less commonly, a traumatic cutting of a salivary excretory duct. Occasionally, the appearance of a mucocele closely resembles a neoplastic lesion, and it can be difficult to diagnose. Presentation of case A 74-year-old Japanese male patient was referred to our clinic with painless swelling related to the upper right canine-premolar area. Preoperative imaging of the lesion revealed that it was fluid-filled and the histopathological biopsy suggested a myxoid tumor. We excised the lesion with the patient under general anesthesia, using safety margins based on the histology of the biopsy specimen to reach the definitive diagnosis and treatment. The final pathological diagnosis was a mucocele in the vicinity with an aberrant small salivary gland. Follow-up visits showed complete healing of the epithelium, and no recurrence has been observed during the subsequent 30 months. Discussion In cases with a difficult definitive diagnosis based on medical history, diagnostic imaging and pathological examination, it is important to proceed carefully with the possibility of a tumor in mind. Conclusion This case emphasizes that some mucous cysts are challenging for clinicians in terms of diagnosis and treatment due to an uncommon presentation., Highlights • Mucoceles are relatively easily diagnosed with a clear clinical picture/history. • Mucocele often occurs on the lower lip due to frequent trauma from biting. • At an unusual site such as gingiva, it is likely to be diagnosed as a neoplasm. • We treated a maxillary gingiva mucocele initially diagnosed as a myxoid tumor.

Background: Bee pollen (BP) has a broad range of beneficial effects on health. The aim of this study was to examine the effect of BP on the oral environment, including the microbiome and antimicrobial peptides. Methods: C57BL/6J mice were randomly divided into two groups: control and BP. The BP group was fed with a 5% BP diet for 1 month. Swabs from the oral and buccal mucosa and samples of the intestinal stool were collected. Genomic DNA was extracted and the microbiome was analyzed via 16S rRNA sequencing. Results: BP inhibited the growth of P. gingivalis at a concentration of &gt, 2.5%. The metagenomic study showed that the abundance of genus Lactococcus was significantly elevated in the oral and intestinal microbiomes of the BP group when compared to those of the control group. Significant alterations in alpha and beta diversity were observed between the oral microbiomes of the two groups. The mRNA levels of beta-defensin-2 and -3 were significantly upregulated in the buccal mucosa of the BP group. Conclusion: A BP diet may have a beneficial effect on oral and systemic health by modulating the bacterial flora and antimicrobial peptides of the oral cavity. Further investigations are needed to clarify how a BP diet affects overall human health.

Carcinoma follows a course of multiple changes that are affected by several important factors, with epigenetic silencing of the promoter gene being one of them. A series of studies have suggested that epigenetic changes in the anti-aging gene Klotho may be one of the emerging areas of concern in the study of carcinogenesis. We hypothesized that epigenetic silencing of Klotho due to hypermethylation of DNMT3a may be one of the causes of carcinoma in the oral and maxillofacial region. In this study, we analyzed the immunohistochemical expressions of Klotho and DNMT3a in tissues obtained from oral dysplasia and oral squamous cell carcinoma. Our results showed increased immune expression of DNMT3a, and decreased expression of Klotho in cells of the cancer tissues when compared with those in the dysplasia and healthy control samples. Chi-square tests complemented by adjusted residual analysis revealed significantly higher number of Klotho-positive and DNMT3a-negative cases in healthy controls, Klotho-negative and DNMT3a-negative cases in ODL, and Klotho-negative and DNMT3a-positive cases in OSCC when compared with the other types among the three groups (X 2 = 46.66, p

Introduction: In cases with gummy smile or asymmetry of the maxilla, superior repositioning of the maxilla is required. If superior repositioning by a Le Fort I osteotomy alone is difficult, a horseshoe Le Fort I osteotomy can be used. Presentation of cases: Case 1: A 24-year-old Japanese woman patient presented with a gummy smile and an open bite. After we performed a horseshoe Le Fort I osteotomy, the maxillary segment was repositioned superiorly 3.0 mm at upper tooth number 1 (U1) and 5.0 mm at upper tooth number 6 (U6). Case 2: A 21-year-old Japanese man presented with severe facial asymmetry. After we performed a unilateral modified horseshoe Le Fort I osteotomy, the maxillary segment was superiorly repositioned 6.0 mm at the right U6. Discussion: This procedure eliminated the risk of intraoperative bleeding because it was unnecessary to remove bones around the descending palatine artery, and it was possible to maintain the chamber size of the nasal cavities. Conclusion: The horseshoe Le Fort I osteotomy is a reliable technique for cases with severe gummy smile or asymmetry of the maxilla.

