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Simple Summary: In recent years, much research has focused on how exercise improves cancer prognosis and how the protein myokine, which is associated with exercise, inhibits cancer progression. However, there have been few detailed studies on oral cancer. This study is the first to show that exercise inhibits the progression of oral cancer. While other studies have shown that exercise suppresses growth, decreases the tumor formation rate, or improves survival in patients with other organ cancers, this study showed that exercise inhibits tumor formation and growth in oral cancer and prolongs survival. Furthermore, while many studies have demonstrated an indirect immune-mediated mechanism by which exercise suppresses cancer, this study suggests the additional possibility that myokines released by exercise directly affect oral cancer cells. This study has the above novelties. Major advances have been made in cancer treatment, but the prognosis for elderly cancer patients with sarcopenia and frailty remains poor. Myokines, which are thought to exert preventive effects against sarcopenia, have been reported to be associated with the prognosis of various cancers, but their effect on head and neck squamous cell carcinoma (HNSCC) is unknown. The aim of this study was to clarify the influence of exercise on the control of HNSCC and to examine the underlying mechanism involved. Mice were injected with HSC-3-M3 cells, a human cell line of highly metastatic and poorly differentiated tongue cancer, at the beginning of the study. Just prior to transplantation, blood was collected from the mice, and the levels of myokines were measured by ELISA. Oncostatin M (OSM), a selected myokine, was added to HSC-3-M3 cells, after which the cell proliferation ability, cell cycle, and protein expression were analyzed in vitro. Tumor cell viability was lower (control: 100%, exercise: 75%), tumors were smaller (control: 26.2 mm3, exercise: 6.4 mm3), and survival was longer in the exercise group than in the control group in vivo. OSM inhibited HSC-3-M3 cell proliferation in a concentration-dependent manner in vitro. The addition of OSM increased the proportion of cells in the G0/G1 phase, decreased the proportion of cells in the G2/M phase, and increased the expression of the CDK inhibitors p21 and p27. These results indicate that exercise may directly inhibit the proliferation of HNSCC cell lines via OSM. [ABSTRACT FROM AUTHOR]

Objective: To quantitatively assess three-dimensional (3D) soft tissue facial asymmetry in patients with unilateral cleft lip and palate (UCLP) who have undergone primary lip repair. Design: Clinical, retrospective, comparative, methodological study. Patients/Participants: Twenty patients with UCLP were selected after a review of the records. Inclusion Criteria: Complete UCLP; surgically treated without secondary repair. An age-matched and sex-matched Control group was employed. Main Outcome Measures: A 3D facial symmetry plane (FSP) was obtained by superimposing the point clouds of the original 3D facial image excluding the surgical site and including lip and nose areas and those of a mirrored facial image using the iterative closest point (ICP) adjustment method. The discrepancies in the depth and angle of the normal vector of the facial surface of each point cloud between right and left sides (cleft and non-cleft sides in the UCLP group, respectively) based on FSP were calculated. Results: Facial asymmetry in the UCLP group was significantly greater than in the Control group regarding both the discrepancies in the depth (1.34 ± 0.62, 0.73 ± 0.32 pixels, respectively) (P =.0004) and surface angle (18.0 ± 5.88, 12.8 ± 4.0°, respectively) (P =.0024). Biaxial assessment of the discrepancies in the depth and surface angle allowed us to visually extract UCLP patients with greater facial asymmetry. Conclusions: Facial asymmetry analysis based on 3D FSP effectively facilitates the facial asymmetry quantification and soft tissue surgical outcome evaluation in patients with UCLP. [ABSTRACT FROM AUTHOR]

