Search

Objective We previously reported that daily concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion for locally advanced oral cancer provided good local control and overall survival rates. This study was performed to evaluate the therapeutic results of daily concurrent intra-arterial chemoradiotherapy for patients with locally advanced squamous cell carcinoma of the mandibular gingiva. Methods Sixteen patients with T3, 4 mandibular gingiva cancer who refused surgery underwent definitive intra-arterial chemoradiotherapy between August 2006 and July 2014. Treatment consisted of concurrent chemoradiotherapy using retrograde superselective intra-arterial infusion (60 Gy, total dose; 60 mg/m2 for docetaxel and 150 mg/m2 for cisplatin). Results Complete response of the primary site was obtained in 14 patients (87.5%). Five-year local control and survival rates were 73.4%and 81.3%, respectively. Grade 3 or 4 toxicities including mucositis and neutropenia were seen in 13 patients (81.3%) and 6 patients (37.5%), respectively. Grade 3 osteoradionecrosis occurred as a late adverse event in 1 patient (6.3%). Conclusions Retrograde daily concurrent intra-arterial chemoradiotherapy for locally advanced carcinoma of the mandibular gingiva provided good local control and overall survival rates. This method can become one of the therapeutic options for patients with locally advanced carcinoma of the mandibular gingiva.

Purpose Dexamethasone seems to suppress postoperative swelling. However, the standard administration dose of dexamethasone for bilateral sagittal split osteotomy (BSSO) has not been reported. This study focused on clarifying the most effective dose of dexamethasone for BSSO. Materials and Methods This research was planned as a prospective, randomized controlled, double-blind study. Patients undergoing BSSO were randomly assigned to receive intravenous preoperative dexamethasone under 3 different dose conditions: 16 mg, 8 mg, and 0 mg (control). The endpoints of this study were 1) postoperative changes in masseter muscle thickness and buccal soft tissue thickness; 2) postoperative changes in maximum incisal opening; 3) postoperative changes in sensation of the chin and lower lip region; 4) postoperative changes in blood examination findings (white blood cell count, neutrophil count, C-reactive protein level, and lymphocyte count); and 5) types of complications. Data were recorded at 2 to 4 time intervals: before surgery, postoperative day 1, postoperative day 2, and postoperative day 3. Average age, gender, average body mass index, average surgery time, and average blood loss also were examined. Data were analyzed by 1-way analysis of variance (Bonferroni multiple-comparisons test) after the Bartlett test. Results We enrolled 24 patients, including 5 men and 19 women, in this study. The rate of increase in the thickness of the masseter muscle 24 hours after BSSO was 38.4% in the 16-mg group (n = 8), 57.7% in the 8-mg group (n = 8), and 56.1% in the 0-mg group (n = 8). The rate of increase in masseter muscle thickness in the 16-mg group was significantly lower than that in the 0-mg group (P < .05). Regarding the number of lymphocytes after surgery, the 16-mg and 8-mg groups maintained preoperative levels whereas there was a reduced number of lymphocytes in the control group. No statistically significant results were obtained for the following study endpoints: postoperative changes in maximum incisal opening and postoperative changes in sensation of the chin and lower lip region. Conclusions This investigation showed that the most effective dose of dexamethasone for BSSO is 16 mg.

Purpose To evaluate the therapeutic results and rate of organ preservation in patients with stage III or IV oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Materials and methods One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. Treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60mg/m 2 , cisplatin, total 150mg/m 2 ) and daily concurrent radiotherapy (total of 60Gy) for 6weeks. Results The median follow-up for all patients was 46.2months (range, 10–76months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1% of patients. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure in 0.9% of patients. Conclusion Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer provided good overall survival and local control.

The aim of this study was to examine the effect of cyclooxygenase (COX)-2 on bone response after the placement of implants in the femurs of mice. titanium implants 1.0mm in diameter were placed into the middle of the femurs of 9-week-old male COX-2 wild-type ( COX-2 +/+ ) and knockout ( COX-2 −/− ) mice. For RNA analysis, the mice were killed 0, 1, 2, 4, 7 and 56 days after implantation. RNA was extracted from the bone surrounding the implants. For histological analysis, the mice were killed 4 and 8 weeks after treatment, and undecalcified sections were prepared. Contact microradiography was performed, and the sections were stained with 1% toluidine blue for histological examination. Histomorphometric measurements were obtained with a computer-based image analyser to quantify bone newly formed around the implant and the rate of implant–bone contact. Expression of COX-2 and osteocalcin mRNA was induced in bone surrounding implants in COX-2 +/+ mice, but not in COX-2 −/− mice. In cortical bone, the implant surface was in direct contact with newly formed bone lamellae in COX-2 +/+ mice; new bone formation was minimal in COX-2 −/− mice. These results suggest that COX-2 plays an essential role in osseointegration and provide evidence that COX-2-selective non-steroidal anti-inflammatory drugs may interfere with osseointegration clinically.