Secretory carcinoma (SC) of the salivary gland was recently added to the fourth edition of the World Health Organization classification of head and neck tumors. Some salivary tumors, including acinic cell carcinoma, have been reclassified as SC. Most of these tumors are located on the parotid gland with very few cases reported in the minor salivary glands of the buccal mucosa. Herein, we present a case of SC of buccal mucosa, which appeared clinically as a benign lesion in a 54-year-old Japanese female patient. Histopathologically, the tumor cells presented with an eosinophilic cytoplasm with microcytic structure along with eosinophilic secretory material and hemosiderin deposit. Immunohistochemical staining revealed strongly positive staining for S100, vimentin, and mammaglobin and negative staining for DOG-1. The tumor was finally diagnosed as secretory carcinoma of the buccal mucosa. We present a review of the medical literature of SC arising from minor salivary glands. We found only 15 cases of SC of buccal mucosa out of 63 cases of SC in the minor salivary glands. They showed good prognoses and only one case of SC in the buccal mucosa exhibited local recurrence and lymph node metastases.

Betel quid chewing is implicated in the high prevalence of oral cancer in Southeast Asian countries. One of the major components of betel quid is arecoline. In the present study, in order to characterize the association between chronic arecoline stimulation and carcinogenesis the expression level of matrix metalloproteinase (MMP)-2, MMP-9, tissue inhibitor of metalloproteinase (TIMP)-1 and TIMP-2 mRNA in human gingival epithelial progenitor cells (HGEPs) stimulated with arecoline was assessed. The HGEPs were alternated between 3 days of incubation with arecoline (50 µg/ml), and 3 days without arecoline, for up to 30 days. The expression levels of the MMPs and TIMPs in the cells stimulated with arecoline were evaluated by reverse transcription-quantitative polymerase chain reaction at 18 and 30 days. The expression of MMP-9 mRNA in the experimental group was significantly increased compared with in the control group (P

Microcracks and trabecular fractures can be observed in physiological bone. Biomimetic hydroxyapatite (HAp) scaffolds have been strongly needed in bone regenerative medicine. We have been developing the combination method of the partial dissolution-precipitation techniques involving the stirring-supersonic treatment in 1.7×10-2 N HNO3 solution containing Ca2＋and PO43- ions to improve the surface and the bulk of commercially available synthetic HAp block (82.5% in porosity, 50-300µm in macropore). The modified HAp was named as a partially dissolved and precipitated HAp (PDP-HAp). The aims of this study are to characterize the PDP-HAp and to observe cell response for the ceramics in rat scalp tissue. The PDP-HAp exhibited the macropore sizes of 50-200µm, the porosities of 85-90%, and the specific surface areas of 1.0-2.0 m2･g-1, with many micro-cracks. Twenty rats were divided into 2 groups. At 9 months, bone induction occurred inside the many pores in the PDP-HAp group, while bone and cartilage were not found in the HAp group. We believe that osteoinduction by the PDP-HAp is different from the process of BMP-loaded HAp-induced bone formation. The PDP-HAp might be applied as potential ceramics with osteoinductive properity and excellent biocompatibility in difficult bone regenerative cases.

Human β-defensin-2 (hBD-2) is a type of epithelial antimicrobial peptide. The expression level of hBD-2 mRNA is lower in oral carcinoma cells (OCCs) than in healthy oral epithelium. Yet, it is still unknown how hBD-2 expression is downregulated in OCCs. The present study investigated DNA hypermethylation of hBD-2 in OCCs and the effect of the demethylation and increased expression of hBD-2 on cell proliferation and invasion. Six different types of oral carcinoma cell lines (OSC-19, BSC-OF, SAS, HSC-2, HSC-4 and HSY) and normal oral keratinocytes (NOKs) were used. The expression levels of hBD-2 in all OCCs were significantly lower than that in the NOKs. Treatment with DNA methyltransferase inhibitor, 5-aza-dC, at the concentration of 50 μM significantly induced upregulation of expression of hBD-2 in the OCCs. Using methylation-specific PCR, DNA hypermethylation was observed in all OCCs. These results suggest that DNA hypermethylation is, at least in part, involved in the decreased expression of hBD-2 in OCCs. We examined the effect of 5-aza-dC on the cell proliferation and invasive ability of OCCs. The cell invasion assays showed that the number of OCCs treated with 5-aza-dC on the filters was significantly lower than that of the controls. We examined whether increased expression of hBD-2 generated by gene transfection inhibited the proliferation and invasion of SAS cells. The number of SAS cells exhibiting increased expression of hBD-2 on the filters in the invasion assay were significantly lower on day 7 when compared with the control. hBD-2 may function as a tumor suppressor. Increased expression of hBD-2 induced by demethylation or increased expression generated by gene transfection may be useful therapeutic methods for oral carcinoma.