Aim: Although ameloblastoma is a benign tumor, its local invasiveness and recurrence rate are both high. Thus, the regulation of the invasiveness of ameloblastoma cells into the surrounding tissue is required to understand its pathogenesis. Ameloblastoma cells secrete several matrix metalloproteinases (MMPs); however, the factors inducing their secretion remain unclear. We previously suggested that interleukin (IL)‐1α derived from ameloblastoma cells triggers the production of inflammatory cytokines by stromal fibroblasts. In this study, we estimated whether IL‐1α affects the behavior of ameloblastoma cells. Methods: The gene expression of MMP‐9 was assessed by real‐time reverse transcription–polymerase chain reaction (RT‐PCR). The secretion of MMP‐9 was assessed by enzyme‐linked immunosorbent assay (ELISA). The motility of AM‐3 ameloblastoma and Raw264.7 （macrophage derived cells） cells and the invasiveness of AM‐3 cells were calculated using the Boyden chamber. The invasiveness of AM‐3 cells toward human foreskin fibroblast (HFF)‐2 fibroblasts were assessed using modified double‐layered collagen gel hemisphere (DL‐CGH). Results: The mRNA expression and secretion of MMP‐9 by AM‐3 ameloblastoma cells were significantly increased by IL‐1α stimulation. The motilities of AM‐3 and RAW264.7 macrophage derived cells and the invasiveness of AM‐3 cells were significantly enhanced by IL‐1α and suppressed by an IL‐1 receptor antagonist (IL‐1Ra). The invasiveness of AM‐3 cells towards HFF‐2 fibroblasts in a DL‐CGH model was suppressed by a treatment with IL‐1Ra or an anti‐IL‐1α neutralizing antibody. Conclusion: IL‐1α itself or the IL‐1α‐dependent production of unidentified chemo attractants by stromal cells may be important for the local invasiveness of ameloblastoma cells, and IL‐1α might be a therapeutic target of the ameloblastoma. [ABSTRACT FROM AUTHOR]

Autologous bone grafting is the primary method for treating alveolar clefts. However, bone grafting materials are desired as alternatives to autogenous bone to reduce surgical invasiveness. Here, we present an animal study evaluating the effect of carbonate apatite (CA) on the spontaneous eruption of permanent teeth. The bone grafting materials included CA, natural bovine bone (BB), and hydroxyapatite (HA). In 15 8-week-old male beagle dogs, the left mandibular deciduous premolars (DP) two and three were extracted and subsequently filled with CA, BB, and HA. The animals were euthanized after a predetermined number of days, and samples were collected for microcomputed tomography and histological evaluation. Spontaneous eruption of the succeeding permanent teeth (P3 and P4) was observed in the CA group at 14 weeks. Delayed eruption of the succeeding permanent teeth was observed in the BB and HA groups. CA could serve as a viable alternative to autogenous bone for treating alveolar clefts. [ABSTRACT FROM AUTHOR]

Aim: It is widely known that orthognathic surgery affects changes in facial soft tissue morphology. However, the effect of orthognathic surgery on facial expression remains to be verified. The purpose of this study was to examine the pros and cons of the effects of orthognathic surgery on facial expression in skeletal Class III patients. Methods: Fifteen patients (5 males, 10 females) were captured pre‐surgery and at 6 months' post‐surgery using Kinect camera while performing facial soft tissue movements (opening mouth, smiling, and blowing). The three‐dimensional coordinates, amount of movement, and velocity of the eight facial soft tissue landmarks during motion were obtained. As controls, 15 Japanese healthy volunteers with Class I occlusion were included. Results: Differences in the three‐dimensional coordinate values during movement were confirmed, and there were some landmarks in the lower face region of the preoperative patient that showed significant differences compared with the control. Total amount of movement and velocity of Pogonion during smiling were significantly smaller than those of the control group, but there was no significant difference between the control and postoperative groups at any landmarks after surgery. It was suggested that patients with skeletal Class III may have limited movement in some movements, and it was confirmed that with orthognathic surgery, the aspect of movement would be similar to that of the control. Conclusions: Orthognathic surgery may be beneficial to the facial muscles without limiting facial movements. [ABSTRACT FROM AUTHOR]

Lipoteichoic acid (LTA) and lipopolysaccharide (LPS) are cell wall components of Gram-positive and Gram-negative bacteria, respectively. Notably, oral microflora consists of a variety of bacterial species, and osteomyelitis of the jaw caused by dental infection presents with symptoms of bone resorption and osteosclerosis. However, the effects of LTA and LPS on osteogenic differentiation have not yet been clarified. We examined the effects of LTA and LPS on osteoblasts and found that LTA alone promoted alizarin red staining at low concentrations and inhibited it at high concentrations. Additionally, gene expression of osteogenic markers (ALP, OCN, and OPG) were enhanced at low concentrations of LTA. High concentrations of LPS suppressed calcification potential, and the addition of low concentrations of LTA inhibited calcification suppression, restoring the gene expression levels of suppressed bone differentiation markers (ALP, BSP, and OCN). Moreover, the suppression of p38, a signaling pathway associated with bone differentiation, had opposing effects on gene-level expression of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), suggesting that mixed LTA and LPS infections have opposite effects on bone differentiation through concentration gradients, involving inflammatory markers (TNF-α and IL-6) and the p38 pathway. [ABSTRACT FROM AUTHOR]