Objective: To assess the transcriptional regulation of cyclooxygenase-2 by bone morphogenetic protein2 in isolated bone marrow stromal cells obtained from cyclooxygenase-2 wild-type and cyclooxygenase-2defrcient mice. Materials and Methods: Bone marrow stromal cells were cultured for 14 days in the presence of osteogenic medium with or without bone morphogenetic protein-2. Real-time polymerase chain reaction analysis of the relative expression of cyclooxygenase-2 and osteocalcin, a late osteogenic differentiation marker mRNA, were examined. Prostaglandin EZ accumulation in the culture media were measured by radioimmunoassay. Activity and staining of alkaline phosphatase, an early osteogenic differentiation marker, were examined. Results: Bone morphogenetic protein-2 induced cyclooxygenase-2 mRNA and prostaglandin production in cultured bone marrow stromal cells derived from cyclooxygenase-2 wild-type mice. Alkaline phosphatase activity was lower in cyclooxygenase-2-deficient control cultures than in cyclooxygenase-2 wild-type cultures, and treatment with bone morphogenetic protein-2 stimulated alkaline phosphatase activity only in cyclooxygenase-2 wild-type cultures. A similar reduction was seen in cyclooxygenase-2 wild-type cells treated with NS-398, a selective inhibitor of cyclooxygenase-2. Alkaline phosphatase staining revealed a 30% decrease in the cyclooxygenase-2-deficient control cultures, and the addition of bone morphogenetic protein-2 increased alkaline phosphatase staining only in cyclooxygenase-2 wild-type cultures. Bone morphogenetic protein-2 stimulated osteocalcin mRNA expression in bone marrow stromal cells derivedfrom cyclooxygenase2 wild-type mice but not in cyclooxygenase-2-deficient cells. Conclusions: Bone morphogenetic protein-2 induces cyclooxygenase-2 in bone marrow stromal cells transcriptionally and the induction of cyclooxygenase-2 may play a role in the effects of bone morphogenetic protein-2 on bone metabolism in vitro.

Objective : To report a simplified technique for nasoalveolar moulding for treatment of infants with unilateral and bilateral cleft lip and palate. Patients and Methods : One or 2 stents made of plastic cobalt-chrome orthodontic wires 0.8-mm thick were used with a conventional palatal plate (Hotz plate) to treat 7 patients with unilateral cleft lip and palate and 3 with bilateral cleft lip and palate. Results : This modified technique for nasoalveolar moulding permitted the nose of patients with unilateral and bilateral cleft lip and palate to be easily and precisely moulded. This technique also reduced stress for the patients and their parents because it did not require extraoral appliances, except for surgical tape over the cleft lip. Time-consuming adjustments of the nasal stent were also unnecessary. Conclusion : The wire nasal stent facilitated nasoalveolar moulding before cheiloplasty for unilateral and bilateral cleft lip and palate.

A two-dimensional intracellular Ca(2+) ([Ca(2+)](i)) imaging system was used to examine the relationship between [Ca(2+)](i) handling and the proliferation of MC3T3-E1 osteoblast-like cells. The resting [Ca(2+)](i) level in densely cultured cells was 1.5 times higher than the [Ca(2+)](i) level in sparsely cultured cells or in other cell types (mouse fibroblasts, rat vascular smooth muscle cells, and bovine endothelial cells). A high resting [Ca(2+)](i) level may be specific for MC3T3-E1 cells. MC3T3-E1 cells were stimulated with ATP (10 microM), caffeine (10 mM), thapsigargin (1 microM), or ionomycin (10 microM), and the effect on the [Ca(2+)](i) level of MC3T3-E1 cells was studied. The percentage of responding cells and the degree of [Ca(2+)](i) elevation were high in the sparsely cultured cells and low in densely cultured cells. The rank order for the percentage of responding cells and magnitude of the Ca(2+) response to the stimuli was ionomycin > thapsigargin = ATP > caffeine and suggests the existence of differences among the various [Ca(2+)](i) channels. All Ca(2+) responses in the sparsely cultured MC3T3-E1 cells, unlike in other cell types, disappeared after the cells reached confluence. Heptanol treatment of densely cultured cells restored the Ca(2+) response, suggesting that cell-cell contact is involved with the confluence-dependent disappearance of the Ca(2+) response. Immunohistological analysis of type 1 inositol trisphosphate receptors and electron microscopy showed distinct expression of inositol trisphosphate receptor proteins and smooth-surfaced endoplasmic reticulum in sparsely cultured cells but reduced levels in densely cultured cells. These results indicate that the underlying basis of confluence-dependent [Ca(2+)](i) regulation is down-regulation of smooth-surfaced endoplasmic reticulum by cell-cell contacts.