Background Osseous choristoma is a very rare, benign lesion in the maxillofacial region. It appears as a benign mass of normally matured bony tissue covered by the normal epithelium of the tongue. It is usually seen in front of the foramen cecum of the tongue. Surgical excision is the treatment of choice with an excellent prognosis and there have been very few cases of recurrence. Case presentation Here we present two cases of osseous choristoma on the dorsum of the tongue. Case 1 was a 15-year-old Japanese girl who presented with a painless but gradually growing swelling on the dorsum of her tongue approximately 1 year before her admission. Case 2 was a 21-year-old Japanese woman with a complaint of pain in the lower left, posterior side of her mouth. Histological findings showed that both lesions were composed of well-organized, mature, compact bone beneath the oral mucosal membrane. Subsequent to simple surgical excision, no recurrence of the lesions was observed after the follow-up period. Previous literatures have proposed both malformation and trauma hypotheses as the etiopathologies of osseous choristoma. However, the histopathological findings of the two cases in the present study do not support the trauma hypothesis. Conclusions Although osseous choristoma is clinically a benign condition, the underlying histopathological processes are important. The outcome of aberrant formation of calcified tissue in the vicinity of vital structures such as nerves and blood vessels may be of clinical significance.

We previously reported functionally graded hydroxyapatite (fg-HAp) with the characteristics of blood permeability into the bulk and osteoinduction by adding low dose of bone morphogenetic protein-2 (BMP-2). In this study, we evaluated the bioactivity of the obtained dense HAp bodies in a simulated body fluid (SBF) and the osteoinductive activity with or without SBF treatment in vivo. The fg-HApSBF was prepared by immersing the fg-HAp in the SBF solution at 14 days and the surface structure was observed by SEM. The fg-HApSBF showed fine bone-like crystal on the surface of the HAp. Ectopic bone formation occurred in the fg-HAp/BMP-2 (1.0, 0.5μg) system at 3 weeks, while only in the fg-HApSBF/BMP-2 (1.0μg), bone induction was found. The histological finding showed body fluid permeation into the fg-HApSBF bulk and bone formation were obserbed.

Our approach to the design of biological material scaffolds for bone regeneration is the creation of cell environments that mimic natural tissues. Recently, we confirmed hitologically that the material surfaces of conventional, nonabsorbable ceramics shed body fluid. For bone engineering, it is known that ideal scaffolds should be bioabsorbable, mimetic, and hydrophilic materials that allow for the permeation of liquid components, such as blood and/or extracellular fluid. In our previous study showed functionally graded hydroxyapatite (fg-HAp) absorbed body fluid including albumin. In this study, we investigated the behavior of human blood adsorption to the fg-HAp by using the scanning electron microscope (SEM). The adsorption of the platelets and the formation of the fibrinous network were observed in the fg-HAp group incubated 20 minutes.

Background: Oral squamous cell carcinoma and the most common oral pre-malignancies appear to be related to the habit of betel-quid chewing in Sri Lanka. Although hypermethylation of the tumour suppressor genes in oral cancer have been well documented, little information has been available concerning hypermethylation in oral pre-cancerous lesions. In the present study, we investigated the hypermethylation of p14, p15 and p16 in pre-cancerous lesions including epithelial dysplasia and submucous fibrosis. Methods: All samples were obtained from patients with a betel-quid chewing habit in Sri Lanka. Sixty-four patients were clinically diagnosed with leukoplakia, and histopathologically diagnosed with mild or severe dysplasia. Ten patients were diagnosed with submucous fibrosis without epithelial dysplasia. CpG island hypermethylation was assessed by a methylation-specific PCR method. Immunohistochemical staining was performed using anti-p53 antibodies. Results: A high frequency of hypermethylation of p14, p15 and p16 was detected in the pre-cancerous lesions, although no hypermethylation was found in normal epithelium. The frequency of hypermethylation was higher than that of positive staining for p53 mutation except in the case of p16 in mild dysplasia. No significant correlation was observed between p53-positive reactions and hypermethylation in any lesions. The hypermethylation was highly detectable even in p53-negative lesions, suggesting that hypermethylation of p14, p15 and p16 occur regardless of whether the lesions have p53 mutations or not. Conclusions: The present study indicates that hypermethylation may be involved in the pathogenesis of oral pre-cancerous lesions associated with betel-quid chewing in Sri Lanka.

Betel-quid chewing, which is closely related to the high incidence of oral cancer, is prevalent in Sri Lanka. p63 has a remarkable structural similarity to p53, suggesting an aberrant expression in oral cancer. Using anti-p63 antibody and immunohistochemistry, the present study investigated the expression pattern of p63 in oral epithelial lesions, including different types of squamous cell carcinoma (SCC), different grades of epithelial dysplasia, and submucosal fibrosis associated with betel-quid chewing. Nuclear immunoreactivity for p63 was detected in all the cases, including normal oral epithelium and epithelial lesions. In normal oral epithelium, nuclear positivity for p63 was observed in some of the basal cell layers and focally in the parabasal layer. Nuclear positivity increased in the epithelial lesions. The percentage of positive nuclei in the epithelial lesions was significantly higher than in normal epithelium (P < 0.01) and was also significantly higher in oral submucosal fibrosis than in epithelial dysplasia (P < 0.05). The results indicate that the overexpression of p63 in oral precancerous lesions and SCC in betel-quid chewers in Sri Lanka may be a useful marker for oral precancerous lesions.