Background: Currently, patients with dysphagia are receiving dietary management that deviates from their original swallowing function. Objective: To evaluate the clinical significance of fibreoptic endoscopic evaluation of swallowing (FEES) and dietary intervention (DI) by multi‐professional collaboration during visit care for determining the actual oral intake status in patients with dysphagia. Methods: Five hundred and eighteen patients with dysphagia underwent FEES, focusing on the penetration‐aspiration scale, and DI. Oral intake status was categorised using the functional oral intake scale (FOIS). FOIS scores at the first visit, after FEES, and at the reassessment were compared. Results: At the first visit, 34.7% of the patients had an FOIS score of level 1 (no oral intake) and 65.3% had a score of level 2 or higher (capable of oral intake). Following FEES, 7.1% of patients had an FOIS score of level 1, and 44.4% had a score of level 2 with resumption of oral intake. At the reassessment, 489 patients (94.4%) were capable of oral ingestion (FOIS level 2 or higher). There were significant differences between the distributions of FOIS scores at the first visit and following FEES (P <.01) and between those at the first visit and at the reassessment (P <.01). Regarding tube feeding, 17 (5.9%) of 289 patients, who had received tube feeding at the first visit, were completely capable of oral intake following FEES and at the reassessment. Conclusion: Appropriate evaluation of swallowing function using FEES and DI helps to understand the definite swallowing function in patients with dysphagia. [ABSTRACT FROM AUTHOR]

Tumor eradication and esthetic and functional recovery of upper jaw defects are two of the greatest challenges in the treatment of an extensive maxillary tumor affecting the paranasal sinus. Here, we report a case of successful treatment of an advanced maxillary ameloblastoma extending to the maxillary and ethmoid sinuses and affecting the orbital floor. A 45-year-old man, who presented with a large mass in the left maxilla and a marked swelling of the cheek was referred to our department. He had a medical history of being given a diagnosis of ameloblastoma in the maxilla 13 years ago, but he had not undergone any treatment. Pre-operative radiographic examinations, CT, and MRI revealed a large tumor destroying the maxillary bone and extending into maxillary and ethmoid sinuses. The left nasal cavity was completely obstructed, and the bone of the orbital floor was lifted and deformed. After confirming the tumor as ameloblastoma, excision of the total left maxilla, palate, and orbital floor bone including the tumor extending to the nasal cavity and ethmoid sinus was carried out in joint surgery with an otolaryngologist. The surgical wound of the orbital floor and in the buccal area was covered by a forearm flap and skin graft in order to maintain a direct view of possible tumor recurrence near the skull base. Two years after the operation, there was no recurrence of the tumor. Disturbance of eyeball movement was not detected. Occlusal and speech functions were recovered using a maxillofacial prosthesis made by a prosthodontist. [ABSTRACT FROM AUTHOR]

The aim of this retrospective cohort study was to compare the recurrence rate and speech outcomes between two techniques for palatal fistula closure of cleft palate (CP). Patients with CP who underwent secondary palatal fistula closure using the single hinge-flap method with double-breasted mattress suture (hinge-flap group) and those who were treated with the conventional sliding palatal flap method (sliding-flap group) were retrospectively evaluated for demographic and perioperative variables. Recurrence rate of palatal fistula, perceptual speech outcomes, and nasalance scores were further reviewed in patients who met the inclusion criteria. A total of 31 patients, 21 in the hinge-flap group and 10 in the sliding-flap group, were included in this study. The fistula recurrence rate in the hinge-flap group (0%) was significantly lower than that in the sliding-flap group (30.0%) (P = 0.027). In the speech assessment, hypernasality and nasalance scores decreased post-operatively in both groups and significance was observed in the hinge-flap group (P = 0.013, P < 0.001, respectively). Articulation disorders were significantly improved in the hinge-flap group (P = 0.001). Within the limitations of the study it seems that the single hinge-flap method with double-breasted mattress suture should be preferred whenever appropriate. [ABSTRACT FROM AUTHOR]

The present study investigated the wound healing process in a rat skin wound model dressed with a hexanoyl group‐modified alkaline‐treated gelatin porous (HxAlGltn) film with angiogenesis‐inducing and strong bioadhesive properties or a collagen sponge (CS). A circular 10‐mm full‐thickness skin defect was created on the backs of 8‐week‐old rats and then dressed with a HxAlGltn film (HxAlGltn group), collagen sponge (CS group), and no dressing (control group). Wound distances and areas were assessed macroscopically at specific time points after surgery, the lengths and thicknesses of the neo‐epithelium histologically, and α‐smooth muscle actin (α‐SMA), collagen type I, and fibronectin immunohistochemically. Wound distances and areas were significantly greater in the HxAlGltn group than in the CS and control groups. The expression of α‐SMA in myofibroblasts was significantly weaker in the HxAlGltn group than in the other groups on day 7. Furthermore, angiogenesis was prominent on days 4 and 7 in the HxAlGltn group. No significant differences were observed in the length of the neo‐epithelium between all groups, whereas the thickness of the neo‐epithelium was greater in the HxAlGltn group than in the CS group. The present results suggest the potential of the HxAlGltn film as a dressing material in the wound healing process of full‐thickness skin defects because it reduces scar contraction and promotes angiogenesis more than CS. [ABSTRACT FROM AUTHOR]

Objective: There is debate on the reliability of the Americleft Yardstick (AY) global nasolabial appearance assessment method. The objective was to analyze the effect of the additional basal view (BV) feature on the reliability of the AY method for Japanese children with complete cleft lip and palate (CUCLP). Design: Blind retrospective analysis of clinical records on 43 patients (5- to 7-year-old) with nonsyndromic CUCLP who underwent primary lip repair from 2005 to 2011. Main Outcome Measure: Color pictures published in AY and Rubin's studies were used as reference pictures. Patients' photographs were cropped and rated on a 5-point scale for the vermilion border (VB), nasolabial frontal (NLF), and nasolabial profile (NLP) according to AY with/without BV assessment by Rubin's methods. Rating was performed twice by 3 oral surgeons. Intra- and inter-rater reliabilities were analyzed using weighted κ, and correlations between BV and other features were analyzed. Results: Overall average assessment scores were 2.742 (0.573) with AY and 2.702 (0.489) with AY+BV methods (P =.728). Average intra-rater reliabilities were 0.605 and 0.611 and average inter-rater reliabilities were 0.525 and 0.48 with AY and AY+BV, respectively. Inter-rater reliability was the lowest for NLP. ρ scores between BV versus VB, NLF, and NLP were 0.025, 0.659, and 0.092, respectively. Conclusions: Present study demonstrates moderate intra- and inter-rater reliabilities obtained with the AY assessment method for Japanese children with CUCLP. Nasolabial profile standard ambiguity may lead to the poor reliability of AY assessment. Addition of the BV feature does not improve overall reliability. [ABSTRACT FROM AUTHOR]

Objective: To visualize and quantitatively analyze facial surface asymmetry following primary cleft lip repair in patients with unilateral cleft lip and palate (UCLP) and to compare this with noncleft controls. Design: Retrospective comparative study. Patients: Twenty-two patients with complete UCLP who underwent primary lip repair from 2009 to 2013 were enrolled in this study. The preserved 3-dimensional (3D) data of 23 healthy Japanese participants with the same age were used as controls. Interventions: All patients had received primary labioplasty in accordance with Cronin triangular flap method with orbicular oris muscle reconstruction. Main Outcome Measures: Shadow and zebra images established from moiré images, which were reconstructed from 3D facial data using stereophotogrammetry, were bisected and reversed by the symmetry axes (the middle line of the face). The discrepancies of the gravity and density between cleft and noncleft sides in 2 regions of interest, facial and lip areas, were then calculated and compared with those of healthy participants. Results: In the UCLP group, the mean discrepancies of gravity on shadow and zebra images were 1.76 ± 0.70 and 2.63 ± 1.72 pixels, respectively, in the facial area and 1.31 ± 0.36 and 3.83 ± 2.08 pixels, respectively, in the lip area. There was a significant difference in the mean discrepancies of gravity and density on zebra images in the lip area between the UCLP and control groups. Conclusions: Our image analysis of digital facial surface asymmetry in patients with UCLP provides visual and quantitative information, and it may contribute to improvements in muscle reconstruction on cleft lip repair. [ABSTRACT FROM AUTHOR]