Ameloblastic carcinoma rarely arises in the oral cavity and is classified into primary type and secondary type. No report, however, has proposed the malignant transformation of a benign tumor into an ameloblastic carcinoma. We report the case of a secondary ameloblastic carcinoma that showed pathological evidence of transformation from a benign to a malignant tumor in the right mandible of a 73-year-old man.The patient was referred to a dental clinic because of swelling of the right side of the mandible. Biopsy yielded a diagnosis of ameloblastoma, plexiform type. A partial resection of the right side of the mandible was performed under general anesthesia in April 2003. The postoperative pathological diagnosis was ameloblastic carcinoma. The patient was given a definitive diagnosis of secondary ameloblastic carcinoma, because evidence of malignant transformation was observed. No recurrence and no metastasis have occurred for 3 years.

A total of 55 patients who underwent orthognathic surgery from July 2002 to June 2005, were observed clinicostatistically. The results may be summarized as follows: 1. There were 11 males and 44 females. 2. The average age was 27.7 years, with an average of 22.3 years for males and 28.8 years for females. 3. The diagnosis of mandibular prognathism was made for 50 of the patients (90.9%). Sagittal split ramus osteotomy (SSRO) was performed on 37 (67.3%) cases. 4. The mean time of operation for SSRO was 2hr. 22min±1hr, and 11min and 4hr. 26min±1hr. 29min for the SSRO+Le Fort I osteotomy. 5. The mean blood loss was 130.9±157.9ml for SSRO and was 220.6±143.7ml for SSRO+Le Fort I osteotomy.

北海道医療大学歯学部付属病院の外来は1978年12月に開始し,入院病棟は1980年6月に24床で開始した.これまでの25年間における病棟入院患者の臨床統計的観察を行ったので報告する.結果は以下に示す.1.総入院患者数は3055例で総歯科新患の10.8%を占めていた.2.口腔外科疾患別では,顎変形症が最も多く393例で入院患者の12.9%を占めていた.3.病床稼働率は17.7%で,平均在院日数は14.2日で経年的に減少傾向にあった.4.25年間の入院診療報酬額は9億5715万円で歯科診療報酬額の20.4%を占めていた., The outpatient division of the Dental School hospital of the Health Sciences University of Hokkaido started in December 1978, and a hospitalization ward started with 24 beds opened in June 1978, and closed in April, 2005. Clinico-statistical observations for 25 the years while the inpatient division, was opened were evaluated. 1. The total number of inpatients was 3055, and comprised 11.8% in all initial patients of the dental hospital for the 25 years. 2. Patients with jaw deformities were the most common, 393 and comprised 12.4% of all hospitalized patients with oral and maxillofacial surgical complaints. 3. The rate of occupiod beds the operating bed ratio was 17.7% and the average length of hospitalization was 14.2 days. This number showed a tendency to decrease over the years. 4. The income from hospitalized care was 957.15 million yen and it comprised 20.4% of the total income of the dental department.

We have previously reported that malotilate (MT) inhibited the invasion and metastasis of rat mammary carcinoma cells through the modification of host endothelial cells. In this study, we examined the inhibitory effects of MT on invasion of human cancer, using five oral squamous cell carcinoma cells (SAS, Ca9-22 and HSC-2, -3 and -4). MT did not affect the growth of these tumor cells and the invasion of reconstituted basement membrane, Matrigel. In an in vitro invasion assay using rat lung endothelial (RLE) cells, invasion of tumor cells which had been treated with MT (10 ng/ml, 24 h) was not affected; however, when RLE cells had been treated with MT, invasion was significantly inhibited in three cell lines (SAS, Ca9-22 and HSC-4) and a tendency to inhibition was also observed in other cell lines. Electron-microscopical examination of the RLE monolayer treated with MT (MT-RLE) showed the development of gap and tight junction-like structures. Subsequently, junction-associated proteins, connexin 43, zonula occludin and desmoglein, were examined by Western blotting. Protein levels of connexin 43 and zonula occludin were elevated dose dependently, and connexin 43 was chronologically enhanced by MT whereas desmoglein was not. The enhanced gap junctional communication of MT-RLE cells was observed in the scrape-loading assay using lucifer yellow CH. These results suggest that MT promotes the development of cell-to-cell adhesion, e. g. gap junction and tight junction in endothelial cells, resulting in the inhibition of invasion by the tumor cells.