Purpose: To develop criteria for the analysis of upper lip configuration of patients with cleft lip while they produce various facial expressions by comparing the 3-dimensional (3D) facial morphology of healthy Japanese adults and patients with cleft lip.Patients and Methods: Twenty healthy adult Japanese volunteers (10 men, 10 women, controls) without any observed facial abnormalities and 8 patients (4 men, 4 women) with unilateral cleft lip and palate who had undergone secondary lip and nose repair were recruited for this study. Facial expressions (resting, smiling, and blowing out a candle) were recorded with 2 Artec MHT 3D scanners, and images were superimposed by aligning the T-zone of the faces. The positions of 14 specific points were set on each face, and the positional changes of specific points and symmetry of the upper lip cross-section were analyzed. Furthermore, the configuration observed in healthy controls was compared with that in patients with cleft lip before and after surgery.Results: The mean absolute values for T-zone overlap ranged from 0.04 to 0.15 mm. Positional changes of specific points in the controls showed that the nose and lip moved backward and laterally upward when smiling and the lips moved forward and downward medially when blowing out a candle; these movements were bilaterally symmetrical in men and women. In patients with cleft lip, the positional changes of the specific points were minor compared with those of the controls while smiling and blowing out a candle. The left-versus-right symmetry of the upper lip cross-section exceeded 1.0 mm in patients with cleft lip, which was markedly higher than that in the controls (0.17 to 0.91 mm). These left-versus-right differences during facial expressions were decreased after surgery.Conclusion: By comparing healthy individuals with patients with cleft lip, this study has laid the basis for determining control values for facial expressions. [ABSTRACT FROM AUTHOR]

Abstract: In this study, we evaluated the three-dimensional (3D) soft tissue configuration of Japanese females with/without jaw deformity in order to establish the polygonal view of facial soft tissue deformity three-dimensionally. A polygonal chart was applied to assess the outcomes of orthognathic surgery for patients with mandibular hyperplasia with/without deviation. The study included 20 Japanese females with mandibular hyperplasia with/without deviation. All patients received mandibular setback surgery, and 3D measurements were carried out pre-operation, and at 1, 3 and 6 months postoperatively using a non-contact laser scanning system. Eighteen soft tissue landmarks were set on each 3D image and used to calculate a set of selected parameters. As controls, 20 Japanese females with class I occlusion were included. A polygonal chart was constructed based on the mean and S.D. of the control group. Patients with mandibular protrusion characteristically demonstrated significant variances in the items around the lower face. In asymmetric patients, deviation in the mental area disappeared postoperatively, but a small deviation remained when compared to the controls. The method used in this study seems to be a useful index for diagnosis and as a treatment plan for patients with mandibular hyperplasia with/without deviation. [Copyright &y& Elsevier]

Simple Summary: As sarcopenia has been shown to be associated with a variety of functional impairments and increased mortality, it has become increasingly important to evaluate sarcopenia comorbidity in oral squamous cell carcinoma (OSCC). We assessed sarcopenia in patients with OSCC in a way that is feasible in daily practice and retrospectively evaluated its impact on prognosis. Patients with both low quality and low quantity of cervical muscles had a significantly worse prognosis. Assessing sarcopenia by evaluating both the quality and quantity of preoperative cervical skeletal muscle mass may be useful in optimizing the treatment of patients with OSCC without requiring additional imaging or patient burden. Accumulating evidence has shown that sarcopenia in patients with oral squamous cell carcinoma (OSCC) is at a risk of poor prognosis. There is no universal consensus on how to assess sarcopenia in patients with OSCC in daily practice. It is important to validate the usefulness of sarcopenia assessment from cervical muscles, which are frequently used in routine clinical practice in patients with OSCC. In this study, we investigated whether preoperative lumbar (L3) skeletal muscle mass and adiposity in OSCC patients were associated with cervical (C3) skeletal muscle mass and adiposity from CT measurements. We also investigated whether skeletal muscle mass and adiposity in the C3 muscles were associated with survival rates in patients with OSCC. We demonstrated that both the quality and quantity of muscle between the C3 and L3 levels were positively correlated with each other. We also demonstrated that the survival rates in patients with low sternocleidomastoid muscle mass index, high processus spinosus muscle-intramuscular adipose tissue content, and the combination of both were significantly lower than those in the controls. These results suggest that the assessment of sarcopenia from multiple neck muscles by preoperative CT measurements may be useful in predicting the prognosis of patients with OSCC. [ABSTRACT FROM AUTHOR]

Simple Summary: Oral squamous cell carcinoma (OSCC) has the highest mortality rate among all head and neck cancers. To date, the impact of preoperative malnutrition and sarcopenia on survival in OSCC patients remains controversial. The aim of our study was to investigate the effects of preoperative nutritional status and abnormalities in body composition on the mortality of OSCC patients. The disease-specific survival (DSS) rate among patients with a high intramuscular adipose tissue content (IMAC) and a low psoas muscle mass index was significantly lower than that in controls. Multivariate analysis revealed that a low preoperative Prognostic Nutritional Index (PNI) and high IMAC were independent risk factors. We demonstrated that preoperative malnutrition and abnormal body composition, such as abnormal preoperative skeletal muscle quality, are associated with DSS in OSCC patients. Our study suggests that the evaluation of preoperative malnutrition and skeletal muscle quality would be useful for predicting mortality in patients with OSCC. The impact of preoperative malnutrition and sarcopenia on survival in oral squamous cell carcinoma (OSCC) patients remains controversial. We investigated the effects of the preoperative nutritional status and abnormalities in body composition on the mortality of OSCC patients. A retrospective study involving 103 patients with OSCC was conducted. Disease-specific survival (DSS) according to the preoperative psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) was evaluated. Univariate and multivariate analyses were performed to determine the predictive performance of the covariates with respect to DSS. The DSS rate in patients with high IMAC and low PMI was significantly lower than that in controls. Multivariate analysis revealed that a low preoperative Prognostic Nutritional Index (PNI) and high IMAC were independent risk factors. We demonstrated that preoperative malnutrition and abnormal body composition, such as preoperative skeletal muscle quality, are associated with DSS in OSCC patients. Our study suggests that the evaluation of preoperative malnutrition and skeletal muscle quality would be useful for predicting mortality in patients with OSCC. [ABSTRACT FROM AUTHOR]

Vascular endothelial cell growth factor C (VEGF-C) is a member of the VEGF family and plays a role in a variety of biological activities including lymphangiogenesis, angiogenesis, and neurogenesis through VEGF receptor 2 (VEGFR2) and 3 (VEGFR3). However, it has not been elucidated whether VEGF-C promotes osteogenic differentiation. Herein, we investigated the effects of VEGF-C on osteogenic differentiation in human mesenchymal stem cells (MSCs) and evaluated the underlying molecular mechanisms. VEGF-C treatment significantly increased RUNX2 expression, and led to the promotion of osteogenic marker gene expression and mineralization of MSCs. VEGF-C treatment induced the phosphorylation of VEGFR2 and VEGFR3 in MSCs. Treatment with the VEGFR3-specific ligand VEGF-C156S also promoted MSC mineralization. Furthermore, co-treatment with VEGFR2 and VEGFR3 kinase inhibitors blocked VEGF-C-induced MSC mineralization. VEGF-C treatment activated ERK signaling in MSCs, and inhibition of ERK signaling effectively suppressed VEGF-C-induced RUNX2 expression and mineralization. These results indicate that VEGF-C-induced MSC osteogenesis is mediated through VEGFR2 and VEGFR3, and followed the activation of the ERK/RUNX2 signaling pathway. [ABSTRACT FROM AUTHOR]

Introduction: The most effective method of assessing sarcopenia has yet to be determined, whether by single muscle or by whole muscle segmentation. The purpose of this study was to compare the prognostic value of these two methods using computed tomography (CT) images in patients with oral squamous cell carcinoma (OSCC)., Materials and Methods: Sex- and age-adjusted Cox proportional hazards models were employed for each parameter of sarcopenia related to overall survival, disease-free survival, and disease-specific survival. Harrell's concordance index was calculated for each model to assess discriminatory power., Results: In this study including 165 patients, a significant correlation was found between the CT-based assessment of individual muscles and their cross-sectional area. Single muscle assessments showed slightly higher discriminatory power in survival outcomes compared to whole muscle assessments, but the difference was not statistically significant, as indicated by overlapping confidence intervals for the C-index between assessments. To further validate our measurements, we classified patients into two groups based on intramuscular adipose tissue content (P-IMAC) of the spinous process muscle. Analysis showed that the higher the P-IMAC value, the poorer the survival outcome., Conclusion: Our findings indicate a slight advantage of single-muscle over whole-muscle assessment in prognostic evaluation, but the difference between the two methods is not conclusive. Both assessment methods provide valuable prognostic information for patients with OSCC, and further studies involving larger, independent cohorts are needed to clarify the potential advantage of one method over the other in the prognostic assessment of sarcopenia in OSCC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Takayama, Yoshimura, Suzuki, Hirano, Tezuka, Ishida, Ishihata, Amitani, Amitani, Nakamura, Imamura, Inui and Nakamura.)

Objective: To quantitatively assess three-dimensional (3D) soft tissue facial asymmetry in patients with unilateral cleft lip and palate (UCLP) who have undergone primary lip repair., Design: Clinical, retrospective, comparative, methodological study., Patients/participants: Twenty patients with UCLP were selected after a review of the records., Inclusion Criteria: Complete UCLP; surgically treated without secondary repair. An age-matched and sex-matched Control group was employed., Main Outcome Measures: A 3D facial symmetry plane (FSP) was obtained by superimposing the point clouds of the original 3D facial image excluding the surgical site and including lip and nose areas and those of a mirrored facial image using the iterative closest point (ICP) adjustment method. The discrepancies in the depth and angle of the normal vector of the facial surface of each point cloud between right and left sides (cleft and non-cleft sides in the UCLP group, respectively) based on FSP were calculated., Results: Facial asymmetry in the UCLP group was significantly greater than in the Control group regarding both the discrepancies in the depth (1.34 ± 0.62, 0.73 ± 0.32 pixels, respectively) ( P  = .0004) and surface angle (18.0 ± 5.88, 12.8 ± 4.0°, respectively) ( P  = .0024). Biaxial assessment of the discrepancies in the depth and surface angle allowed us to visually extract UCLP patients with greater facial asymmetry., Conclusions: Facial asymmetry analysis based on 3D FSP effectively facilitates the facial asymmetry quantification and soft tissue surgical outcome evaluation in patients with UCLP., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Better prognostic biomarkers for oral squamous cell carcinoma (OSCC) must be developed, particularly within the realm of clinically and frequently administered tests, to advise appropriate clinical therapy and follow-up. In this study, we retrospectively investigated which of the several inflammation-nutrition indicators might predict the prognosis of patients with OSCC. Methods:   The preoperative neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio (PLR), CRP-albumin ratio (CAR), Glasgow prognostic score (GPS), modified GPS (mGPS), prognostic nutritional index (PNI), controlling nutrition status (CONUT), and modified CONUT (mCONUT) were retrospectively evaluated using blood samples collected 1-5 days before surgery. To estimate the effect on the prognosis of tumor progression, the mean values of the markers between stages I/II and III/IV were used for subgroup analysis. The multivariate Cox proportional hazards model included all independent variables significantly associated with survival in the univariate analysis to determine the independent variables. Results: A total of 112 patients (69 males and 43 females) with primary OSCC who underwent surgical treatment at our hospital were included. There were statistically significant differences in the mean values of monocytes, platelets, and albumin between stages I/II and III/IV. According to the multivariate Cox proportional hazards regression, a low PNI was associated with shorter overall survival (OS) and disease-free survival (DFS); women were associated with shorter DFS. Conclusion: The pretreatment PNI had excellent predictive value for the 5-year OS and DFS of patients with OSCC. Future large-scale prospective studies with a high sample size are needed to verify our findings in OSCC patients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Yoshimura, Suzuki, Takayama, Higashi, Hirano, Tezuka, Ishida, Ishihata, Amitani, Amitani, Nishi, Nakamura, Imamura, Nozoe, Inui and Nakamura.)

Objective: To visualize and quantitatively analyze facial surface asymmetry following primary cleft lip repair in patients with unilateral cleft lip and palate (UCLP) and to compare this with noncleft controls., Design: Retrospective comparative study., Patients: Twenty-two patients with complete UCLP who underwent primary lip repair from 2009 to 2013 were enrolled in this study. The preserved 3-dimensional (3D) data of 23 healthy Japanese participants with the same age were used as controls., Interventions: All patients had received primary labioplasty in accordance with Cronin triangular flap method with orbicular oris muscle reconstruction., Main Outcome Measures: Shadow and zebra images established from moiré images, which were reconstructed from 3D facial data using stereophotogrammetry, were bisected and reversed by the symmetry axes (the middle line of the face). The discrepancies of the gravity and density between cleft and noncleft sides in 2 regions of interest, facial and lip areas, were then calculated and compared with those of healthy participants., Results: In the UCLP group, the mean discrepancies of gravity on shadow and zebra images were 1.76 ± 0.70 and 2.63 ± 1.72 pixels, respectively, in the facial area and 1.31 ± 0.36 and 3.83 ± 2.08 pixels, respectively, in the lip area. There was a significant difference in the mean discrepancies of gravity and density on zebra images in the lip area between the UCLP and control groups., Conclusions: Our image analysis of digital facial surface asymmetry in patients with UCLP provides visual and quantitative information, and it may contribute to improvements in muscle reconstruction on cleft lip repair.

Objective: There is debate on the reliability of the Americleft Yardstick (AY) global nasolabial appearance assessment method. The objective was to analyze the effect of the additional basal view (BV) feature on the reliability of the AY method for Japanese children with complete cleft lip and palate (CUCLP)., Design: Blind retrospective analysis of clinical records on 43 patients (5- to 7-year-old) with nonsyndromic CUCLP who underwent primary lip repair from 2005 to 2011., Main Outcome Measure: Color pictures published in AY and Rubin's studies were used as reference pictures. Patients' photographs were cropped and rated on a 5-point scale for the vermilion border (VB), nasolabial frontal (NLF), and nasolabial profile (NLP) according to AY with/without BV assessment by Rubin's methods. Rating was performed twice by 3 oral surgeons. Intra- and inter-rater reliabilities were analyzed using weighted κ, and correlations between BV and other features were analyzed., Results: Overall average assessment scores were 2.742 (0.573) with AY and 2.702 (0.489) with AY+BV methods ( P = .728). Average intra-rater reliabilities were 0.605 and 0.611 and average inter-rater reliabilities were 0.525 and 0.48 with AY and AY+BV, respectively. Inter-rater reliability was the lowest for NLP. ρ scores between BV versus VB, NLF, and NLP were 0.025, 0.659, and 0.092, respectively., Conclusions: Present study demonstrates moderate intra- and inter-rater reliabilities obtained with the AY assessment method for Japanese children with CUCLP. Nasolabial profile standard ambiguity may lead to the poor reliability of AY assessment. Addition of the BV feature does not improve overall reliability.

The epithelial-mesenchymal transition (EMT) is a fundamental characteristic of carcinoma cells. EMT is generally associated with a change in cellular morphology from cobblestone to spindle shape, reduced expression of epithelial markers such as E-cadherin, and enhanced expression of mesenchymal markers such as N-cadherin. This EMT-associated reciprocal expression of E-cadherin and N-cadherin has been called the "cadherin switch". Downregulation of E-cadherin enables cells to dissociate from colonies while upregulation of N-cadherin is associated with increased invasiveness. The transcription factor Snail1 induces these changes in various epithelial cell lines, including canine MDCK cells and human A431 cells. In the present study, we introduced a Snail1 expression vector into human DLD-1 cells and isolated stable transfectants. These cells showed changes in morphology, reduced expression of epithelial marker E-cadherin and occludin, and elevated invasion and migration. However, neither expression of N-cadherin protein nor its corresponding mRNA was detected. Therefore, elevated N-cadherin expression is not required for invasiveness of the cells.